Nutrition in Health and Disease Flashcards
What is the definition of diet?
sum total of all foods ingested
What are fixed components of demand?
Basal requirements (membrane function) Mechanical work (cellular and tissue level) Substrate turnover
What are the variable components of demand?
Cost of processing dietary intake
Cost of physical activity
Cost of maintaining body temperature
What is basal metabolic rate?
Minimum to get away with and still being alive
Can be measured by direct colorimetry
Calculated depending on lean body mass + factors for activity and illness
What is nutritional failure?
Failure to meet the nutritional requirements of the individual
Development of deficiencies
Weight loss or excess
What is the definition of malnutrition?
A state of nutrition in which a deficiency or excess of energy, protein ad other nutrients causes measurable adverse effects on tissue/body form, body function and clinical outcome
How is BMI calculated?
Weight (kg)/Height(^2) (m)
What are the metabolic syndromes associated with obesity?
Hypertension CVD Type 2 diabetes mellitus Fatty liver NASH Cirrhosis
What cancers are most associated with obesity?
Breast
Bowel
What is the current UK economic estimate cost of obesity?
£5 billion p.a
What BMI range is classed as underweight?
<20
What BMI range would suggest physical impairment?
<18
What BMI range would suggest increasingly severe consequences?
<16
How is undernutrition screened?
Malnutrition Universal Screening Tool
What is the 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 is the BMI for score 0?
> 20
What is the BMI for score 1?
18.5 - 20
What is the BMI for score 2?
<18.5
What is the weight loss score?
Unplanned weight loss score in past 3-6 months
What is score 0 on weight loss score?
<5%
What is score 1 on weight loss score?
5-10%
What is score 2 on weight loss score?
> 10%
What is the acute disease score?
If the patient is acutely ill and there has been or is likely to be no nutritional intake for more than 5 days = automatic score 2
What makes up the MUST score?
BMI + Weight loss score + Acute disease score
What is a MUST score >2?
Suggests risk of undernutrition
What is a MUST score 1?
Supplements and observation required
What is a MUST score 0?
Monitoring required
What does malnutrition associate with?
Illness
Social isolation
Age
Socially vulnerable groups
What are the clinical consequences of malnutrition?
Impaired immune response Reduced muscle strength Impaired wound healing Impaired psychosocial function Impaired recovery from illness/surgery Poorer clinical outcomes
What is the estimated cost of undernutrition in the UK?
£13 billion p.a
What factors are considered when calculating energy requirements?
Age Weight Sex Disease Activity
What are the causes of undernutrition?
Appetite failure
Access failure
Intestinal failure
What is appetite failure?
Eating disorders e.g. anorexia nervosa
Disease related
What is access failure?
False teeth
Strokes
Cancer of head and neck
Head injury (unconscious)
What is intestinal failure?
Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients
Consequences of surgery
