Nutrition [completed] Flashcards
What are the current UK diet and nutrition recommendations?
- At least FIVE portions of fruit and vegetables a day (11+)
- Intake of red and processed meat should be no more than 70g a day (19+)
- At least ONE portion (140g) of oil fish per week (all)
- Free sugars should be no more than 5% of DAILY CALORIE INTAKE
- Saturated fat should be no more than 11% of DAILY CALORIC INTAKE
What are the BMI ranges?
> 18.5 = underweight
18-5 - 24.9 = healthy weight
24.9 - 29.9 = overweight
29.9 -39.9 = obese
40 = severely obese
How is BMI calculated
Weight (kg) /Height² (m)
What are the adult recommendations for exercise?
Aim to be physically active everyday
Do strengthening activities 2x a week
150 mins of moderate aerobic activity OR 75 mins of vigorous aerobic activity a week
What are some limitations of BMI
Does not consider % of fat, muscle or bone
Does not consider age, gender or muscle mass
- muscular adults classed as overweight or obese
- older adults classes as healthy but could mostly be due to fat as muscle wastage increases
- Pregnancy: women should calculate BMI with pre-pregnancy weight
What are some causes of obesity?
Poor diet and lifestyle choices:
- eating a lot of processed or fat foods
- drinking too much alcohol
- eating out a lot
- oversized portions
- drinking too many sugary drinks
- lack of physical exercise
- comfort eating
What are some non-lifestyle and diet related causes of obesity?
hypothyroidism
Cushing’s syndrome
certain medications such as steroids
How is obesity managed first line?
Calorie restricted duet and increase in physical activity
Aim is to reduce weight by 0.5-1kg per week
When may bariatric surgery be an option?
BMI over 40
BMI 35-40 and other significant disease such as diabetes or hypertension
OR
all appropriate non surgical measures (diet, exercise, orlistat) have been tried but non clinically beneficial weight loss
patient under care of a specialist centre
patient fit for anaesthesia and surgery
patients commits to long term follow up
What will the patient have to do before a consultant will allow for bariatric surgery?
Adjust measures such as diet and exercise
What are the three most common types of bariatric surgery?
Gastric band
Gastric bypass
Sleve gastrectomy
What is a gastric band
Band place around the stomach so patient feels full after eating less food. Least invasive
What is a gastric bypass?
Top part of stomach joined to small intestine - patient feels full quicker and cannot absorb as much calories
What is a sleeve gastrectomy?
Removal of some of the stomach so patient cannot eat as much per meal and feels full sooner
Why do patents often need supplements after bariatric surgery?
Less food passes through stomach –> less absorption of vital vitamins and minerals. May need lifelong supplementation but especially in immediate aftermath.
What are some food pregnant women should avoid?
Raw fish
unpasteurised milk/dairy products
liver - Vit A can be harmful to baby
undercooked meats
cold cured meats
raw or partially cooked duck quail or goose eggs
no more than 200mg of caffeine a day
ALCOHOL
What supplements should pregnant women take?
Folic acid for first 12 weeks to prevents neural defects - 400mcg daily
Pregnacare - low dose multivitamin
What is “eating for two”? Should pregant women do this?
No they should just eat a normal healthy balanced diet whilst avoiding certain food
What is malnutrition?
State of nutrition where deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/ body form etc.
What is mild food insecurity?
Working about ability to obtain food
What is moderate food insecurity?
compromising quality and variety of food.
Reducing quantities and skipping meals
What is severe food insecurity?
experiencing hunger
What is the burden of malnutrition on the NHS?
Affects 3 million people in the UK
25-34% of patients admitted to NHS hospitals at risk of malnutrition
estimated cost of £19.6 billion due to medical AND social care
What is the MUST score?
Malnutrition Universal Screening Tool - completed for all hospital admissions and screens for malnutrition/risk of malnutrition.
What factors does MUST look at?
BMI
Weight loss
Acute disease
Puts people as low, medium or high risk
What is the criteria for people who ARE MALNOURISHED and nutritional support should be considered:
Malnourished
- BMI less than 18.5
OR
- unintentional weight loss over 10% within the last 2-6 months
OR BMI less than 20 AND unintentional weight loss over 5% in the last 3-6 months
What is the criteria for people who are AT RISK OF MALNUTRITION and nutritional support should be considered:
- people who have eaten little or nothing for over 5 days and are likely to eat little or nothing for the next 5 days
- people with poor absorptive capacity/high nutrient loss/increased nutritional needs from causes such as catabolism.
What are the principles of nutritional support based on?
energy protein or fluid