Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Nutrition > Test 2 Inflammation > Flashcards

Test 2 Inflammation Flashcards

1
Q

What help in the storage of fats? What helps in the release of fat as FFA’s?

A

Storage: Chylomicrons, VLDL (lipoprotein lipase)

Release:
ATGL, HSL (hormone sensitive lipase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What neurotransmitters are signals in weight management?

A

NE
Dopamine
Serotonin
Orexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 8 category causes of obesity

A
  • Genetics
  • Sedentary lifestyle
  • Inflammation (overeating and adipose produce inflammatory signals)
  • Sleep patterns/stress (increased cortisol which increases appetite)
  • taste, satiety and portions
  • obesogens
  • viruses
  • gut micro flora
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are examples of obesogens that are one cause of obesity?

A

Endocrine disrupters

BPA, phthalates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What country spends the least amount of money on food? Most?

A

US

Most: azerbaijan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

<16 BMI

A

Severe thinness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

16-16.9

17-18.5

A

Moderate thinness

Mild thinness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal BMI

A

18.5-24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pre-obese BMI

A

25-29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Obese class 1, 2, 3 BMI

A

1: 30-34.9
2: 35-39.9
3: 40+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Health waist circumference in males? Females?

A

Men: < 40
Female: < 35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Healthy waist to hip ratio men? Women?

A

Men: <0.95
Female: <0.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Waist to height ratio male and female:

Underweight
Slim

A

Underweight Male and female: <0.35

Slim-male: 0.35-0.43
Female: 0.35-0.42

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Waist to heigh ratio male/female-healthy?

A

Male: 0.43-0.53
Female: 0.42-0.49

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Waist to height ratio male/female—obese?

A

Male: 0.58-0.63
Female: 0.54-0.58

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rate of weight loss for BMI 27-35?

A

0.5-1lb/wk for 6mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rate of weight loss for BMI >35?

A

1-2lbs/wk for 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lifestyle modifications for weight loss?

A 
-Goal setting
   (Increase walking/1fruit at lunch)
-Self-monitoring (diary/weigh ins)
Stimulus control (ABC)
Cognitive restructuring (challenge/correct negative thoughts)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dietary modifications for weight loss

A
  • restricted energy diets
  • formula diets/meal replacements
  • commercial programs
  • very low calorie diets
  • fasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Restricted-energy diet

A

Calorie deficit of 500-1000
Focus on whole plants
Limit alcohol and high sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Formula diets/meal replacements

A

Lean cuisine, slim fast/cliff bars

Used to promote structure/portion sizes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Very low calorie diets

A

<800 cal/d

Only used on those with >30 BMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fasting

A

<200cal/d

50% of rapid weight loss is fluid
Increases likelihood of gout/gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What diet is best for preservation of lean mass: alternate day fast or very low calorie?

A

Alternate day fasting

And on fasting days may eat up to 500 cal for female and males 600 cal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Recommended amount of physical activity for weight loss?

A

60-90 min/day

Weight maintenance: 150–250min/wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some weight loss medications often prescribed?

A

Orlistat
Lorcaserin
Phentermine-topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Orlistat

A

Pancreatic lipase inhibitor
GI upset, leaky stools

Ex: Xenical
Alli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Lorcaserin

A

Serotonin receptor agonist that acts as an appetite suppressant

HA, cough, fatigue, constipation (do not take with antidepressants)

Ex: Belviq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Phentermine-topiramate

A

Appetite suppressant
Tingling of hands and feet, dizziness, trouble sleeping and birth defects

Ex: Qsymia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Supplement for weight loss

A

CLA—required in 3.4g/day

Used to reduce body fat and build muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What supplements may act as fat burners?

A

Bitter orange
Green Tea Extract (heart arrythmias)
Raspberry ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What nutritional deficiencies are prominent in patients who have undergone bariatric surgery?

A

Iron
Ca
Vit D, B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

General causes of unintentional weight loss

A 
Wasting-chronic infection
Poor food intake
Malabsorption
Hormonal imbalances (thyroid)
Increase in activity without increase in energy intake
Poor living situation
CA (cancer)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some major risk factors for CVD?

A 
HTN
Age
Diabetes
Microalbuminuria
Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some modifiable risk factors for CVD?

