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Preventive and social medicine > Test 4 > Flashcards

Test 4 Flashcards

1
Q

Human Nutrition - goals

A
  1. defining nutritional requirement for health:
    - promoting
    - protecting
    - maintaining
    IN ALL GROUPS OF POPULATION
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2
Q

Purpose of assessing nutritional requirement

A

what is the right amt of diet for any particular group for them to grow proper and (in case of adults) be capable of proper maintenance

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3
Q

Terms defining the nutrition needs

A
  1. recommended dietary allowances or intake
  2. optimum requirement
  3. minimum requirement
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4
Q

RDA of a particular group (of any gender/ age group)

A
  1. average
  2. daily
  3. dietary nutrient intake
  4. meet nutrient requirement of 97-98% healthy individual
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5
Q

Adequate intake

A
  1. used when RDA cannot be determined
  2. it’s estimated or approximated recommended average daily intake
  3. observed or experimentally determined in apparently healthy individual
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6
Q

Tolerable upper intake level

A
  1. highest average daily intake

2, no adverse health risk to almost all the individual in general population

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7
Q

Estimated average requirement

A
  1. average daily nutrient intake level

2. estimated to fulfill needs of half the individuals of a particular gender and age

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8
Q

Deriving of RDA - (factors)

A
  1. individual variability

2. bioavailability

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9
Q

bioavailability depends on

A
  1. release of nutrient from food
  2. it’s absorption in intestine
  3. it’s bioresponse
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10
Q

bioavailability - is

A

level of nutrient in the diet that’ll help meet the requirement

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11
Q

low bioavailability

A

of iron

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12
Q

iron - amt in diet

A

20-30 more than what is required daily

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13
Q

foods in which bioavailability factor plays an important role

A
  1. protein
  2. zinc
  3. iron
  4. calcium
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14
Q

Validity of RDA of a nutrient

A

only if all the other dietary nutrients intakes are satisfactory

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15
Q

individual variability of requirements

A

RDA takes into account

- variability of requirement among individuals of the population

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16
Q

distribution of nutritional requirement of the population (nutritional requirement of infants, nutritional requriement of pregnant women etc) is normal if -

A

RDA (covering 97% of population) corresponds to the said requirement

i.e if RDA covers requirements of all the age groups and genders.
if say one age group requires A lot larger or lesser amt of nutrients than RDA, then the population requirement is’t normal but rather an anomaly.

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17
Q

nutritional requirement of individual depends on

A
  1. age
  2. gender
  3. body weight
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18
Q

body weight and height of children reflects

A
  1. state of health
  2. nutrition
  3. growth rate
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19
Q

body weight and height of adult reflects

A
  1. what can be attained by an individual with a norm la growth
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20
Q

Reference value of anthropometric measurement

A

infants and children of well to do families having good health care and no nutritional constraints

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21
Q

purpose of RDA

A

attaining reference antrhopometric standards

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22
Q

multicentre growth reference standard for 0-60 month boys and girls

A

given by WHO

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23
Q

WHO reference standards - formation

A
  1. exclusively breast fed babies of
    - USA
    - brazil
    - ghana
    - norway
    - oman
    - india
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24
Q

reference values for Indian children

A

median weights of infants and preschool children

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25
Q

Reference man

A
  1. 18-29 years
  2. 60 kg
  3. 1.73 m
  4. BMI is 20.3
  5. free from diseases
  6. physically fit for active work
  7. 8 hours of moderate occupational work
  8. 8 hours of sleep
  9. 4-6 hours sitting and moving about
  10. 2 hours in walking and in active recreation or household duties
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26
Q

Reference woman

A
  1. 18-29 years
  2. non pregnant, non lactating
  3. 55 kg
  4. 1,61 m
  5. BMI - 21,2
  6. free from disease
  7. fit for active work
  8. 8 hours of moderate occupational work
  9. 8 hours of sleep
  10. 4-6 hours sitting and moving about
  11. 2 hours in walking and in active recreation or household duties
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27
Q

Reference infant - 0- 6 months

A

average of

birth weight and body weight at 6 month

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28
Q

Reference infant - 6-12 months

A

average of

body weight at 6 months and at 12 months

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29
Q

Reference body weight- children 1-3 years of age

A

average of WHO median body weight at

18 month, 30 month, and 42 months

i.e what WHO multicentre growth reference standard takes as an median weight of 18 mo, 30 mo and 42 mo child needs to added and then divided by 3 to get the reference child’s weight

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30
Q

Reference body weight - child from 4-6 years

A

average of body weights at

4, 5 and 6 years of

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31
Q

Reference body weight - child of older age groups

A

average of 95th percentile body weights of rural india

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32
Q

Reference body weight- for adult

  1. 18-19
  2. 20-24
  3. 25-29
A

average of body weights for each groups

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33
Q

Energy - role

A
  1. body function
  2. growth
  3. resist infection
  4. ability to work
  5. strong will
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34
Q

measurement of energy - unit

A

kilocalorie
C
Joule

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35
Q

1 Joule

A

energy required to:
move 1 kg mass
by 1 metre distance
by 1 newton force

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36
Q

one newton force

A

force required to:
accelerate 1 kg mass
by 1 m per second square

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37
Q

kilocalorie

A

heat required to:

