RD definitions Flashcards
How are fat soluble vitamins absorbed, transported, and stored
Fat soluble vitamins are absorbed like fat into the lymphatic system, then blood. Transported with protein carriers. Stored in liver or fatty tissue
How are water soluble vitamins vitamins absorbed, transported and stored
Water soluble vitamins are absorbed directly into blood. Travel freely throughout body. Excess is excreted through the kidneys
Vitamin A deficiency symptoms
- Night blindness
- Xerophthalmia and blindness
- impaired growth of teeth and bone
- impaired cell differentiation and gene regulation
- damaged immune function
Vitamin A toxicity is dangerous for what population?
Pregnant women- can cause injury to fetus. Also harmful to infants and children
Name key antioxidant vitamins and mineral
Antioxidant vitamins: Beta carotene, Vitamin E and C
Mineral: Selenium
Good sources of vitamin D
- sardines
- salmon
- enriched cereal
- tuna
- fortified milk
Vitamin K deficiency and toxicity symptoms
deficiency- bruising and abnormal bleeding due to its role in blood clotting. Deficiency can decrease bone density- lead to increase risk for osteoporosis.
Toxicity: can block the effect of anticoapulante medications. Toxicity is rare
Vitamin C deficiency symptoms
weakness, anemia, gum disesase, skin problems, joint pain, slow wound healing
Symptoms of vitamin A toxicity
nausea, abdominal cramps, diarrhea, rashes and interefere with medical therapies
Factors that affect BMR
- Sex- males is higher
- Age-d eclines with age
- pregnancy- higher
- Fever and trauma- higher
How much water loss due to insensible losses
cant be directly measured.
loss range from 0.8- 1.2 L
What is sensible water loss?
water that is lost through sweat, urine and feces
How are eggs graded?
Candling. shell color and size are not considered
What nutrition is found in egg whites and egg yolks
egg whites: fat-free source of protein. Good source of niacin, riboflavin, potassium and magnesium.
Egg yolk: eggs fat source, vitamin A, D, and E, and zinc. Source of cholesterol
Maillard Reaction
Its the nonenzymatic browning process that contribues to the flavor, color and nutrient quality
Name different additives
- preserves
- antioxidants
- coloring agents
- sweetners
- flavoring
- emulsifiers and stabilizers
Who at risk for folate defieincy
- pregant
- infants/young children
- women of reproductive age
Factors that affect folate values
- pregnancy (3rd trimester)
- smoking
- vitamin B12 deficiency
- Iron deficiency
symptoms of thiamin deficiency
edema, muscle wasting, enlarged heart, heart failure, poor short-term memory, weight loss
Whats distribution range for carb, fat and protein
carbs: 45-65%
Fat: 20-35%
Protein: 10-35%
what is RDA for carbs in adults? and during pregnancy and lactation
Adults: 130 grams/day Pregnant: 175 g/day Lactating: 210 g/day
Name the 4 types of dietary fatty acids
- saturated fatty acids
- monounsaturated fatty acids
- polyunsaturated fatty acids
- trans fatty acids
Describe role of sodium in the body
Along with chloride, sodium is a principle ion in the extracellualar compartment, including plasma, interstitial fluid and transcelluar fluid.
Sodium important for membrane potentional, nutrient absorption and transport and BP
Symptoms of zinc deficiency
- growth retardation
- alopeacia
- diarrhea
- eye and skin lesons
- impaired appetite
Name the micronutrients and macronutrients that affect bone health
- Vitamins A, D, K, C
- calcium, phosphorus, magnesium
- Protein
Name the ranges for cholesterol levels
optimal: LDL< 100 mg/dl & total cholesterol < 160 mg/dl
Desirable: LDL 100-129 mg/dl; total cholesterol 160-199 mg/dl
Borderline high risk: LDL 130-159 mg/dl; total cholesterol 200-239 mg/dl
High risk: LDL >160 mg/dl; total cholesterol > 240 mg/dl
Sources of omega 3 FAs
Linolenic acid: oils, nuts and seeds, soybeans
EPA and DHA: milk, fish and seafood (sea bass, oyster, salmon)
Rules for following Kosher diet
(jews). Pork not allowed, only Kosher meats. Animals must have split hooves and chew their cud. Blood must be drained. Milk and meat cant be eaten or prepared in same meal
classification of carbs
monosacchariedes, disaccharides, polysacharrides
Which are monosacchariedes
glucose, fructose and galactose
Which are disaccharides
sucrose (glucose + fructose, maltose (glusose + glucose) and lactose (glucose + galactose)
Which are polysacchariedes
starch, fiber and glycoogen
function of insoluble fiber
acts like a sponge in body by absorbing water. Makes stools and helps prevent constipation.
