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NUTRITION - BIOCHEM > Nutrition in Healthcare > Flashcards

Nutrition in Healthcare Flashcards

1
Q

What is the Hamilton Family Health team?

A
  • services approx 300, 000 pt in hamilton area
  • 166 physicians
  • nurses, NPs, dietitians, pharmacists, physician assistants etc.
  • “our mission is better care, together”
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2
Q

what can RD’s support management for?

A

diabetes, HTN, dyslipidemia, GI issues, IBS, celiac, anemia, eating disorders, bariatric surgery

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3
Q

what factors are included in preventative care with RD’s?

A
  • food security
  • prenatal nutrition
  • infant feeding
  • diabetes prevention, heart health, depression
  • seniors fragility, malnutrition and healthy aging
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4
Q

what do RD’s tackle on a daily basis?

A

nutrition misinformation
- some are evidence based an some are not
- goal is to “do no harm”

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5
Q

what percentage of woman in Canada want to reduce their body wt?

A

70

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6
Q

teens who self report dieting, end up developing what 2 things?

A
  • become overweight
  • develop an eating disorder
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7
Q

self dieting and restriction can lead to:

A
  • metabolic changes
  • mental health impacts (binge, eating, feelings of guilt, shame)
  • weight cycling (wt loss, wt gain, repeat)
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8
Q

what is optimized nutrition?

A
  • meeting nutrient needs
  • flexibility in food choices
  • enjoyment in food
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9
Q

what is disordered eating?

A
  • restricting/limiting
  • food rules
  • lack of enjoyment
  • feelings of shame/guilt
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10
Q

what is eating disorder?

A
  • ++ time spent in eating disorder behaviours
  • impact on function wellness, health
  • self eval based on weight, shape
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11
Q

what is the most common eating disorder?

A

binge eating disorder

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12
Q

what does the HFHT eating disorder toolkit for early detection an intervention include?

A

screening, assessment, lab Rqn, resources, referrals. registry

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13
Q

what physical changes can put someone at risk for eating disorder?

A
  • early puberty
  • abnormal growth
  • activities that emphasize body, wt, shape
  • low BMI, wt suppression
  • T1D
  • amenorrhea
  • fam hx of eating disorders
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14
Q

what populations are at risk for eating disorders?

A
  • racilized persons
  • gay men/trans
  • ppl with ADHD, autism an women with disbilities
  • ppl in larger bodies
  • wt stigma
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15
Q

what are the impacts of weight bias on mental and emotional health?

A
  • stress, depression, anxiety, psychiatric diagnosis, suicidal thoughts
  • poor body image
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16
Q

what are the impacts of weight bias on physical health?

A
  • avoid physical activity
  • unhealthy eating practices
  • delay/avoid seeking healthcare
  • increased BP, pain substance use and stress
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17
Q

what are the impacts of weight bias on social health?

A
  • bullying and harassment
  • social isolation
  • difficulties with relationships
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18
Q

what are the impacts of weight bias on monetary?

A
  • discrimination in education and workplace settings
  • lower performance
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19
Q

can you tell how healthy someone is by looking at them?

A

no

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20
Q

what is “health”?

A

state of complete physical, mental and social well being endnote merely the absence of disease or infirmity (WHO)

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21
Q

what are the 4 M’s in an assessment?

A

mechanical, metabolic, mental, monetary health

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22
Q

what are the 5 A’s in an assessment?

A

ask, assess, advise, agree and assist

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23
Q

what are the tx options to becoming healthier?

A
  • lifestyle
  • meds
  • bariatric surgery
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24
Q

intuitive eaters tend too;

A
  • enjoy food
  • less likely to binge eat or show eating disorder symptomology
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25
Q

what factors can influence wt gain or inadequate nutrition?

A

mental health, dieting, meds, chromic stress, behaviours, physical activity, sleep, metabolism, culture, gut microbiome, environment

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26
Q

what are the main hormones in our appetite control system?