  1. raise the temperature of 1 kg water
  2. at 14.5 degrees C
  3. to 15. 5 degree C
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38
Q

1 kcal =

A

4.184 Kilojoules

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39
Q

1 Kilojoules

A

0.239 kcal

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40
Q

1000 kcal

A

4184 KJ

4.18 MJ

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41
Q

1 MJ

A

239 kcal

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42
Q

values for the reference man and woman

A
  1. for whom the energy intake values are calculated
  2. adjustments are made for the people who deviate from the standard values

this procedure is devised by FAO comittee on calorie requirement

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43
Q

Energy requirement

A
  1. level of energy intake from food that balances energy expenditure:
    of an individual who has:
    - body size
    - body composition
    - level of activity consistent with long time health
    of an individual who can:
    - maintain economically essential activities
    - socially desirable activities
    (deposition of tissues, secretion of milk in amts a healthy person should)
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44
Q

Why are standard deviation values not added in the energy intake

A
  1. energy intake and expenditure is finely balanced
  2. excess is stored as fats
  3. continuous excess can cause obesity
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45
Q

process of Upper limit of adaptation

A
  1. intake increased to suit the expenditure

2. output increased to suit the intake

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46
Q

components of energy requirement - adult

A
  1. BMR- 1 kcal/ kg/ hour
  2. daily activities
  3. occupational work energy expenditure - light, moderate, heavy
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47
Q

procedure for calculating total energy expenditure are given i n

A

WHO expert committee on energy and protein requirements

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48
Q

Energy requirements

A
  1. vary from person to person depending on:
    - inter related variables like
    i. age
    ii. sex
    iii. working condition
    iv. body composition
    v. physical activity
    vi. physiological state
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49
Q

energy requirements are laid down by

A 
FAO and WHO expert groups
Indian council of medical research 
various standards are  
Bristish standards 
american standards 
canadian standards
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50
Q

vulnerable groups

A

pregnant and lactating mothers
children
adults

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51
Q

pregnant mothers -energy requirement

A

+350 kcal through out pregnancy

for deposition of tissue

52
Q

lactating mothers -energy requirement

A

first six months - +600 kcal
next six months - +520 kcal
(for deposition of tissues and secretion of milk in amt that a healthy person should be able to)

53
Q

energy requirement of children is more per kg of weight

A
  1. because of rapid growth rate
54
Q

for catch up growth in malnourished children children

A

RDA based on age and not weight (ICMR standards)

55
Q

children above 13 years - energy requirements equal to those in adults

A
  1. increased activities
  2. increased BMR
  3. increased growth
56
Q

Fall of energy requirements with age

A
  1. 2 percent decline with each decade
57
Q

cause of fall of energy requirement in old age

A
  1. decreasing BMR

2. decreased physical activity

58
Q

FAO/ WHO recommended decline in energy requirement

A
  1. above 40 - 5 % decrease of intake every decade

2. above 60 - 10 % decrease in intake each decade

59
Q

source of energy

A
  1. fats
  2. carbohydrates
  3. proteins
  4. dietary fibers
60
Q

energy supply - fats

A

9 kcal / g

61
Q

energy supply - carbohydrates

A

4 kcal / g

62
Q

energy supply - proteins

A

4 kcal / g

63
Q

dietary fibers

A

2 kcal / g

64
Q

dietary fibers - energy extraction

A
  1. fibers
  2. ferments in colon
  3. yeilds short chain fatty acids - butyric, acetic and propionic acids
  4. fats used as energy by colon cells, liver
65
Q

fermentable dietary fiber %

A

70

66
Q

carbohydrates - energy source

A
  1. cereals - 80 % of our diet

2. provides 50-80% of daily requirement

67
Q

fats as energy source

A
  1. poor - 5 % of diet
  2. very rich - 30% of diet
  3. average person - 10-12 % of diet
68
Q

nutritional individuality - a concept

A

to avoid excess intake of energy by those who need less than average/ standard requirements

69
Q

variation in protein requirement depends on

A
  1. age
  2. sex
  3. physiological variables
  4. infection
  5. infestation
  6. emotional disturbances and stress
70
Q

assessment of protein

A
  1. protein quality

2. protein quantity

71
Q

protein quality testing - methods

A
  1. amino acid score

2. NPU

72
Q

reference protein

A

egg protein

73
Q

amino acid score method

A

measure of concentration of each essential amino acid in test protein/ measure of concentration of the same essential amino acid in the egg protein x 100

(expressed as percentage of EAA in the reference protein)

74
Q

amino acid score for starches

A

50 to 60

75
Q

amino acid score for animal foods

A

70- 80

76
Q

Net protein utilisation

A

biological value x digestibility / 100

77
Q

what protein quality assessment is better

A

NPU

78
Q

NPU is

A

nitrogen retained in the body / nitrogen intake x 100

79
Q

1 gram nitrogen

A

6.25 gram of protein

80
Q

protein requirement

A

varies with NPU of the said protein

- is inversely proportional

81
Q

NPU of proteins of indian diets

A

50-80

82
Q

evaluating foods as a source of protein

A

calculate PE - i.e. what percentage of their total energy is provided by proteins

83
Q

PE per cent =

A

energy provided by protein content / total energy provided x 100

84
Q

why is PE a better scale for calculating protein requirement ?

