Prevention of GI disease

Question 1

who needs nutritional support?

Answer 1

• BMI<18.5
• unintentional weight loss >10% in last 3-6 months
• have eaten or likely will eat little or nothing for 5 days of more
• poor absorptive capacity and / or high nutrient losses and / or increased nutritional needs from causes such as catabolism

Question 2

examples of oral nutrition support

Answer 2

• snacks

- sip feeds

Question 3

examples of enteral tube feeding

Answer 3

-NG tube (used in inadequate/ unsafe oral intake)

Question 4

examples of parenteral nutrition

Answer 4

-IV nutrition

Question 5

benefits of physical activity?

Answer 5

reduced risk of:

• constipation
• diverticular disease
• gall stones
• colon cancer
• mortality from colon cancer

Question 6

what are the recommendations on how much exercise we should be doing?

Answer 6

• 150 minutes of moderate intensity a week

- or 75 minutes of vigorous intensity a week

Question 7

what is dietary fibre?

Answer 7

food (especially plant material) that is not hydrolysed by enzymes secreted in the small intestine, but may be partially digested by microflora in gut

Question 8

what conditions does dietary fibre reduce risk of?

Answer 8

• CHD
• stroke
• hypertension
• diabetes
• obesity
• GI disease

Question 9

soluble dietary fibre?

Answer 9

can be dissolved forming gel, ferments
feeling of fullness
slows rate of glucose and lipid absorption from the small intestine
good sources: beans, lentils, fruit, oats

Question 10

insoluble dietary fibre?

Answer 10

absorbs water and swells, slow and incomplete fermentation, feeling of fullness, greater effect on bowel habit
good sources: wholegrain products, vegetables, beans, lentils

Question 11

why is dietary fibre protective ?

Hint: think “bulk” and “fermentation”

Answer 11

Bulk: reduces transit time and therefore reduces carcinogenic absorption
Fermentation: produces short chain fatty acids (an energy source for colonic cells and bacteria, improving barrier against infection, also lowers the pH in colon, reducing growth of pathogenic organisms and formation of toxins

Question 12

which GI diseases does dietary fibre decrease risk of?

Answer 12

peptic ulcer disease
gastro-oesophageal reflux disease
colorectal cancer
gallbladder disease
diverticular disease
constipation
haemorrhoids (piles)

Question 13

what are the daily recommendations of how much dietary fibre you should have?

Answer 13

30g/day

Question 14

examples of foods containing “wholegrains”?

Answer 14

brown rice
wild rice
barley
red rice
oatmeal
buckwheat
popcorn

Question 15

why are wholegrains beneficial?

Hint: just like fibre, think of bulk and fermentation

Answer 15

bulk reduces transit time
fermentation promotes growth of healthy cells/ bacteria
ALSO: provides antioxidants and phytochemicals which protect against DNA damage

Question 16

what are the benefits of red meat?

Answer 16

rich source of protein, iron, zinc, B vitamins and vitamin A

Question 17

what are the risks associated to red meat?

Answer 17

• source of saturated fat
• form carcinogens (when cooked at high temo, during curing process)
• haem iron content (results in free radical production, which damages lining of the bowels)

Question 18

which cancer risks are especially associated to red and processed meat?

Answer 18

colorectal, gastric, oesophageal

Question 19

max red meat in a week?

Answer 19

500g

max of 70g red meat/ day

Question 20

risks of salt?

Answer 20

hypertension, LV failure, bone health, gastric cancer (because it irritates and causes inflammation of stomach lining - exposing it to carcinogens, increases formation of carcinogenic compounds in stomach, increases growth and action of H pylori - which can cause inflammation and gastric ulcers and potentially progress to cancer)

Question 21

max amount of salt per day?

Answer 21

6g

Question 22

what are the basic principles of behaviour change counselling? (the 5 As)

Answer 22

Ask (permission to discuss diet)
Assess (habits, motivation)
Advise (health benefits, personalised instruction)
Assist (self monitoring tools, feedback, preventing relapse, referral (if needed), social support)
Agree (setting goals)