whole wheat and rye
What is function of solulbe fiber
dissolves in water.
sources: beans, peas, lentils, oats, rice bran and oranges
Role of phospholipids in foods
Emulsifier. most common is lecithin which is found in egg yolks
Name the essential amino acids
9 of them: Histidine, isoleucine, leucine, lysinse, methionine, phyenylalanine, threonine, tryptophan and valine
Name fat soluble and water soluble vitamins
fat soluble: A, D, E, and K (toxic if consumed in excess)
Water soluble: Vitamins C and B comples
which bacteria can withstand stomach acid?
H. pylori
associated with peptic ulcers
flow of food through digestive tract
food bolus enters the mouth and passes into esophagus. Enters stomach via the cardiac sphincter. Leaves via pyloric valve and crosses into small intestine. Moves through duodenum, jejunum, and ileum. Then enters large intestine (colon) and leaves via the rectum
Name the contraction patterns of digestive system
esophagus: peristalic contractions
small intestine: segmentation ( phases of relaxation and contraction help churn contents
Name function of gastrin, pepsinogen and bicarbonate
Gastrin: stimulates gastric acid sectretions
Pepsinogen: cleaved to activate pepsin, which aids in protein digestion
Bicarbonate: buffer to prevent HCL from damaging stomachs epithelium
Diagnostic criteria for metabolic syndrome
Must meet 3 of following criteria:
- abdominal obesity (greater than 40 for men, greater than 35 for womenn
- TG of 150 mg/dl or higher
- HDL < 40 mg/dl in men or < 50 mg/dl in women
- systolic BP (top number) of 130 or greater or diastloic of 85 or greater
- FBG of 100 mg/dl or greater
what is metabolic acidosis?
when the body has lost excess amount of bicarbonate. The bodys pH decreases, due to high level of hydrogen ions
commonly seen in patients experiencing diarrhea
What is metabolic alkalosis?
concentration of hydrogen ions is lower and bicarbonate concentrations rise, causing increase in pH.
common causes: vomiting and excessive ingestion of antacids
Name products of glycolsis
two ATP and two NADH
Name deficiency associated with spina bifida
folic acid deficiency.
folic acid requried for DNA synthesis
Name common chemicals assoicated with vasoconstriction and effect on body
Vasoconstictors: norepinephrine, serotonin, vasopressin and angiotension II
Hydration goals before, during and after exercise
Before: consume 5-10 ml/kg, 2-4 hours before exercise
during: drink enough to replace sweat losses to limit total deficit to <2% BW
after: 1.25-1.5 L fluid for every 1 kg BW lost
which age group has the highest energy needs?
Infants: 90-120 kcal/kg
recommended protein intake for infants
0-6 months?
7-12 months?
0-6 months: 9.1 g/d
7-12 months: 11 g/d
Name medications that may interact with St. John’s Wart
- anticoagulants
- antidepressants
- cancer drugs
- cholesterol lowering drugs (statins)
- diabetes meds
- digotoxin (digitalis) -treats heart problems
- immunosuppressants
- anti-seizure meds
- Nifedipine and verapamil (treat high BP or heart problems)
- omeprazole (acid reducer)
- talinolol (beta blocker used for high BP)
herbal supplements may interact with which OTC drugs
aspirin, pseudoephedrine (decongestant) and fexofenadine (allegra)
Name foods high in vitamin A
sweet potatoes, liver, spinach, orange and yellow F&V
Food sources high in iron
fortified cereal, lysters, liver, beans, lentils, tofu, sardines
Amount of grams of carbs for infants
0-6 months
7-12 months
infants
0-6 months: 60 g/d
7-12 months: 95 g/d
A patient is admitted to the hospital for surgery. All of their postoperative lab values are normal, with no abnormlates in their assessment. On your 3-day check up, you notice their blood pressure has increased, their skin is very moist, they have edema in their legs and their eyes are puffy and swollen.
what is a possible nutrition-related cause in status change?
how should RD intervene?
