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Clinical Foundations > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Main function of lipids

Other functions

A

Energy storage
Insulate and protect the body
Transport fat soluble vitamins
Provide flavor and satiety.

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2
Q

Lipid groups

A

Triglycerides
Phospholipids
Sterols
Essential fa - linoleic acid 18:2 and linolenic acid 18:3

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3
Q

Trans fatty acids

A

Associated with increased risk of cardiovascular disease
Occur naturally and as a result of food processing
Associated with elevated ldl and decreased hdl

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4
Q

Lipoproteins

A

Consists of proteins and phospholipids
How lipids are transported through the body
Act as emulsifiers so that fat and fat soluble substances can be transported in the blood

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5
Q

Bad cholesterol

A

LDL
Idl
Vldl
Chylomicron and cylomicron remnant

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6
Q

Good cholesterol

A

Hdl

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7
Q

What is a more important predictor of serum cholesterol

A

Dietary fat

Saturated fat is important

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8
Q

What contributes to serum triglyceride levels

A

Simple sugars and alcohol

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9
Q

How does the body use dietary fat

A

Dietary fat can be stored, used for energy or act as a precursor to other compounds

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10
Q

2 ways alcohol is metabolized into

A

Fatty acids

Co2 and h2o

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11
Q

Carbohydrates

A

Classified based on the number os saccharine units

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12
Q

Dietary fiber and human digestive enzymes

A

Fibers cannot be digested by human digestive enzymes.
Not absorbed
Helps maintain bowel health
Lowers serum cholesterol levels

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13
Q

Soluble dietary fiber

A

Forms a gel matrix in the GI tract - slow absorption of some substance.
Increases transit time

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14
Q

Examples of soluble dietary fiber

A 
Pectin from apples
Sweet potatoes
Beans
Oats
Prunes
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15
Q

Insoluble dietary fiber

A

Decreases transit time

Can bind or complex with other compounds - not absorbed

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16
Q

Examples of insoluble dietary fiber

A

Lentils
Whole wheat bread
Avocado

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17
Q

Lactose intolerance

A

Occurs when an ind does not synthesize lactase or at least in significant amounts.
So microbiota takes care of it with some sad side effects.

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18
Q

Primary function of carbohydrates

A

Serve as source of energy which in turn spares protein and prevents ketosis

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19
Q

Endogenous source of body energy

A

Made by the body by gluconeogenesis or glycogenolydid

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20
Q

Exogenous source of body energy

A

Carbohydrate containing food

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21
Q

What does adequate carbohydrate intake do?

A

Necessary for normal fat metabolism and provides flavor and sweetness to food.

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22
Q

Normally acetyl coA combines with what to enter the cac

A

Oxaloacetate from glucose

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23
Q

What happens to the cac when glucose is not available

A

Incomplete combustion of fatty acids occurs and ketone bodies are formed.
(Fatty acids > acetyl CoA> acetoacetic acid> ketone bodied Bhydroxybutyric acid and a tone

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24
Q

Nutritional ketosis

A

Mild
Less than 50 g of cho
Complications include dehydration, electrolyte disturbances, hypoglycemia
No acidosis

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25
Q

Diabetic ketoacidosis

A 
Severe
Type 1 diabetes
Insufficient insulin
Can be life threatening
Blood ph decreases as alkali reserves are depleted
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26
Q

Gluconeogenesis

A

Formation of glucose from non cho sources
Occurs in the liver and a little in kidney
Not glycolysis in reverse

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27
Q

Gluconeogenesis substrates

A

Lactic acid
Glycerol
Amino acids (ala pro ser)

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28
Q

Glycogenolysis

A

Breakdown of glycogen into glucose or glucose derivatives

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29
Q

Liver glycogenolysis vs muscle glycogenolysis

A

Liver - direct source of blood glucose

Muscle - indirect source of blood glucose

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30
Q

Liver cell glycogenolysis

A

Glycogen>g1p > g6p>glucose

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31
Q

Muscle cell glycogenolysis

A

Glycogen > g6p> lactic acid

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32
Q

Proteins

A

Polymers of aa joined by peptide bonds

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33
Q

Essential aa

A 
Pro
Val
Thr
Trp
Ile
Met
His
Ala
Leu
Lys
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34
Q

Semiessential / conditionally essential aa

A

Cys (met)

Tyr (phe)

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35
Q

Protein quality is determined by what

A

Types and amounts of amino acids it contains

Digestibility of protein.

