Term
|
Definition
| Substance that must be obtained from the diet because the body cannot make it in sufficient quantity to meet its need |
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Term
| Essential Nutrients for humans |
|
Definition
water
calories
8-10 essential amino acids
essential fatty acids
13 vitamins (organic)
16-20 minerals (inorganic) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
Dietary reference intakes:
EAR
RDA
AI
UL |
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Term
|
Definition
Estimated Average Requirement:
average value which is used as as tarting point for calculating an RDA.
mean Intake for a healthy population in that life and stage group. |
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|
Term
| RDA: reference dietary allowance |
|
Definition
specific for different populations and covers more than 97% of that population.
EAR + 2 SDs |
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Term
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Definition
| recommended intake level for use when an RDA is not available; most commonly seen for young infants. |
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Term
| UL (tolerable upper intake level) TUL |
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Definition
| maximum level of daily nutrient intake that is unlikely to impose risk of adverse health effects on most people: most attention paid to fat soluble vitamins and minerals |
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Term
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Definition
| highest RDA from among the different age and gender groups, used in the denominator for some daily value % |
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Term
| AMDR: acceptable macro-nutrient distribution range |
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Definition
| what macronutrient recommendations are based on. |
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Term
AMDR for:
Carb
Proteins
Fat |
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Definition
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|
Term
Calories per gram for:
protein
Carbs
Fat |
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Definition
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Term
|
Definition
| %DV for total or saturated fat, cholesterol, and sodium, there is no RDA for these nutrients |
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Term
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Definition
| a % of the upper limit for nutrients which no RDA exists for |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| on a food label where are the nutrients you want to get 100% of located |
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Definition
| Below the heavy black line |
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Term
| For nutrients below the heavy black line what is the denominator used in calculating the %DV |
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Definition
| reference daily intake is used |
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Term
| %DV are based upon the highest RDA among the age groups for these vitamins and minerals...(where on food label) |
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Definition
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Term
| %DV on a food label below the heavy black line represents... is higher for someone with.. |
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Definition
the minimum value for any individual:
higher for someone with a lower RDA |
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Term
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Definition
| Assesses nutrition compliance for populations |
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Term
| who developed the HEI and why |
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Definition
| USDA developed this in order to assess whether individuals and populations were complying with recommendations and if they were if it translated to nutrients |
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Term
| Benefits of vegetarianism |
|
Definition
lower: saturated fats, body weight, incidence of heart disease
higher: fiber intake, intake of antioxidants |
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Term
| Vegetarian nutritional concerns |
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Definition
| deficiencies: aas, vit b12, Ca, Vit D, Fe and Zn |
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Term
Basal metabolic rate:
varies with, ?
what is a major determinant |
|
Definition
energy needed to carry out fundamental metabolic functions (very specific condition)
varies with age and between sexes:
Lean body mass is a major determinant |
|
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Term
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Definition
| dividing it by the height squared normalizes this |
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Term
| Estimate for BMR for a 50kg person |
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Definition
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Term
| In a hospital what is the version used for BMR |
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Definition
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Term
| Ideal infant nutrition is? |
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Definition
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Term
