nutrition Flashcards
what does a balanced diet look like
- eat at least 5 portions of a variety of fruit and vegetables every day (see 5 A Day)
- base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
have some dairy or dairy alternatives (such as soya drinks) - eat some beans, pulses, fish, eggs, meat and other protein
- choose unsaturated oils and spreads, and eat them in small amounts
- drink plenty of fluids (at least 6 to 8 glasses a day)
what screening tool can be used for nutrtion
MUST
when do you screen for nutrition
All hospital inpatients on admission and all outpatients at their first clinic appointment should be screened
weekly for inpatients
at first appts with GPs
what clinical concerns would cause for a screen for nutrition
- unintentional weight loss, - fragile skin
- poor wound healing
- apathy
- wasted muscles
- poor appetite
- altered taste sensation
- impaired swallowing
- altered bowel habit
- loose fitting clothes
- prolonged intercurrent illness.
how to recognise dysphagia
- difficult, painful chewing or swallowing
- regurgitation of undigested food
- difficulty controlling food or liquid in the mouth
- drooling
- hoarse voice
- coughing or choking
- before, during or after
- swallowing
- globus sensation
- nasal regurgitation
- feeling of obstruction
- unintentional weight loss – for example, in people with dementia.
when should u cosider nutritional support
- a BMI of less than 18.5 kg/m2
- unintentional weight loss greater than 10% within the last 3–6 months
- a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the last 3–6 months.
have eaten little or nothing for more than 5 days and/or are likely to eat little or nothing for the next 5 days or longer
have a poor absorptive capacity, and/or have high nutrient losses and/or have increased nutritional needs from causes such as catabolism.
Causes of malnutrition
reduced dietary intake - vegan, vegetarian, allergic, finance
reduced dietary intake
reduced absorption of macro- and/or micronutrients
increased losses or altered requirements
increased energy expenditure (in specific disease processes)
Reduced dietry intake> Environment: failure in regular nutritious meals (hospital, living alone no support), Reduced Appetite (mental health,illness), Dysphagia (stroke, GI)
Malabsorption > GI disorders and surgery,
Increased losses or altered requirments > diharrea, vomiting, enterocutaneous fistulae, burns
Increased energy expenditure >major trauma, head injury or burns (only for short period of time)
example of absorption
Cystic fibrosis (the number one cause in the United States)
Chronic pancreatitis
Lactose intolerance
Celiac disease
Whipple disease
Shwachman-Diamond syndrome (a genetic disease affecting the pancreas and bone marrow)
Cow’s milk protein intolerance
Soy milk protein intolerance
Biliary atresia
Abetalipoproteinemia
Vitamin B-12 malabsorption may be due to:
Diphyllobothrium latum infestation
Juvenile pernicious anemia
Parasites
Giardia lamblia
Strongyloides stercoralis
Necator americanus (hookworm)
Sx of malabsorption
- Avoiding specific foods
- Chronic diarrhoea
- Bloating and gas
- Growth failure
causes of dietary intake
reductions in appetite
- cytokines
- glucocorticoids
- insulin
- insulin like growth factors
failure to ptovide nutritious meals
must score includes what
drop in BMI
unintentional weight loss
illness in the past or the future
must score includes what
who are malnourished
risk of malnutrition
current weight (BMI)
history of recent unintentional weight loss
likelihood of future weight loss
vitamin A deficiency
poor wound healing
vitamin C deficiency
scurvy
thiamine deficiency
wernicke encephalopathy
