Nutrition in Health and Disease Flashcards
Define diet.
Sum total of all the food ingested
What are nutrients?
Chemical components required by the body
What happens if food intake exceeds demand?
Put on weight
What happens if food demand exceeds intake?
Lose weight
How can basal metabolic rate be measured directly?
Calorimetry
How can basal metabolic rate be calculated?
Depends on lean body mass
Number of different equations e.g. Harris Benedict or Hernry equation
Define malnutrition.
State of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/body form, function and clinical outcome.
What is the most common micronutrient deficiency?
Iron deficiency anaemia
What does overnutrition lead to?
Obesity
What does undernutrition lead to?
Weight loss and loss of function
How is BMI calculated?
Weight divided by height in metres squared
In overnutrition, what would tend to be the associated BMI?
BMI >25
Which BMI would suggest obesity?
BMI >30
Which factors contribute to obesity?
Environmental factors
Exercise
Genes
What can obesity cause increased risks of?
Metabolic syndromes
Cancer
List some of the metabolic syndromes obesity increases the chances of.
Hypertension
Type 2 diabetes
CVD
Fatty liver
Non-alcoholic fatty liver
Cirrhosis
Which two types of cancer specifically can obesity increase risks of?
Bowel and breast cancer
Which factors contribute to malnutrition?
Environment
Underlying disease
Those considered to have undernutrition have a BMI of??
BMI<20
At which BMI will there be physical impairment due to undernutrition?
BMI<18
What is important to note in terms of obese people and BMI?
If they are losing weight abnormally, it may difficult to tell if they still have a high BMI
What % of loss of body mass can be associated with increased morbitidity?
10%
What is the screening tool used in Scotland for malnutrition?
MUST
Malnutrition
Universal
Screening
Tool
What does MUST look at?
BMI
Unexplained weight loss
According to MUST, what would the score be for someone with a BMI<20?
1
According to MUST, what would the score be for someone with a BMI<18?
2
According to MUST, what would the score be for someone who has unexplained weight loss of 5% in the last 3-6 months?
1
According to MUST, what would the score be for someone who has unexplained weight loss of 10% in the last 3-6 months?
2
According to MUST, what would the score be for someone who has not eaten in the last five days?
2
What score, according to MUST, suggest malnutrition?
2 or more
Add up the scores from the BMI, unexplained weight loss etc
A MUST score of 1 would require what?
Supplements and watch them
List some of the consequences which come about as a result of malnutrition?
-Impaired immune response
-Reduced muscle strength
-Impaired wound healing
-Impaired psycho-social function
-Impaired recovery from illness and surgery
What should you do if you think is malnourished?
Refer to a dietician
->calculating it is so complicated and we are not trained to do so but best referred to someone who knows what they are doing
What are the three main subtypes of aetiology of undernutrition?
Appetite failure
Access failure
Intestinal failure
What may cause appetite failure?
Eating disorders like anorexia
Disease related
What may cause access failure?
Teeth- ill-fitting dentures etc.
Stroke
Cancer of head and neck
Head injury
What is meant be intestinal failure?
Reduction in functioning gut mass below the minimum amount required for absorption and digestion of nutrients.
How does intestinal failure most commonly arise?
As a complication to surgery
What can be used to aid in nutrition in someone who is unable to have food?
Nasogastric tube
What can be used instead of nasogastric tubing in the long term?
Gastronomy- PEG (percutaneous endoscopic gastrostomy tube)
Describe PEG.
Tube that goes through the skin to the stomach and can aid in nutrition.
What is kwashiorkor?
Severe protein malnutrition characterised by oedema and an enlarged liver with fat deposits.
What type of feeding may you have to use in rare circumstances rather than gasto tubing?
IV feeding
What is the biggest cause of malabsorption?
Coeliac disease
In order to have malabsorption, which symptoms will be present?
Diarrhoea
Vitamin defiency
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Which antibody do you test for in coeliac disease?
IgA