A
  • ghrenlin
  • leptin
  • pancreatic peptides
  • cortisol
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27
Q

the body is designed to defend against what?

A

weight loss

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28
Q

high stress levels increasing cortisol can override what?

A

our appetite (hypothalamus)

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29
Q

what is the HFHT bariatric toolkit?

A

ongoing follow up and pre surgical support to help pt achieve their health goals and reduce complications

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30
Q

what are some long term complications of bariatric surgery?

A
  • weight regain
  • nutritional deficiencies
  • high suicide rates an depression
  • relapse of diabetes an HTN
  • coping after surgery
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31
Q

what is a main common post op complication of bariatric surgery?

A

hair loss, 1 year post op

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32
Q

what should be assessed and completed for a pt recovery bariatric surgery?

A
  • assess for deficiencies in protein, fatty acids, iron, zinc
  • annual bloodwork
  • treat deficiencoes
  • ensure taking adequate supplementation
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33
Q

what meds can be poorly absorbed after bariatric surgery?

A
  • SSRI
  • levothyroxine
  • antibiotics
  • BC pills
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34
Q

when should you watch for signs of rapid wt gain or loss?

A
  • pregnancy
  • infancy/children
  • teens
  • menopause
  • older adults
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35
Q

at 1 year of age, what do infants eating patterns usually look like?

A

infants diet often mimics the unhealthy eating patterns seen in older children and adults

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36
Q

9-18 months is critical time for nutrition and adequate diets. t or f

A

t

37
Q

how many extra cals should be consumed in first trimester?

A

none

38
Q

how many extra cals should be consumed in second trimester?

A

350

39
Q

how many extra cals should be consumed in third trimester?

A

450

40
Q

how much wt gain should there be in first trimester?

A

1-2 kg

41
Q

when a womens pre pregnancy BMI is over 30, it is highly linked with increased risk for what?

A
  • gestational diabetes
  • pre eclampsia
  • c sec
  • pre term birth
42
Q

meeting with an RD to improve OB outcomes can improve what factors in pregnancy?

A
  • optimize dietary intake
  • ensure appropriate supplementation
  • slow down rate of wt gain
43
Q

what infants are at high risk of anemia?

A
  • pre term, low birth wt
  • breast fed babies
  • low socioeconomic status
  • born to new immigrants
  • insufficient iron rich foods at 6 months of age
  • excessive milk consumption
44
Q

in children an youth, wt loss of what percentage indicates malnutrition and is a medical emergency?

A

10-20%

45
Q

<80-88% usual wt for children is an indication of what?

A

malnutrition and requires urgent assessment

46
Q

vasomotor symptoms in menopause are associated with a higher incidence of CVD and depression. t or f

A

t

47
Q

if menopausal hormone therapy started within first 10 years of menopause, risk of HD and dying of any cause is reduced by what percentage?

A

40%

48
Q

what is a key factor in reducing menopausal symptoms and CVD risk?

A

optimized diet

49
Q

what dietary pattern has been shown to reduce menopausal symptoms?

A

Mediterranean diet

50
Q

what is the A, B, C, D, E, F, G lifestyle?

A

A- avoid caffeine, alcohol, excess Na an sugars, smoking
B-balanced healthy diet
C- calcium from foods to maintain bones an BP
D- D3 for bone health an immune function
E- exercise - 30 mins x 5 days = 150 min/week
F- chose foods rich in heart healthy fats
Fan- stay cool, dress in layers, stay hydrated

51
Q

what are common foods challenges amongst seniors?

A
  • food an drug interactions
  • constipation
  • dehydration
  • cooking for one
  • eating well on fixed income
52
Q

what things may you notice about seniors eating habits?

A
  • low appetite
  • easily full
  • fatigue (skip more meals, rely on processed food, settle for tea)
  • trouble chewing, dry mouth, dentures, constipation
53
Q

what amount of seniors are at risk for malnutrition?

A

1/3

54
Q

what population is the most vulnerable and most at risk for malnutrition?

