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SMP - MNE Exam 2 > Nutrition Module 9: Nutrition & Aging - Chronic Disease > Flashcards

Nutrition Module 9: Nutrition & Aging - Chronic Disease Flashcards

1
Q

How long can a 65 yo woman in the US expect to live to?

A

85

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2
Q

How long can a 65 yo man in the US expect to live to?

A

82

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3
Q

How many deaths in the US are caused by either heart disease, cancer, and stroke?

A

60%

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4
Q

What do nutritional recommendations for elder patients depend on?

A

Age and stage of disease

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5
Q

What are the 2 factors that may cause age-typical diseases?

A
  1. Normal wear and tear: hardening of arteries, accumulation of DNA mutations, minor loss of bone minerals
  2. Accelerated damage: deposition of lipids, calcium, and proteins due to obesity, lack of folate, high rate of DNA mutations due to charbroiled meat, lack of antioxidants, lack of vitamin D or calcium or lack of exercise leading to bone loss
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6
Q

What are the 3 age-typical diseases?

A
  1. Myocardial infarction
  2. Cancer
  3. Bone fracture
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7
Q

Can nutritional changes made in the second part of life make a difference?

A

Yes

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8
Q

What are the 7 nutrient intake goals?

A
  1. Total energy should maintain healthy weight
  2. Saturated + trans fat below 10% of energy intake
  3. Monounsaturated fats below 20% of energy intake
  4. Fat below 35% of energy intake
  5. 20-35g of fiber/day
  6. Carotenoids, polyphenols, and other antioxidants
  7. Micronutrients
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9
Q

What does the amount of fiber recommended per day depend on?

A

Age and sex

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10
Q

What is primary prevention of disease? Are these only applicable to older adults?

A

Reduce exposure to risk factors to decrease chances of developing chronic disease

NOPE, applicable to everyone

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11
Q

What is secondary prevention of disease?

A

Detect early and treat before symptoms develop and cause damage OR prevent event recurrence

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12
Q

What is tertiary prevention of disease?

A

Slow the progress of a clinically overt disease and lessen its effects by improving nutritional status

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13
Q

What are the 6 benefits of disease prevention for older adults?

A
  1. Maintenance of health/vitality
  2. Restoration of function when possible
  3. Repleneshing nutrient stores/improving nutrient status
  4. Correction of nutritional deficiencies
  5. Delay/minimization of disease side effects
  6. More successful chronic disease rehab
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14
Q

Are the benefits of disease prevention for older adults the same as for younger adults?

A

NOPE

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15
Q

What are 4 examples of primary disease prevention?

A
  1. Consumelowsaturatedfatandtrans­fat
  2. Consumedietrichinwholegrains,fruits,andveggies
  3. ConsumeadequatecalciumandvitaminD
  4. Achieveandmaintainappropriatebodyweight
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16
Q

What are 3 examples of secondary disease prevention?

A
  1. Diet,weightcontrol/physicalactivity,andmedication
  2. Increasedietarycalcium,potassium,andmagnesiumfor BP
    management.
  3. Reduceserumlipidsbyreducingsaturatedfatandtrans­fatintake
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17
Q

What are 3 examples of tertiary disease prevention?

A
  1. Nutritionalsupportduringcancertherapy
  2. VitD,vitaminK,andcalciumsupplementation​aspart ofacomprehensiveosteoporosistreatmentprogram
  3. High intake of omega-3 FAs to decrease chronic arthritis inflammation
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18
Q

What is the practical nutritional advice to give to patients? 5 of them

A
  1. Maintainregular,age ­appropriateexercise
  2. Eat4-5cupsfruitandveggiesperday
  3. Eatprocessedfoodandmealslessoften
  4. Choosewholegrain
  5. UseRDA­levelsupplement
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19
Q

Describe the 4 steps of athreosclerosis.

A
  1. Lumen of arteries is smooth = healthy
  2. Reversible fatty streaks or tears appear
  3. Bulging intima = arterieshardenandnarrowdueto cholesterolandcalciumdeposits
  4. Bloodclotsblocksmallarteries;myocardialinfarctionorstroke mayoccur = thrombus
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20
Q

What disease are more than 60% of older people die of?

A

CVD

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21
Q

What stage of atherosclerosis are most 65 yo at?

A

3

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22
Q

How can you prevent atherosclerosis to go from stage 2 to 3?

A
  1. Normal body weight
  2. Low saturated fat intake
  3. Vitamin E, C, and K, and folate rich foods
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23
Q

How can you prevent atherosclerosis to go from stage 3 to 4?

A

Foodsrichinomega­3fattyacidsandsalicylatesreduce

thrombosisrisk

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24
Q

What are the 4 mechanisms resulting in the narrowing and occlusion of arteries?