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36
Q

Animal proteins

A

Tend to be complete proteins

Includes meat, poultry, fish, eggs, dairy products

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37
Q

Plant proteins

A

Tend to be incomplete (except soy and quinoa)

Grains, nuts, seeds, legumes, veggies

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38
Q

Primary function of proteins

Other functions

A 
Tissue maintenance and growth 
Fluid balance 
Acid base balance
Hormones and enzymes
Immune funciton
Gluconeogenesis
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39
Q

Protein needs measurement

A

0.8 G protein per kg healthy body weight

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40
Q

Total protein requirements deviations

A

Total protein per day is higher at older ages but protein per body weight is highest during the first year of life

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41
Q

What factors are important in determining protein needs

A

Health status of ind (malnourished? Other medical conditions?)
Medications (nutrient drug interactions, prednisone)

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42
Q

Vitamins

A

Organic compounds that cannot be synthesized by the body

Natural component of food

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43
Q

Water soluble vitamins

A 
Vitamin c
Vitamin b (1,2,6,12,folate, biotin etc)
44
Q

Fat soluble vitamins

A

A
D
E
K

45
Q

Why are some sign and symptoms of deficiency similar?

A

Interrelated nature of vitamins

46
Q

Excretion of fat soluble vs water soluble bitamins

A

Water soluble vitamins are excreted more readily

Fat soluble are not readily excreted

47
Q

Which vitamin can be stored

A

Fat soluble vitamins

48
Q

Which type of vitamin does vitamin deficiency symptoms occur quickly

A

Water soluble

49
Q

How are fat soluble vitamins handled

A

Similar to other fat soluble compounds

Absorbed along with dietary fat. Packaged with chylomicrons and transported by vldl and ldl

50
Q

Where does vitamin d come from

A

Synthesized from cholesterol derivative

51
Q

Vitamin k from

A

Synthesized by bacteria within gi tract

52
Q

Niacin synthesized from

A

Trp

53
Q

What causes vitamin loss

A

Food processing and preparation

Over cooking, cut up and exposed to air

54
Q

Which type of vitamin is more likely to be toxic

A

Fat soluble vitamins

Especially from supplements.

55
Q

Deficiency symptoms

A

Occur late in deficiency state

56
Q

Subclinical deficiency

A

Occurs in early stages when few/no symptoms are observed
Assessment of body stores as measures of recent dietary intake are lacking.
Biomarkers of deficiency that occur prior to deficiency are limited and flawed

57
Q

Groups considered at risk for micronutrient deficiency or toxicity

A 
Elderly
Babies and young ins 
Preggos
Alcoholics
Chronic health conditions - dialysis, malabsorption
58
Q

Vitamin c deficiency disease

A

Scurvy

59
Q

Vitamin d deficiency disease

A

Ricketts

Osteomalacia

60
Q

Thiamin deficiency disease

A

Beri beri

61
Q

Niacin deficiency disease

A

Pellagra

62
Q

Why is assessing vitamin status challenging

A

Signs and symptoms similar for many vitamins
If deficient in one vitamin, likely to be deficient in serveral vitamins
Blood and tissue levels may be controlled by factors other than dietary intake

63
Q

Niacin
Forms
Toxicity
Uses

A

Nicotinic acid and nicotinamide.
Nicotinic acid is associated with toxicity at high doses and lowers ldl - powerful drug
60 mg trp > 1 mg niacin

64
Q

Deficiency of vitamin b6

A

Rare, but can occur when patient is on isoniazid

Isoniazid is used to treat tb.

65
Q

Excess b6

A

Can lead to irreversible nerve damage

Long term use of 200mg/day to treat pms.

66
Q

Folic acid / b12 deficiency

A

Result in macrocytic / megaloblastic anemia

And increased neural tube defects

67
Q

Vitamin a deficiency

A

Most preventable form of blindness

Loss of sensitivity to green light> impairment to adapt to dim light > night blindness > complete blindness

68
Q

Excessive vitamin a

A

Result in unbound vitamin a causing tissue damage
Chronic - death and other symptoms
Acute - death and other symptoms
Teratogenic - fetal malformations

69
Q

Carotenoids

A

Not toxic for most people and some vitamin manufacturers use beta carotene in place of vitamin a.
Beta carotene is converted to vitamin a when needed.

