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Pharm 220 IPFC 1! > Nutrition Deficiencies > Flashcards

Nutrition Deficiencies Flashcards

1
Q

What is Estimated Average Requirement (EAR) ?

A

It is the median usual intake value estimated to meet the requirement of **half the health individuals **in a life-stage and gender group.

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2
Q

What is Recommended Daily Allowance (RDA)?

A

It is the average daily dietary intake level that is sufficient to meet the nutrient requirement of **nearly all healthy individuals **in a life-stage and gender group

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3
Q

What is the Adequate Intake (AI) ?

A
  • It is used when there is insufficient data to establish EAR/RDA;
  • recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates by a group of apparently healthy people who are assumed to be maintaining an adequate nutritional state
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4
Q

What is the Tolerable Upper Intake Level (UL)?

A

It is the highest level of continuing daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals in the life-stage group

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5
Q

Understand this graph for DRIs

A
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6
Q

Vitamin A

A
  • Preformed Vitamin A and provitamin A carotenoids
  • Dark coloured fruits and leafy vegetables
  • Toxicity associated with pre-formed vitamin A: teratological effects, liver toxicity

Fat-soluble vitamin

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7
Q

Vitamin D

A
  • Maintenance of serum calcium and phosphorus concentrations
  • Required for proper bone growth and mineralization
  • Present in fatty fish, fortified dairy products or obtained from sunlight
  • Toxicity: hypercalcemia

Fat-soluble vitamin

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8
Q

Vitamin E

A
  • Several stereoisomers
  • Functions as an antioxidant
  • Found in many oils, grains, nuts, fruits, vegetables, meats
  • Toxicity: high doses= hemorrhagic toxicity

Fat-soluble vitamin

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9
Q

Vitamin K

A
  • Coenzyme for blood clotting and bone metabolism
  • Green vegetables
  • Newborns often given injections
  • Clinical - intake must be monitored for pts on anticoagulant therapy

fat-soluble vitamin

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10
Q

Vitamin B1 is called?

A
  • Thiamin
  • coenzyme in metabolism of Carbs + branched ammino acids
  • Nerve and myocardial function

Water-soluble vitamin

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11
Q

Vitamin B2 is called?

A
  • Riboflavin
  • Coenzyme in redox reactions, energy + protein metabolism
  • mucous membrane integrity
  • DEFICIENCY: problems with mouth/lips

Water-soluble vitamin

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12
Q

Vitamin B3 called?

A
  • Niacin
  • Coenzyme in redox reactions, energy metabolism
  • Skin health, nervous and digestive systems
  • FOR DYSLIPIDEMIA: may cause flushing, GI distress

Water-soluble vitamin

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13
Q

Vitamin B5 called?

A
  • Pantothenic acid
  • coenzyme in fatty acid metabolism

Water-soluble vitamin

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14
Q

Vitamin B6 called?

A
  • pyridoxine
  • coenzyme in metabolism of aa, glycogen, sphingoid bases
  • Used to treat nausea and vomiting in pregnancy
  • TOXICITY: snsory neuropathy

Water-soluble vitamin

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15
Q

Vitamin B7 called?

A
  • Biotin
  • coenzyme in synthesis of fat, glycogen, and aa

Water-soluble vitamin

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16
Q

Vitamin B9 called?

A
  • Folate
  • Coenzyme
  • Important in RBC development and new cell synthesis
  • DEFICIENCY: megaloblastic anemia, neural tube defects
  • FOOD: enriched and whole grain products, vegetables
  • CONSUMPTION: may mask B12 deficiency
  • Pregnant women needs supplemenatation

water-soluble vitamin

17
Q

Vitamin B12 called?

A
  • Cobalamin
  • coenzyme
  • important for RBC maturation and new cell synthesis
  • Maintains nerve cell function
  • DEFICIENCY: megaloblastic anemia, nervous system disorder
  • FOOD: animal products (meat, fish), and fortified products
  • DEFICIENCY: common in elderly, consider suppl.

water-soluble vitamin

18
Q

Vitamin C called?

A
  • Ascorbic acid
  • antioxidant
  • IMPORTANT IN: collagen synthesis, wound healing, cartilage and bone formation
  • ENHANCES IRON absorption
  • fruits, veggies
  • TOXICITY: high doses may cause GI disturbances, kidney stones
  • Higher amounts needed in smokers.

water-soluble vitamin

19
Q

**Calcium Profile **

Whats the function, food source, and toxicity?

A
  • FUNCTION: stored in bones and teeth, supports structure and hardness. Needed for vascular contraction, muscle movement, nerve functions, intracellular signalling, hormone secretion
  • FOOD SOURCE: Dairy products, canned sardines, salmon, kale, broccoli, spinach, fortified foods
  • TOXICITY: hypercalcemia: renal sufficiency, vascular/soft tissue calcification, hypercalciruia, kidney stones. High intake can cause constipation, kidney stones. CV risk?
20
Q

**Magnesium Profile **

Whats the function? Role in preventing and managing chronic disease?

