Nutrition (shannon hugh)-Exam 3 Flashcards
what is nutrition?
- The study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease.
- The chemical and functional components of food
- The physiological effects of food components
- How human behavior affects food choices
- The impact of the surrounding environment on food choices
- Biochemistry!
Medical Nutrition Therapy=
Nutritional diagnostic, therapy, and counseling services for the purpose of disease management which are furnished by a registered dietitian or nutrition professional
ex’s of diseases with MNT: DM, HTN, CVD, IBD, IBS, Food allergies, celiac disease , HIV, cystic fibrosis, cancer etc
Main nutritional disorders in the US (list 3)
Acute or chronic protein-energy malnutrition (PEM)
Linear growth failure= height
Combination of PEM and linear growth failure
Growth Charts:
WHO (birth to 2 years/5 years) vs CDC
WHO (birth to 2 years/5 years):
- Weight
- Length/Height
- Weight-for-length
- Head Circumference
CDC:
- Birth to 36 months: Weight, Length, Head Circumference, BMI
- 2 to 20 years: Height, Weight, BMI
Growth Charts:
Z-score=
-Dx of malnutrition is used with ___
Number of SDs from the mean height and weight values for age
(Z score of -2 for weight for age= underweight)
**Dx of malnutrition is used with weight for height and BMI for age!!!!! KNOW
Arthropometrics= used for evaluating ______
growth
Age: Avrg. weight gain Newborn--> 30 (g/day) 6 months--> 15 (g/day) 12 months--> 10 (g/day) 1-3 yrs (6 g/day)
Most babies lose about ___% of birth weight and regain by 2-3 weeks of age
10%
Most healthy infants double birth weight by __ months of age and triple by 12 months of age
6
After 3 months of age, the rate of weight gain in breastfed infant may be ____ than a formula-fed infant
lower
BMI=
Kg/m2
- Waist circumference
- Tool for assessing body fat
- Fat located in the abdominal region may be associated with greater health risks than fat below the abdomen
weight stigma=
weight bias=
=Negative social impact of weight bias and discrimination
=Beliefs & preferencesfororagainstparticular body shapes and sizes
–The inclination to form unreasonable judgements based on a person’s weight
Undernutrition:
- Acute?
- Chronic?
Acute: weight for age
Chronic: length for age and head circumference
Undernutrition:
-Wasting?
-Stunting?
Wasting= <5% tile in weight for height
Stunting= <5% tile for height for age
KNOW!!
Undernutrition:
-Marasmus=
severe wasting
<70% IBW (ideal body weight)
Peds undernutrition:
Growth faltering “failure to thrive” =
slower rate of growth compared with standards for age and sex
Peds undernutrition:
Wasting=
reduced weight for height due to lack of weight gain or acute weight loss
Peds undernutrition:
Stunting=
reduced length or height for age (Z-score < -2)
PEM: Kwashiorkor=
-PE findings? (skin findings)
=Inadequate protein intake, fair to good energy intake
PE findings:
-Normal or nearly normal weight and height for age
- Anasarca= full body edema
- Pitting edema in the lower extremities and periorbitally
- Rounded prominence of the cheeks (“moon-face”)
- Pursed appearance of the mouth
- Dry, atrophic, peeling skin with confluent areas of hyperkeratosis and hyperpigmentation
- Dry, dull, hypopigmented hair that falls out or is easily plucked
- Hepatomegaly
- Distended abdomen with dilated intestinal loops
PEM: Marasmus=
-PE findings?
=Wasting of muscle mass, depletion of fat stores
–Inadequate intake of all nutrients, including energy
PE findings:
- Diminished weight and height for age
- Emaciated and weak appearance
- Bradycardia, hypotension, and hypothermia
- Thin, dry skin
- Redundant skin folds caused by loss of subcutaneous fat
- Thin, sparse hair that is easily plucked
Energy (kcal) Requirements: Children:
Approximate daily energy calculation=
Approximate daily energy calculation:
1000 kcal +100 kcal for every year over 1 year of age
Carbs=
main source of energy
4kcal/gram
Protein:
-__ essential that are NOT made by the human body (list)
*9 essential:not made by the human body
Histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine
(notes: Kids who are pre term and young infant–> it’s essential that they get cystine and tyrosine cuz they don’t have the enzymes to form these)
Protein Requirements:Adults
10-35% of daily calories
- 8 gm/kg for maintenance
- 8-1.2 gm/kg for increased needs
> 1.2 gm/kg for hypermetabolic state
Lipids/Fat:
-Fx?