A
  1. Inflammation/proliferation
  2. Lipid infiltration
  3. Calcification
  4. Embolism/thrombosis
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25
Q

What are the 2 ways that lipids infiltrate arteries?

A
  1. It accumulates as LDL is altered by oxidative damage

2. Foam cells rupture in the intima

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26
Q

What is the arterial intima?

A

Layer of artery closest to the lumen

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27
Q

What are foam cells?

A

Cholesterol filled macrophages

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28
Q

How to avoid lipid infiltration of arteries?

A

Reduce amount of LDLs circulating:

  1. Low fat
  2. High-fiber
  3. Antioxidants
  4. Exercises
  5. Normal body weight
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29
Q

How does inflammation/proliferation of arteries occur?

A

Intimaldepositsofcholesterolandbrokenupfoamcellsattract
macrophagesandinduceproliferationofsmoothmusclecellsand
fibroblasts

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30
Q

What can promote inflammatory changes leading to even more inflammation/proliferation of the arteries?

A

Dental and other chronic infections

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31
Q

How to avoid inflammation/proliferation of arteries?

A
  1. Omega-3 FAs
  2. Phytochemicals
  3. Good oral hygiene
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32
Q

Where are salicylates found? 3

A
  1. Fruits
  2. Veggies
  3. Aspirin
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33
Q

Describe thrombosis.

A
  1. Platelets aggregate in intimal bulges, tears, and ruptures
  2. Coagulation factors are activated by platelets and endothelial damage
  3. Blood clots form and blocks vessel
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34
Q

How to prevent thrombosis?

A
  1. Salicylates

2. Omega-3 FAs

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35
Q

What can cause calcification of arteries?

A
  1. Diabetes
  2. Low vitamin K intake
  3. Inflammation with lipid deposits
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36
Q

What does calcification of arteries cause?

A
  1. Decreases vascular elasticity

2. Increases BP

37
Q

How to avoid calcification of arteries?

A
  1. Vitamin K

2. Good glycemic control

38
Q

What are the 3 basic prevention strategies of CVD before the disease progresses?

A

● Consumeadietlowinsaturatedandtransfat(<10%of
totalenergy)
● 5+servingsoffruitsandveggies/day
● achieveandmaintainappropriatebodyweight

39
Q

What are the 9 therapeutic lifestyle changes (TLC) for patients with CVD to make? What are their main goal?

A
  1. Saturatedandtransfatbelow 7% of TE
  2. PUFA: up to 10% of TE
  3. MUFA: up to 20% of TE
  4. Total fat: 25-35% of TE
  5. Carbs: 50-60% of TE
  6. 20-30 g fiber/day
  7. Protein: 15% of TE
  8. Cholesterol below 200 mg/day
  9. TE should maintain desirable body weight
40
Q

How can folate, B12, and B6 contribute to CVD?

A

They can lower homocysteine levels which can slow vessel damage

41
Q

What common diet can help improve lipid profiles of CVD patients?

A

Semi-vegetarian or vegetarian

42
Q

Why can it be dangerous for old people to lose weight?

A

Because they are at risk for dangerous muscle loss = sarcopenia

43
Q

How can you help your patient improve body composition but avoid sarcopenia? Overall goal?

A
  1. Exercise
  2. Eat regularly
  3. Improve diet with nutrient-rich foods

GOAL: maintain or increase muscle mass while reducing excess fat

44
Q

Normal LDL levels?

A

Optimal if it is less than 100

45
Q

Normal HDL levels?

A

60 or more

46
Q

Can dietary modifications reverse the progression of CVD at any age?

A

YUP

47
Q

What are free radicals generated by?

A

Many normal cellular functions: cellular immune defense, oxidative phosphorylation, uric acid production, peroxisomal oxidation

48
Q

What do free radicals damage?

A

Cellular components: mito, DNA, proteins, membrane lipids

49
Q

What can neurological and cognitive impairment in old people be due to?

A

Loss of mito function due to DNA damage

50
Q

What can free radical damage cause?

A

Many age typical diseases like cancer and atherosceloris

51
Q

What can excess intake of antioxidants cause?

A

More harm than good

52
Q

What 2 types of molecules can help against free radical damage?

A
  1. Enzymes with selenium, zinc, iron, copper, and manganese as cofactors
  2. Antioxidant compounds: fat-soluble and water-soluble
53
Q

What are 3 examples of enzymes that protect against ROS damage?

A
  1. Superoxide dismutase (Zn, Cu, Mn)
  2. Catalase (Fe)
  3. Gluthathione peroxidase (Se)
54
Q

What are 8 examples of antioxidant compounds?

A
  1. Ascorbic acid (water soluble)
  2. Polyphenols
  3. Glutathione proteins
  4. Vitamin E
  5. Carotenoids (lipid soluble)
  6. Uric acid (water soluble)
  7. Alpha-tocopherol in LDLs (lipid soluble)
  8. Flavonoids/isoflavonoids
55
Q

What are the 2 main photoprotectice carotenoids in the retina? What foods are they found in?

