Nutrition in Health and Disease

Question 1

What is Diet?

Answer 1

The sum total of all foods ingested with food being the individual items ingested

Question 2

What are Nutrients?

Answer 2

Chemically defined compounds required by the body

Question 3

What factors decide our food choice?

Answer 3

• Likes
• Dislikes
• Religious and ethical considerations
• Social and psychological components

Question 4

What do we mean when we say the “Requirement” for a Nutrient

Answer 4

Requirement for a nutrient is that amount required to sustain life and prevent a deficiency

Question 5

What two factors can you boil nutrition down to?

Answer 5

Intake and diet

Question 6

What are the two components of Demand?

Answer 6

Fixed Component:

• Basal requirements
• -Membrane function (pumps, Transport and signalling)
• -Mechanical Work (Cellular and tissue level)
• -Substrate turnover

Variable Component:

• Cost of processing the dietary intake
• Cost of Physical activity
• Cost of maintaining body temperature
• Cost of growth

Question 7

How do you measure the Basal Metabolic Rate?

Answer 7

• Using the Schofield Equation
• Depends on lean body mass
• Various adjustment factors for activity and illness

Easy to overestimate requirements

Question 8

What is nutritional failure?

Answer 8

Failure to meet the nutritional requirements of the individual
Development of deficiencies
Weight loss or obesity

Question 9

What are the two presentations of large weight loss and what are their pathophysiology?

Answer 9

Marasma (person is very thin)

Inflammatory response causes leak of albumin into abdominal tissue.
Massive fluid movement.

This causes kwashiorkor

Question 10

How do weight loss and obesity differ in the problems they cause?

Answer 10

Weight loss = the problem is now

Obesity = the problem will be in the future

Question 11

What is the Malnutrition Universal Screening Tool?

Answer 11

Pick up patients at risk of malnutritions

Validated in the community and is hospital

Can be carried out by people without special training

Question 12

What are the steps of the Malnutrition Universal Screening Tool?

Answer 12

Measure height and weight
Calculate BMI
-If >20 - Score 0
-If

Question 13

How do you calculate BMI?

Answer 13

BMI = Weight (kg)/ Height^2 (m)

Question 14

What are the results of the Malnutrition Universal Screening Tool?

Answer 14

A score over 2 suggests risk of undernutrition

Score 1: Supplements and watch

Score 0: Monitor

Question 15

If a patient suffers from malnutrition what should you do?

Answer 15

Refer the patient to a state registered dietitian

Question 16

What are some of the reasons people don’t eat?

Answer 16

Appetite Failure:

• Anorexia nervosa
• Disease related

Access Failure:

• Teeth
• Stroke
• Cancer of head and neck
• Head injury

Intestinal Failure (less common)
-Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients

Question 17

what are some of the treatments for malnutrition due to an Access Failure?

Answer 17

Sip Feeding
Fine Bore Nasogastric Tube
PEG

Question 18

What is PEG?

Answer 18

Percutaneous Endoscopic Gastrostomy

• Patient is sedated
• Endoscopy is carried out
• Needle and guide wire passed into stomach
• Tube passed down guide and out of the stomach
• Can be placed radiologically too

Patient can be fed directly into stomach and can use at home