| Major concern for a 1-3 year old is what? |
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Definition
| Iron deficiency anemia and inadequate calcium intake for good bone development |
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Term
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Definition
| often to eggs, peanuts, and milk. can be life threatening. Immune response |
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Term
|
Definition
non-immune response
ex. lactose intolerance |
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Term
| What is represented by the Food pyramid? |
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Definition
| grains, vegetables, fruits, oils, meat/beans, milk (dairy) |
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Term
| Adolescence is characterized by what? |
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Definition
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|
Term
| Adolescent food habits can lead to what? |
|
Definition
deficiencies in some nutrients (Vit A, B6, Ca, Fe, Folate, Zn)
excess of fat and sodium
Eating disorder (more so for females) |
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Term
| elderly have a high probability for what |
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Definition
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|
Term
| At least ?% of the elderly consume less than RDA for vitamin and minerals |
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Definition
| 50% consume less than RDA due to a decreased consumption of food |
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Term
| Greatest risk for inadequacy in the elderly is for what? affects how many? |
|
Definition
protein
vitamin B12
Ca
Vitamin D
1/3 of elderly affected |
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|
Term
Achlorhydria
what does it affect? |
|
Definition
| reduced output of stomahch: prevents release of B12 from conjugated protein and hence decreases its availability |
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Term
| Special nutritional problems associated with aging |
|
Definition
sensory change
physical limitations
Social factors |
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Term
| what is the importance between MAOIs and tyramine containing foods? |
|
Definition
patients may suffer hypertensive crisis
due to tyramine increasing the BP |
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Term
|
Definition
| total of all calories expended during the course of one 24 hour day |
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Term
|
Definition
| 60% of TEE is due to basal metabolism also known as this |
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Term
|
Definition
| more realistic than BMR, so is close enough to use as basal |
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Term
| empirical equation used to estimate BMR |
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Definition
|
|
Term
| what parameters does estimating BMR depend on |
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Definition
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|
Term
| Measuring RMR: estimating number of Kcal expended during a period of measurement per hour |
|
Definition
amount of O2 consumed
amount of Co2 produced |
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Term
|
Definition
| measurement of O2 and Co2 to measure RMR or BMR |
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Term
|
Definition
ratio of Co2/O2
tells us what proportion of calories comes from fat and how much from carbs |
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Term
| Patients with COPD benefit from what? why? |
|
Definition
burning more fat than carbs for calories
because fat has a lower RQ (more O2 produced) |
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Term
| RQ for carbohydrates (100%) |
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Definition
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Term
|
Definition
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Term
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Definition
|
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Term
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Definition
| excess calories and hence fat synthesis |
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Term
|
Definition
|
|
Term
| For weight loss to occur you need a deficit of what? |
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Definition
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|
Term
| Each activity is assigned a ? |
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Definition
| PAR: physical activity ratio |
|
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Term
|
Definition
1. light (1-1.8)
2. moderate (2-4)
3. Heavy (>4) often to 15 |
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Term
| calculation of TEE requires the following: |
|
Definition
BMR or RMR
estimate of energy expenditure (physical activity)
estimate of thermic efect |
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Term
|
Definition
| heat produced by the body accompanying food ingestion |
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Term
|
Definition
| (BMR*24hrs + PAR*time exercising) *1.10 |
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Term
|
Definition
| often sick or injured people enter this state, where the counterregulatory hormones rise |
|
|
Term
| counterregulatory hormones |
|
Definition
