Nutrition in Health and Disease

Question 1

What is the fixed components in the demand of food

Answer 1

Basal requirements
-membrane functions

Mechanical work

Substrate turnover

Question 2

What is the variable components in the demand of food

Answer 2

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

Question 3

Hoe do you measure Basal Metabolic rate

Answer 3

Direct calorimetry

• dependant on lean body mass
• adjusted with activity and illness

Question 4

What are two conditions that occur due to undernourishment

Answer 4

Marasmus

Kwashiorkor

Question 5

Define malnutrition

Answer 5

As state of nutrition in which a deficiency or excess (or imbalance) of energy, protein, and other nutrients, causes measurable adverse effects on tissue / body form, (body size, shape, composition) body function and clinical outcome.

Question 6

What is the outcome of over nutrition

Answer 6

Obesity

Long term problems that become apparent over time

Question 7

What does under nourishment lead to

Answer 7

Weightless and impaired function

strong associate with illness

Question 8

What BM shows overweight and obesity

Answer 8

> 25 Overweight

>30 Obese

Question 9

What is the aetiology of obesity

Answer 9

environment
exercise
Genes

Question 10

what is the clinical disease development of Obesity

Answer 10

Metabolic:
Hypertension.
Cardiovascular disease.
Type II diabetes mellitus.
Fatty liver.
NASH
Cirrhosis 

Cancer:
Breast
Bowel

Question 11

What is the aetiology of undernourishment

Answer 11

Paritaly enviroment

Most disease related:

• appetite failure
• access failure
• intestinal failure

Question 12

What is the BMI of undernourishment

Answer 12

BMI less < 20 underweight
BMI < 18 physical impairment
BMI < 16 increasingly severe consequences

Question 13

What is the disadvantage to BMI

Answer 13

Does not consider rapid Body mass loss,

as 10% loss of body mass becomes associated with increasing morbidity

Question 14

When is it easiest treat rapid weight loss

Answer 14

When only 10% of body mass has been lost

Question 15

What is the step by step approach of screening for undernourishment

Answer 15

Step 1:
weight and heigh to work out BMI
<20 = 1
<18 = 2

Step 2:
Have you lost weight unintentionally in last 3-6months
10% = 2
5% = 1

Step 3:
Has patient eaten in last 5 days
No = 2

RESULT- scores
2 = undernourishment
1= Supplement and watch
0= monitor

Question 16

What is malnourishment associated with

Answer 16

Illness
Social Isolation
Age
Socially Vulnerable groups

Creates a “Food Deserts”

Question 17

What is the clinical consequences of malnourishment

Answer 17

• Impaired immune response
• Reduced muscle strength
• Impaired wound healing
• Impaired psycho-social function
• Impaired recovery from illness and surgery
• Poorer clinical outcomes

Question 18

How is malnourishment managed

Answer 18

Work out their requirements using schofileds method

refers to state registered dietitian

Question 19

What are causes of appetite failure that results in undernourishment

Answer 19

anorexia nervosa

Disease related

Question 20

What are causes of access failure that result in under nourishment

Answer 20

Teeth
Stroke
Cancer of head and neck
Head injury

Question 21

How does intestinal failure result in undernourishment

Answer 21

Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients

Question 22

What is the treatment options for undernourishment

Answer 22

Fine bore nasogastric tube

PEG (percutaneous endoscopic gastronomy)

Sip

IV feeding

Question 23

Define nutritional failure

Answer 23

Failure to meet the nutritional requirements of the individual
Development of deficiencies 
[Weight loss]
Or Excess
[Obesity]