Nutrition Test 3

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kcosen01
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189808
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Nutrition Test 3
Updated:
2012-12-20 11:35:28
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Nutrition final
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assessment, life cycle, Consumer issues
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  1. 4 Stages of Nutrient Deficiency 
    • 1. Food requirements are not met 
    • 2. Storage/Tissue Depletion
    • 3. Clinical signs/symptoms
    • 4. Morbidity/Mortality
  2. 4 ways to asses the Deficiency
    • 1. Diet Analysis
    • 2. Biochemical/physiologic measures
    • 3. Clinical examination
    • 4. Vital statistics 
  3. Why perform a nutrition assessment? 
    • - prevent/reduce health problems related to nutrition
    • - to improve the quality of life
    • - reduce health care costs 
  4. Nutritional screening
    • - identify characteristics associated with nutrition problems
    • - identify high risk patients 
    • - focus on warning signs
    • - cost effective
    • - incorporates relevant data
  5. Assessment
    • - measurement of food and nutrient intake 
    • - evalutation of nutrition-related health indicators
    • - make sure data used has standards to compare to, use data that accurately reflects the needs of the patient
    • - go backwards to get a 24 hour recall from patient to help them remember 
  6. Medical nutrition therapy
    used by dietition to treat symptoms of disease
  7. ABCD
    • - Anthropometric measures 
    • - Biochemical indices
    • - Clinical evaluation
    • - Dietary data
  8. Data from?
    • - medical record 
    • - patient interview
    • - lab tests/results 
    • - anthropometric measurements
    • - 24 hour recall
  9. Nutritional history
    • - physical activity
    • - culture
    • - food allergies
    • - dental/oral health (acid from bulima)
  10. Biochemical indices
    • - most objective 
    • - sampled from serum, plasma, blood cells (red/white)
    • - urine
    • - feces 
    • - tissue samples
  11. Measure proteins/iron levels 
    • - proteins through nitrogen balance 
    • - iron: hemoglobin, ferritin
  12. Anthropometric measures 
    • - measurements of physical characteristics of the body
    • - height, weight, skin fold thickness, head circumference 
  13. Percent weight change
  14. Percent usual body weight 
  15. BMI - body mass index
    • - weight to height
    • - does NOT take muscle into account
  16. Bioelectric impedance
    • - most accurate 
    • - hook up electrodes to fingers and toes 
    • - lie down flat
  17. Underwater dunk tank 
    • - amount of water dispersed is equal to the body composition
    • - mass by volume displacement 
  18. Clinical examination
    • - physical examination of the body
    • - hair, eyes, skin, teeth, oral cavity, gums, tongue
  19. Signs and symptoms of nutrient deficiencies
    • - focus on hair, eyes, skin, teeth, oral cavity, gums, tongue
    • - epithelial cell turn over: obvious indicators through these cells 
    • - gums - can check for vitamin C (scurvy)
  20. Global assessment
    - blood test, physical assessments, combination of all global assessments to make a decision about deficiency
  21. Physical activity
    Some foods expend calories greater than their calorie intake 
    expend calories through digestion
  22. Basal metabolic rate
    • - energy the body requires for basic life functions while at complete physical and mental rest
    • - amount of E body expends based on no net movement (just lying there)
  23. Factors that increase BMR
    • - leaner body mass
    • - taller 
    • - younger age
    • - increased levels of thyroid hormone 
    • - stress, fever, illness,
    • - males
    • - pregnancy/lactation
    • - stimulant drugs (caffeine and tobacco)
  24. Decreasing BMR 
    • - shorter
    • - older age
    • - decreased levels of theyroid hormone
    • - starvation/fasting
    • - females! 
  25. Factors that effect BMR
    • - thyroid hormone and BMR have a direct relationship
    • - illness (fever) weight loss because BMR increases 7%
    • - muscle mass increases with BMR (direct)
    • - boys have a faster BMR (higher)
    • - as you age, BMR goes down, decreasing muscle mass
    • - k cal diet influences BMR
  26. What age is your BMR the highest?
    • - infant
    • - growing so fast, double your body weight
    • - can consume the most calories during adolesence 
  27. Obesity
    - having over a 30 BMI
  28. Ethnic groups that are most obese
    Black and Mexican American women 
  29. Heath risks associated with obesity
    • - Heart disease
    • - All cancers 
    • - Stroke
    • - Pulminary disease
    • - Diabetes
  30. Genetic factors
    • - influence height, weight, body shape, metabolic rate
    • - 25 % of one's body fat is accounted for by genetic influences 
    • - 2 theories: Thrifty gene v. set-point
    • - thrifty gene = gene that causes some people to be energetically thrifty/expend less energy than other people 
    • - set- point = body weight stays within a narrow range 
  31. Health Nation
    • - obesity epidemic
    • - cheap/fast food epidemic
    • - TV/media weight images
    • - on the go 
    • - watching TV: eating is a habit 
    • - diet is only short term: need to make lifestyle changes ! 