A 
Lipoproteins
High LDL
High TG
High TMAO
Low HDL
Inflammatory markers (CRP, fibrinogen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are lifestyle risk factors for CVD

A 
Smoking
Poor physical activity
Poor diet
Stress
Lack of sleep
Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are co-morbidities for CVD

A

HTN
Obesity
Metabolic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Desirable level for:

Total cholesterol

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Desirable level for:

HDL

A

> 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Desirable level for:

LDL

A

<100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Desirable level for:

Triglycerides

A

<150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is metabolic syndrome?

A

Having 3+ of the following:

Waist circumference > 40(M), >35 F
TG: >150
HDL: <40
BP: >130/85
Fasting glucose: >110
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are some recommended swaps for decreasing risk of CVD?

A
  1. Swap trans fat for MUFA/PUFA
  2. Swap saturated fat for PUFA
  3. Do not swap UFA for carbs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Diets proved to decrease risk of CVD?

A
  • Mediterranean
  • DASH
  • Vegan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the basics of the Mediterranean diet?

A 
0-1 serving: eggs/dairy
0-2: vegetable oils
1-2: nuts/seeds
3-4: fruits
6-9: veggies
5-12: whole grains
1-3: legumes/soy

***mostly whole grains, veggies, and fruits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the basics of the DASH diet?

A

Low fat, low sodium diet

  • plant based
  • lean meats
  • nuts
  • seeds
  • low-fat diary
  • high potassium, mg, Ca, fiber

25-30% fat (MUFA) 25% protien

Limit foods that have more sodium than calories!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Nutritional therapy for elevated LDL?

A
  1. Consume high veggies, fruits, whole grains. Some: low-fat dairy, poultry, fish, legumes/nuts
  2. Limit sweets, sugar sweetened beverages and red meat
  3. Aim for 7-10% of energy from saturated fat
  4. Avoid trans fat
  5. Exercise 3-4x/wk of mod/Vig.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Nutritional therapy for elevated TG

A
  1. Eat high veggie, fruit, whole grain. Some: low fat diary, poultry, fish, legumes, and nuts
  2. Limit sweets, sugar sweetened beverages and red meats
  3. 2-4g of EPA & DHA daily (omega 3)—FISH!!
  4. 3-4x/wk exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Normal BP

A

> 120

>80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Elevated BP

A

120-129 and >80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

High BP stage 1

A

130-139 or 80-89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

High BP stage 2

A

140+ or 90+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hypertensive crisis

A

180+ and/or 120+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What 3 food/nutrients have the largest affect on BP?

A

Sodium (less than 2300mg)
Plant-based diet
Weight loss (3-5% body weight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the nutritional therapy for hypertension?

A
  1. High veggies, fruits, whole grains. Some: low-fat dairy, poultry, fish, legumes, nuts
  2. Lower Na, increase K intake
  3. 3-4x/wk exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are the 3 most preventable risk factors for chronic disease?

A

Unhealthy diet
Smoking
Physical inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Deficiency

A

Low level of nutrient found in blood that CAUSES a specific disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Insufficiency

A

Subclinical or deficiency nutrient pools due to chronic poor intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Deficiency vs insufficiency-which MC to see in practice

A

Insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are some chemical mediators in inflammation?

A

Cytokines
Lipid-derived compounds (prostaglandins, leukotrienes, thromboxanes)
ROS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Estimated that 30% of patients baseline level of inflammation is due to _______ produced by________q

A

Cytokines produced by adipocytes

More adipocytes= more inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Gut inflammation precedes weight gain and adipocytes inflammation and can cause M2 macrophages to switch to M1 that have what effects?

A

M1: pro-inflammatory
Microbicidal
TH1 Rxn
Tissue damage

M1 means “kill”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Pathway of inflammation

A
  1. Diet/stress lead to changes in the gut microbiome. (More LPS-lipopolysaccharides produced with high fat diet.).
  2. Gut changes:
    —> increased LPS activates NF-kB—> stimulate production of inflammatory cytokines—> produce ROS (also increase NF-kB)
  3. Immune cell activation—aka systemic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are some biomarkers of chronic inflammation

A

CRP
TNF-a
ESR

Liver: ALT/AST (liver inflammation), GGT (liver disease)
Eosinophils (allergies, parasites, autoimmune, CA)
Lipid peroxides (oxidative stress)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are some nutrient modulators of inflammation

A 
Omega 3/6
Mg
Zn
B complex vitamins
Flavonoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are the co-enzymes and cofactors for AA and EPA?

A

Mg, Zn,
Vitamin A, C, B6, Niacin

Coenzyme: desaturase and elongase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What mineral acts as a calcium-channel blocker and low dietary intake is a major risk factor for chronic disease?

