Midterm Flashcards
(36 cards)
Name the benefits of using a diet diary for dietary counseling… [Hint: 4 key things]
- Facilitates AWARENESS of the patient
- Provides OBJECTIVE INFORMATION to the practicioner
- Data can be entered into a DIET ANALYSIS
- Diary itself is a THERAPY
What are the basic patient instructions for completing a diet diary?
Record of 2-7 days; 4 days is typical, 1 weekend day is recommended
REQUIRED INFORMATION FROM PATIENT:
- Time
- Write down everything… food, drinks, meds, supplements
- Brand of food/drink/supplement if possible
- Approximate amount at MINIMUM, EXACT AMOUNT IF POSSIBLE
Name times or reasons why you would prescribe a diet diary…
- Before first visit (review data at @FOV)
- After first visit (review data @1st ROV)
- When you feel the need to have to be more detailed information on the patient’s diet
- Ongoing diet diary can be used for WEIGHT MANAGEMENT or to track particular FOOD RELATED SYMPTOMS
Name the basic ways of assessing a diet diary? [hint: 4 things]
Evaluate diet according to:
- Food categories
- Macronutrients and Micronutrients
- Specific therapeutic foods
- Food to decrease or avoid
* *Note: A combo of these is often used to yield better results**
How are the different types of food reactions (allergy, intolerance, sensitivity) mediated and what does the clinical presentation of each look like?
- Food allergy = IgE mediated, Type 1 allergy. Symptoms increase in severity with increased exposure. Mild to life-threatening.
Common food allergies (IgE): egg, shellfish, nuts, peanuts, fish. - Food reaction/Type 2 sensitivity = IgG mediated. Symptoms are variable and may be interchangable.
Common delayed food reactions (IgG): dairy, chocolate, citrus, gluten, colorings, additives. - Food intolerance = lacking an enzyme/cofactor that allows digestion of the food.
Describe a hypoallergenic (allergy elimination) diet, including basic guidelines, the top allergenic foods that should be eliminated, and the challenge process.
Eliminate the top allergens for 1-3 weeks: wheat, dairy, soy, corn, egg, food additives/preservatives, peanuts, refined sugar, coffee, tea, chocolate, any food you eat 3 or more times a week…
What is the recommended amount of fiber intake for an adult (NIH recommendation)?
35 grams daily is NIH
35-50 is even better
Describe reasons why one would supplememt with digestive aids (HCL, enzymes, bitters) and how each works to improve digestive health.
- Enzymes: Protease 30,000 USP, Amylase 32,000 USP, Lipase 2100 FIP, Lactase 1,600 ALU, Sucrase 300 INVU, Maltase 32,100 DPo, Phytase 1.7PU, Cellulase 350 CU
- HCl: to tolerance/HCl challenge
- Sours/bitters: foods, tinctures, lemon/lime juice
Define these terms, RDA, ODI, and Toxic daily dose.
RDA: recommended daily allowance (minimum)
ODI: optimal daily dose (falls b/w RDA and TDD)
- Toxic daily dose: dosage that will lead to toxicity signs over months of consumption
Given a patient’s weight, beverages, and activity level, calculate their daily recommended pure water intake.
- Half of the body weight (in ounces)
- +8 ounces for every non-water drink
- +8-16 ounces for every 45 minutes moderate exercise
- Herbal teas, soups, fresh juices are neutral
- Majority of water should be between meals
Name reasons for including whole fruits, vegetables, legumes, and whole grains in the diet and recommended servings per day.
- Fruit: 2-4 servings/day
- Veggies: 5-9 servings/day
- Legumes: 2-3 servings/day
- Grains: 3-5 servings/day
- serving vegetables/legumes: 1/2 cup cooked or 1 cup raw
Give several examples of vegetables in the cruciferous family and name the purpose of a major constituent of this group.
- Cruciferous vegetables: lettuce, dandelion, endive, escarole, chicory (composite family), brussel sprouts, cabbage, collards, watercress, kale, mustard, greens, turnip greens (cabbage family), chard, spinach, beet greens (goosefoot family).