glucocorticoids and adrenergic horomones
- cause an increase in protein breakdown, gluconeogenesis, glycogenolysis |
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Term
|
Definition
| the increased catabolism accompanying injury or sickness |
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Term
| thermic effect as of % of calories ingested |
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Definition
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|
Term
Approximate injury factors for
trauma, sepsis, and burns |
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Definition
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|
Term
| TEE for an eating hospitalized patient |
|
Definition
| BMR*injury factor*activity factor*1.10*24hrs |
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Term
| TEE for hospitalized patient not eating |
|
Definition
| RMR*activity factor*24hrs |
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Term
Thamin (B1)
- metabolic acvities
- highly concentrated in? |
|
Definition
- cofactor for decarboxylation reactions & coenzyme for carb metabolism
- muscle, and CNS |
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Term
|
Definition
|
|
Term
|
Definition
| muscle weakness, ataxia, footdrop, opthalmoplegia, nystagmus, neuropathy, |
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Term
|
Definition
|
|
Term
| why is beri beri considered a medical emergency |
|
Definition
| it can lead to heart failure |
|
|
Term
Wernicke-Korsakoff Syndrome:
- characterized by |
|
Definition
TPP binding is weak
- thiamine intake compromised |
|
|
Term
| What additional symptoms are presented with wernicke and korsakoff syndromes |
|
Definition
memory problems
disorientation
coma |
|
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Term
|
Definition
| Whole grain cereals, legumes, yeast, lean pork |
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|
Term
| What decreases thamin content |
|
Definition
| milling of grains (removes bran and germ) |
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Term
|
Definition
occurs in diet mostly as NAD+ and NADP
Niacin or niacinamide |
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Term
|
Definition
| legumes, and cereals, meat and fish |
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Term
|
Definition
cosubstrates for DH rxns
substrates for ADP ribosylation
precursors for cyclic ADP ribose |
|
|
Term
| Niacin can be made from... |
|
Definition
| Vitamin B6 and dietary tryptophan |
|
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Term
|
Definition
|
|
Term
|
Definition
diarrhea
dementia
dermatitis |
|
|
Term
| Niacin in high doses can cause... |
|
Definition
|
|
Term
| Niacin is used clinically for? |
|
Definition
| reduction of elevated blood cholesterol levels |
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|
Term
Folic acid
- fxn
- structure |
|
Definition
one carbon donor
bears a chain of glutamate residues in peptide linkage |
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|
Term
| Folate transport and absorption |
|
Definition
| most is taken up by a saturable transport system then reduced and some is metylated to 5-NTHF before entering blood stream |
|
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Term
|
Definition
| Leafy green vegetables, and some fruits |
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|
Term
| Commonly exhibited in folate deficient people |
|
Definition
|
|
Term
| In fetuses Folate defiency is associated with what? |
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Definition
|
|
Term
| Pregnant women should consume this amount of folic acid. |
|
Definition
|
|
Term
Inadequate intake of folate results in the following:
1. 2. 3. 4. 5. |
|
Definition
1. serum folate drops
2. RBC folate drops
3. hypersegmented neutrophils
4. MCV increases
5. Hb drops |
|
|
Term
| Folate defiency symptoms: |
|
Definition
| macrocytic anemia, villous atrophy, and depapillation of tongue |
|
|
Term
| Blood smear of a folate deficient person |
|
Definition
hypochromic and macrocytic RBCs
hypersegmented neutrophils |
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|
Term
| What has been linked to deficient folate |
|
Definition
| Hyperhomocysteinemia, increased risk of heart disease |
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Term
| Vitamin B12 is also known as |
|
Definition
|
|
Term
| Vit B12 is involved in what bodily processes? |
|
Definition
1. the demetylation of of 5-MTHF:
2. conversion of methylmalonic acid to succinyl CoA |
|
|
Term
| Defiency in B12 results in what? (2 things from reactions) |
|
Definition
1. Folate being trapped in metylated form
2. Neuropathy |
|
|
Term
| Neuropathy from B12 defiency can result from what> |
|
Definition
| treating anemia with folate alleviating only the anemia but masking the B12 deficiency which then causes neuropathy which takes longer than anemia to develop |
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Term
| Absorption of B12 requires: |
|
Definition
|
|
Term
|
Definition
| protein secreted by the stomach |
|
|
Term
| Vitamin B12 is very efficienty absorbed or reabsorbed in the? only 1% via |
|
Definition
|
|
Term
| If absorption is intact, B12 stores can last? |
|
Definition
| 10-12 years since B12 is recaptured for reuse |
|
|
Term
| If absorption mechanisms are damaged how long does long does B12 store last? |
|
Definition
| 3-6 months (anemia can appear that fast) |
|
|
Term
| Who is at risk for B12 defiency? |
|
Definition
Strict vegetarian and vegans.
