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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.
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Define Nutrients:
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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.
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Macro Vs. Micro Nutrients
Examples of Each |
Macro - body requires in large amounts
-Protein, CHO, and fats Micro - small amounts - Vitamins and minerals |
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What are Energy-Yielding Nutrients?
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Break down to yield energy the body can use...Carbs, fats, and proteins
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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 |
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What is energy and what kind of energy is in food?
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The capacity to do work - the energy in food is chemical which the body can convert to mechanical, electrical, or heat energy.
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Energy Density:
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A measure of the energy a food provides relative to the amount of food
ex: 500kcal/450g = 1.1kcal/g |
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Kcal
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One Kcal is the amount of heat necessary to raise the temperature of 1 kg of water 1 degree Celsius.
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American Diet Recommendations:
CHO Protein Fat |
CHO = 45-65%
Protein = 10-35% Fat = 20-35% |
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Why do we make the food choices we make?
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Availability, personal choice, cultural influence, social setting, peer groups, etc.
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How much does the average American get of the following?
CHO Protein Fat |
CHO = 52%
Protein = 15% Fat = 33% |
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Malnutrition:
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Condition caused by excess or deficient food energy or nutrient intake or an imbalance of nutrients.
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Undernutrition:
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Deficient energy or nutrients (thin)
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Overnutrition:
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Excess energy or nutrients (obese)
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Nutrition Assessment:
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Analysis of a person's nutrition status
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Anthropometric:
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Measurement of height and weight compared to standards.
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Body Mass Index
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Weight (kg) / Height (m^2)
weight(lbs)/2.2=kg height(in)x2.54cm/100=^2 |
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What are the overweight and obese BMI's for adults and children?
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Adult Children
over 25 85th% obese 30 95th% |
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Healthy People 2010
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A national public health initiative
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Chronic Diseases:
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Slow progression and long duration
ex: heart disease, cancer, diabetes |
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Risk Factor:
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A condition or behavior associated with an elevated frequency of a disease but not proved to be casual
ex: smoking, overweight, poor diet, etc |
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Epidemiology
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Determines the incidence and distribution of diseases in a population
-exposures -distribution -outcome |
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Epidemiological studies include what kind of research methods?
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-Cross-Sectional
- Cohort -Case-Control |
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Cross-Sectional Study
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Measuring exposure and disease at the same time
-what came first the chicken or the egg? |
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Case-Control Study
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Researchers compare people who do and do not have the given condition/disease, closely matching them in age, gender, etc.
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Cohort Study
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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 |
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What was the purpose of the Framingham Heart Study?
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To study the incidence and prevalence of cardiovascular disease and its risk factors, trends, and familial patterns.
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What particular kind of study was the Framingham Heart Study?
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Cohort Study (initiated in 1948)
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Significant Milestones in the Framingham Heart Study:
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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 |
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Dietary Reference Intakes (DRIs)
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A set of nutrient intake values for healthy people
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Recommended Dietary Allowances (RDAs)
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The average daily amount of nutrient considered adequate to meet the known nutrient needs of 98% of the population
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Estimated Average Requirement (EAR)
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Average amount of each nutrient sufficient for half the population
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Adequate Intakes (AI)
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Average amount of a nutrient that healthy people consume
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Tolerable Upper Intake Levels (UL)
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Maximum daily amount of a nutrient that appears safe for most healthy people (beyond which is bad)
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What are the 5 major food groups for "My Pyramid"?
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1. Grains
2. Vegetables 3. Fruit 4. Dairy 5. Meat, poultry, fish, legumes |
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What regulates food labeling with the exception of meat and poultry products?
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FDA
-the USDA regulates meat and poultry product labeling |
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What are some of the basics that food labels contain?
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-Name
-Net contents/weight -Date should be sold by -Name/place of manufacturer |
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What are some of the most common causes of premature death (before 65 years)?
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-Smoking
-Unhealthy diets -Lack of exercise -Uncontrolled hypertension -Poor stress control |
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What are the 2 main goals of Healthy People 2010?
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1. Increase the quality and years of healthy life
2. Eliminate health disparities |
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What is NHANES?
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National Health And Nutrition Examination Survey - collects info on the health and nutritional status of Americans.
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What kind of study is NHANES?
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Cross-sectional - measuring disease and exposure at the same time
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What kinds of questions are on the NHANES survey?
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Knowledge, attitude, behavior, and food/nutrient consumption questions.
