Written Flashcards
43q1- What are the WHO recommendations for promoting a healthy diet
for the WHO Eastern Mediterranean region?
- Maintain a healthy body weight
- Be active every day.
- Children and youths (90 minutes /day).
- Adults: (30 minutes /day) on most days of the week.
- For maintenance of body weight: 60 minutes of moderate to vigorous intensity most days of the week.
Discuss eating healthy: limit fats and sugar and salt more fruits and vegetable and fish and protein.
2- What are the differences between Food guides and Dietary reference
intake?
Food guides: educational tools that graphically display all or some of the messages of the dietary guidelines. Help individuals with day-to-day meal planning. Based on nutrient content, recommend a certain number of serving based on life style
Dietary reference intake: used to calculate daily nutrient recommendations. Mainly used by health care workers for diet planning. Based on BMI, calorie intake and macronutrients.
3- Illustrate how diet planning (diet therapy) can be used for management of disease
- Texture/consistency (routine hospital diets):
a. Clear Liquid Diet : transparent fluids that leaves no residue as clear juice, broth, tea and gelatin, Honey and Ice pops.
➔ Indicated in postoperative patients, GI illness , before some lab.
.
b. Full Liquid Diet : foods that are liquid or become liquid on reaching the stomach as milk, plain ice cream, milk shakes,
→ Indicated post-operative after clear liquid diet, acute infections, GIT conditions, chewing difficulties and heart attack.
c. Soft Diet: easy to chew and digest low fiber, low fat diet as Eggs (not fried), fish, tender beef,
→ It is appropriate for patients post-operative after full liquid diet,
d. General Diet balanced diet for patients not requiring dietary modifications. All
foods are allowed.
- Nutrient content (therapeutic diets): Normal diets altered to include or exclude certain components, such as calories, fat, vitamins and minerals.
→ They are part of overall treatment regimen, prescribed by physician and planned by dietitian.
4- Give a short account on the nutritional advice during pregnancy? (Give details about the requirements of specific nutrients during)
Malnutrition is bad for fetus so increase calories by 300/day in 2nd trimesters. Increase protein by 25g/day
Vitamins: Vitamin D, Vitamin C, lots of calcium to prevent osteoporosis, Iron during 3rd trimesters and Zinc (antibacterial activity)
5- What is the impact of malnutrition during pregnancy?
Impact on the mother: General impairment of health and maternal nutritional deficiency disease especially iron deficiency anemia.
Impact on Fetus: Higher incidence of LBW, premature birth, deficient body stores of the new born, rickets
6- Give a short account on the nutritional advice during Lactation?
● Maternal dietary intake does not affect the macronutrient of milk
● The levels of most nutrients in milk are maintained at the expense of maternal stores.
Eat well balanced diet, Emphasize fruit/vegetables, foods high in calcium and vitamin D, avoid fatigue/keep hydrated, avoid sugars and exercise regimen of 45 min.
What is impact of malnutrition during lactation?
On the lactating mother: general impairment of health, predispose to nutritional deficiency, anemia and tetany
On the nursed baby: composition1 of milk is unique and not influence by maternal malnutrition
Give reason for why breast feeding is encouraged
For the baby: nutritionally superior, sanitary, provides immunity, stimulates infants immune system, reduces risk of allergy and decrease tendency towards child obesity
For the mother: promotes physiological recovery from pregnancy, helps uterine anovulation, decrease risk of breast and ovarian cancer, saves money, bonding of infant with mother
9- What are the principles of infant feeding?
(dietary requirements for infants?)
Three stages: colostrum, transitional milk and mature milk.
- Colostrum: yellowish opaque fluid secreted during the first few days after birth.
- Colostrum contains: a higher amount of protein, carotene, and electrolytes; less fat and sugar a number of anti-infective factors3.
- Mature human milk has the best composition for the infant
WHO recommendations for breastfeeding
- Early initiation of breastfeeding within 1 hour of birth
- breast-milk only for the first 6 months of life;
- Introduction of solid foods at 6 months together with continued breastfeeding up to 2 years of age or beyond
Explain what must be done when feeding of LBW Infant
LBW infant is at-risk of health hazards, including under nutrition and so needs special feeding system with special consideration for:
-Giving more protein, calcium, iron and vitamins C and D.
-Managing suckling and other feeding problems.
-Giving parenteral vitamin K if necessary.
What are the requirement of successful breast feeding:
- start breast feeding very early after delivery , better first half hour, which have the following Advantages:
a-stimulate milk secreation
b-sucking of colostrum have anti infection value.
c-early mother baby bonding
d-help involution of uterus - baby be given enough time for suckling
- mother must be comfort and psychologically relaxed..
10 What are the Disadvantages of Bottle feeding:
- associated with infection
- expensive
- allergy to cow milk.
- may be unsterile
- -impair maternal-baby bonding
11- Define weaning, suggest a scheme for successful weaning plan
Weaning: the process, of gradually replacing milk feeds by a variety of foods, until reaching regular diet
A- 7th month:
* Milk pudding for protein, starch
* Vegetable soup for iron, minerals and vitamins.
* Mashed vegetables and fruits
* Yolk of boiled egg: for protein
B- 8th and 9th month : Boiled potatoes or sweet potatoes
* Mashed liver of chicken.
* Minced meat of chicken, cattle or fish.
C- l0th to 12th month:
* Peeled mashed stewed beans
* By end of the 10th month an infant could share family food within the consistency he can handle
Q12. Ten steps for successful breast feeding:
- Written breastfeeding policy
- Train all health care staff in skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within a half-hour of birth.
- Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
- Give newborn infants NO food or drink other than breast milk unless medically indicated.
- Allow mothers and infants to remain together - 24 hours a day.
- Encourage breastfeeding on demand.
- Give no artificial teats or pacifiers
- Breastfeeding support groups.
13- List the nutritional disorders of school children and their predisposing factors?
1- Iron deficiency anemia.
2- Retarded growth due to deficient intake
of protein and calories
3- Vitamin A and riboflavin deficiency.
4- Goiter in endemic area.
5- Dental caries.
6-Excessive weight gain leading to overweight and obesity.
16- What are Nutritional disorders of adolescents?
1- Obesity (Overweight) : An increasing problem.
- Nearly 75% of obese adolescents remain obese as adults.
- Lack of physical activity and improper dietary habits
- Global energy drink consumption rose. These beverages have potential negative health consequences for children and adolescents
2- Eating disorders as anorexia nervosa. Preoccupation with body image
3- Iron, Vitamin A, iodine and calcium deficiencies.
Nutritional disorders of elderly
- Wasting, due to difficult intake of foods
- Obesity, due to overeating.
- Osteomalacia & osteoporosis.
- Anemia.