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are Mg’s balanace parterns?

A

Mg: Ca and Zn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What mineral is associated with obesity-induced inflammation?

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

RDA for Magneium (roughly)

A

310-320mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What foods is Mg rich in?>

A

Nuts/seeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What mineral deficiency causes decrease production of T-lymphocytes?

A

Zinc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Low Mg and Zn alter what?

A

Gut permeability

=leaky gut

74
Q

What is the biomarker for zinc deficiency?

A

Alkaline phosphate

75
Q

What is zincs balance partner

76
Q

What mineral is required for signaling during inflammatory reactions?

77
Q

Zinc rich foods?

A

Oysters**

Beef, crab

78
Q

S/s of zinc toxicity? Deficiency?

A

Tox: metallic taste
Def: lack of taste

79
Q

What vitamin is most important for methylation? And stimulated epigenetic-induced gene expression

80
Q

What vitamin alters redox status within organelles

81
Q

Functions of B complex

A
  • methylation
  • stimulated epigenetic-induced gene expresssion
  • alters redox status
82
Q

Zinc functions

A
  • signaling during inflammatory reactions
  • maintain gut permeability (+ Mg)
  • maintains production of T-lymphocytes
83
Q

Magnesium functions

A
  • ca+ channel blocker

- decreases risk for chronic disease

84
Q

Flavinoids and example foods they are found in

A

Phytonutrients that often provide color to plants

Ex: alpha lipoic acid
Curcumin (turmeric)
Quercetin (everything)
Lycopene (tomatoes)
Catechins (tea/coffee/wine/chocolate)
Epigallocatechin-3-gallate (green tea)
85
Q

What are on the anti-inflammatory index?

A 
Turmeric
Fiber
Flavones
Tea
Beta-carotene
Isoflavones
Mg
Omega 3
86
Q

Increased inflammation leads to increase in what other health issue

A

Mental health

87
Q

What constitutes the mind diet

A 
Green leafy: 6x/wk
Nuts: 7/wk
Berries: 2/wk
Beans: 3/wk
Whole grains: 3+/d
Fish: 1/wk
Poultry: 2/wk
Olive oil
Wine: 1glass/d

Avoid:

Red meat: <4/wk
Butter: <1TBsp/d
Cheese: <1/wk
Sweets: <5/wk
Fast food: <1/wk
88
Q

What are some side effects of chronic inflammation

A
  • energy dysregulation due to mitrochondrial dysfunction
  • changes in gut microbiome
  • alter body fat distribution

Plus many diseases: CA, CVD, Alzheimer’s, DM, Arthritis,Autoimmune, neurologic, pulmonary etc.

89
Q

What decreases bone mineral density?

A

Imbalance in protein and low calcium intake

High animal protein and low calcium triples risk of fracture

90
Q

What does protein do to the acid load?

91
Q

What increases PRAL (potential renal acid load)

A 
Proteins
Bread
Jello
Pudding
Bacon
Walnuts
Sunflower seeds
Peanuts
92
Q

What are alkaline/decrease PRAL?

A 
Fruits
Veggies
Herbs/spices
Brown sugar
Molasses
Cocoa
Coffee
93
Q

Neutral foods in regards to PRAL

A 
Corn
Butter
Oils
Cows milk
Honey
White sugar
Water
Tea
94
Q

What things affect calcium absorption?

A
  • protein increases
  • foods with mineral binders (phytate/oxalate) lower absorption
  • doses less than 500mg at a time
95
Q

What minerals have an affect on bone density

A

Calcium
Potassium/Magnesium (eat more)
Sodium (eat less)

96
Q

Vitamins that have an effect on bone density

A

Vitamin A, D, K

97
Q

Ca:P ratio ideal for bone

98
Q

What is the nutritional therapy for GERD?

General

A

5R protocol

Remove 
Replace
Reinoculate
Repair
Rebalance
99
Q

What should you remove for GERD?

A 
Arginine
Alcohol
Caffeine
Chocolate
High fat
Spicy food
Acidic food
Smoking
Stress
100
Q

What should you replace with GERD?

A

Betaine HCL

101
Q

What should you re-inoculate in GERD?

