review

Question 1

differences in med diet and dash diet and similarities

Answer 1

med diet promotes the use of red wine and olive oil but dash does not

• both say use meat rarely and limit sweets

Question 2

assessment of dietary intake

Answer 2

make sure weekend is included

Question 3

dietary recall

Answer 3

24hr recall and not very reflective

Question 4

food frequency questionnaires

Answer 4

research

Question 5

food disappearance data

Answer 5

at a population level but patient to patient- not helpful at a patient level

Question 6

dietary patterns and/or foods

Answer 6

dietary guidelines for americans (DGA_

Question 7

specific nutrients guidance (3)

Answer 7

RDA- a lot of evidence for (dietary reference intakes DRI)
AI- enough data less precision
UL- upper limit, above level we worry about toxicities

Question 8

additional guidance offered by professional societies

Answer 8

AHA

Question 9

measure of chronic disease risk

Answer 9

BMI

Question 10

obesity is recognized as a chronic disease

Answer 10

yep

Question 11

BMI

Answer 11

easily calculated but we recognize that it has limitations: fat distribution, edema, body builders, gender, age and race

Question 12

high waist circumference

Answer 12

easier to implement in the field and measure visceral fat better than BMI

Question 13

energy expended at rest in a fasting state

Answer 13

basal energy expenditure

Question 14

BEE determined by (3)

Answer 14

1. fat free mass: higher correlates with higher
2. thyroid: hypo BEE is lower
3. age: older age BEE is lower (1-2% decline per year)

Question 15

TEE of BEE

Answer 15

60-70%

Question 16

TEE of TEF

Answer 16

10-15%

Question 17

NEAT

Answer 17

non-exercise activity- 1/3 of TEE

Question 18

Fiber

Answer 18

very important, delayed absorbance of carbohydrates with increased fiber and decreasing cholesterol by increasing its excretion

• good for HTN and diabetic people too include in their diet

Question 19

Fat soluble

Answer 19

ADEK- upper levels of toxicity

Question 20

vitamin A precursor

Answer 20

carotenoids and with plant based form there is a decrease toxicity

• we turn orange with tox

Question 21

sunshine vitamin

Answer 21

vitamin D- helps us absorb calcium

• not a lot of food sources that contain this vitamin.

Question 22

Vitamin E

Answer 22

antioxidant

Question 23

vitamin K

Answer 23

• newborns are repleted with vitamin K

- blood coag

Question 24

vitamin C

Answer 24

• deficiency results in skin issues

Question 25

thiamin

Answer 25

alcohol but not only restricted to that | - thiamine repletion in refeeding syndrome

Question 26

Vitamin B12

Answer 26

- vegan dieters are in risk of being deficient

Question 27

B6

Answer 27

peripheral neuropathy

Question 28

iron

Answer 28

phytates that inhibit absorption of iron but vitamin C helps with absorption

Question 29

zinc

Answer 29

deficiency leads to skin rashes and impaired would healing phytates limit absorption

Question 30

copper

Answer 30

mimics B-12 deficiency and we see it in patients that have bypass surgery

Question 31

insulin and leptin are _____ in obesity

Answer 31

increased while ghrelin is decreased

Question 32

diabulimia

Answer 32

seen in type I diabetes- patients do not use insulin to loose weight

Question 33

obesity is increased in

Answer 33

1/3 of the population

Question 34

consumption of simple carbohydrates trigger the greates ____ release

Answer 34

insulin

Question 35

goal of obesity intervention

Answer 35

5-10% loss for improved cardiometabolic risk profile - small changes can add up and be helpful - 1-2 lb per week

Question 36

dietary counseling pearls

Answer 36

1. beverages 2. increasing protein intake 3. limiting sugar to no more of 25 grams (WHO)!!!!!!!!! 4. self-monitoring is key

Question 37

liraglutide

Answer 37

good amount of weight loss 6k not associated with HTN and seizures

Question 38

diet medication and surgery weight loss

Answer 38

surgery the most weight loss but increased risk like the route

Question 39

keto diet

Answer 39

diet depends on the patient good for the jump but long term is unsure - type 2 diabetes we are concerned for ketoacidosis and hypoglycemia and instead recommend a DASH diet or med diet

Question 40

intermittent fasting

Answer 40

again we are worried about hypoglycemia in our patients

Question 41

paleo diet

Answer 41

lower carbohydrate intake, focuses on quality but not quantity - limit dairy and grains - we are worried about bone health

Question 42

COR 1

Answer 42

intervention should be based on this- strong evidence - diet to include veggies, fruits, legumes and fish

Question 43

COR 2

Answer 43

ok, evidence is sort of there

Question 44

COR 3

Answer 44

HARM!!! avoid!!!!!! trans fat is evillllll

Question 45

wasting diminished subcutaneous fat and growth failure

Answer 45

marasmus

Question 46

edema, fatty infiltration of the liver, late wasting growth failure, dermatitis - lower protein

Answer 46

kwashiorkor

Question 47

inflammation induced loss due to a underlying disease condition with loss of fat free mass, more classic anorexia

Answer 47

cachexia

Question 48

age associated loss of skeletal muscle

Answer 48

sarcopenia

Question 49

malnutrition screening tools

Answer 49

1. SNAQ 2. MNA 3. MAG

Question 50

temporal wasting

Answer 50

malnutrition physical exam clue

Question 51

increased cytokines and inflammation in starvation or sepsis

Answer 51

sepsis

Question 52

if your gut works use

Answer 52

enteral nutrition

Question 53

protein catabolims leads to ____ nitrogen excretion

Answer 53

increased

Question 54

parenteral nutrion

Answer 54

IV only indicated when the gut cannot be used - water, macronutrients and electrolytes

Question 55

parenteral or enteral increased risk of

Answer 55

reefeding syndrome

Question 56

refeeding syndrome

Answer 56

give thiamine!!!! replete electrolytes especially phosphate, potassium and magnesium - start slowly

Question 57

Formula breast milk substitute

Answer 57

different based on considerations - age, protein,fat or medical condition

Question 58

preterm breast milk is generally not sufficient to meet nutrients needs of the preterm infant

Answer 58

yep and HMF is used in conjuction - increase in specific nutrients

Question 59

brestfed infants need what type of supplementation

Answer 59

vitamin D

Question 60

older adults needs what type of supplement

Answer 60

vitamin B12

Question 61

take supplements to prevent chronic disease

Answer 61

nope, no evidence

Question 62

regulation of supplements

Answer 62

FDA once it is considered unsage and FTA only advertising

Question 63

allergic reaction needs to be reproducible

Answer 63

yep

Question 64

mpst of IgE allergies is too

Answer 64

protein only exception is to galactose-alpha 1.3 which comes from tics

Question 65

lower protein intake is recommended in

Answer 65

CKD patients but CKD patients who are in dialysis we should increase protein but restrict phosphorus, potassium and sodium and fluid

Question 66

food insecurity

Answer 66

taking financial constrains into account - associated with chronic diseases

Question 67

in pregnancy how much calorie is needed

Answer 67

300 extra in second and third trimester

Question 68

lactation energy needs increased?

Answer 68

yep, 400 extra but if formula is used instead no additional intake is needed

Question 69

beef increases environmental methane accumulation

Answer 69

yep mostly through belching