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. What would you like to do?
how many cals in pound?
what are micronutrients used for?
- required for use of major nutrients
- provide structural materials
- regulate metabolism, A/B balance, osmotic P
- maintain nerve and muscle irritability
amt of carb body store in g
where are carb body stores stored? as what?
in liver and mm as glycogen
how long do carb body stores last before depleted?
how much energy does PRO store in body in g?
what is PRO stored as in body?
- plasma protein
- clotting components
- skeletal and smooth mm
what is the amt of our bodies fat stores in g?
how is fat stored in body?
why is fat an excellent energy source?
b/c breakdown doesn't compromise essential body fx
what happens in first 15-20 hrs of starvation?
all glycogen stores depleted (from mm and liver)
in starvation, which energy is used after carbs?
what happens to metabolism in starvation?
slows, to conserve PRO
what happens once PRO breaks down in starvation process
- impaired wound healing
- decrease resistance to infection
- impaired work of breathing
- multi system organ failure
what conditions cause stress process?
- major trauma
what happens in first 15-20 hrs of stress process?
CHO / carb stores depleted. then PRO loss.
what differs b/w stress and starvation process (2)
- 1. in stress, PRO lost following CHO loss. in starvation, fat lost following CHO loss.
- 2. metabolism slows in starvation, speed up in stress
where are catecholamines released?
where are growth hormones released?
where are glucocorticoids released?
where is glucagon released?
alpha cells of pancreas
at what age is brain at 100% of adult size
what age should you switch to low fat diet?
how should calorie intake change following puberty?
decrease by 200-300 cal
avg wt gain / yr in women ages 20-40 y/o
list 2 ways that med side FX can affect GI system
- nausea decreases intake
- diarrhea decreases absorption
what happens to a person calorie needs in old age?
- decreased cal needs
- d/t decreased metabolic rate and decreased activity
define overwt and underwt as a percentage of IBW
- underwt: <80% IBW
- overwt: >120% IBW
mypyramid.gov recommends serving sizes bades on what? which important body statistic is ignored?
based on: age, gender, activity level
what's recommended % of cals from fat?
25-35% from fat
what's recommended % of cals from saturated fat?
what's recommended % of cals from polyunsaturated fat?
what's recommended % of cals from monounsaturated fats?
what is daily rec for cholesterol in mg?
ex of saturated fat?
anything solid at room temp
ex: meat fat, palm oil, coconut oil
ex of polyunsaturated fat?
corn oil, safflower oil
ex of monounsaturated fat?
avocado, olive oil
where is cholesterol found?
any animal source
which type of fat is most athrogenic?
approximate % of cal from fat in fast food?
recommended % of total cal from CHO, PRO, FAT?
- CHO: 50-60%
- PRO: 14-20%
- FAT: 25-35?
amt of daily recommended fiber?
define binge drinking
>= drinks at once
define ETOH moderation.
- men: 2 drinks / day
- women: 1 drink / day
define "1 drink" in amt of wine, beer, hard liquor
- beer: 12 oz
- wine: 5 oz
- hard liquor: 1 oz
list # cals, total fat, sat fat in whole milk (4%).
- cal: 150
- total fat: 8 g
- sat fat: 5 g
list # cals, total fat, sat fat in 2% milk?
- cal: 120
- total fat: 5g
- sat fat: 3g
list # cals, total fat, sat fat in 1% milk?
- cal: 100
- total fat: 3 g
- sat fat: 1.5
list # cals, total fat, sat fat in skim milk?
what is ACE in regards to nutritional health?
adverse childhood events
why ask about meds in health history?
affect absorption, utilization, and metabolism of nutrients
what is WDWN?
well developed, well nourished
where do nutritional problems manifest themselves? (where to look in PE?)
where there is rapid turnover of epithelial cells:
how can you observe decreased intravascular PRO in PE? why?
fluid moves out of blood vessels d/t decreased oncotic P
what causes oncotic P?
"pulling force" of plasma proteins, pulling fluid to where the proteins are
how do you measure ideal body weight in women?
100 lbs for the 1st 5 ft plus 5 lbs for each additional inch
How do you measure the ideal body weight in men?
106 lbs for the 1st 5 ft plus 6 lbs for each additional inch
What is the % variation allowed for ideal body weight in men AND women based on frame size?
+ or - 10% for a large or small frame
how does BMI define underweight?
how does BMI define normal?
how does BMI define overweight?
how does BMI define obese?
> or = to 30
What are the diseases that increase as the BMI increase?
ex. CV disease, HTN, OA, DM, etc.
How is mild malnutrition defined as % of IBW
80-90% of IBW
How is moderate malnutrition defined as % of IBW?
how is severe malnutrition defined as % of IBW?
