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Nutrition > Nutrition week 1 > Flashcards

Nutrition week 1 Flashcards

1
Q

A healthy diet results in

A

Appropriate growth and development, absence of illness or discomfort.
Fitness, longevity, and optimum health

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2
Q

Factors which influence nutritional demands

A

Stage of development
Level of inflammatory stress
Previous nutritional exposure in utero
Genotype

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3
Q

Nutritional disease problems of 21st century not involving immune system

A

Hypertension

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4
Q

“Hormones” of the immune system

A

Pro-Inflammatory cytokines

  • IL1
  • IL6
  • TNF-a
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5
Q

Feedback systems that activate pro-inflame cytokines

A

IL10

Heat shock proteins

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6
Q

TWEAK/Fn14

A

Tissue remodeling system

Activated by pro-inflame cytokines (IL1, IL6, TNFa)

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7
Q

How are antioxidant defenses strengthened?

A

Via glutathione synthesis

  • glutamine–> glutathione
  • sulphur AAs–> glutathione
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8
Q

Nutrients released from host tissues in response to pro-inflam cytokines

A

Sulphur AAs
Glucose
Glutamine

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9
Q

Nutrients that activate T and B cells

A

Glucose

Glutamine

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10
Q

Inflammatory effects on Albumin

A

Serum Albumin= negative acute phase protein.

Becomes reduced when levels of inflammatory stress are raised

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11
Q

NFkB

A

activated by oxidants–> activates gene transcription during inflammation

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12
Q

Level of significant weight loss

A

10% of normal within one month

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13
Q

Lethal weight loss

A

40% of normal

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14
Q

Examples of Disadvantageous Inflammation

A 
Diabetes
Insulin insensitivity
Hyperlipidemia
Atherosclerosis
MI
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15
Q

Tissues that need insulin for glucose uptake

A

Skeletal mm.

Adipose tissue

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16
Q

Tissues that don’t require insulin for glucose uptake

A

Brain and nervous tissue

Immune cells

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17
Q

Insulin insensitivity

A

During inflammation, glucose is taken up by inflammatory/immune cells bc they don’t require insulin–> causes insulin insensitivity after inflammation ceases.

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18
Q

Factors influencing level of inflammation in the body

A 
Antioxidant intake
Type of fat in diet
Obesity
Gender
Aging
Genetics
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19
Q

Essential nutrients

A 
Cannot be synth'd in humans
-minerals
-most vitamins
-some AAs
-some FAs
Must get from diet
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20
Q

Non-essential nutrients

A 
Can be synth'd in humans
-few vitamins
-some AAs
-many FAs
-Carbs
May also come from diet
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21
Q

Macronutrients

A

Carbs
Fat
Protein
Alcohol

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22
Q

Micronutrients

A

Vitamins

Minerals

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23
Q

Malnutrition

A

Demand is not met by food supply, or is grossly exceeded

  • Poor growth
  • Impaired development
  • Impaired Function (cognitive, physical, immune)
  • Poor repair of damage and injury
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24
Q

Excess energy

A

Stored as fat in adipose tissue. No matter how it enters the body

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25
Q

Overweight/Obesity categories

A

25-29.9 BMI –> Grade 1 Overweight
30-39.9 BMI –> Grade 2/Obese
>40 BMI –> Grade 3/Morbidly Obese

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26
Q

Energy balance equation

A

E intake - E expenditure = Change in body E stores

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27
Q

Components of Energy expenditure

A

aka Metabolism

  1. Activity
  2. Thermogenesis
    • Dietary
    • Thermoregulatory
    • Adaptive
  3. Maintenance (BMR)
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28
Q

Types of Malnutrition

A
  1. Undernutrition - low food intake
  2. Specific deficiencies - imbalanced nutrient intake
  3. Excess energy - overweight/obesity
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29
Q

Impacts of rate of whole body protein synthesis

A

Speed of wound healing

Recovery from infection

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30
Q

Energy expenditure in obesity

A

Raises greatly

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31
Q

Lifestyle Diseases

A

aka Chronic diseases of Aging

  • Cardiovascular disease
  • Metabolic disease
  • Sarcopenia
  • Osteoporosis
  • Respiratory disease
  • Cancer
  • Cognitive decline/Dementia
32
Q

1 CoD worldwide

A

CVDs

33
Q

Breastfeeding recommendations

A

Exclusive breastfeeding up to 6months, and then continue w other foods up to 2 years.

