Nutrition I and II Flashcards
BMI formula
Wt in kg/(Ht in m)^2 OR Wt in kg/(Ht in m)^2 x 703
BMI ranges
Healthy: 19.5-25 Overweight 25.1-29.9 Obese: >30 Morbidly obese: >40
3 macronutrients
- Carbohydrates 2. Lipids 3. Proteins
Micronutrients
Vitamins (fat and water soluble) and minerals essential for proper metabolism
4 factors which influence energy need
- Body surface area (proportional to heat loss) 2. Age and hormonal status 3. Gender 4. Activity level
Basal metabolic rate (BMR)
Weight in kg x 24 kcal/kg per day Amount of energy that keeps an individual alive without physicial activity
Hormone effects on BMR
Thyroxin, sex hormones, growth hormone, epinephrine and cortisol increase BMR
How age affects BMR
Decrease in BMR of 2% each decade
BMR in hospitalized pts
BMR x 1.2 for bed rest activity and BMR x 1.5 for stress factor (more important in severely sick patients)
How are food calories measured?
kcal/g
of kcal/g for protein, fat, carbs, alcohol
Fat: 9 kcal/g Protein: 4 kcal/g Carbs: 4 kcal/g Alcohol: 7 kcal/g
Amount of carbs, protein, fat, fiber to consume daily
Carbs: 45-65% (at least 130g, 300-400g) Protein: 10-35% (70-90g) Fat: 20-35% (60-100g) Fiber: Men-38g Women-25g
Most common nutritional problems
Carbohydrate intolerances–diabetes and lactose intolerance
How much essential fatty acids in diet?
10% of total fat intake
How is excess fat stored?
Triacylglycerol
What diseases are high fat intake associated with?
Heart disease, colon, breast, and prostate cancers
Relationship between coronary artery disease and fat intake
Excess saturated fat directly related to high serum cholesterol thus the development of CAD
Monounsaturated fatty acids
Lower plasma cholesterol levels (olive, safflower, canola, peanut oils)
Polyunsaturated fatty acids
Essential linoleic and linoleic acid. omega-3 (flaxseed oil, salmon) and omega-6 (sunflower, soybean, corn oils)
Scaly dermatitis
Symptom of essential fatty acid deficiency. Hair loss, poor wound healing.
What happens to excess protein?
Converted to glucose or fats. Eventually all converted to triglycerides in adipose tissue.
Nitrogen balance
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.
Protein requirements in illness, surgery, trauma
Catabolic response with release of chemicals which cause acceleration in body protein breakdown and negative nitrogen balance
Dietary fiber
Components of food which cannot be broken down by human digestive enzymes
Benefits of fiber
Reduce risk of colon cancer, benefit diverticular disease, lower cholesterol, slow rise of blood sugar, bind carcinogens
What has fiber in it?
Water insoluble: Vegetables, wheat, grain Water soluble: fruits, oats, legumes
Fat-soluble vitamins
DEKA Too much of them can be problematic
Water-soluble vitamins
B family, C Unknown if risk of too much
Macrominerals
Sodium, potassium, calcium, phosphate, magnesium
Vitamins
Organic molecule required for certain metabolic functions and cannot be synthesized (or cannot make enough of it)
What is special about vitamin C?
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.
What is the prudent diet? (3)
- Reduce consumption of total calories, fat, cholesterol, simple sugars, salt 2. Increase fiber 3. Increase physicial activity
Macronutrients vs micronutrients
Macronutrients needed to generate energy and build the body. Micronutrients are needed to run biochemical and physiological processes.
Vitamin A (active/inactive forms and functions)
Active: retinol, retinal Inactive: carotenoids Functions: antioxidant, act like steroid hormones and bind chromatin to affect cell growth/differentiation, good for vision
Vitamin A sources
Liver, egg yolk, butter, milk, dark green/yellow veggies
Vitamin A deficiency
Night blindness, anemia, follicular hyperkeratosis (rough keratinized skin)
Vitamin A toxicity
10x RDA in pregnant women can cause brain damage to infants, toxicity also found in arctic and with acne treatment
Vitamin D (active/other forms and functions)
Active: 1-alpha,25-dihydroxy-cholecalciferol Other: cholecalciferol, ergocalciferol Functions: regulate calcium, calcium transport
Vitamin D deficiency
Rickets (osteoid and cartilage not mineralized), osteomalacia (bone softening), fat malabsorbtion
Vitamin D toxicity
10-100x RDA causes hypercalecemia with widespread calcification and kidney stones
Vitamin E (active forms and functions)
Active: Tocopherols Functions: antioxidant, stabilizes coenzyme Q in cellular respiration, enhances heme synthesis, protects CNS
Vitamin E deficiency
None are known
Vitamin K (active/other forms and functions)
Active: phytylmenaquinone Other: multiprenylmenaquinones Functions: cofactor in post-translational synthesis of gamma-carboxy glutamic acid (Gla) from Glu on proteins which bind calcium
Vitamin K deficiency
Increased clotting time
Timeline for nutritional deficiencies (4)
- Loss of nutrient stores 2. Biochemical changes 3. Early clinical symptoms 4. Histopathological changes
Diseases for which obesity is a primary risk factor
Coronary artery disease, hypertension, type 2 diabetes, dyslipidemia, stroke, gallstones, osteoarthritis, respiratory problems, cancers
Blood levels affected by obesity
Elevation in serum free fatty acids, cholesterol, triacylglycerides regardless of dietary fat intake. Higher fasting blood glucose and decreased glucose intolerance.
Waist circumference risk assessment
Men: >40in Women: >38in Abdominal fat cells more active and sensitive to hormones, release fat into portal circulation.
3 meds for obesity
- Orlistat (lipase inhibitor–inhibits digestion/absorbtion of fat) 2. Phentermine (appetite supressant) 3. Sibutramine (sends satiety signals to brain)
Protein-calorie malnutrition starvation
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)
Marasmus
Starvation-not enough calories or nutrients. Most common in children <1yr from early weaning. In adults seen in disorders that affect food intake.
Kwashiorkor
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