A

because if the energy requirement is not sufficient, the protein will be sued up for providing energy instead of doing it’s usual growth and repair maintenance function

85
Q

if the PE ratio of the diet is less than 4

A

subject won’t be able to eat enough to satisfy the protein requirement

86
Q

normal % of protein intake

A

10-12

87
Q

unit of protein requirement

A

gm / kg/ day

88
Q

protein requirement - ICMR expert group

A

1 g / kg/ day (of 65 NPU proteins)

89
Q

vulnerable groups - protein requirement increased

A
  1. pregnant women
  2. lactating women
  3. 0-6 years old children
90
Q

pregnant women with 10 kg GWG - protein requirement

A

1st trimester - +1 g/ day
2nd trimester - + 7 g/ day
3rd trimester - +23 g/ day

91
Q

lactating women -protein requirement

A

13 g per day for 0-6 months

92
Q

protein requirement - of young children aged 0-6 years

A

increased protein per kg per day intake

93
Q

protein requirement - elderly

A

not less than adult because protein utilisation decreases in old age

94
Q

WHO expert committee report on energy and protein requirement (2007)

A

gives amino acid requirement in mg/kg/ day

95
Q

role of all the essential amino acids

A

new tissues cannot be formed unless all the essential amino acids are present in diet

EAA requirement decreases with age

96
Q

fat intake in infants

A

50% of total energy intake

97
Q

fat intake in adults

A

20 % of total energy intake (of which half should be vegetable oils rich in essential fatty acids)

98
Q

requirement of essential amino acids in infants

A

3 to 5. 7%

99
Q

RDA carbohydrate

A

50-80%

100
Q

carbohydrates in indian diet -

A

upto 90%

101
Q

vitamin A RDA

A

600 mcg

102
Q

Beta carotene RDA

A

4800 mcg

103
Q

vitamin E RDA- males

A

10 mg Alpha tocoferol

104
Q

vitamin E RDA- - females

A

8 mg alpha tocoferol

105
Q

thiamine RDA

A

0.5 mg/ 1000 kcal

106
Q

riboflavin RDA

A

0.6 mg / 1000 kcal

107
Q

niacin RDA

A

6 mg/ 1000 kcal

108
Q

calcium RDA man

A

60 mg

109
Q

iron RDA man

A

17 mg

110
Q

zinc RDA man

A

12 mg

111
Q

magnesium RDA in man

A

340 mg

112
Q

RDA net energy in a man

A

2320 kcal

113
Q

RDA protein in a man

A

60 g

114
Q

RDA visible fats in a man

A

25- 40 g

115
Q

nutritional requirements are interrelated

A
  1. protein and energy
  2. Ca, P and vitamin D
  3. carbohydrates and vitamins
  4. fats and vitamins
116
Q

food - role

A 
collection of nutrients 
system of communication 
protocol for customs
protocol for situations 
protocol for behaviour
117
Q

Diet

A
  1. kinds of
  2. food
  3. people
  4. live on
118
Q

balanced diet

A
  1. has a variety of foood
  2. in such quantities and proportions
  3. that it provides all the nutrients
  4. adequately to maintain health, vitality and general well being
  5. the amt of nutrient it has should also make small provision for extra nutrients to withstand short duration of leanness
119
Q

role of balanced diet

A

it safeguards the person from nutritional deficiencies

120
Q

principles of constructing a balance diet

A
  1. RDA of protein should be met (10-15 % of total E)
  2. fat intake limited to 15-30%
  3. carbohydrate + nautral fibers - remaining 50-80%
  4. micronutrient demands should be met
121
Q

type of food in a country depends on its

A
  1. economic status
  2. climatic conditions
  3. region
  4. customs
  5. taboos
  6. tastes
  7. habits
122
Q

balanced diet is formulated by

A

ICMR

123
Q

The food guide pyramid - five major food groups (irreplaceable)

A

from top to bottom
each group provide some but not all nutrients

  1. fats and oils and sweets - use sparingly
  2. milk and milk product, meat, poultry, fish , dry beans eggs and nuts (2-3 servings)
  3. vegetable group (3-5 servings), fruits group ( 2-4 servings)
  4. bread, cereals, rice, and pasta (6-11 servings
124
Q

dietary goals

A

prudent diet

125
Q

national nutrition and food policy

A

sets dietary goals

126
Q

WHO’s expert committee - dietary goals

A
  1. fats - 15-30%
  2. SFA - <10 %
  3. unsaturated fats - rest
  4. refined carbohydrates - avoided; natural fiber carbs preferred
  5. sources rich in energy like fats and alcohol avoided
  6. salt intake reduced from 15 g in tropical countries to less than 5 g
  7. protein 10-15 %
  8. junk foods reduced
  9. diet should be adapted for special needs like growth, pregnancy, lactation, physical activity and mental disorders

Preventive and social medicine (13 decks)

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