A
  • older women
  • socially isolated
  • living with depression
  • polypharmacy
  • poor oral health
55
Q

malnourished seniors are more likely to:

A
  • more visits to doc
  • more likely to have a fall
  • admitted to hospital
  • increased med use
  • reduced quality of life
56
Q

during hospital admission in malnourished seniors, what is the result?

A
  • worsen during their stay
  • stay 2-7 days longer
  • high 30 day re admission rate
57
Q

symptoms of hypoglycaemia:

A

headache, sweating, dizziness, hunger, blurred vision, fast HR, shaking, anxiety, tired, weakness, irritability

58
Q

losing wt without trying increases risk of:

A
  • muscle loss
  • risk of malnutrition
  • falling
  • hospitalization an further decline
59
Q

what is the EMR Tool - Screen?

A

looks at wt loss, changes in appetite, dysphagia, etc
- consists of 8 questions

60
Q

what does DASH diet stand for?

A

dietary approaches to stop HTN

61
Q

what does combination of Mediterranean and DASH diet reduce?

A

cognitive decline

62
Q

Med diet reduces ____ by 28-30%.

A

CVD

63
Q

1/3 of participants with depression in the SMILES study reported no symptoms of depression after following which diet?

A

Mediterranean diet

64
Q

protein an carbs work tg to boost ____________ in the brain which helps with mood, sleep and feelings of joy.

A

Serotonin levels

65
Q

lack of tryptophan an glucose can cause:

A

low mood, difficulty sleeping, lacking joy, pain inhibition

66
Q

lack of tyrosine can cause:

A

lacking drive, motivation an or enthusiasm for life

67
Q

lack of glutamine can cause:

A

anxiety, irritable, inability to relax

68
Q

lack of glucose, methionine and folate can cause:

A

memory, learning, recall

69
Q

how much protein should be consumed at each meal?

A

25g protein/meal

70
Q

how can you prevent feeling hangry?

A

eat at reg times, q4-5 hours

71
Q

is olive oil or coco nut oil better?

A

olive oil

72
Q

benefits to olive oil:

A
  • boost in HDL, lowers LDL
  • anti inflammatory
    -reduce impact of Alzheimers
  • prevents stroke CVD
  • antioxidant
73
Q

benefits of coconut oil:

A
  • boosts HDL but also LDL
  • improve body composition
  • handles heat well
74
Q

DASH diet can lower sbp by how many points of mercury?

A

11
- this is = to 1 BP med

75
Q

what is gas an bloating cause by?

A

swallowed air, certain foods, drinks, meds, supplements

76
Q

what can gas an bloating indicate?

A

lack of fibre, an intolerance, or IBS

77
Q

soluble fibre can lower LDL cholesterol by what percentage?

A

10

78
Q

soluble fibre sources:

A

psyllium, barely, legumes, oats, ground flax an chia seeds and several fruits/veggies

79
Q

what yogurt should you buy to reduce constipation?
a) danactive
b) yoptimal or logo
c) activia

A

activia

80
Q

low levels of vitamin D3 are associated with what?

A

falls, depression an poor immune function

81
Q

is vitamin D3 in a lot of our foods?

A

no it is limited (fish an milk)

82
Q

who is at risk for vitamin B12?

A

1/3 of adults over age of 50

83
Q

risk factors for low B12 status including:

A
  • vegan diet
  • med use
  • older age
  • heart burn
  • other GI conditions
  • gastric surgery
84
Q

what is the #1 deficiency in the world?

A

iron

85
Q

what populations are mostly deficient in iron?

A

infants, women and children

86
Q

when should iron start to be given in life?

A

5-6 months of age

87
Q

why should more fruits an veggies be added to meals when you are deficient in iron?

A

fruits an veggies as vit C can enhance iron absorption

88
Q

what drink should be avoided when eating a meal (associated with low iron)?

A

avoid tea/coffee

89
Q

in child bearing years, what should be tested for? (due to low levels of iron)

A

test CBC and ferritin

NUTRITION - BIOCHEM (22 decks)

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