A
  1. Lutein
  2. Zeaxanthin

Red fruits and veggies like tomatoes and watermelon

56
Q

Why are old people more at risk for ROS damage?

A

Inadequate intake of foods to protect them

57
Q

What are the 4 basic prevention strategies against cancer?

A
  1. Diet rich in fruits, veggies, and whole grains
  2. Maintain healthy body weight
  3. Limit exposure to charbroiled meats, cured meats, alcohol, and fat
  4. Consume adequate calcium
58
Q

What is the nutrition therapy once metastasis has been established?

A

Focus on promoting food intake and fluid intake and weight maintenance as weight loss is a major cause of death

59
Q

Is it ok for patients to take supplements for fruits, veggies, and whole grains? Why?

A

NOPE cause they are usually toxic

60
Q

What 2 foods can help with nausea associated with chemo?

A

Calorie-dense and protein-sense beverages

61
Q

List the 11 cancer protective foods.

A
  1. Phenolics
  2. Flavonoids
  3. Isothiocyanates
  4. Indoles
  5. Saponins
  6. Phytosterols
  7. Folate
  8. Antioxidants
  9. Fiber
  10. Omega-3 fatty acids
  11. Calcium
62
Q

What % of osteoporosis patients are women?

A

75%

63
Q

When should I be concerned about salt intake?

A

When patient has hypertension

64
Q

What are the 3 basic prevention strategies for T2DM?

A
  1. Maintain healthy weight
  2. Regular exercise
  3. Moderate saturated fat intake
65
Q

Treatment for overweight patients with impaired glucose tolerance?

A
  1. Exercise

2. Weight loss

66
Q

What are 7 sources of chromium to ensure proper insulin function?

A
  1. Brewer’s yeast
  2. Whole grains
  3. Wheat germ
  4. Broccoli
  5. Nuts
  6. Cheese
  7. Organ meats
67
Q

Should patients take chromium supplements?

A

Very little evidence around this so NOPE

68
Q

How many meals a day should T2DM pts have?

A

5 to 6 small meals/snacks

69
Q

Focus of T2DM patients who are elderly?

A
  1. Exercise

2. Medications3. Liberalized diet

70
Q

How can one limit sodium intake?

A

LIMIT:

  1. Cheese
  2. Canned veggies and soups
  3. Processed or pickled foods
  4. Snack foods
  5. Added salt
71
Q

Does everyone’s BP respond the same to salt reduction?

A

NOPE

72
Q

What 3 renal functions does aging decrease?

A
  1. GFR
  2. Tubular function
  3. Ability to concentrate urine
73
Q

What 2 diseases can further damage the kidneys, esp the glomerulus?

A
  1. DM

2. HT

74
Q

What happens in end-stage renal disease?

A

Patients can no longer excrete waste products nor metabolize vitamin D

75
Q

What are the 3 issues that patients with kidney disease may experience as a result of poor nutrition? What is the nutrition rec for each?

A
  1. Weight loss/anorexia: appropriate energy intake and lower protein pre-dialysis
  2. Bone mineral loss: limit phosphate intake and take VD and Ca supplements
  3. High CVD risk: take supplemental vitamins
76
Q

What causes weight loss/anorexia in patients with kidney disease?

A

Increase release of leptin and cytokines suppress appetite

77
Q

What causes bone mineral loss in patients with kidney disease?

A
  1. Phosphate retention

2. Lack of active VD = high PTH

78
Q

What does PTH regulate?

A

Raises [Ca2+] in blood

79
Q

What causes high CVD risk in patients with kidney disease?

A

Low B6, B12 and folate = high homocysteine

80
Q

How to reduce the amount of N that needs to be processed by the kidney?

A

Eat high quality protein

81
Q

What is the most common type of arthritis?

A

Osteoarthritis

82
Q

What % of people over 65 have osteoarthritis?

A

50%

83
Q

What are the 3 recommendations for OA improvement?

A
  1. Avoid weight gain
  2. Weight loss if appropriate
  3. Antioxidants and VD
84
Q

Should OA patients eat omega-6 FAs? Why?

A

NOPE, it’ll increase inflammation

85
Q

What are some side effects of nonsteroidal anti-inflammatory drugs used for OA pain?

A

Stomach irritation/ulcers = limited food intake and impaired absorption

86
Q

What are some symptoms of RA?

A
  1. Loss of lean body mass

2. Bone loss (cytokine mediated)

87
Q

What are RA patients at increased risk for?

A

CVD

88
Q

How can FAs affect RA?

A

Need more 3s and less 6s

89
Q

How can RA drugs affect nutritional status?

A
  1. Methotrexate interfere with folate use

2. Corticosteroids promote protein loss

SMP - MNE Exam 2 (17 decks)

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