<70% of IBW
What are the ranges for significant unintentional weight loss?
- >5% in 1 month
- >7.5% in 3 months
- >10% in 10 months
How do you calculate recent weight change as a percentage?
[(usual weight -current weight)/usual weight x 100]
what does abd obesity predispose you to?
- type II DM
- CV disease
what waist circumference is significant for ^ disease risk for men and women?
- men: > 40 in
- women: > 35 in
what are anthropometric measurements?
what does it indicate?
for what pop is it not helpful?
triceps skin fold
indicates % body fat
not useful for elderly d/t changes in fat distribution and saggy skin
2 methods for measuring frame size
- elbow breadth
- ht to wrist ratio
when would you use arm span to estimate ht?
when pt is bent over and can't stand straight
what do BMR and REE stand for?
- BMR: basal metabolic rate
- REE: resting energy expenditure
what to BMR and REE measure? what units are they in?
measure minimal rate of energy expenditure needed to sustain life
what regulates BMR/REE?
thyroxin, a thyroid hormone
what factors cause ^ BMR?
- children, pregnant women
- lean body mass
- hot or cold environmental temps
- ^ thyroixin
what factors cause decreased BMR?
- fasting or starvation
- decreased thyroxin
what is the harris-benedict equation used for? what is its shortcoming?
overestimates BMR in overwt/obese ppl
what is the mifflin equation used for? why is it preferred over harris-benedict?
used to measure BMR. factors in activity level
what are approximate cal needs for kids?
1000 cal/day for 1 yr, then 100 additional cal/day for each yr up to age 12
in pregnancy, what deviation from IBW indicates risk?
< / > 10% IBW
what height decrease is expected for males and females in aging?
what causes this?
- females: 2 in
- males: 1.25 in
compression of vertebral space, kyphosis, bent knees
what are normal hgb ranges for men and women?
- men: 14-18 g/dl
- female: 12-16 g/dl
what hgb levels indicate anemia in men and women?
pss causes of anemia?
- Fe, b12, folic acid deficiency
- blood loss
- chronic disease
- bone marrow disease
- overhydration --> hemodilution
what would cause elevated hgb?
what is polycythemia? what causes it?
polycythemia = too many RBC
how does dehydration contribute to elevated hgb?
^ hemoconcentration of blood
what is formula for HCT?
hgb x 3 = hct
what are normal hct levels for males and females?
- male: 37-49% (meaning 37-49% of total blood vol comes form RBCs)
- females: 36-46%
goal lipid level for HDL
goal lipid levels for LDL for person with:
0-1 CAD risk factors
2 or more CAD risk factors
- 0-1 CAD risk factors: < 160 mg/dl
- 2 or more CAD risk factors: <130
- DM, CAD: <100 or <70 in some cases
what is goal lipid level for triglycerides in blood, fasting?
know CAD risk factors from notes
how does high sat fat diet influence cholesterol and LDL?
low sat fat diet?
- high: raises cholesterol & LDL
- low: lowers chol. & LDL
How does exercise influence cholesterol and HDL?
lowers cholesterol and increases HDL
Know that genetics influence HDL levels
What does Serum Albumin measure?
it measures visceral PRO stores
What is the normal value of serum albumin levels?
What protein store has the longest half life?
Serum Albumin- 17-20 days- indicates nutritional status almost 3-weeks prior
How do we measure malnutrition with serum albumin?
- 2.8-3.5 = moderate visceral protein depletion
- < 2.8 g/dl = severe malnutrition
What does serum transferrin do?
It is a protein that carries iron
What is the half life of serum transferrin?
Shorter half life than albumin (8-10 days), therefore this is an earlier indicator of malnutrition than serum albumin.
What protein has the shortest half life?
Prealbumin. Its half life is (2-3 days), therefore this is more reflective of current nutritional status.
What is nitrogen measured by?
BUN= blood urea nitrogen.
Nitrogen is the by-product of what?
What is a negative nitrogen balance?
Increase BUN may indicate protein catabolism and is referred to as "negative nitrogen balance"
When is an increase BUN seen?
high protein intake, muscle trauma/destruction and decreased excretion as seen with renal failure.
What is the normal nitrogen value?
What is primary malnutrition?
- Due to dietary deficiencies
- Types- Marasmus and Kwashiorkor
What is Marasmus?
PRO and calorie malnutrition (eg cancer cachexia)
What is Kwashiorkor?
diets high in CHO/calories; low only in PRO
What is secondary malnutrition?
- Malabsorption (e.g. gastrointestional disease, vomiting)
- Medication side effects (e.g. N & V, decreased absorption of nutrients)
What would you like to do?
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