A

Lactobacillus acidohilus

102
Q

What should you repair with GERD

A

DGL
Antioxidant rich foods
Fish oil

103
Q

What should you rebalance with GERD

A

Breathing
Exercise
Meditation

104
Q

What are micronutrients of concern in patients with stomach conditions

105
Q

What are some natural eradicators of H. Pylori

A 
Green tea
Broccoli
Black currant oil
Kimchi
Probiotics (lactobacillus/bifidobacterium)
106
Q

Etiology of constipation

A

Lack of fiber or fluid intake ***
Low energy intake
Iron + Ca supplements (binders)
Lack exercise

107
Q

Nutritional therapy for constipation

A
  1. Increase whole grain intake to 6-11/d
  2. Increase veggies to 5-8/d
  3. High fiber cereals to get at least 25g-F, 38g-M
  4. Increase fluid intake to 2L/d
108
Q

Treatment for diarrhea

A

Replenish fluids
Limit: lactose, sugar alcohols, fructose and lots of sucrose

Try probiotics

109
Q

Test for fat malabsorption

A

72 hour fecal fat test

> 6g/24hrs

110
Q

S/s of fat malabsorption

A

Pale, greasy, smelly stools

Diarrhea WITHOUT distention or gas

Frothy

111
Q

Test for protien malabsorption

A

Fecal nitrogen

Serum albumin

112
Q

S/s of protein malabsorption

A

Edema

Muscle atrophy

113
Q

Test for carb malabsorption

A

Hydrogen breath test

114
Q

S/s of carb malabsorption

A

Watery diarrhea
Flatus
Abdominal distention

115
Q

Test for fluid/e-lyte malabsorption

A

Serum electrolyte panel
Creatinine
Urea nitrogen

116
Q

S/s of fluid/e-lyte malabsorption

A

Tachycardia

Dry mouth

117
Q

Test for bile salt malabsorption

A

Serum 7-a-hydroxy-4cholesten-3-one

118
Q

S/s of bile salt malabsorption

A

Watery diarrhea

119
Q

Generally, how do you test for micronutrient malabsorption

A

Serum tests

120
Q

What is leaky gut

A

Increased intestinal permeability

121
Q

What might cause leaky gut

A

Infections, medications, dysbiosis

122
Q

What patients might you find leaky gut in?

A

Celiac, crohns, MS, IBS, SIBO

123
Q

What test is done to diagnose leaky gut?

A

Lactulose-mannitol test

Lactulose—non-absorbable disaccharide

Mannitol—sugar alcohol

124
Q

Celiac disease 4 step pathyphysiology

A

Genetic susceptibility
Exposure to gluten
Environmental trigger
Autoimmune response

Requires all 4 to cause celiac

125
Q

What is the physiology behind celiac disease

A

Autoimmune reaction to protein that over time causes damage to small intestinal lining—villi that leads to medical complications and malabsorption

126
Q

Nutritional celiac disease symptoms

A 
Anemia (low iron/folate)
Increased fx risk
Clotting issues (Vit K Def)
Delayed growth
Lactase deficiency
127
Q

Extraintestinal s/s of celiac disease

A
  • malaise
  • arthritis
  • dermatitis herpetiformis
  • infertility
  • hepatitis
  • ataxia
  • psychiatric syndromes

***cluster diseases: hepatitis, type 1 diabetes, hashimotos, and celiac

128
Q

Cluster/associated disorders with celiac disease

A 
Autoimmune cluster: type 1 diabetes
Thyroiditis
Hepatitis
GI malignancy
IgA deficiency
129
Q

Dermatitis herpetiformis seen with which disease?

A

Celiac disease

130
Q

Celiac disease vs. gluten sensitivity/intolerance

A

Disease: autoimmune disease where the body attacks itself
Tests to diagnose

Intolerance: NO immune rxn
Could be due to IBS and is diagnosed using elimination diet

131
Q

Diagnosing celiac disease for high probability cases (anemic, dermatitis herpetiformis, psychiatric issues, C. HA, GI issues)

A

Duodenal biopsy and TTGA IGA.

Yes if both positive.

If only one + —> HLA DQ2, IgA level, DGP IgG

132
Q

Diagnosing celiac disease in low probability group

A

*** test TTGA & IgA.
+ TTGA= duodenal biopsy
- TTGA but low IgA—> TTGA IgG…if positive= duodenal biopsy
-TTGA and normal IgA= unlikely

MUST BE EATING GLUTEN DURING TESTING

133
Q

Diagnosing kiddos under 2 years with celiac

A

Screen for TTGA and DGP (IgA and IgG)

134
Q

Nutritional therapy for celiac disease

A

Gluten free for life

Avoid: wheat, rye, barley and malt

Up to 50g/d of oats potentially tolerated

135
Q

Initial nutritional therapy for gluten patients

A

1-2months: limit sugars, diary, lactose and sucrose

Then follow diet recommendations of avoiding, wheat, rye, barley and malt

136
Q

What are some safe gluten-free options?