A
  • FUNCTION: needed for biochem reactions, muscle/nerve function, heart rhythm,BP maintenance, immune function, bone strength, regulation fo blood glucose levels
  • May have role in hypertension, CV disease, diabetes, migraine prevention
21
Q

**Magnesium Profile **

Food source? Toxicity?

A
  • FOOD SOURCE: green veggies, legumes, nuts, seeds, whole grains
  • TOXICITY: Diarrhea, abdominal cramping from magnesium supp
    *Changes in mental status, nausea, diarrhea, appetite loss, muscle weakness, difficulty breathing, hypotension, irregular heartbeat
22
Q

**Iron Profile **

What is the Function, food sources, toxicity?

A
  • FUNCTION: proteins, oxygen transport, cell growth and differentiation
  • FOOD SOURCE: heme iron- red meat, fish, poultry, non heme iron- lentils, beans, fortified cereals
  • TOXICITY: GI effects- constipation, nausea, vomiting, diarrhea. Accumulation in organs (liver, heart), metabolic acidosis, death
23
Q

Clinical: Vitamin A deficiency

What does it cause?

A

Xerophthalmia ( extreme eye dryness leading to conjunctival destruction), night blindness

24
Q

Clinical: Thiamin (B1) deficiency

A

Beriberi- nervous system disorder leading to peripheral neuropathy, edema, heart failure
Wernicke-Korsakoff syndrome- causes mental confusion, psychosis, memory loss, encephalopathy. * Common in alcoholics *

25
Q

Clinical: Vitamin B12 deficiency

A

Megaloblastic anemia, neurological symptoms (paresthesias, disrupted reflexes), diarrhea, fatigue, shortness of breath, glossitis, brittle nails.
vegans are at higher risk

26
Q

Clinical: Vitamin C deficiency

A

Scurvy: inadequate collagen synthesis leads to spongy and bleeding gums, bleeding from all mucous membranes and under skin, extreme weakness, purple spots on skin, tooth loss, impaired wound healing, diarrhea

27
Q

Clinical: Vitamin D deficiency

A

Rickets: (softening of bones in children, leading to fractures and deformity, osteomalacia (softening of bones in adults, leading to aches, deformity, weakness)

28
Q

Clinical: Vitamin K deficiency

A

Impaired coagulation, leading to hemorrhage. Given prophylasctically after birth to prevent hemorrhagic disease of newborn

29
Q

Clinical: Iron deficiency

A

Causes anemia- fatigue, pallor, irritability, weakness, nail deformities, impaired immune function, atrophy of oral mucosa

30
Q

Causes of malnutrition

A
  1. Reduced nutrient intake (nausea, vomiting, anorexia)
  2. Reduced nutrient absorption (short bowel syndrome, diarrhea)
  3. Altered nutrient metabolism ( hypermetabolic and catabolic state due to spesis trauma, burns)
  4. Increased nutrient loss (bleeding, fistulas)
31
Q

Alcoholism and Nutrition

A

Alcoholism is major cause of nutritional deficiency (esp. if >30% of energy is from alcohol). Decreased Vitamins A, B (espeically thiamine), C , minerals iron, calcium

32
Q

Iron Supplementation in Infants

A

Babies born with reserve ( supplementation needed in low birthweight infants)
Introduce iron rich foods around 6 months of age
If using formula, use iron fortified formula
Iron deficiency can impact cognitive development

33
Q

Vitamin D Supplementation in Infants

A

Breastfed babies require Vitamin D supplementation , 400 IU per day
Formula fed babies do not need except those in northern communities

34
Q

Vitamin D counselling

A

Children/Adults 9-70 need RDA 600 IU, Upper limit 4000
Adults >70 need 800 IU, Upper limit 4000

35
Q

Calcium DRIs in Adults

A
36
Q

Calcium counselling

A

The required amounts can be achieved by diet alone. 2 dairy servings plus typical diet for those 50 and under, while 3 dairy servings plus typical diet for those over 50

37
Q

Multivitamins counselling

A

Best is to get from diet, but if not balanced diet, then its helpful. May help if diet is restricted. Some vitamins/minerals can be toxic at high elvels, Vitamin A, niacin, Calcium, Iron, Vitamin C

38
Q

Vitamin B12 counselling

A

Those at risk for deficiency:
Pernicious anemia – no production of intrinsic factor
*Elderly *– due to conditions like atrophic gastritis
Usually can still absorb synthetic B12, not form found in food though
Vegans/vegetarians – vitamin B12 is only found in animal products
GI disorders, surgery
Users of certain medication
Metformin
Proton pump inhibitors, H2RAs (ex. ranitidine)
RECCOMENDATION FROM DIETITIANS OF CANADA: A daily supplement of at least 2.4 ug of vitamin B12 is needed for adults over age of 50

39
Q
A
  • Men and postmenopausal women should choose a vitamin and mineral supplement that does not contain any or much iron.
  • Young women who are vegetarian may need to take an iron supplement.
  • People of any age who smoke should take a supplement containing vitamin C, as well as including food sources such as oranges, grapefruit and potatoes.
  • Specific conditions may require supplementation
  • – Ex. anemia, osteoporosis, alcoholism, diuretic use, malnutrition, etc.

Pharm 220 IPFC 1! (3 decks)

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