Poor Nutrition

Question 1

What things can cause poor nutrition?

Answer 1

Inability to eat - MS, parkinson, Stroke, arthritis

Illness/Inflammation and appetite suppression

Hospital based - NBM, wrong food, no supervision

Question 2

What are some effects of poor nutrition?

Answer 2

• Low immune response
• Low muscle mass - respiratory distress and pneumonia
• Impaired wound healing
• Decreased mobility and thromboembolisation
• Increased gut permiability and infection risk
• Depression and anxiety
• Impaired drug metabolism
• Impaired heat production

Question 3

What is refeeding syndrome?

Answer 3

This occurs when someone is fed to quickly after a period of poor nutrition

Question 4

What happens in refeeding syndrome?

Answer 4

There is a switch from a catabolic to anabolic state.

Insulin, which is suppressed in starvation is released on carb intake and this triggers the use of minerals for fat and protein synthesis

Question 5

What mineral are used?

Answer 5

Potassium (Hypokalamia)

Phosphate (hypophosphatemia)

Magnesium (Hypomagnesaemia)

Thiamine

Salt and water

Question 6

What does refeeding syndrome cause?

Answer 6

• Hypotension
• Arrhythmias and cardiac failure
• Coma, seizures due to low thiamine (neuropathy, encepalopathy)
• Organ failure due to low ATP
• DEATH

Question 7

How do you prevent refeeding syndrome?

Answer 7

Give supplementary electrolytes

Monitor for drop in relevant electrolytes

Assess risk (Anorexic, bariatric surgery, alcoholism, malignancy)

Vitamin B prescription (for thiamine)