A

Grains and flour: amaranth, bean flours, corn, rice, soybean, potato, quinoa, flax

Alcohol: wine, distilled liquor, gluten free beer

Cheese, eggs, meats, fish, beans, legumes, nuts, seeds, fruits, veggies normal

137
Q

What are some hidden sources of gluten?

A
  1. Medications
  2. Communion wafers
  3. Toothpaste, mouthwash, lipstick
  4. Cross contamination
138
Q

Nutritional deficiencies in celiac patients

A 
Niacin
riboflavin
B12
folate 
Iron

+(Ca, Mg, Vit D —at time of diagnosis)

139
Q

Refractory celiac disease

A

Patients who do not respond to a gluten free diet

Present with severe malabsorption diarrhea and weight loss

140
Q

Gluten free diets high in what?

A

Saturated fats
Starch
Sucrose

(Recall low in niacin, riboflavin, folate, B12 and iron and fiber)

141
Q

What is a nutritionally complete gluten free diet?

A
  • focus on foods naturally gluten free
  • 5 fruits/veggies per day
  • add amaranth, quinoa and buckwheat
  • meat, fish and dairy
142
Q

What is the 5R protocol for gluten related disorders

A 
Remove: gluten grains
Replace: digestive enzymes, DPP-IV
Reinoculate: VSL #3
Repair: L-glutamine, zinc, vitamin A
Rebalance: mindful eating and relaxation
143
Q

Replace what in those with celiac?

A

Digestive enzymes

DPP-IV (dipeptidylpeptidase)

144
Q

Reinoculate what in those with celiac?

145
Q

Repair what in those with celiac

A

L-glutamine
Zinc
Vitamin A

146
Q

What are the most common burst boarder enzyme deficiencies?

A

Lactose intolerance and fructose malabsorption

147
Q

What is the most common form of cab malabsorption

A

Lactose intolerance

148
Q

How is lactose intolerance diagnosed?

A

Hydrogen breath test

149
Q

How is fructose malabsorption diagnosed

A

Hydrogen breath test

150
Q

What is the protein requirement for those with IBD

A

1.3-1.5g/kg/d

151
Q

Supplements required for those with IBD

A 
Folate
B6,12
Iron
Zinc
Mg
K
Fe
Omega 3
PERT (pancreatic enzyme replacement therapy)
Boswelia
152
Q

IBD 5R protocol

A

Remove: food triggers. Mc: cereal, milk, egg, veggies/citrus fruits
Replace: digestive enzymes
Reinoculate: VSL #3
Repair: boswelia serrata, zina, vitamin A, mastic gum
Rebalance: meditate, yoga, deep breathing, acupuncture (moxibustion)

153
Q

What are the IBS subtypes?

A

IBS-C (constipation)
IBS-D (diarrhea)
IBS-M (mixed)
Unsubtyped IBS-insufficient evidence to meet the others

154
Q

FODMAP diet. What is it and for what?

A

Fermentable oligo, di, and monosaccharides and polyols restriction

Limit fermentable foods (sugars, oligosaccharides and sugar alcohols)

Start very restrictive and then slowly add things back in

155
Q

What are the foods to eliminate on the FODMAP diet?

A

Dairy: all except lactose free and hard cheese

Non-dairy: NO: coconut milk, beans, hummus, lentils (yes to almond and rice milk and nuts/seeds)

Grains: only wheat free grains

Fruits: avocado, apples, canned fruit, cherries, guava, mango, pear, papaya, peach, plum, prunes, watermelon

Veggies: artichokes, asparagus, beets etc

156
Q

What is diverticular disease associated MC with?

A 
Obesity
Low fiber
Vitamin D deficiency 
Sedentary lifestyle
NSAID use
157
Q

Nutritional therapy for diverticular disease

A
  1. High fiber
  2. Probiotic

You CAN have nuts, seeds, corn, popcorn and berries

158
Q

SIBO

A

Small intestinal bacterial overgrowth

Overproliferation of bacteria in the SI that is normally only found in the LI potentially due to low stomach acidity, liver/gallbladder disease or pancreatitis

159
Q

What probiotics are avoided with SIBO

A

Lactobacillus acidophilus and lactobacillus fermenti

Produce D-lactate that could cause life threatening lactic acidosis

160
Q

Causes of SIBO

A

Low stomach acidity
Liver or gallbladder disease
Pancreatitis

161
Q

What diet is useful for treating SIBO?

