Nutrition in Health and Disease Flashcards
diet
sum of total of all foods ingested
food
individual item ingested
nutrients
chemically defined compounds required by the body
variable components of energy demand in the body
- processing of dietary intake
- physical activity
- maintaining body temperature
- growth
what is used to estimate nutritional requirements of a person
basal metabolic rate (via Schofield equation)
Key concepts of nutritional failure
- failure to meet the nutritional requirements of the individual
- development of deficiencies
- weight loss
- obesity
different ways malnutrition can present
- marasmus
- kwashiorkor
- obesity
malnutrition definition
a state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/ body for, body function and clinical outcome
how do we define over-nutrition
BMI>25 overweight
BMI>30 obese
how is malnutrition defined
BMI < 20 underweight
BMI < 18 physical impairment
BMI < 16 increasingly severe consequences
malnutrition universal screening tool
- picks up patients at risk of malnutrition
- validated in the community and hospital
- can be carried out by people without special training
what score on the malnutrition universal screening tool suggests malnutrition
2+
what factors increase risk of malnutrition
increasing age female social isolation illness socially vulnerable groups
clinical consequences of malnutrition
- impaired immune function
- reduced muscle strength
- impaired wound healing
- impaired psycho-social function
- poorer clinical outcomes
- impaired recovery from illness and surgery
how much does undernutrition cost the UK per annum
£13billion
what is the procedure for determining treatment in a patient with suspected malnutrition
- take a history
- examine the patient
- analyse the problem
- work out what their nutritional requirement is
2 ways of working out nutritional requirement, and which is easier and harder
- work it out yourself using the Schofield method
2. refer patient to a dietician and get them to work out the nutritional requirement
3 primary causes of undernutrition
- appetite failure
- access failure
- intestinal failure
examples of appetite failure
- anorexia nervosa
- disease related
examples of access failure that can lead to malnutrition
- teeth
- stroke
- cancer of head and neck
- head injury
describe intestinal failure
reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients
solutions to access problems
fine bore nasogastric tube
PEG
describe a percutaneous endoscopic gastronomy
patient sedated
endoscopy carried out
needle and guide-wire into stomach
tube pulled back down and out of the skin
can be placed radiologically
safe but carries definite risks
can last 18 months without replacement
can be used at home
management of nutritional failure
- establish IV feeding
- deal with sepsis urgently
- small amounts of enteral feeding