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.
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
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
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
5
Q
Understand this graph for DRIs
A
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
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
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
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
10
Q
Vitamin B1 is called?
A
- Thiamin
- coenzyme in metabolism of Carbs + branched ammino acids
- Nerve and myocardial function
Water-soluble vitamin
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
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
13
Q
Vitamin B5 called?
A
- Pantothenic acid
- coenzyme in fatty acid metabolism
Water-soluble vitamin
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
15
Q
Vitamin B7 called?
A
- Biotin
- coenzyme in synthesis of fat, glycogen, and aa
Water-soluble vitamin
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
Clinical: Vitamin B12 deficiency
Megaloblastic anemia, neurological symptoms (paresthesias, disrupted reflexes), diarrhea, fatigue, shortness of breath, glossitis, brittle nails.
vegans are at higher risk
26
Clinical: Vitamin C deficiency
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
Clinical: Vitamin D deficiency
Rickets: (softening of bones in children, leading to fractures and deformity, osteomalacia (softening of bones in adults, leading to aches, deformity, weakness)
28
Clinical: Vitamin K deficiency
Impaired coagulation, leading to hemorrhage. Given prophylasctically after birth to prevent hemorrhagic disease of newborn
29
Clinical: Iron deficiency
Causes anemia- fatigue, pallor, irritability, weakness, nail deformities, impaired immune function, atrophy of oral mucosa
30
Causes of malnutrition
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
Alcoholism and Nutrition
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
Iron Supplementation in Infants
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
Vitamin D Supplementation in Infants
Breastfed babies require Vitamin D supplementation , 400 IU per day
Formula fed babies do not need except those in northern communities
34
Vitamin D counselling
Children/Adults 9-70 need RDA 600 IU, Upper limit 4000
Adults >70 need 800 IU, Upper limit 4000
35
Calcium DRIs in Adults
36
Calcium counselling
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
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Multivitamins counselling
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
Vitamin B12 counselling
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
* 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.
