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17 Cards in this Set
- Front
- Back
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How is energy produced? |
From oxidative phosphorylation CHO, fats, protein: catabolised through individual pathways -> production of acetyl CoA Glucose ->pyruvic acid ->Acetyl CoA (involve Thiamine) FA -> Fatty acyl CoA -> acetyl CoA (involve beta-oxidation) From Kreb's cycle: 2NADH + 2H + O2 + 6ADP +Pi -> 2NAD+ +6ATP + 6H20 |
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Energy balance |
Energy intake - energy expenditure = change in energy
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Positive energy balance |
intake > expenditure Obesity dev, pregnance. recovery from depletion, growth |
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Negative energy balance |
expense > intake Wasting energy, anorexia, voluntary weight loss, starvation |
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Energy requirement in clinical practice |
It is a need to maintain energy balance to prevent: unitentional weight loss leading mortality and morbidity overfeeding -> immediate, serous derangement of biochemistry |
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3 major sources of energy expenditure |
Basic metabolic rate: constant Thermic effect on food: constant Physical activity: variable |
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Daily variation in energy due to |
People consume the constant weight, vol. of food The amount of food is not dependent on the energy density of food Same vol. of food but use food with less energy density -> weight loss Food with high density of energy is more palatable, appealing |
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Schofied's equation |
estimate the energy requirement, calculate Basal Metabolic Rate (BMR) |
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Basal Metabolic Rate |
Provide enough energy to maintain basic functions, and energy is needed for food digestion, activity, maintain BP, growth, repair |
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Total energy expenditure composed of which section? |
BMR>PA>TEF PA is variable |
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Physical activity level |
This incl: posture, job, leisure, -> overall PAL This depends how active they are PAL=Total energy expenditure/ BMR In patient: PAL of 1.25 because they have no physical activity |
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Injury factor |
Increase BMR -> 1 celsius degree leads to increase of 10% BMR requirement Fever, burn Lv energy require depends the degree of injury increase from 20-70% in BMR required |
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Why do we have to reassessed energy expenditure regularly? |
Patient energy intake and expenditure is constantly changing Eg patient in the hospital -> discharge -> recovery |
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Assessment of nutrition stt |
ABCD Anthropometry Biochemical and haematology parameters Clinical and physical assessment Dietary intake |
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Anthropometry |
Height, weight, BMI, waist circumference Body composition eg skinfolds use triceps to measure subcutaneous fat |
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Biochemical and Haematological parameters |
General: plasma proteins, electrolytes, vit, lipids Disease specific indicators: haematology: full blood count Clinical and physical assessment: muscle strength, ability of wounds to heal, appearance, mobility, can they feed themselves? |
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Dietary intake |
measurement of food intake by food diaries, 24hr of food recall, food frequency questionaires change in appetite: duration and severity |
