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120 Cards in this Set
- Front
- Back
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What are the 5 major food groups?
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fruits, vegetables, whole grains, protein, and dairy
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Macronutrients are ____
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nutrients needed in larger amounts
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What are micronutrients?
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nutrients needed in smaller amounts
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What are phytochemicals?
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non-nutrients that contribute to health
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What are antioxidants?
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substance that significantly decreases the adverse effects of free radicals on normal physiological function
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How is MyPlate set up to work?
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1/2 plate fruits and veggies
1/4 plate protein 1/4 plate grains 1 serving low-fat dairy |
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What is the formula for BMI?
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{703x Lbs) / In^2
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Classify BMI for each category: underweight, normal, overweight, obese
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<18.5 = underweight
18.5-24.9 = normal 24.9-29.9 = overweight 30-34.9 = obese stage 1 35-39.9 = obese stage 2 40+ = extreme obesity |
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What factors does metabolic syndrome include?
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3 of the following:
- waist >40 (men) >35 (women) - HTN >130 or >85 dias, or HTN meds - Inc. triglycerides >150 - Low HDL: <40mg/dL men, <50mg/dL women - impaired glucose >100mg/dL |
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What dietary interventions should be used in metabolic syndrome?
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- low fat (<7%)
- low cholesterol (<200mg) - minimize trans fat - high fiber (10-25g) - DASH - more K+, Ca - minimize alcohol |
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Formula for IBW.
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Males = 106+ (6*#in >60")
Female = 100 + (5*#in >60) |
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Formula for ABW.
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For pt's weight > 125% IBW
[0.25(current - IBW0] +IBW |
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Calculate % weight change:
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[(usual wt - current wt) / usual] x 100
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At what rate is weight change safe?
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1 week: 1-2% sig…>2% bad
1 month: 5% sig…>5% bad 3 months: 7.5% sig…>7.5% bad 6 months: 10% sig…>10% bad 1 year: 20% sig…>20% bad |
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How do you calculate energy needs using Harris Benedict Equation?
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1. use ABW in equation,
2. Calculate equation, then multiply by activity factor: - hospital/ bedridden =1.2 - sedentary = 1.3 - healthy/ active = 1.5 |
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What are the protein needs of an unstressed, well-nourished person?
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0.8-1g/kg/day
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What are the protein needs in a post-surgery patient?
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1.5-2g/kg/day
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What are the protein needs of a pt with high catabolic demands (fever, infection, burns, etc)?
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may be >2g/kg/day
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Identify normal labs:
Glucose Potassium Cholesterol Triglycerides HDL LDL |
Glucose: 70-100
K+: 3.5-5 Cholesterol: <200 Triglycerides: <150 HDL >50 (40 men) LDL <100 |
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What are the six classes of nutrients?
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water, vitamins, minerals, proteins, carbohydrates, fats.
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How many calories/g of energy do carbs provide?
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4
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How many calories/g of energy do proteins provide?
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4
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How many calories/g of energy do fats provide?
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9
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What is the best way to meet daily nutritional needs?
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eat a balanced diet
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What is Kwashiorkor's?
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deficiency of protein. Lethargy, apathy, irritability, water/ electrolyte imbalances. Seein in children especially in rice-heavy diet (big belly but no other wasting
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What is Marasmus?
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deficiency of calories AND protein. Significant wasting (aka StARVING).
- Pernicious anemia – red, sore, smooth tongue. Deficiency of B12. No coating on tongue. |
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What is MNT?
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Medical nutrition therapy. intervention of assessment with nutritional diagnosis, plan, implementation, monitoring, and evaluation of progress
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How many amino acids are there?
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20
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How many amino acids are "essential". What does "essential" mean?
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9 essential, must be consumed in diet, body cannot synthesize them
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What are the fat soluble vitamins?
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KADE
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What are the water soluble vitamins?
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B,C, Choline, Folic acid
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What are the B vitamins?
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The Rhythm Nearly Proved Contagious
B1- thiamine B2 - riboflavin B3 - Niacin B6- pyroxidine B12- cobalamine |
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What are the "major" microminerals?
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Ca, P, Mg, K, Na, Cl
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What are the "minor" microminerals?
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Fe, Zn, Cu, Ch, S, I, Manganese, Molybdenum
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Where do you measure waist circumference?
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at the iliac crest, parallel to floor, on expiration
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What factors may influence BMR?
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age, gender, surface area, caloric intake, pregnancy, lactation, fever, thyroid, drugs, exercise
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Which vitamins play a role in homocysteine metabolism?
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B6, B12, folate
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Low B6, B12, and folate are associated with what?
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High homocysteine (increased risk of heart disease, stroke, etc)
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An appropriate regimen for supplementation in osteoporosis would include what?
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Calcium 1,200 to 1,500mg and Vitamin D is 400 IU with low sun exposure).
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Who is at risk for iron deficiency anemia?
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vegetarians, pregnant women, children, infants, menstruating women
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What are good food sources of iron?
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spinach, liver, instant cerials (fortified), soybeans, pumpkin/ squash seeds, white beans, lentils, clams, sardines, duck, prune juice.
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What is the role of sodium in the body?
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Regulation of fluid balance, hydration, cell membrane potentials, etc
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What is teh predominant EXTRAcellular cation?
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Sodium
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What is the prominent INTRAcellular cation
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K+
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What is the UL for sodium?
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2300mg/ day
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What are some strategies to reduce sodium?
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Drink water instead of sodas, don't eat pre-packaged foods, etc
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Pregnant women who are obese are at risk for?
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increased risk for HTN, gestational DM, and developmental delays
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Should overweight women try to lose weight during pregnancy?
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not really
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What are risks for underweight women in pregnancy?
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increased risk of low birthweight baby
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Excess weight gain during pregnancy is associated with what?
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Maternal AND fetal mortality
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What is the cut off for inadequate weight gain in pregnancy?
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< 2lbs/month in 2nd and 3rd trimester
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What is the Kcal change needed in pregnancy?
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1st trimester: little change needed
2nd trimester: +340 kcal/day 3rd trimester: +450 kcal/day |
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What is the expected weight gain pattern in pregnancy?
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1st trimester: 2lbs
2nd trimester, just under 1lb/week 3rd trimester, about 1lb/seek |
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What is the total approximate weight gain during pregnancy? What is the range for pregnant adolescents?
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normally about 30lbs,
adolescents : 28-40lbs |
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What is the expected weight gain during gestation of twins?
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35-45lbs
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Protein need is increased by what percent in pregnant women?
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65%
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How much water should pregnant women drink?
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at least 64oz daily
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How much folic acid is recommended pre-pregnancy?
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400mcg/day
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How much folic acid is recommened during pregnancy?
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600mcg/day
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How much folic acid is recommended 1 month prior to pregnancy in mothers with prevoius complications?
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4000mcg/day
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What is GDM?
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Gestational diabetes mellitis
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When are most women diagnosed with GDM?
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2nd and 3rd trimester
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When should women be screened for GDM?
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24-28 weeks gestation, high risk patients by 16 weeks
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What should women with GDM be screened for after delivery?
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Type II DM
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What are some maternal benefits of breastfeeding?
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return to pre-gravid weight
reduced risk of chronic dieseases decrease accumulation of adipose tissue delayed ovulation cost benefit bonding with baby |
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WHat are some benefits of breastfeeding to the baby?
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nutritional benefits
immunologic benefits, brain development |
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How quickly can a postpartum woman expect to lose weight?
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Average mother: 15lbs in 1st week, then 1-2lbs/month during 4-6 mos lactation
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What are some techniques for monitoring infant growth and nutritional status?
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Head circumference, length, weight, and growth charts
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Overweight infants are above what percentile when compared for age and sex?
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85%
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When are children tested for Type II DM?
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If they are overweight + 2 risk factors:
- fam hx, race (non-caucasian), signs of insulin resistance, |
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Iron deficiency in children is associated with what?
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poor growth and neuro-cognitive development
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What children may need higher supplementation of vitamin D?
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-premies
- dark-skinned children - living higher than 40th parallel |
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What nutritional deficiencies are infants at risk for?
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iron, vitamin D, protein energy
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How many calories should children consume for first 6 months?
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106 cal/kg
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Eggs can be introduced when?
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Age 6mos
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Fresh fruits or pureed fruit juice can be introduced at what age?
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8-10mos
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At 1 year, what foods can be introduced?
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vegetables, whole milk (don't resrict fat)
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What factors are contributing to childhood obesity?
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sugar drinks in schools, unhealthy cafeteria choices, lack of daily physical activity, no safe place to play, limited access to affordable and healthy foods, televiison and media, lack of breastfeeding supprot,
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How much exercise should a child and adolescent get?
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60 minutes activity daily
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How is BMI correlated to obesity, etc in infants?
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<5th percentile= underweight
5th-84th percentile = normal 85th-94th = overweight 95th-97th = obesity 98-99 = moderately obese >99th = severe obesity |
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What is PEM?
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Protein energy malnutrition. Includes marasmus (total nutrient starvation), and khashiorkor (protein deficiency)
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What test do you use to test for vitamin D deficiency?
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measure for 25-hydroxy. [25(OH)D]... aka calcidiol
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What occurs in vitamin A toxicity?
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>30mcg/day; bone & skin changes, hepatomegaly, HA, nausea, vertigo, blurred vision, poor muscle coordination, if consumed from food as beta kerotene not an issue.
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What occurs in vitamin A deficiency?
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most common malnutrition in the world. Perifollicular hyperkeratosis, night blindness progressing to total blindness, impaired immunity, increased mortality from other diseases.
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What occurs in vitamin D deficiency?
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rickets, osteomalacia, leg pain, easily fractured bones, impaired growth, malformed joints,
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What occurs in vitamin D toxicity?
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“hypervitaminosis D”, may cause hypercaclemia, kidney stones, nausea, HA, weakness, weight loss, palpitations, etc. (not an issue with sunlight acquisition). UL = 2000IU
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What is the role of vitamin K on the body?
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- synthesis of 4 blood clotting factors, enables bone growth by binding with calcium
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What drugs affect vitamin K in the body?
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Coumadin/ anticoagulants,
long-term antibiotic use (kills normal bacteria that produce it) |
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What occurs in deficiency of vitamin C?
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– in elderly, burns, alcoholics.
Scurvy (muscle weakness, joint pain, poor wound healing, loose teeth, bleeding gums, fatigue. (“Sailor disease”. |
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What occurs in toxicity of vitamin C?
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>2000mg. diarrhea, nausea, abdominal cramping, oxalate excretion (Kidney stones)
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What occurs in thiamin (B1) deficiency?
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Beriberi – loss of appetite, irritability, weightloss, confusion, nervous and cardiovascular problems. Cardiomyopathy and edema. Wernicke-Korsakoff syndrome is severe form with damaging brain disorder.
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What occurs in niacin (B3) deficiency?
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fatigue, loss of appetite, weakness, mild GI problems, anxiety, irritability, Pellagra: 4D’s Dermatitis, Diarrhea, Dementia, Death.
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What occurs in niacin (B3) toxicity?
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>2000mg/day. Liver damage, hyperglycemia, Nausea, EKG abnormalities, acidosis.
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What occurs in pyroxidine (B6) deficiency?
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Include sore tongue, inflammation of skin, EEG abnormalities, confusion, anemia, pellagra-like dermatitis.
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What occurs in pyroxidine (B6) toxicity?
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UL: 100mg/day, polyneuropathy, photosensitivity, failure of muscle coordination
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What occurs in cyanocobalamin (B12) deficiency?
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may take years to show up due to storeage in liver. Fatigue, depression, memory loss
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Who is most at risk for calcium deficiency?
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post-menopausal women, amenorrheic women, those who don't consume dairy, pregnant women, alcoholics
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What occurs during calcium deficiency?
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hypocalcemia= “pins and needles” in hands and feet, tetany, convulsions, osteoporosis.
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What occurs during calcium toxicity?
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dehydration, lethargy, nausea, anorexia, death, renal failure, kidney stones.
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Who is most at risk for calcium deficiency?
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post-menopausal women, amenorrheic women, those who don't consume dairy, pregnant women, alcoholics
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Who is most at risk for magnesium deficiency?
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asthmatics, pts on antidiuretics or cancer meds, severe vomiting, hyperparathyroidsm, alcoholics, those with low Ca and K+, DM and pre-DM, and the elderly
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What occurs during calcium deficiency?
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hypocalcemia= “pins and needles” in hands and feet, tetany, convulsions, osteoporosis.
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What occurs in magnesium deficiency?
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: rare..., fatigue, lethargy, weakness, poor appetite, speech, anemia. Irregular heart beats, tremors, convulsions.
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What occurs during calcium toxicity?
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dehydration, lethargy, nausea, anorexia, death, renal failure, kidney stones.
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Who is at risk for phosphorus deficiency?
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alcoholics in withdrawal, DKA, those who stop taking aluminum hydroxide
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Who is most at risk for magnesium deficiency?
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asthmatics, pts on antidiuretics or cancer meds, severe vomiting, hyperparathyroidsm, alcoholics, those with low Ca and K+, DM and pre-DM, and the elderly
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what occurs in phosphorus deficiency?
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decreased LOC, decreased ATP production, weakness, anorexia, bone pain, rickets, osteomalacia.
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What occurs in magnesium deficiency?
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: rare..., fatigue, lethargy, weakness, poor appetite, speech, anemia. Irregular heart beats, tremors, convulsions.
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Who is at risk for phosphorus deficiency?
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alcoholics in withdrawal, DKA, those who stop taking aluminum hydroxide
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what occurs in phosphorus deficiency?
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decreased LOC, decreased ATP production, weakness, anorexia, bone pain, rickets, osteomalacia.
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Who is most at risk for iron deficiency?
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pregnant women, infants, menstruating women,
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What is the most common nutritional disorder in the world
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Iron deficiency
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What occurs in iron deficiency?
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weakness, fatigue, poor work performance, adverse outcomes, developmental delays, cognitive impairment.
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Who is at risk for sodium deficiency?
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Very rare, those with prolonged vomiting or diarrhea, or excessive sweating. some types of kidney disease
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What occurs in sodium deficiency?
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vomiting, headache, diarrhea, muscle cramps , vomiting, fainting, fatigue, death.
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Who is at risk for potassium deficiency?
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patients on diuretics, severe vomiting, diarrhea, anorexia, bulemia, kidney disease, laxative use, excessive sweating
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What occurs in potassium deficiency?
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weakness, cramps, irregular heart rhythms, paralysis
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What occurs in potassium toxicity, what is it called?
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Hyperkalemia: risks in renal failure or supplementation, symptoms include tingling in extremities, cardiac arrhythmias, etc
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Who is at risk for iodine deficiency?
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Those with food not supplemented with iodine or low iodine available in soil or water.
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What occurs in iodine deficiency?
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goiter (enlarged thyroid), congenital hypothyroid, dry skin, thick lips, enlarged tongue, lethargy, reduced growth, cretinism.
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