Elderly are at most risk (achlorydria) |
|
|
Term
|
Definition
inability to make IF:
leads to a B12 deficiency, poor absorption |
|
|
Term
| Pernicious anemia treatment |
|
Definition
High doses orally
injections |
|
|
Term
| An assessment for B12 deficiency |
|
Definition
| Schilling test: determine if the patient has pernicious anemia. |
|
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Term
|
Definition
synthesized by microorganisms
Meats, fishes, dairy, eggs |
|
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Term
|
Definition
pyridoxine
pyridoxal
pyridoxamine |
|
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Term
|
Definition
| rare: widely distributed in foods |
|
|
Term
|
Definition
glycogen breakdown
steroid hormone action
reduce homocysteine |
|
|
Term
| Effects of large doses of B6 (>500mg/d) |
|
Definition
| Neuropathy in legs and arms (irrversible peripheral neuropathy) |
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| prosthetic group of enzyme for carboxylation |
|
|
Term
| What vitamin deficiencies are rare? |
|
Definition
Biotin
Riboflavin
B6
Pantothenic acid |
|
|
Term
| what can cause a biotin deficiency in a specific subgroup? |
|
Definition
| Raw egg whites in athletes |
|
|
Term
Pantothenic acid:
fxn
structure |
|
Definition
effects acyl group transfer as part of coenzyme A
Beta alanine in amide linkage with pantoic acid |
|
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Term
| Recommendation for % of fat as MUFA |
|
Definition
|
|
Term
| Recommendation for % of fat as saturated fats |
|
Definition
| <10% (no more than 8-10% of total calories) |
|
|
Term
| Recommended protein for healthy adults |
|
Definition
|
|
Term
| effect of illness on protein requirements |
|
Definition
|
|
Term
| What are the three most common reactive oxygen species |
|
Definition
Superoxide
Hydrogen peroxide
hydroxyl radical |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Very reactive hydroxyl radical does what? |
|
Definition
| initiates by a chain reaction by acting on unsaturated fatty acid groups forming a lipid carbon-centered radical |
|
|
Term
|
Definition
| occurs when the preoxidant conditions lead to a production of ROS more rapidly than the antioxidant defenses can consume them |
|
|
Term
| Ischemia-reperfusion injury |
|
Definition
| occurs on reperfusion of a cardiac infarct or other ishcemic tissue, reexposure to oxygen after tissue undergoes narcosis, and death |
|
|
Term
| Phagocytic leukocytes when stimulated increase |
|
Definition
| oxygen consumption and superoxide production via respiratory burst |
|
|
Term
| ROS are believe to play a role in the development of: |
|
Definition
| cancers, atherosclerosis, Alzheimers, and aging |
|
|
Term
Atherosclerosis and ROS relationship:
what do they form |
|
Definition
| due to the oxidation of LDL and its subsequent uptake by macrophages to form foam cells. |
|
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Term
|
Definition
| grains, wheat germs, nuts, vegetable oils (corn and safflower oils) |
|
|
Term
|
Definition
| tocopherols (saturated side chains) and tocotrienols (three double bonds in the side chain) |
|
|
Term
| What is known as Natural Vitamine E |
|
Definition
|
|
Term
Vitamine E properties:
absorbed?
fxn |
|
Definition
absorbed in the intestine and transferred to the liver as a component of a chylomicron
Its function is as a chain-breaking antioxidant that prevents the propagation of the lipid carbon-centered radicals of fatty acid residues |
|
|
Term
| What patients should be monitored if they are taking vit E supplements? why? |
|
Definition
| People on anticoagulants since it interferes with blood clotting time |
|
|
Term
| What is the major hydrophilic antioxidant vitamin? |
|
Definition
|
|
Term
| Which Vitamin C play an important role in returning Vitamin E to its reduced state? and why? |
|
Definition
| Ascorbate, so that it impacts on the oxidation of membrane components indirectly. |
|
|
Term
| What are the benefits of ascorbate? |
|
Definition
lowered markers of DNA oxidation
lowered markers for membrane oxidation |
|
|
Term
|
Definition
Glutathione peroxidases
superoxide dismutases
Catalases |
|
|
Term
| Glutathione peroxidase Fxn |
|
Definition
| This enzyme catalyzes the reduction of H202 by Glutathione. oxidized GSSG is then returned to the reduced state by the enzyme glutathione reductase utilizing NADPH |
|
|
Term
|
Definition
| results from defiency of vitamin C |
|
|
Term
|
Definition
loose teeth
bleeding gums
eccymoses