  32. Recommendation
    • - realistic goals
    • - structured meals
    • - small steps (achievable goal)
    • - portion control
    • - take note of times that normally you over eat
    • - only eat when you're at the table 
    • - put the fork down between bites
  33. Proteins that affect the regulation of appetite and storage of body fat
    • - leptin: reduces food intake
    • - ghrelin: stimulates appetite
    • - peptide YY: decreases appetite
  34. Increased satiety/decrease food intake
    • - increase in blood glucose levels after meal 
    • - stomach expansion
    • - nutrient absorption from the small intestine 
    • - hormones secreted serotonin and CCK
  35. Decreased satiety/increase food intake 
    • - hormomes (beta endorphins)
    • - neuropeptide Y 
    • - decreased blood glucose levels 
  36. Nutrition is affected by cultural and economic factors 
    • - religious beliefs
    • - fast-food culture
    • - sedentary lifestyle
    • - economic status 
    • - access to healthcare 
  37. Dietary recommendations
    • -establish realistic health goals 
    • - obtain information from a reliable source 
    • - obtain medical supervision for weight loss 
    • - consume a variety of healthy foods 
    • - select an energy intake that would promote 1-2 lbs/week weight loss
  38. female athlete triad
    • - osteoporosis
    • - ammenorhea (stop menstruating)
    • - eating disorder 
  39. Questions to ask females:
    - Are you menstruating?
    - Do you take birth control?
    • - low estrogen, low vitamin D
    • - low vitamin D, decrease calcium absorption, do you have enough calcium
  40. anorexia
    • - decreases 50 % of metabolism
    • - become obsessive with food (no matter who is eating it and what they are eating)
    • - talk about food all the time to compensate/cover up ?
  41. bulima
    • - a silent disease
    • - normal weight, abnormal dieting
    • - acid on enamel of the teeth
    • - induced vommitting
  42. Pre-conceptual health
    • - important to stay healthy before pregnant
    • - folic acid/folate (prevent spina bifida)
    • - no drinking, smoking,....
  43. Critical period
    • week 2 - week 8
    • (1st trimester)
    • - development of brain, eye, liver,
    • - some women don't know they're pregnant during this period (this is a problem!!!!!! have to watch their eating/drinking habits)
  44. placenta
    • - product of conception
    • - how the baby is connected to the mother
    • - anything mother ingests goes through the placenta 
  45. teratogens
    • - substances/chemicals that cause birth defects
    • - drugs, alcohol, cigarettes
  46. What is a low birth weight?
    anything below 5.5lbs
  47. Weight gain during pregnancy
    • Normal: 25 - 35lbs 
    • Twins: 50 - 60 lbs
    • Underweight/Teen: 28-40
    • Overweight: 15-25
    • Obese: 11-20
  48. Rate of weight gain
    • 1st trimester: 1lb/month
    • 2nd/3rd trimester
    • Normal: 1 lb/week
    • Overweight: .6lb/week
    • Obese: .5lb/week
  49. abnormal weight gain
    • - less than needed weight
    • - can cause baby to have interuterine growth retardation 
  50. Recommended kcal intake
    • 1st trimester: normal kcal intake
    • 2nd/3rd: and additional 350/400 kcal
  51. Nutrient recommendations during pregnancy
    -** increase folate, iron, iodine, zinc
  52. Results of gastrointestinal problems
    • - nausea/vomitting
    • - constipation
    • - heartburn
  53. Other weird food matters during pregnancy
    • food cravings 
    • PICA: non-edible craving items (clay/chalk)
    • ***deficiency in iron can cause cravings in non-food items 
    • (habits like chewing on ice)
  54. WIC
    • - Women's Infant and Children's supplemental food program
    • - USDA program
    • - promote healthier pregnancy outcomes
    • - vouchers for healthy cereals
    • - low income families 
  55. Characteristics of a high-risk pregnancy
    • - low prepregnancy BMI
    • - poor/excessive weight gain
    • - short interval between pregnancies 
    • - HBP
    • - diabetes 
    • - age 
    • -smoking, alcohol, drug use 
  56. FAS
    • - fetal alcohol syndrome
    • - growth retardation
    • - developmental delays 
    • - low birth weight infants
    • - characteristics: flat nose bridge, wide space b/w eyes, thin upper lip, small head circumference
    • - #1 cause of mental retardation in America
  57. Foods that can be a threat to health of mother and baby during pregnancy
    • - raw fish, meat, poultry, eggs
    • - unpasteurized milk/juice
    • - large fish (swordfish, shark, tilefish, tuna)
    • - soft cheeses