May be due to OVERHYDRATION.
symptoms should be noted in their chart.
If they are experiencing overhydration, their fluid needs should be recalculated and communicated to the medical team
what is target HgB A1C for diabetics?
under 7%
common symptoms of hypoglycemia
sweating, tremors, anxiety, tachycardia, hunger, weakness, headaches, confusion
Name the government food and nutrition assistance programs available to the public
WIC, SNAP, NSLP, school commodity supplement food program and temporary assistance to needy families
Name the federal agencies that oversee food safety in the US
FDA, CDC, food safety inspection service
food sources of gluten that should be avoided by a person with a gluten allergy
wheat, farina, semolina, couscous, spelt, beer, jelly beans, hard candies, gelatinized starch, vegetable gum
what foods to limit with PKU
meat, dairy, bread and pasta. consume low-phe foods, F&V
Foods that patients with GERD should avoid
fatty foods, mint, alcohol, chocolate, citrus juices, tomato products and spicy foods
What is drug-nutrient interaction for persons taking statins or cyclosporine
grapefruit and grapefruit juice.
grapefruit contains naringenin, which can inhibit metabolic enzymes
Normal lab values for hematocrit for men and women
Men: 38.8-50
women: 34.9-44.5
Stages of change.
Name and explain each
- Precontemplation: not accepted or acknowledge health risk or need to change
- contemplation: recognized they have problem, but not sure how or when to begin to address
- preparation: creating an action plan
- action: moving forward and are implementing behavior change
- maintenance: sustained changes for more than 6 months
The four key messages from MyPlate
- all food and beverage choices matter-focus on variety, amount, and nutrition
- choose eating style low in saturated fat, sodium and added sugars
- make small changes to create a healthier eating style
- support healthy eating for everyone
what constitutes significant weight loss?
- > = 1-2% BW in 1 week
- > =5% BW in 1 month
- > = 7.5% BW in 3 months
- > = 10% BW in 6 months
SNAP eligibility requirements
- live in state where applying
- net income at or below the poverty level
- work more than 20 hrs per week for 3 months
based on income, household size, assets, housing costs,
vitamin deficiency associated with pellagra
vitamin B3 (niacin) the 4 D's: dementia, dermatitis, diarrhea, death
US dietary guidelines for sodium
limit intake to 2300 mg or less/day
risk factors for developing CHD
- age- Male > 45 yrs, Female > 55 years
- family history of CHD
- cigarette smoking
- HDL < 40 mg/dl
- HTN: > 140/90
- DM
- sedentary
8 obesity
Optimal level of LDL
LDL < 100 mg/dl
Nutrition management for kidney stones
- daily urine volume > 2 L
- calcium based on age
- avoid high-oxalate foods
- reduce sodium intake
- not exceed vitamin c intake of 500 mg/d
define low food security and very low food security
low food security: reduced quality, variety or desirability of diet. little or no indication of reduced food intake
very low food security: multiple disruptions in eating pattern and reduced food intake
What are the biomarkers for iron-deficiency anemia
- HCT
- ferritin
- iron
- total iron-binding capacity
explain the laboratory test serum albumin
- albumin is a protein made by the liver.
- test measures the amount of albumin in blood
- used to evaluate overall health status, liver and kidney function
- test should not be used alone to determine diagnosis
what is microcytic anemia
form of iron deficiency, with small red blood cells
what is macrocytic anemia?
associated with folate or vitamin B12 deficiency with larger than normal RBCs
pathophysiology of nonalcoholic fatty liver disease
steatosis–> nonalcoholic steatohepatitis (NASH)–> cirrhosis
–> fat dispostion in liver
Diet management for non-alcoholic fatty liver disease
low CHO,
mediterranean diet
avoid sugary drinks
what is pancreatitis and its symptoms
inflammation of the pancreas with edema, cellular exudate and fat necrosis
acute pancreatitis symptoms:
upper ab pain that radiates to back, ab pain after eating, fever, rapid pulse, N/V, oily smelly stools (steatorrhea)
Nutrition intervention for acute pancreatitis
- initiate EN/ resume oral feeding
- support with IV fluids
- provide easily digestible foods, low-fat diet, adequate protein once oral nutrition is resumed
- increased energy needs
how to determine calculations for UBW?
If severely underweight, use current weight for calculations
