Nutrition I and II

Question 1

BMI formula

Answer 1

Wt in kg/(Ht in m)^2 OR Wt in kg/(Ht in m)^2 x 703

Question 2

BMI ranges

Answer 2

Healthy: 19.5-25 Overweight 25.1-29.9 Obese: >30 Morbidly obese: >40

Question 3

3 macronutrients

Answer 3

1. Carbohydrates 2. Lipids 3. Proteins

Question 4

Micronutrients

Answer 4

Vitamins (fat and water soluble) and minerals essential for proper metabolism

Question 5

4 factors which influence energy need

Answer 5

1. Body surface area (proportional to heat loss) 2. Age and hormonal status 3. Gender 4. Activity level

Question 6

Basal metabolic rate (BMR)

Answer 6

Weight in kg x 24 kcal/kg per day Amount of energy that keeps an individual alive without physicial activity

Question 7

Hormone effects on BMR

Answer 7

Thyroxin, sex hormones, growth hormone, epinephrine and cortisol increase BMR

Question 8

How age affects BMR

Answer 8

Decrease in BMR of 2% each decade

Question 9

BMR in hospitalized pts

Answer 9

BMR x 1.2 for bed rest activity and BMR x 1.5 for stress factor (more important in severely sick patients)

Question 10

How are food calories measured?

Answer 10

kcal/g

Question 11

of kcal/g for protein, fat, carbs, alcohol

Answer 11

Fat: 9 kcal/g Protein: 4 kcal/g Carbs: 4 kcal/g Alcohol: 7 kcal/g

Question 12

Amount of carbs, protein, fat, fiber to consume daily

Answer 12

Carbs: 45-65% (at least 130g, 300-400g) Protein: 10-35% (70-90g) Fat: 20-35% (60-100g) Fiber: Men-38g Women-25g

Question 13

Most common nutritional problems

Answer 13

Carbohydrate intolerances–diabetes and lactose intolerance

Question 14

How much essential fatty acids in diet?

Answer 14

10% of total fat intake

Question 15

How is excess fat stored?

Answer 15

Triacylglycerol

Question 16

What diseases are high fat intake associated with?

Answer 16

Heart disease, colon, breast, and prostate cancers

Question 17

Relationship between coronary artery disease and fat intake

Answer 17

Excess saturated fat directly related to high serum cholesterol thus the development of CAD

Question 18

Monounsaturated fatty acids

Answer 18

Lower plasma cholesterol levels (olive, safflower, canola, peanut oils)

Question 19

Polyunsaturated fatty acids

Answer 19

Essential linoleic and linoleic acid. omega-3 (flaxseed oil, salmon) and omega-6 (sunflower, soybean, corn oils)

Question 20

Scaly dermatitis

Answer 20

Symptom of essential fatty acid deficiency. Hair loss, poor wound healing.

Question 21

What happens to excess protein?

Answer 21

Converted to glucose or fats. Eventually all converted to triglycerides in adipose tissue.

Question 22

Nitrogen balance

Answer 22

Comparison between intake of nitrogen in protein and excertion of nitrogen. Negative balance means inadequate protein intake or lack of essential AAs and positive balance means increased intake.

Question 23

Protein requirements in illness, surgery, trauma

Answer 23

Catabolic response with release of chemicals which cause acceleration in body protein breakdown and negative nitrogen balance

Question 24

Dietary fiber

Answer 24

Components of food which cannot be broken down by human digestive enzymes

Question 25

Benefits of fiber

Answer 25

Reduce risk of colon cancer, benefit diverticular disease, lower cholesterol, slow rise of blood sugar, bind carcinogens

Question 26

What has fiber in it?

Answer 26

Water insoluble: Vegetables, wheat, grain Water soluble: fruits, oats, legumes

Question 27

Fat-soluble vitamins

Answer 27

DEKA Too much of them can be problematic

Question 28

Water-soluble vitamins

Answer 28

B family, C Unknown if risk of too much

Question 29

Macrominerals

Answer 29

Sodium, potassium, calcium, phosphate, magnesium

Question 30

Vitamins

Answer 30

Organic molecule required for certain metabolic functions and cannot be synthesized (or cannot make enough of it)

Question 31

What is special about vitamin C?

