N202 Nutrition

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N202 Nutrition
2010-11-13 15:00:02
N202 Nutrition

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  1. # cal / g in PRO
  2. # cal / g in carbs
  3. # cal / g in fat
  4. how many cals in pound?
  5. 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
  6. amt of carb body store in g
    250 g
  7. where are carb body stores stored? as what?
    in liver and mm as glycogen
  8. how long do carb body stores last before depleted?
    15-20 hrs
  9. how much energy does PRO store in body in g?
  10. what is PRO stored as in body?
    • plasma protein
    • hgb
    • clotting components
    • hormones
    • Abs
    • skeletal and smooth mm
  11. what is the amt of our bodies fat stores in g?
  12. how is fat stored in body?
    as triglycerides
  13. why is fat an excellent energy source?
    b/c breakdown doesn't compromise essential body fx
  14. what happens in first 15-20 hrs of starvation?
    all glycogen stores depleted (from mm and liver)
  15. in starvation, which energy is used after carbs?
  16. what happens to metabolism in starvation?
    slows, to conserve PRO
  17. what happens once PRO breaks down in starvation process
    • impaired wound healing
    • decrease resistance to infection
    • impaired work of breathing
    • multi system organ failure
    • death
  18. what conditions cause stress process?
    • major trauma
    • surgery
    • sepsis
    • burns
  19. what happens in first 15-20 hrs of stress process?
    what next
    CHO / carb stores depleted. then PRO loss.
  20. 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
  21. where are catecholamines released?
    adrenal medulla
  22. where are growth hormones released?
    anterior pituitary
  23. where are glucocorticoids released?
    adrenal cortex
  24. where is glucagon released?
    alpha cells of pancreas
  25. at what age is brain at 100% of adult size
    8 y/o
  26. what age should you switch to low fat diet?
    2 y/o
  27. how should calorie intake change following puberty?
    decrease by 200-300 cal
  28. avg wt gain / yr in women ages 20-40 y/o
  29. list 2 ways that med side FX can affect GI system
    • nausea decreases intake
    • diarrhea decreases absorption
  30. what happens to a person calorie needs in old age?
    • decreased cal needs
    • d/t decreased metabolic rate and decreased activity
  31. define overwt and underwt as a percentage of IBW
    • underwt: <80% IBW
    • overwt: >120% IBW
  32. mypyramid.gov recommends serving sizes bades on what? which important body statistic is ignored?
    based on: age, gender, activity level

    ignores wt
  33. what's recommended % of cals from fat?
    25-35% from fat
  34. what's recommended % of cals from saturated fat?
  35. what's recommended % of cals from polyunsaturated fat?
  36. what's recommended % of cals from monounsaturated fats?
  37. what is daily rec for cholesterol in mg?
    <200 mg/day
  38. ex of saturated fat?
    anything solid at room temp

    ex: meat fat, palm oil, coconut oil
  39. ex of polyunsaturated fat?
    corn oil, safflower oil
  40. ex of monounsaturated fat?
    avocado, olive oil
  41. where is cholesterol found?
    any animal source
  42. which type of fat is most athrogenic?
  43. approximate % of cal from fat in fast food?
  44. recommended % of total cal from CHO, PRO, FAT?
    • CHO: 50-60%
    • PRO: 14-20%
    • FAT: 25-35?
  45. amt of daily recommended fiber?
  46. define binge drinking
    >= drinks at once
  47. define ETOH moderation.
    • men: 2 drinks / day
    • women: 1 drink / day
  48. define "1 drink" in amt of wine, beer, hard liquor
    • beer: 12 oz
    • wine: 5 oz
    • hard liquor: 1 oz
  49. list # cals, total fat, sat fat in whole milk (4%).
    • cal: 150
    • total fat: 8 g
    • sat fat: 5 g
  50. list # cals, total fat, sat fat in 2% milk?
    • cal: 120
    • total fat: 5g
    • sat fat: 3g
  51. list # cals, total fat, sat fat in 1% milk?
    • cal: 100
    • total fat: 3 g
    • sat fat: 1.5
  52. list # cals, total fat, sat fat in skim milk?
    • cal: 90
    • fats: 0
  53. what is ACE in regards to nutritional health?
    adverse childhood events
  54. why ask about meds in health history?
    affect absorption, utilization, and metabolism of nutrients
  55. what is WDWN?
    well developed, well nourished
  56. where do nutritional problems manifest themselves? (where to look in PE?)
    where there is rapid turnover of epithelial cells:

