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36 Cards in this Set
- Front
- Back
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... and ... determine largely what we need to consume.
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age and disease states
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The average energy intake is about ...-... kcal/d for American men and about ...-... kcal/d for American women, although these estimates vary with body size and activity level.
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2000-2800
1400-1800 |
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what are the 9 essential AAs?
All AAs can be used for energy, and certain AAs (e.g., ...) can also be used for gluconeogenesis |
histidine
isoleucine leucine lysine methionine/cystine phenylalanine/tyrosine threonine tryptophan valine alanine |
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When energy intake is inadequate, ... intake must be increased, since ingested amino acids are diverted into pathways of glucose synthesis and oxidation. In extreme energy deprivation, ...-calorie malnutrition may ensue
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protein
protein |
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Proteins and AAs:
-Necessary for nearly all biochemical reactions. -Enzymes, antibodies, hormones, structural elements. -Needs ... with stress, protein depletion, pregnancy, lactation. -Restriction in ... and ... failure. |
increase
renal and hepatic |
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Protein requirements:
Adults -RDA: ... g/kg (... g/lb) -... and ... g good-quality protein/kg Elderly -...-... g/kg high-quality protein If you are more active, you need more protein |
0.8 (0.36)
0.65-0.83 1.0-1.25 |
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Protein Requirements:
Muscle building: ...-... g/lb* -High protein diet led to 5- 10% more muscle gain than RDA. -... protein: *Highest bcaa (branched chain AA) content. *Enhances glutathione (impt for GI fx) production. -... protein (considered less biologically active) |
0.5-1.0
Whey Soy |
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Lack of protein has been shown to correlate with a lack of response to ... medications. When protein is added back into their diets, they respond to the medication again.
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anti-depressant
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...:
Reduces glucose needs by >75%. Appetite suppression. Diuresis. Living on protein suppresses the appetite. Need to drink lots more water when increasing consumption of protein. |
Ketosis
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... – age-related loss of skeletal muscle mass
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sarcopenia
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Studies have shown that consumption of ... protein rather than animal protein significantly decreased serum concentrations of total cholesterol, LDL cholesterol and triglycerides.
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soy
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general ... loss is a daily thing. Stool, evaporation, urine, indications in disease processes (fever increases need for more ...)
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water
water |
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For adults, ...-... mL water per kcal of energy expenditure is sufficient under usual conditions to allow for normal variations in physical activity, sweating, and solute load of the diet. Water losses include :
-...-... mL/d in the feces, -...-... mL/d by evaporation or exhalation, and, depending on the renal solute load, -... mL/d in the urine. |
1.0-1.5
50-100 500-1000 1000 |
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Water:
If external losses increase, intakes must increase accordingly to avoid under hydration. -Fever increases water losses by approximately ... mL/d per °C; -Diarrheal losses vary but may be as great as ... L/d with severe diarrhea. -Heavy sweating -Vomiting -Obligatory urine outputs can compromise hydration status when there is inadequate intake or when losses increase in disease or kidney damage. |
200
5 |
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... have high requirements for water because of their large ratio of surface area to volume, the limited capacity of the immature kidney to handle high renal solute loads, and their inability to communicate their thirst.
During lactation, milk production increases water requirements by approximately ... mL/d, or ... mL for each mL of milk produced. Special attention must be paid to the water needs of the ..., who have reduced total body water and blunted thirst sensation, and may be taking diuretics. |
Infants
1000 1 elderly |
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Estimated Average Requirement (EAR):
When florid manifestations of the classic dietary deficiency diseases such as rickets, scurvy, xerophthalmia, and protein-calorie malnutrition were common, nutrient adequacy was inferred from the absence of their clinical signs. Later, it was determined that ... and other changes were evident long before the clinical deficiency became apparent. |
biochemical
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Estimated average requirement:
Consequently, criteria of nutrient adequacy are now based on ... when they are available. Priority is given to sensitive biochemical, physiologic, or behavioral tests that reflect early changes in regulatory processes or maintenance of body stores of nutrients. Current definitions focus on the amount of a nutrient that minimizes the risk of .... |
biologic markers
chronic degenerative diseases |
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Estimated Average Requirement:
The EAR is the amount of a nutrient estimated to be adequate for ... of the healthy individuals of a specific age and sex. The types of evidence and criteria used to establish nutrient requirements vary by nutrient, age, and physiologic group. The EAR ... useful clinically for estimating nutrient adequacy in individuals because it is a median requirement for a group; 50% of individuals in a group fall below the requirement and 50% fall above it. Thus, a person with a usual intake at the EAR has a 50% risk of an inadequate intake. |
half
is not |
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The ... is the nutrient-intake goal for planning diets of individuals; it is used in the MyPyramid food guide of the U.S. Department of Agriculture (USDA), therapeutic diets, and descriptions of the nutritional content of processed foods and dietary supplements.