34
Q

Mothers more likely to breastfeed

A

First time mothers
>30 yrs
Higher social class
Longest in education

35
Q

Protein intake requirements for breastfeeding mothers

A

No need to increase protein intake with breastfeeding. Already get enough with balanced diet.
-Meet Protein and E requirements for infants up to 6 months

36
Q

When lactation performance is compromised

A

In famine/near-famine conditions.

Unaffected by fasting (Ramadan) and with low BMIs (18-26)

37
Q

Human breast milk composition

A
  • Protein: 9g/l (compared to 34 in cow)
  • Fat: 38g
  • Lactose: 70g
  • Casein: 40% total protein
  • Whey: 60% total protein
  • B-lactoglobulin: ABSENT
  • Sodium: 15mg (Compared to 65 in cow)
    Abs, immune cells, and stem cells are also present
38
Q

Breast milk Micronutrients

A

Vit A and B6 normally sufficient
Vit D is insufficient in breast milk for infant needs
Poor source of Fe and Zn, but stores in infant should be sufficient up to 6 months

39
Q

Breast milk Carbs

A

Lactose is main carb

  • disaccharide of glucose and galactose (only in mammals)
  • requires hydrolysis by lactase on gut brush border
40
Q

Breast milk Fat

A

provides ~50% of F
Allows for absorption of fat soluble vitamins (A,D,E and K)
Provides FAs for brain, eye, skin and hair development as well as immunity

41
Q

Brain growth

A

Rapid growth from birth to 2 years, then slows and plateaus by about 6 years

42
Q

DHA

A

needed for brain and visual development in infants/children
In adults: lowers TGs, increases HDL, lowers heart rate.
Low levels assoc w cognitive decline, risk of dementia, and macular degeneration

43
Q

Other human milk components and their roles

A

Lactoferrin- Fe uptake and immune defense
Abs- immune defense (sIgA)
Cytokines- immune defense
Immune cells- Immune defense
Oligosaccharides- gut and immune maturation, and immune defense

44
Q

Benefits of breast feeding

A

Decreases risk of neonatal infections and risk of infant allergy
Promotes development of immature gut.

45
Q

HIV and breastfeeding recommendations

A

In countries with endemic HIV with no antiretroviral drugs- formula if available, breastfeeding if not for first few months.

In US HIV women should never breastfeed their babies

46
Q

Contraindications for breast feeding

A

Infants: inborn errors of metabolism (galactosemia, congenital lactase def, PKU)

Mother:

  • maternal infection where transmission is possible (HIV, HTLV, CMV, TB)
  • on therapeutic drugs that can be transferred
  • mother consuming other drugs
47
Q

What reduces acidity in formula (1857)

A

Cooking with potassium carbonate

48
Q

Short term advantages of breastmilk v. formula

A

Decreases:

  • necrotising enterocolitis
  • diarrhea
  • GI infections
  • Resp infections
  • Otitis media
  • Risk of DM Type I
49
Q

Long term advantages of breastmilk v. formula

A

Decreased:

  • IBD
  • Diastolic BP
  • Systolic BP
  • Risk of DM type II
  • Risk of obesity
  • Risk of CVD
  • Severity/delayed onset of Celiac disease
50
Q

Number of centiles raising concern on growth charts

A

> 2 up or down

51
Q

Diseases smaller babies are at risk for

A

Greater risk for
Type 2 DM
CHD
Metabolic syndrome

52
Q

Epigenetics

A

Stable DNA changes– modify gene expression and are carried between generations

  • DNA methylation (CpG dinucleotides) - gene promoter region
  • Histone modifications
53
Q

DNA methylation

A

Cytosine methylated–> 5-methyl cytosine (majority found as dinucleotide CpG)
- CpGs clustered at 5’ends of genes–> inhibit transcription

54
Q

Life expectancy at birth

A

White female >
Black female >
White male >
Black male

55
Q

Detoxification systems

A

Efficiency declines with age

Enzymes involved in xenobiotic detoxification systems declines with aging.

