Nutritional Science

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what is parental nutrition

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Parental nutrition is feeding a person intravenously and nutrition is provided for patients who are unable to use the GI tract and who are either malnourished or likely to become so.

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PPN vs. TPN

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PPN is peripheral parenteral nutrition and is the infusion of nutrient solutions into peripheral veins, usually a vein in the arm or back of the hand. TPN is total parenteral nutrition and is the infusion of nutrient solutions into central veins.

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3. Describe the nutrients found in a parenteral solution.

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Parenteral solutions provide the combinations of amino acids, carbohydrates, lipids, vitamins, and minerals that are best suited to meet patient’s requirements.

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1. Discuss the importance of water. What are some key functions? What are sources of water? How is water lost from the body?

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-Carries nutrients and waste products throughout body
-Maintains the structure of large molecules such as proteins and glycogen
-Participates in metabolic reactions
-Serves as solvent for minerals, vitamins, amino acids, glucose, and many other small molecules so that they can participate in metabolic activities
-Regulates body temp
-Maintains blood volume
-makes up 60% of adults body weight

Sources: obviously water itself, but also, really any foods (fruit, vegetables, crackers, meats, etc.)

Lost from body: lungs from vapor, sweat, urine, GI tract

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3. Discuss fluid balance. What are sources of hydration and how much do these sources typically contribute? How much fluid is lost form the body and how much do these contribute?

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If too much water were to enter the cells, they might rupture, if too much water were to leave, they would collapse
1450-2800 ml is lost from the body through kidneys, skin, lungs, and GI tract

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4. Identify caffeine sources in the diet.

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People who drink caffeine lose a little more fluid than when drinking water because caffeine acts as a diuretic.

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1. Describe the current prevalence of obesity in the United States. How does Missouri compare?

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Obesity in the United States continues to rise dramatically. In the past two decades it has increased in every state, in both genders, all ages, races, and educational levels. 66% of all adults in US are considered overweight or obese.

Missouri, highest category of obesity, 31.4% obese

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2. Define BMI. What are the four categories noted in class?

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(body mass index)- index of persons weight, in comparison to height
Underweight: <18.5
Healthy weight: 18.5-24.9
Overweight: 25-29.9
Obese: >30

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3. Differentiate between central and lower obesity. What is it and how does it impact the risk of disease?

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Central- excess fat around the trunk of the body (upper body fat)
Lower- excess fat around hips of the body

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4. Discuss fat cell development.

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When “energy in” exceeds “energy out,” the excess energy is stored in the fat cells if adipose tissue. The amount of fat in a person’s body reflects both the number and the size of the fat cells. Obese people have more fat cells than healthy-weight people; their fat cells are also larger. When cells enlarge they expand in size, when the cells enlarge, their numbers increase, thus developing obesity.

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5. List diseases/conditions for which obesity is a contributor or risk factor.

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Heart disease
Type 2 diabetes mellitus
HTN
Stroke
Some cancers
Osteoarthritis
Gallbladder disease
Sleep apnea
Nonalcoholic fatty liver
And much more

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6. Explain “weight cycling.” Why is this of concern? What leads to weight cycling?

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I am fat and unhappy->I want to be happy->if I lose weight. I will be happy->I try too hard to reach an unrealistic goal->I lose a little weight but then regain it (and sometimes more)
This is a concern because people never keep their weight off and regain it back and sometimes gain even more. Depression and physcological burdens lead to weight cycling.

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7. Identify guidelines to evaluate the “soundness” of a diet or weight-loss program.

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½-2 pounds per week
Don’t use drugs to lose weight

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1. Describe energy balance. How does energy balance relate to a person’s weight status?

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When the energy consumed equals the energy expanded. If more energy is taken in then expended, a person gains weight. If more energy is energy is expended then taken in, a person loses weight.

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2. Define the following: appetite, hunger, satiation, satiety

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Appetite: the integrated response to the sight, smell, thought, or taste of food that initiates or delays eating.
Hunger: the painful sensation caused by a lack of food that initiates food-seeking behavior
Satiation: the feeling of satisfaction and fullness that occurs during a meal and halts eating. Satiation determines how much food is consumed during a meal.
Satiety: The feeling of fullness and satisfaction that occurs after a meal and inhibits eating until the next meal. Satiety determines how much time passes between meals.

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3. Discuss the controls of food intake from hunger to satiety.

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Satiety continues to suppress hunger and allows a person to not eat a while. Satiation tells us to “stop eating,” satiety reminds us to “not start eating again.”

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4. Identify and discuss the four components of energy expenditure. What factors influence BMR and what effect do these factors have on BMR?

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Basal Metabolism: the energy needed to maintain life when a body is at complete digestive, physical, and emotional rest.
Physical activity: voluntary movement of the skeletal muscles and support system.
Thermic Effect of food: An estimation of the energy required to process food (digest, absorb, transport, metabolize, and store ingested nutrients).The process of a person eating and the GI tract muscles speed up their rhythmic contractions, the cells that manufacture and secrete digestive juices begin their tasks, and some nutrient are absorbed by active transport.
Adaptive thermogenesis:the regulated production of heat in response to environmental changes in temperature and diet (i.e shivering when cold)

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5. Identify health risks associated with body weight and body fat.

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Diabetes, hypertension, cardiovascular disease, sleep apnea, osteoarthritis, some cancers, gallbladder disease, kidney stones, respiratory problems, infertility, and complications in pregnancy and surgery.