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What are the life expectancies for males and females?
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Males = 72.5 years
Females = 78.9 years |
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What has been said about income and the length of life?
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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.
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What are some health disparities that Healthy People 2010 would like to eliminate?
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Race and Ethnic disparities
Income and Education disparities |
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African American Vs. Caucasian disparities:
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-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 |
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What are 3 ways Healthy People 2010 wants to eliminate disparities due to low income/education?
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-Increased access to medical care
-Live in safer neighborhoods -Greater opportunity to engage in health-promoting behaviors |
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Nutrition Screening (not to be confused with Nutrition Assessment)
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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.
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What is JCAHO and what do they have to do with Nutrition Screening?
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Joint Commission on Accreditation of Healthcare Organizations
They require screening to be conducted on each patient within 24 hours of admission. |
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What are some Nutrition Screening tools?
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1. Mini Nutritional Assessment (MNA)
2. Subjective Global Assessment (SGA) |
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Mini Nutritional Assessment
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Developed to assess the nutrition status as a part of the standard geriatric evaluation in clinics, nursing homes, and hospitals.
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What are the two parts to the MNA?
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-Subjective clinical evaluation
-Objective laboratory, anthropometric, and dietary evaluation |
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What are the 4 main things the MNA concerns itself with?
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-Weight loss in the past 3 months
-Food intake in the past 3 months -Mobility Problems -Dementia |
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Subjective Global Assessment - 5 parameters:
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1. Weight Change
2. Dietary Intake 3. Gastrointestinal Symptoms 4. Functional Impairment 5. Physical Examination |
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What are the features of the Physical Examination?
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Muscle wasting, subcutaneous fat loss, and edema
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Individual Nutrition Assessment
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1. Anthropometrics
2. Biochemical/Laboratory Parameters 3. Clinical/Physical 4. Dietary Intake |
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Biochemical Analysis - Hematology
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Indication of anemia and types of anemia
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Iron Deficiency Anemia
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Decrease in RBC count, decrease in iron, decrease in mean corpuscular volume (MCV) - microcytic anemia
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Anemia due to B12 or Folic Acid Deficiency
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Decrease in RBC count, increase in mean corpuscular volume (MCV) - macrocytic anemia
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Biochemical Analysis - Serum Proteins
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Albumin, prealbumin, transferrin, C-reactive protein
-monitor over a long period of time |
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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. |
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What are the half-life's for albumin and prealbumin?
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Albumin = 21 days (total body turnover)
Prealbumin = 2 days |
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Liver disease patients' serum proteins are not representative of dietary intake. Why?
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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.
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Dual X-Ray Absopitometry
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Measures body composition: % body fat, % muscle, and bone mass
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Biochemical Analysis - Serum Electrolytes
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Sodium, potassium, and chloride
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What are serum electrolytes affected by?
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medications, kidney disease, and hydration
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Biochemical Analysis - Glucose, what is it an indication of?
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Indication of Stress or Diabetes
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Biochemical Analysis - Glycosylated hemoglobin (HgA1c), what is it an indication of?
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Indication of elevated glucose over a long period of time
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Biochemical Analysis - What are Urea Nitrogen (BUN) and Creatinine (Cr) an indication of?
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Hydration status and kidney disease
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What is a reason that BUN would be elevated?
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Due to renal insufficiency
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What should HgA1c be?
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6-7%
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What are some physical signs of malnutrition?
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-Hair - falling out, brittle
-Lips/Gums - bleeding, sores (Vitamin C) -Skin - dry, rough, decubitus, ulcers, loose, swelling (Vitamin B) -Nails - color |
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What are 3 Dietary Assessment methods?
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24 Hour Recall
Food Frequency Questionnaire Food Record |
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24 Hour Recall Dietary Assessment
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The individual states all the foods and beverages consumed in the past 24 hours.
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What are the pros and cons of the 24 Hour Recall Dietary Assessment?
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Pros: Gives general idea of food habits
Cons: Does not address fluctuations in food intake or seasonal variations (no indication of adequacy) |
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Food Frequency Questionnaire Dietary Assessment
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Survey of foods and beverages routinely consumed over a period of time (usually 1 year)
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Food Record Dietary Assessment
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Record all foods eaten in a specific period of time
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What are 2 cons of the Food Record Dietary Assessment?
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1. Influences Intake
2. May not indicate long-term intake |