56
Q

Fasting proteins and age

A

Fasting TGs and CRP both increase with increasing age

57
Q

Theories of aging

A

Programmed aging- loss of telomeres. Limited # of cell divisions

Inefficient DNA repair- proportion of cells carrying DNA abnormalities increases w age.

Free radical damage

Summation of damage to life systems sustained throughout lifetime- accumulation of damaged cell lipids and proteins and raised levels of oxidant and inflammatory stress

58
Q

Telomere length and exercise

A

Exercise is assoc w longer telomeres later in life.

59
Q

Biological Growth v. Aging

A

Growth= accumulating capacity. Increasing form and fxn

Aging= losing capacity. Decreasing form and fxn.

60
Q

Impact of vitamin D on muscle function

A

1,25(OH)2D3 binds a VDRE in muscle tissue–> protein synthesis and muscle cell growth with improved muscle cell function

61
Q

Inflammatory stress & mortality

A

High blood IL-6 and CRP double mortality risk in healthy non disabled elderly.

62
Q

Vit B6, B12 and selenium effects on age related disorders

A

Improve immune fxn if deficient

63
Q

Bit B6, B12 and folate effects on age related disorders

A

protect against lung cancer in non-smokers

64
Q

Carotenoids, vit C & E effects on age related disorders

A

Prevent decline in cognitive function

65
Q

Omega-3 FAs effects on age related disorders

A

Prevent or reverse atherosclerosis, reduce inflammation, and improve immune fxn.

66
Q

Memory decline factors

A

Memory declines quicker in both smokers as well as overweight individuals

67
Q

Decreased food intake in elderly

A
  • Tooth and gum problems
  • Swallowing difficulties
  • Less snacking between meals
  • Smaller meals eaten at slower pace
  • Decline in olfaction and taste sensation
  • Higher level of satiation and reduced gastric emptying
68
Q

Frailty

A

Syndrome characterized by 3+ of the following:

  • Weight loss (>5kg/year)
  • Self reported exhaustion
  • Weakness (fall in hand grip strength)
  • Slow walking speed
  • Low physical activity
69
Q

Aging and body mass

A

Lean body mass (particularly skeletal m.) is greatly reduced with aging

70
Q

Sarcopenia

A 
Excessive loss of skeletal muscle. Causes:
- Impairment in daily living activities
- Loss of strength
- Increased incidence of falls
- Increased hip fractures
Creates 18.5 B in health care costs
71
Q

Factors of increased morbidity/mortality in elderly

A

Sarcopenia
Undernutrition
Frailty

72
Q

Criteria for undernutrition in elderly

A

Weight loss >5% in 3m or 10% in 6
BMI <20
Serum albumin <3.5
Calf circumference <31 cm (sarcopenia)

73
Q

Causes of undernutrition in hospital

A 
Hospital catering:
- Unappetizing
- 50% left on the plate
Patient mil-by-mouth or missing meals for investigations
Staff shortages/lack of help w/feeding
74
Q

Non-hospital associated causes of undernutrition in elderly

A

Poverty
Chronic disease/disability
Unfit housing

75
Q

Consequences of undernutrition in elderly

A 
Increased mortality
Falls and bone fragility
Stroke, CHD, heart failure
Increased susceptibility to infection
Anemia
Poor response to vaccination
Edema, Ulcers
Constipation
Cognition and self care
Social functioning
Poor recovery from illness or hospitalization
76
Q

12 recommendations for nutrition in the elderly

A 
1- Dietary reference values
2- Nutrient dense, varied diets
3- Moderate fat intake
4- Reasonable fibre intake
5- Vegs, fruit and cereals
6- good milk/Ca2+ intake
7- Reduced Na+ intake
8- More sunlight or VitD supplements
9- Increase health professional awareness
10- active lifestyle
11- Improve institutional catering 
12- Nutritional assessment as routine part of hospital admission

Nutrition (5 decks)

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