PAS Week 4_nutrition Flashcards
<p>What element of the diet needs to be modified in following diseases: CKD Coeliac T2DM T1DM</p>
<p>CKD: varies with stage: sodium, potassium, phosphate, small amounts of good protein fluid.
Coeliac: gluten. Modify cereal intake. beware gluten in processed foods.
T2DM: low fat, reduce simple sugars, low GI choices
T1DM: diet is less important, eat normal 'healthy' diet, spread carbs, lower GI preferable.
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<p>What may be some barriers to someone changing their diet or reasons behind inability to maintain?</p>
<p>Nutrition overlaps with social norms: Limiting, altering or otherwise interfering with nutritional choice can have significant psychological implications. nb. very few of our eating habits are driven by nutritional need to eat but rather they are cultivated around spending time with other people, habit, time of day etc.</p>
<p>What basic nutritional recommendations are made by Australian national guidelines pamphlet?</p>
<p>Enjoy a wide variety of foods from following 5 categories:
1. Vegetables and legumes/beans (approx 30%) (6 serves/day)
2. Fruit (2 peices/day)
3. Grain (cereal) foods, mostly wholegrain or high fiber cereal varieties (approx 30%)(6 serves /day)
4. Dairy (mild, yoghurt, cheese, mostly reduced fat) (2.5 serves /day)
5. Lean meats and poultry, eggs, soy, nuts and seeds and legumes/beans (3, 2.5 serves /day)
Other guidelines;
- drink plenty of water
- Oils: use in small amounts. Substitute saturated fats for polyunsaturated where possible.
- Limit discretionary foods such as fast foods, sugary foods, alcohol etc (sometimes or in small amounts)</p>
<p>List healthy eating guidelines and the rationale behind them.</p>
<p>1. To achieve and maintain healthy weight, be physically active and choose nutritious food and drinks to meets your energy needs. (PORTION SIZE)
2. Enjoy a variety of nutritious foods from the 5 groups mentioned above every day. (VARIETY)
3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.(NOT EATING CRAP)
• Replace high fat foods which contain saturated fats with foods that contain predominantly polyunsaturated fats
• Low fat diets are not suitable for children <2years.
4. Encourage, support and promote breastfeeding
5. Care for your food, prepare and store it safely.
NOTE: for children:
beware choking hazards ie. hard fruit and veg should be grated/mashed remove bones.
Adult considerations: people who have trouble with teeth may also need softer textures of cooked veg, finely milled wholegrain cereal foods and dishes like soups, casseroles and stews. </p>
<p>Give examples of micronutrients required in human diets.</p>
<p>vitamins; minerals; phytonutrients/phytochemicals, iodine, calcium</p>
<p>What are the macronutrients?</p>
<p>Carbs
proteins
fats</p>
<p>What dietary modifications are required for vegetarians?</p>
<p>• In practice, clarify what the patient’s definition of vegetarian is, before advising them. Usually, to be a vegetarian means that ‘no animal products that require the animal to be killed’ are consumed.
• Protein requirements do not change – alternative sources are needed, e.g. tofu, legumes, eggs.
• Some micro-nutrients can be challenging (e.g. iron) but adequate intake should be achievable.
- Lots of grains- lentils, beans, rice</p>
<p>What dietary modifications are required for food allergies and intolerances? ( what is the difference b/w the 2?)
Food reaction?
Food intolerance- eg Lactose vs dairy intolerance
- vEgetarian?
In the case of multiple allergies, what is the best way forward?</p>
<p>- food allergy: potentially serious inflammatory response which can affect numerous organs- IgA- mediated.
- food intolerance: generally less severe- often ltd to digestive problems (migraines, hives, eczema may also be present). Person with intolerance may be able to eat small amounts of offending food.
- When cutting food a person is intolerant to from diet, alternative sources of certain nutrients may be required: supplements can be used but where possible use whole food choices. eg. if cutting out dairy- can get calcium from salmon, sardines, lentils, beans etc... If Lactose intolerant; does patient know they can still have lactose free milk, hard cheeses still ok?
Vegetarians; still require protein- can't get all essential amino acids in one vegetable so need to be aware of this. We require 0.8-1.0g/Kg body weight protein
- multiple allergies, especially in children require advice from dietician.
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<p>What are the 2 basic issues associated with assessing nutrition?</p>
<p>What is the nutritional status?
Why do they have this nutritional status? (social, psychological, emotional, physiological). you cannot help them if this is not identified.</p>
<p>What are the lab tests required to assess nutritional status?</p>
<p>Blood tests: albumin, urea, vitamin levels BGL Lipid profile, Calcium Iron studies liver-function tests renal-function tests</p>
<p>What does a clinical assessment include when assessing a nutritional status?</p>
<p>Hx, height, weight, waist-circumference, BMI (looking for trajectory- not actual number), their appearance (ie pallour)</p>
<p>How is malnutrition defined?</p>
<p>significant weight loss: 5% loss in 1 month, 7.5% loss in 3 months, 10% loss in 6 months
Severe- as above but more than instead of equal to.
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<p>What info should be provided to a dietition within referral?</p>
<p>• From; To • Patient demographics • Clinical information (medical condition/diagnosis, medications, anthropometric data, relevant biochemistry). • Client consent </p>
<p>Apart from obvious benefits of exercise, list physiological adaptations that occur within the body during exercise:</p>
<p>- increased lean body mass and decreased fat mass
- Increased bone mineral density
- Increased CO (CO= HR x SV)
- Increased metabolic rate
- improved neurotransmitter regulation, mood and self-efficacy</p>
<p>How to Exercise, physical activity and incidental activity differ?</p>
<p>Exercise: physical activity that is planned or structured, and repetitive for purpose of conditioning any part of body. Used to improve health, maintain fitness, and is important as a means of physical rehab.
- physical activity is athletic, recreational, or occupational activities that require physical skills and utilise strength, endurance, speed...etc..
- Incidental activity: any activity that is build up in small amounts over the day. eg. Walking up stairs or to bus stop. </p>
