Nutrition in Health and Disease Flashcards
What is Diet?
The sum total of all foods ingested with food being the individual items ingested
What are Nutrients?
Chemically defined compounds required by the body
What factors decide our food choice?
- Likes
- Dislikes
- Religious and ethical considerations
- Social and psychological components
What do we mean when we say the “Requirement” for a Nutrient
Requirement for a nutrient is that amount required to sustain life and prevent a deficiency
What two factors can you boil nutrition down to?
Intake and diet
What are the two components of Demand?
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
How do you measure the Basal Metabolic Rate?
- Using the Schofield Equation
- Depends on lean body mass
- Various adjustment factors for activity and illness
Easy to overestimate requirements
What is nutritional failure?
Failure to meet the nutritional requirements of the individual
Development of deficiencies
Weight loss or obesity
What are the two presentations of large weight loss and what are their pathophysiology?
Marasma (person is very thin)
Inflammatory response causes leak of albumin into abdominal tissue.
Massive fluid movement.
This causes kwashiorkor
How do weight loss and obesity differ in the problems they cause?
Weight loss = the problem is now
Obesity = the problem will be in the future
What is the Malnutrition Universal Screening Tool?
Pick up patients at risk of malnutritions
Validated in the community and is hospital
Can be carried out by people without special training
What are the steps of the Malnutrition Universal Screening Tool?
Measure height and weight
Calculate BMI
-If >20 - Score 0
-If
How do you calculate BMI?
BMI = Weight (kg)/ Height^2 (m)
What are the results of the Malnutrition Universal Screening Tool?
A score over 2 suggests risk of undernutrition
Score 1: Supplements and watch
Score 0: Monitor
If a patient suffers from malnutrition what should you do?
Refer the patient to a state registered dietitian
What are some of the reasons people don’t eat?
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
what are some of the treatments for malnutrition due to an Access Failure?
Sip Feeding
Fine Bore Nasogastric Tube
PEG
What is PEG?
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