slow wound healing |
|
|
Term
| Ascorbate in diet is impt for? |
|
Definition
| reducing Fe2+ to Fe3+ improving its absorption |
|
|
Term
| Mammalian enzyme contains selenium? where? |
|
Definition
| glutathione peroxidase contains this at its active site |
|
|
Term
| Selenium is important in which two antioxidant enzymes? |
|
Definition
| glutathione peroxidase and thioredoxin reductase |
|
|
Term
| Superoxide dismutases fxn |
|
Definition
| this enzyme catalyzes the dismutation of superoxide to H202 and O2 |
|
|
Term
|
Definition
| this enzyme catalyzes the dismutation of H202 into H2O and O2. |
|
|
Term
| What two enzymes work in tandem? |
|
Definition
| Catalase and superoxide dismutase |
|
|
Term
|
Definition
| It is located in peroxisomes as a hemoprotein |
|
|
Term
| What are other hydrophilic antioxidants? |
|
Definition
|
|
Term
| what are some sources of flavonoids? |
|
Definition
|
|
Term
| smokers require an additional ? over that of non smokers? |
|
Definition
|
|
Term
| General causes of nutritional inadequacies |
|
Definition
Inadequate Intake and absorption
decreased utilizations
increased losses
increased requirements |
|
|
Term
| Anthropometric measures for children |
|
Definition
Weight and height
midarm circumference |
|
|
Term
Calculating desirable body weight: Medium
Male
Female |
|
Definition
1. Base=100 lb
Add 5lb for each additional inch
2. Base=106
add 6lb for each additional inch |
|
|
Term
| Calculating desirable body weight for small people |
|
Definition
| subtract 10% from the medium frame size |
|
|
Term
| Calculating large frame size desirable body weight |
|
Definition
| Add 10% to medium frame weight |
|
|
Term
| Anthropometric measures for adults |
|
Definition
BMI , waist measurement
skin fold thickness |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| BMI for overweight person |
|
Definition
|
|
Term
|
Definition
|
|
Term
| BMI for severely obese person |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Nitrogen balance equation |
|
Definition
intake (g/24h) -UUN (g/24hr) -4g
applies when urinary urea nitrogen is measured |
|
|
Term
| What are normal albumin serum levels? |
|
Definition
| Normal levels are 3.5-5.5 g/dL |
|
|
Term
| Normal fasting blood glucose level |
|
Definition
|
|
Term
| How do you convert mM to mg/DL |
|
Definition
|
|
Term
| Common criterion for malnutrition |
|
Definition
| Unintentional weight loss of >10% in 6mths |
|
|
Term
| What is a criterion for obesity? |
|
Definition
|
|
Term
Obesity waist size:
women
men under 40 & 40 and older |
|
Definition
1. waist>35.5
2. waist>40 inch
3. waist >36 inches |
|
|
Term
Interpretation of percent of transferrin saturation
1. iron deficient
2. normal
3. hemochromatosis |
|
Definition
Translating transferring saturation:
1. <25%
2. 25-50%
3. >50% |
|
|
Term
| Common biochemical measures for assessment (5) |
|
Definition
1. Serum albumin
2. serum prealbumin (transthyretin)
3. transferrin
4. hemoglobin, hematocrit |
|
|
Term
| Most common visceral protein evaluated as a part of nutritional assessment? and why? |
|
Definition
serum albumin
because gives an integrated picture of nutritional intake over a period of several weeks |
|
|
Term
| measure of choice for monitoring the progress of patients while in the hospital (short term changes) |
|
Definition
|
|
Term
| Measure of choice for establishing the cumulative nutrition status over an intermediate time interval |
|
Definition
| Transferrin (8-9 day T1/2) |
|
|
Term
| These may be detected as a first sign of severe protein malnutrition |
|
Definition
|
|
Term
|
Definition
| all foods and beverages consumed over the past 24 hrs |
|
|
Term
| Food frequency Questionnaire |
|
Definition
| retrospective review of intake frequency |
|
|
Term
|
Definition
| patient orally reports all foods and beverages consumed on a typ day |
|
|
Term
|
Definition
| ONLY prosepctive approach for dietary assessment |
|
|
Term
| Patients needing nutrition but unable to take food by mouth receive it how? |
|
Definition
|
|
Term
|
Definition
| liquid diet fed directly into the stomach by a tube |
|
|
Term
|
Definition
|
|
Term
| Which type of nutrition preserves gut integrity and is less expensive? |
|
Definition
| Enteral is typically used over parenteral because of this. |
|
|
Term
Why parenteral formulas are more expensive?
specficis |
|
Definition
require aas and must be sterile
NO FIBER |
|
|
Term
| Creatine height index is sometimes used to estimate what |
|
Definition
| Skeletal muscle mass is estimated using this. |
|
|