- 9 kcal/gm
- Major energy source
- Stored body fat for insulation to reduce body heat loss and protective padding for organs
- Absorption of fat soluble vitamins (A, D, E, and K )
- Brain and eye development, healthy skin and hair, immune function
-AAP endorses:
No restriction of fat and cholesterol is recommended for infants <2 years of age
T/F: Cholesterol is present in breast milk
True
Vitamin A:
=retinol, retinal, retinoic acid)
Action: Vision
Vitamin D:
-how can you measure deficiency?
*serum 25(OH)D concentration
Deficiency signs:
Osteomalacia, rickets, hypocalcemia, hypophosphatemia, hyper-alkaline phosphatemia, Craniotabes
Thiamine (Vitamin B1):
-at risk for deficiency?
=Cofactor for protein and carbohydrate metabolism
At-Risk:
Alcohol abuse
Malabsorption
Thiamine (Vitamin B1) Deficiency:
“wet” Beriberi:
VS
“dry” beriberi
“Wet” beriberi: edema, cardiac failure, +/- “dry”
“Dry” beriberi: peripheral neuropathy, ataxia, ophthalmoplegia, increased ICP, vomiting
(note: Wet beriberi can present with dry beri beri)
Niacin (Vitamin B3):
Pellagra=
=Fat, protein, and carbohydrate metabolism
Deficiency:
**Pellagra= diarrhea, dermatitis, dementia/encephalopathy
Pellagra= Triple D
Long term Isoniazid Pts NEED to be on _____
Pyridoxine (Vitamin B6)
Worry about this demographic becoming deficient in Vit B12 (cobalmin)
vegans
Vitamin B12 (Cobalamin): Pernicious anemia
Pernicious Anemia: Lack of intrinsic factor made in gastric cells needed to absorb B12 in ileum
Vitamin C (Ascorbic Acid) Deficiency: -Scurvy?
Scurvy: joint tenderness, petechiae, capillary hemorrhage, gingivitis/bleeding; poor wound healing
Copper (Cu) Inborn errors:
- Wilson’s disease?
- Menke’s disease?
- Wilson’s disease= Copper excretion, signs of toxicity
- Menke’s disease= Copper absorption, signs of deficiency
Monitoring of Nutrition Requirements:
indirect calorimetry=
GOLD standard!
-Measures REE and respiratory quotient (ratio of CO2 produced to O2 consumed)
-Used to assess for overfeeding on the ventilator
Solid foods can be introduced in infants at ___
4-6 months when neuromuscular development is sufficient
Infants: Breastfeeding: KNOW!!
-WHO: states infants should be exclusively breastfed until _ months
- breast milk content?
- Absolute contraindications for breastfeeding (list 2) ?
WHO:
- Exclusive until 6 months
- Continued BF until 2 years of age with complementary foods
Breast milk content:
- IgA, lyzozyme, lactoferrin, bifidus factor, macrophages
- Protect against GI and upper respiratory tract infections
**Absolute contraindications:
Mother with active TB, galactosemia in infant
Foods to avoid under one year of age
Hard, round foods (e.g., nuts, grapes, raw carrots, and round candies)
Honey= botulism
Maple Syrup Urine Disease
these Pts cant process Leucine, isoleucine, valine
Know for test!!
Vitamin K deficiency: Hemorrhagic Disease of Newborn (VKDB)
Hemorrhagic disease of the newborn! This is why newborns get an injection of vitamin K at birth
Deficiency signs for Vitamin K: Hemorrhage (especially mucosal), ecchymosis, petechiae, elevated PT, INR
