Nutrition-Elderly & Pregnancy

Question 1

If you want your parents to be better nourished in old age, where should you send them?

Answer 1

To community retirement centers. Elderly in hospitals tend to be more malnourished.

Question 2

Generalized and progressive loss of muscle mass and strength w/decrease in function

Answer 2

Sarcopenia

Question 3

Metabolic process associated with underlying illness and loss of muscle mass

Answer 3

Cachexia

Question 4

What is the best way to assess the nutritional state of a geriatric patient?

Answer 4

Multi-factorial approach to include: mini-nutritional assessment, anthropometrics (BMI), labs (prealbumin, decreasing cholesterol) and diet.

Question 5

Why do elderly patients have a higher risk for reflux, decreased appetite and nausea?

Answer 5

Decreased motility, sometimes from diabetic gastroparesis.

Question 6

How do you assess an elderly patient’s diet?

Answer 6

Multiple Pass Method: What did you eat? When did you eat it? Summarize what they said and allow them to correct you.

Question 7

Key areas to “foot stomp” with elderly and their diets?

Answer 7

Eat more lean meat and limit dairy in addition to DASH diet.

Question 8

What micronutrient decreases the risk of falls?

Answer 8

Vitamin D supplementation between 200-1000 IU

Question 9

How much protein should an elderly person be consuming per day? What effect does this have?

Answer 9

75-90g. Protein supplementation can increase mass, but has not been shown to improve quality of life.

Question 10

How do you treat an elderly patient who has had an aspiration pneumonia or has trouble swallowing?

Answer 10

Speech therapy

Question 11

What socioeconomic factors contribute to malnutrition in the elderly?

Answer 11

Poverty, isolation,

Question 12

What elderly population is at severe risk for malnutrition?

Answer 12

Advanced dementia. They often get feeding tubes, but in the end this does not improve quality of life.

Question 13

Where do you start with assessment of the nutritional status in a pregnant woman?

Answer 13

Prior eating habits, past history and prior pregnancy.

Question 14

Why are women with a predisposition for diabetes more likely to get diabetes during pregnancy?

Answer 14

The body switches from carbohydrate to fat metabolism that causes insulin resistance. HCG causes the pancreas to enlarge and produce more insulin.

Question 15

Who gets what energy in a pregnant woman?

Answer 15

Baby gets glucose. Mom gets fatty acids and ketones

Question 16

Should a pregnant obese woman try to lose weight when pregnant?

Answer 16

No, they will have an increased risk for small-for-gestational-age baby

Question 17

RDA for folic acid in pregnant women

Answer 17

400 ucg, 1mg for twins, 4mg w/history of neural tube defect

Question 18

RDA for iron in pregnant women

Answer 18

30-33mg, Fe-supplementation has no proven benefit for the mom, good for fetal neurological development

Question 19

RDA for protein in pregnant women

Answer 19

1g/kg/day (60-65g)

Question 20

Why don’t pregnant women eat deli meats?

Answer 20

Prepackaged meats are at risk for listeria.

Question 21

Why should pregnant women eat large fish?

Answer 21

Methylmercury is harmful to fetal neurodevelopment (shark, swordfish, mackerel or tile fish). You can eat up to 12 oz of tuna, salmon, pollock, catfish and shrimp.

Question 22

Why shouldn’t pregnant women eat raw meat or uncooked foods?

Answer 22

Toxoplasmosis, listeria, brucellosis all cause stillbirth.

Question 23

RDA for calcium in pregnant woman?

Answer 23

1000mg/day