  58. Nutritional requirements for Infants 
    • - 40 - 50 kcal/kg body weight 
    • - 600-650 kcal/day for 6 month olds
  59. Breastfeeding
    • - benefits:
    • - not processed
    • - mother burns calories
    • - less costly
    • - immune system booster
    • - bond with infant
    • - decrease breast cancer risk 
    • - decrease uterine size
  60. colastrum
    • - thick, yellow, liquid secretion 
    • - provides antibodies
  61. pituitary gland (in brain)
    • - releases prolactin 
    • - prolactin: stimulates milk production
    • - oxytocin: stimulates milk release
    • - brain simulates an association with milk: if a mother hears a baby crying, they could release milk "unconsciously"
  62. Human milk
    • - provides more energy in kcal than formula 
    • - if only breast fed, infants should receive iron, fluoride, and vitamin D supplements
    • - breast milk is easier to digest
    • - breast-feeding is a natural contraceptive
    • - decrease SIDS: sudden instant death syndrome
  63. Scenarios when you don't want the woman to breastfeed
    • - HIV + 
    • - contaminated H20
    • - alcohol/drug abuse 
  64. infant bottle syndrome
    sugar degrades the teeth
  65. Infants (4 - 6 months)
    • - iron-fortified rice cereals 
    • - single-grain cereals
    • - mix with breast milk/formula/water
  66. Infants 6-8 months 
    • - strained fruits and veggies 
    • - limit juice intake to 8oz /day 
  67. 7 - 10 months 
    • - mashed veggies
    • - chopped meat
    • - finger foods
  68. 9-12 months 
    - yogurt, soft cheese, macaroni, scrambled eggs 
  69. Food allergies
    • - immune response (IgE) to any food that the body perceives to be harmful
    • - symptoms: inflammation, irritation, GI irritation, bronchial constriciton
    • - anaphylaxic shock: occurs when histamine causes obstruction of airway (hypoxia) 
  70. Common food allergens
    • - shellfish
    • - peanuts 
    • - tree nuts 
    • - eggs
    • - soy 
    • - wheat 
  71. Celiac Disease
    • - Digestive disorder that damages the small intestinal wall 
    • - must avoid gluten, the protein found in wheat, rye, barley 
    • - genetic diease 
    • - causes nutrient malabsorption 
  72. FALCPA
    - food allergen labeling and consumer protection act 
  73. Food jags
    • consistency is common
    • when a toddler is hung up on their one food
    • no nutritional variety 
  74. Toddler nutrition issues
    • - sensitivity to green veggies (bitter taste/weird smell)
    • - anemia
    • - constipation
    • - dental caries
    • - food insecurity
    • - obesity
  75. Recommendations for obesity
    • - increase physical activity 
    • - involve the entire family 
    • - offer healthy meals and snacks 
    • - do not restrict kcal
  76. Critical nutrients for Teens 
    • - iron
    • - calcium 
    • - vitamin A 
    • - vitamin D 
  77. Physiological factors for the elderly
    • - inability to drive
    • - low E 
    • - brittle bones: osteoporosis
    • - slow digestive function
    • - arthritis 
  78. Psychological factors 
    • - depression
    • - forgetfulness
    • - loss of independence
    • - loneliness
  79. Factors that contribute to geriatric weight loss
    • - drugs
    • - diarrhea
    • - depression
    • - disease
    • - dysfunction
    • - dementia
    • - dysphagia (altered swallowing) 
    • - dysgeusia
    • - dentition
  80. Elderly nutritional issues
    • - oral cavity (dentures)
    • - weight loss
    • - lack of exercise
    • - lethargic
    • - dry mouth, decreased saliva production
    • - constipation (IBS)
    • - increase of dehydration
    • - diruetics: hypertension
    • - senses change: less sensitivity to salt/sugar 
  81. Older Americans Act
    • - Meals on Wheels 
    • - Congregate meals program
  82. Government agencies that regulate food safety 
    • - USDA
    • - FDA (labeling) 
    • - CDC: center for disease control and prevention (education of the public on disease)
    • - EPA: environmental protection agency (pesticides and water quality)
  83. Risky foods (known for contamination/outbreaks) 
    • - leafy greens 
    • - eggs 
    • - tuna 
    • - oysters 
    • - potatoes 
    • - cheese 
    • - ice cream
  84. DANGER ZONE for meat temperatures 
    -do not keep at 40 - 140 F for more than 2 hours 
  85. Symptoms of bacterial illness 
    • - gastrointestinal distress
    • - vomitting, diarrhea, abdominal cramping 
  86. Hemolytic Uremic Syndrome 
    • - kidney failure and stroke 
    • - caused by undercooked ground beef, raw milk, salad, raw sprouts, swimming pools, petting zoos 