Answer 31

Does not always need an enzyme to work in the body. All the other vitamins are taken up in inactive form and require cofactors or coenzymes to work.

Question 32

What is the prudent diet? (3)

Answer 32

1. Reduce consumption of total calories, fat, cholesterol, simple sugars, salt 2. Increase fiber 3. Increase physicial activity

Question 33

Macronutrients vs micronutrients

Answer 33

Macronutrients needed to generate energy and build the body. Micronutrients are needed to run biochemical and physiological processes.

Question 34

Vitamin A (active/inactive forms and functions)

Answer 34

Active: retinol, retinal Inactive: carotenoids Functions: antioxidant, act like steroid hormones and bind chromatin to affect cell growth/differentiation, good for vision

Question 35

Vitamin A sources

Answer 35

Liver, egg yolk, butter, milk, dark green/yellow veggies

Question 36

Vitamin A deficiency

Answer 36

Night blindness, anemia, follicular hyperkeratosis (rough keratinized skin)

Question 37

Vitamin A toxicity

Answer 37

10x RDA in pregnant women can cause brain damage to infants, toxicity also found in arctic and with acne treatment

Question 38

Vitamin D (active/other forms and functions)

Answer 38

Active: 1-alpha,25-dihydroxy-cholecalciferol Other: cholecalciferol, ergocalciferol Functions: regulate calcium, calcium transport

Question 39

Vitamin D deficiency

Answer 39

Rickets (osteoid and cartilage not mineralized), osteomalacia (bone softening), fat malabsorbtion

Question 40

Vitamin D toxicity

Answer 40

10-100x RDA causes hypercalecemia with widespread calcification and kidney stones

Question 41

Vitamin E (active forms and functions)

Answer 41

Active: Tocopherols Functions: antioxidant, stabilizes coenzyme Q in cellular respiration, enhances heme synthesis, protects CNS

Question 42

Vitamin E deficiency

Answer 42

None are known

Question 43

Vitamin K (active/other forms and functions)

Answer 43

Active: phytylmenaquinone Other: multiprenylmenaquinones Functions: cofactor in post-translational synthesis of gamma-carboxy glutamic acid (Gla) from Glu on proteins which bind calcium

Question 44

Vitamin K deficiency

Answer 44

Increased clotting time

Question 45

Timeline for nutritional deficiencies (4)

Answer 45

1. Loss of nutrient stores 2. Biochemical changes 3. Early clinical symptoms 4. Histopathological changes

Question 46

Diseases for which obesity is a primary risk factor

Answer 46

Coronary artery disease, hypertension, type 2 diabetes, dyslipidemia, stroke, gallstones, osteoarthritis, respiratory problems, cancers

Question 47

Blood levels affected by obesity

Answer 47

Elevation in serum free fatty acids, cholesterol, triacylglycerides regardless of dietary fat intake. Higher fasting blood glucose and decreased glucose intolerance.

Question 48

Waist circumference risk assessment

Answer 48

Men: >40in Women: >38in Abdominal fat cells more active and sensitive to hormones, release fat into portal circulation.

Question 49

3 meds for obesity

Answer 49

1. Orlistat (lipase inhibitor--inhibits digestion/absorbtion of fat) 2. Phentermine (appetite supressant) 3. Sibutramine (sends satiety signals to brain)

Question 50

Protein-calorie malnutrition starvation

Answer 50

Usually in third world countries, poor, elderly. Risk factors include insufficient protein intake, accelerated loss of lean body mass, functional impairments (broken bones, dementia, loss of strength), medical complications (slower wound healing, increased mortality)

Question 51

Marasmus

Answer 51

Starvation-not enough calories or nutrients. Most common in children <1yr from early weaning. In adults seen in disorders that affect food intake.

Question 52

Kwashiorkor

Answer 52

Most widespread nutritional problem in young children. Results from weaning infant from breast milk to starchy protein-poor diet (adequate in calories but lack of dietary AAs results in diminished protein synthesis in tissues. Poor growth, low plasma protein, muscle wasting, edema (especially in abdomen), diarrhea, infections, malabsorbtion of calories proteins and vitamins