    • skin
    • hair
    • mouth
    • lips
    • eyes
  57. how can you observe decreased intravascular PRO in PE? why?
    generalized edema

    fluid moves out of blood vessels d/t decreased oncotic P
  58. what causes oncotic P?
    "pulling force" of plasma proteins, pulling fluid to where the proteins are
  59. how do you measure ideal body weight in women?
    100 lbs for the 1st 5 ft plus 5 lbs for each additional inch
  60. How do you measure the ideal body weight in men?
    106 lbs for the 1st 5 ft plus 6 lbs for each additional inch
  61. 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
  62. how does BMI define underweight?
  63. how does BMI define normal?
  64. how does BMI define overweight?
  65. how does BMI define obese?
    > or = to 30
  66. What are the diseases that increase as the BMI increase?
    ex. CV disease, HTN, OA, DM, etc.
  67. How is mild malnutrition defined as % of IBW
    80-90% of IBW
  68. How is moderate malnutrition defined as % of IBW?
  69. how is severe malnutrition defined as % of IBW?
    <70% of IBW
  70. What are the ranges for significant unintentional weight loss?
    • >5% in 1 month
    • >7.5% in 3 months
    • >10% in 10 months
  71. How do you calculate recent weight change as a percentage?
    [(usual weight -current weight)/usual weight x 100]
  72. what does abd obesity predispose you to?
    • type II DM
    • dyslipidemia
    • HTN
    • CV disease
  73. what waist circumference is significant for ^ disease risk for men and women?
    • men: > 40 in
    • women: > 35 in
  74. 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
  75. 2 methods for measuring frame size
    • elbow breadth
    • ht to wrist ratio
  76. when would you use arm span to estimate ht?
    when pt is bent over and can't stand straight
  77. what do BMR and REE stand for?
    • BMR: basal metabolic rate
    • REE: resting energy expenditure
  78. what to BMR and REE measure? what units are they in?
    measure minimal rate of energy expenditure needed to sustain life

    in cals
  79. what regulates BMR/REE?
    thyroxin, a thyroid hormone
  80. what factors cause ^ BMR?
    • children, pregnant women
    • lean body mass
    • fever
    • stress
    • hot or cold environmental temps
    • ^ thyroixin
  81. what factors cause decreased BMR?
    • fasting or starvation
    • obesity
    • malnutrition
    • decreased thyroxin
  82. what is the harris-benedict equation used for? what is its shortcoming?
    estimates BMR.

    overestimates BMR in overwt/obese ppl
  83. what is the mifflin equation used for? why is it preferred over harris-benedict?
    used to measure BMR. factors in activity level
  84. 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
  85. in pregnancy, what deviation from IBW indicates risk?
    < / > 10% IBW
  86. 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
  87. what are normal hgb ranges for men and women?
    • men: 14-18 g/dl
    • female: 12-16 g/dl
  88. what hgb levels indicate anemia in men and women?
    • women: <12 g/dl
    • men: < 13
  89. pss causes of anemia?
    • Fe, b12, folic acid deficiency
    • blood loss
    • chronic disease
    • bone marrow disease
    • overhydration --> hemodilution
  90. what would cause elevated hgb?
    • polycythemia
    • dehydration
  91. what is polycythemia? what causes it?
    polycythemia = too many RBC

    chronic hypoxia
  92. how does dehydration contribute to elevated hgb?
    ^ hemoconcentration of blood
  93. what is formula for HCT?
    hgb x 3 = hct
  94. 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%
  95. goal lipid level for HDL
    >50 mg/dl
  96. goal lipid levels for LDL for person with:
    0-1 CAD risk factors
    2 or more CAD risk factors
    DM, CAD
    • 0-1 CAD risk factors: < 160 mg/dl
    • 2 or more CAD risk factors: <130
    • DM, CAD: <100 or <70 in some cases
  97. what is goal lipid level for triglycerides in blood, fasting?
    <150 mg/dl
  98. know CAD risk factors from notes
  99. how does high sat fat diet influence cholesterol and LDL?
    low sat fat diet?
    • high: raises cholesterol & LDL
    • low: lowers chol. & LDL
  100. How does exercise influence cholesterol and HDL?
    lowers cholesterol and increases HDL
  101. Know that genetics influence HDL levels
  102. What does Serum Albumin measure?
    it measures visceral PRO stores
  103. What is the normal value of serum albumin levels?
    3.5-5.5 gm/dl
  104. What protein store has the longest half life?
    Serum Albumin- 17-20 days- indicates nutritional status almost 3-weeks prior
  105. How do we measure malnutrition with serum albumin?
    • 2.8-3.5 = moderate visceral protein depletion
    • < 2.8 g/dl = severe malnutrition
  106. What does serum transferrin do?
    It is a protein that carries iron
  107. 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.
  108. What protein has the shortest half life?
    Prealbumin. Its half life is (2-3 days), therefore this is more reflective of current nutritional status.
  109. What is nitrogen measured by?
    BUN= blood urea nitrogen.
  110. Nitrogen is the by-product of what?
    protein breakdown
  111. What is a negative nitrogen balance?
    Increase BUN may indicate protein catabolism and is referred to as "negative nitrogen balance"
  112. When is an increase BUN seen?
    high protein intake, muscle trauma/destruction and decreased excretion as seen with renal failure.
  113. What is the normal nitrogen value?
    8-25 mg/dl
  114. What is primary malnutrition?
    • Due to dietary deficiencies
    • Types- Marasmus and Kwashiorkor
  115. What is Marasmus?
    PRO and calorie malnutrition (eg cancer cachexia)
  116. What is Kwashiorkor?
    diets high in CHO/calories; low only in PRO
  117. What is secondary malnutrition?
    • Malabsorption (e.g. gastrointestional disease, vomiting)
    • Medication side effects (e.g. N & V, decreased absorption of nutrients)