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Nutrition Lecture Series > Nutritional Requirements > Flashcards

Nutritional Requirements Flashcards

1
Q

Human Milk and Infant formula components per 100ml:

A
  • Calories: breast milk: 20 cal/oz, formula: 19-20 cal/oz.
  • Carb source: breast milk: Lactose 7.2, oligosaccharides. Formula: Lactose, GOS 7.6, glucose, corn syrup solids, rice starch, maltodextrin.
  • Protein source: Human milk 1.1, alpha lactalbumin 99%, albumin, lactoferrin, lysozyme, IgA. Formula: nonfat milk and whey concentrate (1.4), Whet:Beta lactoglobulin (65%), alpha lactablumin (25%), albumin (6%)
    -Whey/casein ratio: Breast milk: 60/40-70/30. Formula: 18/82-100/0.
  • Fat source: Human milk 3.9, triglyceride >98%, oleic and palmitic acids most abundant. ARA and DHA +. Formula: High oleic safflower, soy and coconut oils (0.14% DNA, 0.4% ARA) (3.7)
    -Na/K Breast milk: 0.78/1.34. Formula: 0.71/1.82.
  • Ca/Phos: breast milk: 28/14. Formula: 53/28.
  • Fe: 0.3 (very bioavailable). Formula: 1.2.
    -Zinc: 0.1-0.3. Formula 0.5-0.7
    Vitamins D and K: breast milk: inadequate. Formula: adequate.
    mOsmol/kg water: breast milk: 290. Formula: 310.
    Other: Breast milk: lower mineral and protein content but higher bioavailability. faster gastric emptying, digestive enzymes, immune factors, growth factors, hormones, microbiome, protection against diarrhea, OM, UTI, NEC, botulism, hospitalization, infant mortality, IDDM, Crohn’s disease, lymphoma, leukemia, allergy, obesity.
    Other: formula: supplemented with prebiotics: ARA and DHA.
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2
Q

Human Milk and Infant formula: Carbohydrates

A
  • Carb source: breast milk: Lactose 7.2, oligosaccharides. Formula: Lactose, GOS 7.6, glucose, corn syrup solids, rice starch, maltodextrin.
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3
Q

Human Milk and Infant Formula: Protein

A
  • Protein source: Human milk 1.1, alpha lactalbumin 99%, albumin, lactoferrin, lysozyme, IgA. Formula: nonfat milk and whey concentrate (1.4), Whet:Beta lactoglobulin (65%), alpha lactablumin (25%), albumin (6%)
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4
Q

Human Milk and Infant Formula: Whey/Casein

A

-Whey/casein ratio: Breast milk: 60/40-70/30. Formula: 18/82-100/0.

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5
Q

Human Milk and Infant Formula: Fat

A
  • Fat source: Human milk 3.9, triglyceride >98%, oleic and palmitic acids most abundant. ARA and DHA +. Formula: High oleic safflower, soy and coconut oils (0.14% DNA, 0.4% ARA) (3.7)
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6
Q

Human Milk and Infant Formula: Electrolytes

A

-Na/K Breast milk: 0.78/1.34. Formula: 0.71/1.82.
- Ca/Phos: breast milk: 28/14. Formula: 53/28.
- Fe: breast milk 0.3 (very bioavailable). Formula: 1.2.
-Zinc: breast milk 0.1-0.3. Formula 0.5-0.7
- mOsmol/kg water: breast milk: 290. Formula: 310.

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7
Q

Human Milk and Infant Formula: Vitamins:

A

Vitamins D and K: breast milk: inadequate. Formula: adequate.

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8
Q

Human Milk and Infant Formula: Other

A
  • Breast milk: lower mineral and protein content but higher bioavailability. faster gastric emptying, digestive enzymes, immune factors, growth factors, hormones, microbiome, protection against diarrhea, OM, UTI, NEC, botulism, hospitalization, infant mortality, IDDM, Crohn’s disease, lymphoma, leukemia, allergy, obesity.
  • Formula: supplemented with prebiotics: ARA and DHA.
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9
Q

Nutritional Requirements vary depending on age, activity, level and disease state

A

highest needs in infancy, decrease with age, needs are high during periods of growth, parental needs are lower than enteral needs because of thermic effects of growth.

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10
Q

Recommended Dietary Allowance (RDA)

A

Average daily dietary level that is sufficient to meet the nutrient requirement of nearly all healthy individuals in a particular life stage and gender group. Should be the goal for daily intake by individuals.

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11
Q

Estimated Average Requirement (EAR)

A

Daily intake value that is estimated to meet the requirement in half of the healthy individuals in a life stage or gender group

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12
Q

Adequate Intake (AI)

A

Used if sufficient scientific evidence is not available to calculate an EAR and used instead of the RDA. Based on experimentally derived intake levels or approximations of observed mean nutrient intakes by a group of healthy people.

