Nutrition malabsorption Flashcards
Complete the table on malabsorption and specific disease
What is the primary fuel for energy?
In health glucose primary fuel for energy – metabolism and citric acid cycle.
Fat and proteins are conserved
Complete the diagram on energy balance
What happens to energy metabolism without food?
In absence of food glucose maintained through mobilisation of stores of glycogen and if prolonged gluconeogenesis, lipolysis
What happens to energy balance in disease?
In disease inflammatory response – cytokines
TNFα Insulin resistance, glycolysis
IL2 glucose metabolism
IL4 lipid & glucose metabolism
IL6 lipolysis
activity and appetite reduced
What changes to the diagram occur in illness?
Name some diseases with increased energy requirements
- Cancer
- Acute Renal
- Liver failure
- COPD
- Crohns
- COVID-19
Which disease can also have decreased energy requirements?
Acutre renal
What is the effect of growth hormone?
Contributes to insulin resistance in acute illness
•What do patients with an acute illness need?
meet energy demand
conserve muscle mass – avoid negative nitrogen balance
Manage blood glucose
What are the feeding issues they are facing?
Poor appetite or inability to eat
Extended periods of time nil by mouth
Not a priority
Unclear roles and responsibilities
What are the risk factors of refeeding syndrome?
Patient has one or more of the following:
- BMI less than 16 kg/m2
- unintentional weight loss greater than 15% within the last 3–6 months
- little or no nutritional intake for more than 10 days
- low levels of potassium, phosphate or magnesium prior to feeding.
Or patient has two or more of the following:
- BMI less than 18.5 kg/m2
- unintentional weight loss greater than 10% within the last 3–6 months
- little or no nutritional intake for more than 5 days
- a history of alcohol abuse or drugs including insulin, chemotherapy, antacids or diuretics.
What do you need to check in patients at risk of refeeding syndrome?
Remember to check Urea and electrolytes, including phosphate and magnesium prior to feeding and then daily
How can you support provide adequate nutrition in chronic illness?
Chronic Illness – start with food – may have long term enteral feeding
Focus on balanced diet
Diet to increase energy intake
Diet to manage blood glucose
Diet to reduce workload of kidney
Diet to reduce inflammation
Diet to support treatment
How can you provide adequate nutritional in acute illness patients?
Acute Illness- start with food but consider other routes such as enteral/parenteral
Diet to meet energy demand and reduce catabolism
Diet to support recovery – micronutrients & macronutrients