The nutrient content in a food is stated by weight or as a percentage of the daily value (DV), a variant of the RDA that, for an adult, represents the highest RDA for an adult consuming 2000 kcal/d, of average workload without disease. |
RDA
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Recommended Dietary Allowances:
The RDA is the average daily dietary intake level that meets the nutrient requirements of nearly all ... persons of a specific sex, age, life stage, or physiologic condition (such as pregnancy or lactation). The RDA is defined statistically as ... standard deviations (SD) above the EAR to ensure that the needs of most individuals are met. |
healthy
2 |
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Adequate intake:
It is not possible to set an RDA for some nutrients that do not have an established .... In this circumstance, the AI is based on observed, or experimentally determined, approximations of nutrient intakes in healthy people. In the DRIs established to date, ... rather than RDAs are proposed for infants up to age 1 year, as well as for calcium, chromium, vitamin D, fluoride, manganese, pantothenic acid, biotin, choline, sodium, chloride, potassium, and water for persons of all ages. |
EAR
AIs |
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Tolerable Upper Levels of Nutrient Intake:
The lack of a UL does not mean that the risk of adverse effects from high intake is nonexistent. Individual nutrients in foods that most people eat rarely reach levels that exceed the UL. Nutritional supplements provide more concentrated amounts of nutrients per dose and, as a result, pose a greater potential risk of .... Nutrient supplements are labeled with "Supplement Facts" that express the amount of nutrient in absolute units or as the percent of the DV provided per recommended serving size. |
toxicity
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Factors altering nutrient needs:
The DRIs (dietary reference intakes) are affected by: -... -... -rate of ... -... and lactation -... activity -composition of ... -coexisting ... -drugs Some of these criteria can change what people need nutritionally |
age
sex growth pregnancy physical diet diseases |
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FACTORS ALTERING NUTRIENT NEEDS:
Dietary composition affects the biologic availability and utilization of nutrients. For example, the absorption of iron may be impaired by high amounts of ... or lead; non-heme iron uptake may be impaired by the lack of ... and amino acids in the meal. |
calcium
ascorbic acid |
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Which has higher biological values, animal foods or plant proteins?
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animal foods
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Disease:
-Specific dietary deficiency diseases include protein-calorie malnutrition; iron, iodine, and vitamin A deficiency; -... due to vitamin B12 or folic acid deficiency; -vitamin D-deficiency ...; -... due to lack of ascorbic acid; -... due to lack of thiamine; and -... due to lack of niacin and protein |
megaloblastic anemia
rickets scurvy beriberi pellagra |
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Disease:
-Imbalances in nutrient intakes are recognized as risk factors for certain chronic degenerative diseases, -such as saturated and trans-fat and cholesterol in ... disease; -sodium in ...; -... in hormone-dependent endometrial and breast cancers; and ethanol in .... |
coronary artery
hypertension obesity alcoholism |
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Disease:
The etiology and pathogenesis of these disorders are ..., and diet is only one of many risk factors. Osteoporosis, for example, is associated with calcium and Vitamin D deficiency as well as: Risk factors related to environment (e.g., smoking, sedentary lifestyle), physiology (e.g., estrogen deficiency), genetic determinants (e.g., defects in collagen metabolism), and drug use (chronic steroids) |
multifactorial
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Dietary assessment:
In clinical situations, nutritional assessment is an iterative process that involves (1) screening for ...; (2) assessing ... and ... intake, and establishing the absence or presence of ... and its possible causes; and (3) planning for the most appropriate .... Some disease states and drugs* affect the bioavailability, requirements, utilization, or excretion of specific nutrients. In these circumstances, specific measurements of various nutrients may be required to ensure adequate replacement |
malnutrition
food and dietary supplement malnutrition nutritional therapy |
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Dietary assessment:
Diagnoses with known nutritional implications -... disease, any disease affecting the gastrointestinal tract, alcoholism, and others); -present therapeutic dietary prescription; -Chronic poor appetite; presence of chewing and swallowing problems or major food intolerances; - Need for assistance with preparing or shopping for food, eating, or other aspects of self care; and social isolation. -... of nutrition status should occur periodically in hospitalized patient at least once every week. |
metabolic
Reassessment |
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Acute care settings:
Acutely ill patients with diet-related diseases such as diabetes require assessment because an inappropriate diet may exacerbate these conditions and adversely affect other therapies. Abnormal biochemical values [serum albumin levels <... g/L (<... mg/dL); serum cholesterol levels <... mmol/L (<... mg/dL)] are nonspecific but may also indicate a need for further nutritional assessment. |
35
3.5 3.9 150 |
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Acute care settings:
Most therapeutic diets offered in hospitals are calculated to meet individual nutrient requirements and the RDA. However, there are exceptions including clear liquids, some full liquid diets, and test diets, which are inadequate for several nutrients and should not be used, if possible, for more than 24 h. As much as half of the food served to hospitalized patients ... eaten, so it cannot be assumed that the intakes of hospitalized patients are adequate. |
is not
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The outpatient dietary assessment should review the adequacy of present and usual food intakes, including vitamin and mineral supplements, ..., and alcohol, as all of these may affect the patient's nutritional status.
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medications
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Assessment of Nutritional Status:
Diet diary BMI: ... x wt(lb)/height(in)/height(in) Physical exam -... distribution -Evidence of nutritional ... Protein status -Skeletal protein -Visceral proteins -Nitrogen balance |
704.5
Fat deficiencies |
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Measures of Visceral Adipose Tissue:
Waist circumference -Men >= ... in -Women >= ... in Waist/hip ratio -Men > ... -Women > ... |
40
35 0.8 1.0 |
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The ... is independently associated (is a strong factor) with the risk to CHD in women.
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Waist/Hip ratio
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