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13
Q

Tolerable Upper Intake Level (UL)

A

Highest level of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals in the specified life stage group

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14
Q

Vitamin A Deficiency

A
  • Eye findings: night blindness, xerophthalmia, keratomalacia
  • Follicular hyperkeratosis,
  • Poor bone growth,
  • Impaired resistance to infection (measles)
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15
Q

Vitamin D Deficiency

A
  • Rickets
  • Osteomalacia
  • Hypocalcemia
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16
Q
A
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17
Q

Vitamin K Deficiency

A
  • Bleeding
  • Bruising
  • Bone Health
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18
Q

Thiamine Deficiency

A

Beriberi
- Dry Beriberi: neurological: progressive symmetrical peripheral neuropathy–> weakness, wasting, ataxia, paresthesias, loss of DTR.
-Wet Beriberi: cardiac failure and edema.
-Infantile: breast fed child, mom had subclinical thiamine deficiency: sudden onset of shock in a previously well fed child between 2-3 months of age, preceding by hoarse, weak cry, poor feeding, and vomiting.
-Wernicke encephalopathy: ophthalmoplegia, nystagmus, ataxia, altererd consciousness, hoarseness, anorexia, restlessness, and aphonia.
-Acute: refeeding syndrome, vitamin free PN and in alcoholics.

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19
Q

Riboflavin Deficiency

A
  • Angular stomatitis, cheilosis, glossitis, or magenta tongue
  • Seborrheic dermatitis in nasolabial folds, flexures of extremities and genital areas
  • Photophobia, corneal vascularization
  • Poor growth
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20
Q

Niacin Deficiency

A

Pellagra: Dermatitis, Diarrhea, Dementia
- Hartnup disease: malabsorption of tryptophan

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21
Q

Pyridoxine Deficiency

A

Infants: irritability, convulsions, microcytic anemia. Pyridoxine dependent seizures. Depression, dermatitis, glossitis, angular stomatitis, cheilosis, peripheral neuritis

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22
Q

Vitamin C Deficiency

A

Scurvy: capillary hemorrhage of gingiva, skin, bone, and poor wound healing.

23
Q

Cobalamin Deficiency

A

Megalobastic anemia

24
Q

Folate Deficiency

A

Macrocytic anemia, neutral tube defects

25
Q

Biotin deficiency

A

Seen in children given biotin free TPN: dermatitis, paresthesias, alopecia

26
Q

Pantothenic acid deficiency

A

Headache, fatigue, insomnia, paresthesias,

27
Q

Calcium deficiency

A

cramping, tetany, osteomalacia, muscle weakness/spasms

28
Q

Phosphorus deficiency

A

Rickets, neuropathy

29
Q

Magnesium deficiency

A

cardiac arrhythmias, tremor, weakness, resistant hypocalcemia, hypokalemia and seizures

30
Q

Iron Deficiency

A

anemia, exercise intolerance, poor concentration, glossitis, nail change

31
Q

Essential fatty acid deficiency: Linoleic acid n-6 and alpha-linoleic acid n-3

A

hair loss, hematologic disturbances, poor growth, poor wound healing,

32
Q

Carnitine deficiency

A

Hypertriglyceridemia

33
Q

Zinc deficiency

A

Anorexia, impaired wound healing, skin lesions, hair loss, increased susceptibility to infections.

34
Q

Copper Deficiency

A

hypochromic anemia, retarded growth, osteoporosis, neutropenia, neuropathy, depigmentation of hair and skin, Menkes syndrome: soon after birth: pallor, anemia, steely hair and progressive neurological deterioration

35
Q

Manganese Deficiency

A

Rare: done demineralization, impaired growth, skin rash, hypocholesterolemia

36
Q

Selenium Deficiency

A

Keshan cardiomyopathy, macrocytic anemia, loss of hair and skin pigmentation, yositis

37
Q

Iodine Deficiency

A

Goiter, hypothyroidism, short stature

38
Q

Chromium Deficiency

A

Impairment of glucose utilization, weight loss and confusion

39
Q

Nutritional Requirements with illness and trauma

A

Overall energy expenditure is not necessarily increased during critical illness, protein needs do not usually change unless the illness causes increased protein losses. Excessive carbohydrate intake can result in hyperglycemia which can be deleterious.
Enteral route preferred

40
Q

Trauma

A

Feed early: start post trauma day 1-day 3. Do not over feed.
Protein goals:
- 2-3gm/kg/day for infants and kids <2
-1.5-3gm/kg/day for kids 2-13
-1.5gm/kg/day for adolescents.

41
Q

Malnutrition can affect a drug’s half life

A

Example: Vitamin K

42
Q

Drug nutrient interactions:

A

Example Phenytoin and tube feeds.

43
Q

Indirect drug/nutrient interactions

A

PPI decreased gastric acid and leads to decrease vitamin B12 absorption

44
Q

PPI can block absorption of:

A

Vitamin B12, Zinc, and Copper

45
Q

Medications can inhibit enzymes:

A

Cimetidine: Vitamin D
Methotrexate: Folate

46
Q

Medications can enhance enzyme activity

A

Phenobarbital and Vitamin D

47
Q

Medications can damage mucosa:

A

NSAIDS result in Fe deficiency

48
Q

Medications can bind nutrients in gut lumen

A

Cholestyramine, mineral oil, antacids.

49
Q

Medications can alter gastric pH

A

PPI

50
Q

Medications can affect electrolyte balance

A

Thiazides and renal wasting of potassium

51
Q

Medications can decrease appetite

A

Metronidazole

52
Q

Medications can affect weight loss

A

ADHD Medications

53
Q
A

Nutrition Lecture Series (7 decks)

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