  87. Prevention of food bourne illnesses
    • - cook raw beef 
    • - drink only pasteurized milk, juice, cider 
    • - wash all fruits and veggies 
  88. Listeriosis
    • - found in water and soil
    • - deli meat, soft cheeses
    • - Animals are carriers 
    • - plants contaminated with manure 
    • - symptoms: infection of the brain and CNS, spontaneous abortion, high fever, nausea, severe headaches 
  89. Salmonella 
    • - bacteria that pass from human/animal feces to other people or animals 
    • - diarrhea, fever, raw meat/eggs 
  90. Botulism
    • - low acid foods that may have come in contact with spores
    • - serious illness that causes flaccid paralysis of muscles (coma)
    • - neurotoxin 
    • - from a bacteria found in soil all over the world 
    • - spores from canned foods (low acid)
    • - fermented fish
  91. norovirus
    • - a virus that causes illnesses for a few days with diarrhea, fever, headache, nausea, vomitting (bad flu)
    • - spread through feces/vomit
    • - enters food through contaminated hands/surfaces
    • - cruise ships = highly contagious
  92. Hep A 
    • - fecal contamination of food during growth, processing, or prep
    • - water contamination, raw shellfish, 
  93. Mad cow disease
    • - high risk in Europe
    • - cows that eat infected sheep
    • - prion: a protein that destroys brain cells in cows 
    • - called downers ! 
  94. Food additives
    • - unintentional v. intentional
    • - intentional: sugar, salt, thiamin, niacin, Vitamin A/D, folic acid, iron
    • - unintentional: animal feces, hair, lead, nut products
    • - need to report certain additives with a purpose to FDA
  95. GRAS
    • - generally recognized as safe list 
    • - do not need to be reported to the FDA or go through rigorous testing 
    • - salt, sugar, caffeine, spices
    • - to remain on this list, the additive must not have been found to cause cancer in man or laboratory animal
  96. Sulfites
    • - vino, dried fruits, vinegars, 
    • - food preservative, dough conditioner, antioxidant, antimicrobial, color stabilizer
    • - **symptoms: asthma attacks, rashes, bronchi constriction
    • - cannot be used in salad bars
    • - must be indicated on label
  97. MSG
    • - monosodium glutamate
    • - people are sensitive to the glutamate
    • - flavor enhancer for asian cooking
    • - on GRAS list
  98. Caffeine
    • - a psychostimulant
    • - beans of coffee, tea, guarana, absrobed by the stomach/small intestine in 45 minutes
    • - recommended 250mg/day
    • - increases levels of epinephrine/adrenaline
    • - increases heart rate, BP, and blood flow to muscles
    • - pseudosober feeling
  99. Irradiation
    • - use of low ionizing gamma rays to control food maturation and contaimination
    • - creates free radicals which kill insects and bacteria 
    • - flour, potatoes, pork, fruits/veggies, poultry, meat
    • - is approved for certain foods 
  100. Pesticides
    • - herbicides, fungicides, insecticides, 
    • - man made or natural (ladybugs)
    • - health risks to farmers and applicators
  101. What does it mean to be Organic?
    • - meat that have no antibiotics or growth hormones
    • - promote the use of renewable resources 
    • - without most conventional pesticides 
    • - studies have shown that organic has a higher nutritional value, not definitive research though 
  102. Environmental contaminants 
    • - methyl mercury
    • - PBB and PCB
    • - most dangerous to pregnant women and infants/children
  103. GMF
    • - genetically modified food 
    • - combining genes of different foods to improve yield, decrease contamination and enhance quality 
    • - monsanto has a monopoly on farmers so that they are forced to use Monsanto products which are GMF seeds
    • - winter tomatoes
    • - gene from desired trait
  104. rBGH
    • - recombinant bovine growth hormone 
    • - genetically engineered growth hormone used to produce more muscle tissue and less fat in beef heards 
    • - also used in cows to produce more milk
    • - milk DOES NOT HAVE TO BE LABELED, unless its organic
  105. Food Disparangment/Veggie Libel law
    • - CANNOT make a public statement about a particular food 
    • (Food Inc)
    • - challenging the first amendment
  106. Ecotarian
    - eats a plant based diet with small amounts of organic meat poultry and fish
  107. 1 kcal food consumption, 7 kcal energy of expenditure
    • - transportation
    • - manufacture the food
    • - grow the food 
    • - fuel costs

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