Nutrition in Medicine Flashcards
Why nutrition
- 2nd leading cause of death
- Unhealthy eating and inactivity contrbute to 310,000-580,000 deaths/yr
10 leading causes of death
- CVD
- Cancer
- Stroke
all have underlying nutritional issues
ROI from community initiatives that limit 3 things is what?
$5.60 per person
Less than what % of physicians feel that they are adequately trained to counsel patients on diet or physical activity
How many visits include nutrition counseling
Stats
- Smoking discussed with 77% of pts
- Diet discussed with only 50\5 of pts
- But those that were discussed with were far more likely to adjust their diet and lose weight
Why doctors don’t discuss diet & activity with their patients
- doesnt make a difference
- not enough time
- not enough reimbursement
- personalized, requires more training
- translating evidence
- lack of consensus
Nutrition assessment
- Hx
- Anthropometry/measurements
- Physical exam
- Labs
Who’s at high risk?
- very young
- very old
- underweight/overweight
- hypermetabolic
- alcoholic
- impoverished/marginalized/altered mental capacity
- chronic conditions
What things do you look for in social history?
- diet
- physical activity
- habits
- SES
Screening questions
” Tell me about your diet”
“Tell me what you ate yesterday”
“Where do you eat most of your meals”
Listening for in an assessment
- variety (vs. restriction)
- Excess/inadequacy (restaurants)
- Issues relevant to the patient: saturated fat, calories, Na+, Ca++, Fe++
Assessment by foods
- Variety
- Excess (calories, fats, added sugars, salt)
- F/V, whole grains, dairy
- Habits
DRIs
- Less emphasis on prevention of deficiency
- More emphasis on decreased risk of chronic disease/health promotion
- current version of DRI includes “upper limits” for nutrients
EAR vs. RDA
EAR - estimated adequate intake for 50% of population
RDA - meets requirements for 95097% of population (set high); used as a goal for healthy individuals;
- intake above the average requirement by an amount that includes the range of variability in requirements and availability from diet (95% of pop)
