Week 6- Nutrition, Nutraceuticals and Nutrition Disorders Flashcards

Question

how is lactose intolerance diagnosed?

Answer 1

• Symptoms – check with GP • Hydrogen breath test – Lactose metabolised by gut bacteria , producing hydrogen that’s absorbed into blood and excreted in lungs • Dietary elimination – Does diarrhoea resolve when milk and products removed? – Do symptoms recur upon reintroduction?

Answer 2

-gluten intolerance -autoimmune disease -caused by – Genetic predispositionand Consumption of gluten proteins -– >95% patients express HLA-DQ2 or DQ8 – Receptors they encode bind gliadin peptides more tightly, activating T lymphocytes and initiating autoimmune response – 75% concordance among monozygotic twins – Up to approx 20% of first degree relatives affected – Increased risk in Type 1 Diabetes, Down Syndrome, Turner’s syndrome, autoimmune thyroid disease and dermatitis herpetiformis

Answer 3

• Consumption of gluten: – Gluten proteins sometimes incompletely digested – Peptides are extremely immunogenic to affected patients – Prolamines - alcohol-soluble fractions of gluten absorbed in small intestine and presented to APC in lamina propria, resulting in immune response in mucosa • Gliadins in wheat • Hordeins in barley • Secalins in rye • Possibly avidins in oats

Answer 4

• Common – Diarrhoea – Fatigue – Borborygmus – Abdominal pain – Weight loss – Failure to thrive – Abdominal distension – Flatulence

Answer 5

• Symptoms – persistent diarrhoea, malabsorption, weight loss, gas, abdominal pain, bloating or extra-gastrointestinal manifestations – Restricted to mucosa of small bowel so can differentially diagnose from inflammatory bowel diseases • Serological tests from blood sample – tissue transglutaminase (tTG) antibodies – endomysial antibodies – Total IgA antibodies if either of these negative but suspected disease • Home kits eg Biocard – approx £20 in pharmacy and online – but important to get medical diagnosis • Endoscopy – Macroscopic changes possibly visible eg scalloping – Biopsy required to confirm diagnosis

Answer 6

* Removal of gluten from diet – No wheat, rye, barley – Check whether tolerant to oats and use pure source of oats * Avoid manufactured products from flours – Flans, custards, ice creams – Malted foods – Beer, ale – Sauces, gravy and thickening agents – Sausages, pate, luncheon meats, – Cheese spreads – Soups, Chocolate and milk-flavoured drinks – Chocolate bars – Any canned food unless specifies gluten-free

Answer 7

• Avoid manufactured products from flours – Flans, custards, icecreams – Malted foods – Beer, ale – Sauces, gravy and thickening agents – Sausages, pate, luncheon meats, – Cheese spreads – Soups, Chocolate and milk-flavoured drinks – Chocolate bars – Any canned food unless specifies gluten-free

Answer 8

Advantages Nasal Not invasive Quick Cheap Dysphagia ``` Disadvantages Irritation Risk of sinusitis, oesophagitis Dysphagia Risk of misplacement Risk of reflux Easy tube movement or removal Regular tube replacement X-ray confirmation Stigmatising ```

Answer 9

``` Type Advantages Disadvantages Abdominal + Less stigmatising Invasive +Less tube migration Sedation and antibiotics +Less tube removal Irritation at site +Less reflux Leakage into abdomen +No nasal irritation Translocation of bowel +No dysphagia X-ray confirmation +No tube replacement Tube clogging Hematomas causing bowel occlusion ```

Answer 10

• Diarrhoea – temp of feed / rate / check date / fibre • Constipation – fluid balance / fibre • Vomiting – rate of feed / position of pt / infection? • Blocked tube – feed / meds / not flushed

Answer 11

``` • Reduced food intake • Decreased absorption • Decreased activity of co-factors eg intrinsic factor and vitamin B12 • Increased metabolism • Underlying disease ```

Answer 12

• Physical – Impaired immune function – Delayed wound healing – Decreased muscle strength and fatigue – Hypothermia – Reduced respiratory muscle function and cough pressure, predisposing to chest infections – Immobility predisposing to venous thrombosis and embolism and pressure sores – Reduced final height in women leading to reduced pelvic size and small birth weight infants • Psychological and behavioural – Depression – Anxiety – Reduced will to recover – Self-neglect – Poor bonding with mother and child – Loss of libido

Answer 13

``` • Healthy lifestyle and increased awareness • Prevent or decrease disease • Explosion in range and availability • Media coverage • Increasing scientific evidence linking diet and health or disease prevention • Rising healthcare costs • Ageing population • Growing fixation with beauty ```

Answer 14

``` • Vitamins and minerals - multi-complex and single • Selected vitamins and minerals with extra nutraceuticals aimed at targeting disease/health benefit • Pick-me-ups • Anti-oxidants • Amino acids • Fatty acids and oils • Bioflavonoids and phytoestrogens • Probiotics • Weight loss • Glucosamine, chondroitin sulphate • Stimulants ```

Answer 15

• Fruit, vegetables, nuts - contain antioxidants, folic acid, other vitamins and minerals, and fibre • Juices, tea, wine, beer, chocolate, herbs and spices – contain vitamins, phenolic antioxidants and other active compounds • Wholegrains – contain fibre and micronutrients • Oily fish and low-fat products – contain PUFA, MUFA, plant sterols and stanols • Pre and probiotics • Soy – contain phytoestrogens, fibre and protein • Energy-boosting, stimulants, ‘ feel good’ drinks • Foods with herbal extracts – novel

Answer 16

- genetic= will you react to it - adverse affects - drug ineraction with body and ohters - processing - active where in the body - physiological state

Answer 17

Sources – green leafy vegetables, oils and liver K1 (+ synthesised by intestinal flora K2 ) Functions – formation of prothrombin (II) and factors VII, IX and X Warfarin is a competitive inhibitor Interactions eg antibiotics Evidence that increases bone mass No RNI – Safe intake =1 μg/kg/d Deficiencies – rare newborn - ALL BABIES are given injection with consent 8

Answer 18

``` Most abundant mineral in body, 99% in skeleton • Active forms are calcium phosphate and ionic form, Ca2+ • Calcium balance regulated by Vit D, parathyroid hormone and calcitonin Functions • Structural - bone and teeth • Muscle contraction • Nerve impulse transmission • Blood clotting • Cell signalling and ion transport (second messenger) RNI = 700 mg/day adults Low intakes in teenage girls (11-18y) ```

Answer 19

``` Sources various Functions Enzymes eg decarboxylation, phosphorylation Skeletal development Protein synthesis Muscle contraction and Neurotransmission Closely linked with calcium metabolically RNI – 300 mg/d men, 270 mg/d women Low intakes in adolescents (NDNS) ```

Answer 20

``` Sources various -especially protein-rich foods Functions Energy formation (ATP) Bone mineralisation Component of cell membranes Cell signalling Component of nucleic acids Acid-base homeostasis Deficiency – rare (loss of appetitie, muscle weakness, bone fragility, numbness in extremities, rickets) RNI – 550 mg/d men ```