162
Q

5R protocol for SIBO

A

Remove: microbes using antibiotics, artificial sweeteners
Replace: betaine HCl
Reinoculate: introduce prebiotic-free probiotic
Repair: omega 3 from cold water fish, L-glutamine, zinc, vitamin A
Rebalance: eat every 3-5hr, acupuncture, deep breathing yoga

163
Q

What are the two forms of IBD? And which is MC?

A

Chron’s and ulcerative colitis

Chrons

164
Q

What test can you order to test for liver function

A

AST/ALT tests

GGT

165
Q

Nutritional requirements for liver disease

A

B vitamins
Vit ADEK (if steatorrhea)
Mg and Zn

(Avoid Iron)

166
Q

Herbal supplements for liver disease

A

Milk thistle

Contains antioxidants that may reduce free radicals

167
Q

Diets at risk for gallstones

A

Low fiber
High fat diet
High animal protein diet

(Vitamin C may be protective to gallstones)

168
Q

Nutritional recommendations for those with cholecystitis/gallstones

A

Low fat diet: 30-45g/d
Supplement Vitamin C
Increase citrus foods
Ox bile (bile salt supplement)

169
Q

What lab tests can assess pancreatic function?

A
  1. Secretin stimulation test (pancreatic secretions)
  2. Glucose tolerance test (endocrine function)
  3. 72 hour fecal fat test (exocrine function)
  4. Fecal elastase <15mcg/g = insufficiency
170
Q

What are the nutritional recommendations for patient with pancreatitis?

A
  • Easy digestible carbs (sugar/starches)
  • low fat (not producing enzyme—> cannot digest)
  • PERT
  • ADEK, B12 supplements
171
Q

How can kidney stones be prevented?

A
  1. FLUID!!!!!
  2. Juicies (cranberry for struvite and black currant for uric acid)
  3. Reduce Animal protein—> limit food with + PRAL
  4. Reduce Oxalate + increase Ca (binds oxalates and doesnt allow them to be absorbed)
  5. Na: K <1
  6. Decrease: citrate, fructose, Vit C supplements and high doses of VitD
  7. Increase B6 and EPA (omega 3)
172
Q

Calcium stones

A

Associated with increased intake of calcium.

To prevent, make sure ca is taken with meals to balance urinary oxalate

173
Q

Oxalate stones. Etiology and recommendation

A

Fatty malabsorption
Low Vit B6
Excess Vit C
Lack of oxalobacterformigens

=Limit oxalate containing foods

174
Q

What are oxalate containing foods

A 
Rhubarb
Spinach
Strawberries
Chocolate
Wheat bran/whole grain wheat
Nuts
Peanuts
Beets
Tea
High dose turmeric
175
Q

Pathway of fat malabsorption oxalate stones

A

Increased lipids in the SI cause ca++ to bind to them instead of oxalate and oxalate is then free to be absorbed by the body

176
Q

Uric acid stones. Etiology and recommendation

A

MC due to low urine pH
(Too many acidic foods, too few alkaline foods)

= limit meat, fish, poultry
Avoid Oran meat, anchovies, sardines, broth and gravy

177
Q

Treatment for inflammation

A

Increase omega 3
Decrease omega 6

Increase:
B Vitamines
Mg, Zn

178
Q

Lifestyle recommendations for inflammation

A

Weight loss
Decrease smoking and alcohol
MIND DIET!!!
Poultry 2x, beans 3x, berries 2x, nuts 5x, fish 1x, whole grain 3xd, veggies 1xd
Avoid: added sugars, processed grains, refined oils, trans fat

179
Q

Recommendation for weight loss

A

BMI 27-35: .5-1lb/wk, 35+ = 1-2lb/wk

Increase protein 20-25%

180
Q

Strong bone dietary recommendations

A

Protein
Limit excess fiber

Vit D, K
Ca, K, Mg

LIMIT Vit A (excess) and Na

Limit caffine, alcohol, smoking
Decrease high acid foods
Ca: P >1

181
Q

Recommendations for CVD

A
  • Decrease trans fat, sugars, starches, Na
  • increase omega3, K
  • Mediterranean diet: moderate fat, olive oil, plants, legumes
  • DASH diet: low fat, plants, moderate protein
182
Q

General Mediterranean diet vs DASH

A

Mediterranean

Clinical Nutrition (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions