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78 Cards in this Set

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Define Nutrition:
The science of foods and the nutrients and other substances they contain, and of their actions within the body.
Define Nutrients:
Substances the body uses for the growth, maintenance, and repair of its tissues - can be essential (nutrients must be obtained from food) or non-essential.
Macro Vs. Micro Nutrients
Examples of Each
Macro - body requires in large amounts
-Protein, CHO, and fats
Micro - small amounts
- Vitamins and minerals
What are Energy-Yielding Nutrients?
Break down to yield energy the body can use...Carbs, fats, and proteins
Nutrient Energy Content of:
CHO, Protein, Fats/Lipids, and Alcohol (in kcal/g)
CHO 4 kcal/g
Protein 4 kcal/g
Fat/Lipid 9 kcal/g
Alcohol 7 kcal/g
What is energy and what kind of energy is in food?
The capacity to do work - the energy in food is chemical which the body can convert to mechanical, electrical, or heat energy.
Energy Density:
A measure of the energy a food provides relative to the amount of food

ex: 500kcal/450g = 1.1kcal/g
Kcal
One Kcal is the amount of heat necessary to raise the temperature of 1 kg of water 1 degree Celsius.
American Diet Recommendations:
CHO
Protein
Fat
CHO = 45-65%
Protein = 10-35%
Fat = 20-35%
Why do we make the food choices we make?
Availability, personal choice, cultural influence, social setting, peer groups, etc.
How much does the average American get of the following?
CHO
Protein
Fat
CHO = 52%
Protein = 15%
Fat = 33%
Malnutrition:
Condition caused by excess or deficient food energy or nutrient intake or an imbalance of nutrients.
Undernutrition:
Deficient energy or nutrients (thin)
Overnutrition:
Excess energy or nutrients (obese)
Nutrition Assessment:
Analysis of a person's nutrition status
Anthropometric:
Measurement of height and weight compared to standards.
Body Mass Index
Weight (kg) / Height (m^2)

weight(lbs)/2.2=kg
height(in)x2.54cm/100=^2
What are the overweight and obese BMI's for adults and children?
Adult Children

over 25 85th%

obese 30 95th%
Healthy People 2010
A national public health initiative
Chronic Diseases:
Slow progression and long duration

ex: heart disease, cancer, diabetes
Risk Factor:
A condition or behavior associated with an elevated frequency of a disease but not proved to be casual

ex: smoking, overweight, poor diet, etc
Epidemiology
Determines the incidence and distribution of diseases in a population
-exposures
-distribution
-outcome
Epidemiological studies include what kind of research methods?
-Cross-Sectional

- Cohort

-Case-Control
Cross-Sectional Study
Measuring exposure and disease at the same time

-what came first the chicken or the egg?
Case-Control Study
Researchers compare people who do and do not have the given condition/disease, closely matching them in age, gender, etc.
Cohort Study
Researchers analyze data collected from a selected group of people at intervals over a certain period of time.

ex: measure BMI at ages 3, 5, and 9
What was the purpose of the Framingham Heart Study?
To study the incidence and prevalence of cardiovascular disease and its risk factors, trends, and familial patterns.
What particular kind of study was the Framingham Heart Study?
Cohort Study (initiated in 1948)
Significant Milestones in the Framingham Heart Study:
1960: Smoking is a risk factor
1961: Chol. level, bp, ecg abnormality
1967: Activity to reduce risk of CVD
1976: Menopause increase risk
1978: Psycosocial factors affect
1988: High HDL chol reduce risks
Dietary Reference Intakes (DRIs)
A set of nutrient intake values for healthy people
Recommended Dietary Allowances (RDAs)
The average daily amount of nutrient considered adequate to meet the known nutrient needs of 98% of the population
Estimated Average Requirement (EAR)
Average amount of each nutrient sufficient for half the population
Adequate Intakes (AI)
Average amount of a nutrient that healthy people consume
Tolerable Upper Intake Levels (UL)
Maximum daily amount of a nutrient that appears safe for most healthy people (beyond which is bad)
What are the 5 major food groups for "My Pyramid"?
1. Grains
2. Vegetables
3. Fruit
4. Dairy
5. Meat, poultry, fish, legumes
What regulates food labeling with the exception of meat and poultry products?
FDA

-the USDA regulates meat and poultry product labeling
What are some of the basics that food labels contain?
-Name
-Net contents/weight
-Date should be sold by
-Name/place of manufacturer
What are some of the most common causes of premature death (before 65 years)?
-Smoking
-Unhealthy diets
-Lack of exercise
-Uncontrolled hypertension
-Poor stress control
What are the 2 main goals of Healthy People 2010?
1. Increase the quality and years of healthy life

2. Eliminate health disparities
What is NHANES?
National Health And Nutrition Examination Survey - collects info on the health and nutritional status of Americans.
What kind of study is NHANES?
Cross-sectional - measuring disease and exposure at the same time
What kinds of questions are on the NHANES survey?
Knowledge, attitude, behavior, and food/nutrient consumption questions.
What are the life expectancies for males and females?
Males = 72.5 years

Females = 78.9 years
What has been said about income and the length of life?
Those with an annual income greater than $25,000/yr can expect to live 3-7 years longer than those with incomes less than $10,000/yr.
What are some health disparities that Healthy People 2010 would like to eliminate?
Race and Ethnic disparities

Income and Education disparities
African American Vs. Caucasian disparities:
-Infant mortality 2x greater
-Heart disease, 40% higher
-All cancers, 30% higher
-Breast cancer, higher
-Death rate from HIV 7x higher
-Death rate from homicide 6x greater
What are 3 ways Healthy People 2010 wants to eliminate disparities due to low income/education?
-Increased access to medical care

-Live in safer neighborhoods

-Greater opportunity to engage in health-promoting behaviors
Nutrition Screening (not to be confused with Nutrition Assessment)
A process to identify an individual who is malnourished or who is at risk for malnutrition to determine if a detailed nutrition assessment is needed.
What is JCAHO and what do they have to do with Nutrition Screening?
Joint Commission on Accreditation of Healthcare Organizations

They require screening to be conducted on each patient within 24 hours of admission.
What are some Nutrition Screening tools?
1. Mini Nutritional Assessment (MNA)
2. Subjective Global Assessment (SGA)
Mini Nutritional Assessment
Developed to assess the nutrition status as a part of the standard geriatric evaluation in clinics, nursing homes, and hospitals.
What are the two parts to the MNA?
-Subjective clinical evaluation
-Objective laboratory, anthropometric, and dietary evaluation
What are the 4 main things the MNA concerns itself with?
-Weight loss in the past 3 months
-Food intake in the past 3 months
-Mobility Problems
-Dementia
Subjective Global Assessment - 5 parameters:
1. Weight Change
2. Dietary Intake
3. Gastrointestinal Symptoms
4. Functional Impairment
5. Physical Examination
What are the features of the Physical Examination?
Muscle wasting, subcutaneous fat loss, and edema
Individual Nutrition Assessment
1. Anthropometrics
2. Biochemical/Laboratory Parameters
3. Clinical/Physical
4. Dietary Intake
Biochemical Analysis - Hematology
Indication of anemia and types of anemia
Iron Deficiency Anemia
Decrease in RBC count, decrease in iron, decrease in mean corpuscular volume (MCV) - microcytic anemia
Anemia due to B12 or Folic Acid Deficiency
Decrease in RBC count, increase in mean corpuscular volume (MCV) - macrocytic anemia
Biochemical Analysis - Serum Proteins
Albumin, prealbumin, transferrin, C-reactive protein

-monitor over a long period of time
Where are serum proteins synthesized and what are they affected by?
(SEE DIAGRAM IN NOTES)
-Synthesized in the liver

-Affected by nutritional status, hydration status, inflammatory status, liver, and kidney disease.
What are the half-life's for albumin and prealbumin?
Albumin = 21 days (total body turnover)

Prealbumin = 2 days
Liver disease patients' serum proteins are not representative of dietary intake. Why?
Because the liver thinks it has an infection and its trying to fight off the infection so it doesn't synthesize albumin and prealbumin, but C-Reactive protein and Acute phase protein instead.
Dual X-Ray Absopitometry
Measures body composition: % body fat, % muscle, and bone mass
Biochemical Analysis - Serum Electrolytes
Sodium, potassium, and chloride
What are serum electrolytes affected by?
medications, kidney disease, and hydration
Biochemical Analysis - Glucose, what is it an indication of?
Indication of Stress or Diabetes
Biochemical Analysis - Glycosylated hemoglobin (HgA1c), what is it an indication of?
Indication of elevated glucose over a long period of time
Biochemical Analysis - What are Urea Nitrogen (BUN) and Creatinine (Cr) an indication of?
Hydration status and kidney disease
What is a reason that BUN would be elevated?
Due to renal insufficiency
What should HgA1c be?
6-7%
What are some physical signs of malnutrition?
-Hair - falling out, brittle
-Lips/Gums - bleeding, sores (Vitamin C)
-Skin - dry, rough, decubitus, ulcers, loose, swelling (Vitamin B)
-Nails - color
What are 3 Dietary Assessment methods?
24 Hour Recall

Food Frequency Questionnaire

Food Record
24 Hour Recall Dietary Assessment
The individual states all the foods and beverages consumed in the past 24 hours.
What are the pros and cons of the 24 Hour Recall Dietary Assessment?
Pros: Gives general idea of food habits

Cons: Does not address fluctuations in food intake or seasonal variations (no indication of adequacy)
Food Frequency Questionnaire Dietary Assessment
Survey of foods and beverages routinely consumed over a period of time (usually 1 year)
Food Record Dietary Assessment
Record all foods eaten in a specific period of time
What are 2 cons of the Food Record Dietary Assessment?
1. Influences Intake

2. May not indicate long-term intake