- Benefit: vitamin A, C, B6, K, folic acid, Ca, Cu, Mn, Mg, Fe, chromium (lettuce), potassium, fiber, chlorophyll, lutein, zeaxanthin, indole-3 carbinol (cabbage family), oxalates (goosefoot family)
Give several examples of vegetables in the nightshade family and name a reason why they might be avoided.
- Nightshade: Tomato, eggplant, peppers, potatoes
- RISKS: increased ALKALOIDS, CALCITRIOL and LECTINS
Name the 3 methods of oil extraction and the qualities of each type of finished oil.
- Chemical: a solvent (hexane_ is used, then the solvent is removed. refined to take out impurities (aromatic oils, lecithin, antioxidants)
- Mechanical: cooked then pressed (generates heat). Can be refined further. Cold pressed = no added heat
- Hydrogenation: oil is mixed with metal particles, then exposed to hydrogen under heat and pressure. Refined for texture (emulsifiers and thickeners), smell (artificial flavors), and color (dyes).
Give an example of an oil suitable for low heat cooking, for medium heat cooking, and high heat cooking. Name the major EFA’s predominant in each example.
- Low: flax, olive, hemp
- Medium: butter, sesame, soy, coconut
- High: canola, grapseed, sunflower, macadamia
- omega-3 : flax, hemp, soy
- omega-6: canola, grapeseed, sesame
- omega-9: macadamia, olive, sunflower
Give an example of a grain/grain like seed that has gluten, one that contains trace gluten, and one that is gluten-free.
- Gluten-containing: wheat, kamut, spelt, rye, triticale, barley, oat
- Trace gluten: rice, wild rice, corn millet
- Gluten-free: quinoa, buckwheat, teff, amaranth
What are the limiting amino acids in grains?
Lysine and Methionine
Give several examples of fermented foods.
Yogurt, sourdough breads, some aged cheeses (bleu cheese), beer, wine, cider, pickles, vinegar, sauerkraut, tempeh, miso, kimchee, kefir, sour cream, kombucha
Name the 2 processing methods for dairy and the basic effects of each.
- Pasteurization: To kill bacteria, Also decrease enzyme activity, Milk is heated to 145 degrees for 30 minutes, or 163 degrees for 15 seconds, All milk sold in retail is pasteurized except in a few states.
- Homogenization: breaking fat globules under pressure, covered with a protein film that prevents the fat from re-forming, reduced fat milk is then possible
Define the following terms: - 100% organic - USDA organic - Contains organic ingredients What are the criteria for use of each term?
- 100% organic = all organic ingredients
- USDA organic = 95% or more organic ingredients
- 100% organic or USDA organic can use seal
- Contains organic ingredients = 70% or more organic ingredients
Define the following terms: - Grass-fed - Grain-fed - Cage-free - Free-range - Fair trade - Marine stewardship council What are the criteria for use of each term?
- Cage-free or free-range = chicken that are not kept in cages, but may not have been housed outdoors; no third party certification to use this term
- Grass-fed or pasture-raised = usually the same but grass-fed may be housed indoors
- Fair trade certified = for coffee, chocolate, tea, rice, sugar; farmers receive fair prices for their goods; third-party certified
- Marine stewardship council = seafood caught without harming local ecosystem or endangering the species
Recognize the BMI ranges for underweight, normal, overweight, obese.
- Underweight <18.5
- Normal: 18.5 - 24.9
- Overweight: 25.0-29.9
- Mild Obesity: 30.0-34.9
- Moderate obesity: 35.0-39.9
- Severe obesity: >40.0
What is the ZONE diet?
Balanced ratio at each meal
- 30% protein
- 30% fats
- 40% carbs
- SMall, frequent meals
- <500 cal meal
- <100 cal snack
What is the weight watchers diet?
- Portion and calorie-controlled pre-packages meals
- Heat and eat
- Low in saturated, trans fats and sodium
- Variety in plans: low glycemic, M or F, seniors, diabetics, etc
- Access to other weight control tools such as on-line or in-person support