70
Q

Vitamin d synthesis

A

Cholesterol derivative

Requires 2 hydroxylation steps (in liver and kidney) to make vitd125 vitd125 = active form of vitamin d

71
Q

Medical conditions at risk of vitamin d deficiency

A

Elderly - especially in northern climates or nursing homes
Kidney diseased
Liver diseased
Stomach, gallbladder, intestinal diseased

72
Q

Vitamin e toxicity

A

Assumed to be least toxic of fat soluble vitamins. Toxic in high doses though
High douses can inhibit vitamin k metabolism> possible hemorrhage.

73
Q

Vitamin k concerned people

A

Newborns, at risk for deficiency - no microbiota to create

Patients taking anticoagulants - nutrient drug interaction

74
Q

How are minerals classified

A

Based on requirement

75
Q

Macrominerals

A 
More than 100 mg
Ca
Phos
Mg
N.A.
K 
Cl
76
Q

Trace mineral

Less than 100 mg/day

A 
Fe
An
Cu
We
Cr
I 
Man
Fl
Co
77
Q

Fe mineral

A

Trace mineral

78
Q

An mineral

A

Trace mineral

79
Q

Ca mineral

A

Macromineral

80
Q

K mineral

A

Macromineral

81
Q

Mg mineral

A

Macromineral

82
Q

N.A. mineral

A

Macromineral

83
Q

Bioavailability

A
  1. Percent of consumed material that enters the body via the intenstinal absorptive cell
  2. Used for its intended purpose
84
Q

Minerals 100% absorbed

A 
N.A.
K
Cl
We
Mg
85
Q

Absorption dependent factors

A

Solubility
Presence of compounds such as phytates and oxalates
Amount of element to be absorbed

86
Q

Why are animal products usually the best sources of mineral

A

More concentrated

More bio available

87
Q

Antioxidants

A

Natural/ synthetic compound readily oxidized and prevents the oxidation of another compound

88
Q

Phytochemicals

A

Nonnutrient compounds found in plant foods that have biologic activity

89
Q

Dietary supplement

A

Broad range considered food by fda, regulates differently than conventional food

90
Q

Nutrient based approach diet

A

Type of approach would include the dris

Focuses on specific nutrient.

91
Q

Food based diet approach

A

My plate

Focuses on food groups as means of evaluating dietary intake

92
Q

My plate breakdown

A

1/2 fruits and veggies
1/4 grains (whole)
1/4 protein (lean)
Dairy foods are side items

93
Q

Dash diet

A

For lowering bp
Low sodium
Emphasizes fruits and veggies
Low fat/non fat dairy products

94
Q

Ada exchange plan

A

Diabetes
Organizes food into groups with each groups having similar kcal and macronutrient content based on serving size indicated.

95
Q

Food labels tell you

A

Size of single serving
Kcals per serving
Key nutrients
List of ingredients

96
Q

Medical nutrition therapy

A

Concerned with meeting nutritional needs of patients who require some type of diet modification as result of illness/disease.

97
Q

Enteral nutrition

A

Method of providing nutrient solutions into a gi through tube
Can be placed in several different locations depending on functional gi status
Requires adequate absorptive capacity

98
Q

Parenteral nutrition

A

Direct entry of nutrients into systemic circulation
Iv or tpn.
Appropriate when pt cannot be adequately nourished by oral or enteral feeding methods.
Gi tract not functional

99
Q

Determining energy needs

A

Needs are based on energy expenditure and protein utilization.

100
Q

Determining protein requirements

A

24 hr urinary urea nitrogen

Positive protein balance needed to restore protein stores

101
Q

Dietary reference intake

A

Set of nutrient intake values for healthy people in us and canada
Used fo planning and assessing diets

102
Q

Recommended dietary intake

A

Average daily amount of a nutrient considered adequate to meet known nutrient needs of practically all healthy people

103
Q

Estimated average requirement

A

Average daily amount of nutrient that will maintain a specific biochemical or physiological funciton in half of they healthy people of a given age and gender.

104
Q

Adequate intake

A

Average daily amount of a nutrient that appears to maintain a specified criterion

105
Q

Tolerable upper limit

A

Max daily amount of nutrient that appears safe for most healthy people

106
Q

Daily value

A

Reference values developed by fda specifically for use on food labels.

Clinical Foundations (10 decks)

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