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Advanced Medical Nutrition Therapy > MNT for Psychiatric Disorders > Flashcards

MNT for Psychiatric Disorders Flashcards

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1
Q

The brain is made up of about ___% fat

A

80

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2
Q

The fatty acid composition of neuronal cell membranes reflects ___ ___

A

Dietary intake

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3
Q

Essential fatty acids are involved in the synthesis of _____

A

Neurotransmitters

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4
Q

Effect of nutrients on mental health:

A

-Support the normal development of the brain and central nervous system
-Maintain structure and function of neurons
-Serve as precursors and cofactors for neurotransmitter production
-Provide an energy source for the brain
-Support mood and sense of well-being

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5
Q

What amino acids are needed for neurotransmitter production?

A

-Phenylalanine
-Tyrosine
-Tryptophan
-Glutamine

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6
Q

What vitamins are needed for neurotransmitter production?

A

-B1
-B2
-B3
-B6
-B12
-Folate

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7
Q

What minerals are needed for neurotransmitter production?

A

-Zinc
-Copper
-Iron
-Iodine
-Selenium
-Magnesium

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8
Q

___ ___ are also needed for neurotransmitter production

A

Fatty acids

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9
Q

The gut contains about ____ million neurons

A

100

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10
Q

What are three major neurotransmitters in the enteric nervous system?

A

-Acetylcholine
-Serotonin
-Norepinephrine

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11
Q

Neural activity in the gut is triggered by receptors responding to what three types of stimuli?

A

-Mechanical
-Osmotic
-Chemical

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12
Q

Bidirectional information continually passes between the ___ and ___

A

Gut, CNS

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13
Q

Gut bacteria and byproducts influence brain ____ and ____

A

Function and behavior

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14
Q

Rapid and abrupt increases in blood glucose can trigger rapid and excessive release of ____, followed by a rapid drop in blood glucose

A

Insulin

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15
Q

The body compensates for this rapid drop in blood glucose by raising levels of ____ and ____, which can trigger emotional changes and erratic behavior

A

Epinephrine and cortisol

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16
Q

Reducing ____ carbohydrate and sugar intake can decrease these blood glucose fluctuations considerably

A

Refined

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17
Q

What are two examples of of Omega-3 Fatty Acids?

A

-Eicosapentaenoic acid (EPA)
-Docosahexaenoic acid (DHA)

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18
Q

Omega 3 fatty acids are the preferred fatty acids in the ___ and ___ ____

A

Brain and nervous system

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19
Q

EPA and DHA (omega-3s) may have benefits in the management of…

A

-Anxiety
-Depression
-Post-partum depression
-Bipolar disorder
-Schizophrenia

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20
Q

Higher intake of fish (high in omega-3) is associated with decreased risk of ____, especially for women

A

Depression

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21
Q

____ is an essential coenzyme for neurotransmitters (like serotonin) that are potential targets for antidepressant therapies

A

Thiamin

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22
Q

Vitamin B12 deficiency may be involved in the pathogenesis of…

A

Depression
Bipolar
Panic disorders
Psychosis
Phobias

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23
Q

Folate deficiency is associated with…

A

Depression
Schizophrenia

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24
Q

Vitamin D deficiency is associated with…

A

Major and minor depression in older adults

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25
Iron deficiency is associated with ____
Depression
26
Magnesium deficiency can cause ____
Anxiety
27
Selenium deficiency is linked to ____
Depression
28
____ may reduce depressive symptoms
Zinc
29
Amino acids are precursors for what three neurotransmitters?
-Serotonin -Dopamine -Norepinephrine
30
____ and ____ are targeted by depression medication
Serotonin and dopamine
31
Amino acids are precursors for the antioxidant ____
Glutathione
32
Research suggests that ____ found in plant-based foods are important for normal brain function and mental health
Phytochemicals
33
____ have antioxidant activity and protect and preserve brain cell structure and metabolism
Flavonoids
34
What foods contain flavonoids?
-Berries -Onions -Kale -Red cabbage -Grapes and red wine -Tea -Curcumin -Dark chocolate -Citrus fruit
35
What are specific nutrition factors to consider for someone with a psychiatric disorder?
-Increase or decrease in appetite -Increase or decrease in activity level and therefore calorie requirements -Use of medications that cause dry mouth, thirst, constipation, and weight change -Decrease in ability to concentrate, understand, and follow directions -Altered nutritional needs due to use of alcohol or tobacco -Possible decrease in ability for self-care such as adequate income, shopping, or meal preparation -History of comorbid conditions that may have resulted in suboptimal nutritional intake -Use of nutrition supplements
36
_____ disorders are the most common type of mental illness in the United States
Anxiety
37
Common to anxiety disorders are ____ and poorly controlled emotional, somatic, and neurological symptoms triggered by a specific situation
Heightened
38
The underlying etiology of anxiety is not well understood, but may be related to...
-Genetics -The stress of an adverse childhood experience can constitute a significant etiologic factor for anxiety that may impact the individual into and throughout adulthood
39
What are 3 classes of medication that may be used for medical management of anxiety?
-Benzodiazepines -Selective serotonin reuptake inhibitors (SSRI) -Serotonin and norepinephrine reuptake inhibitors (SNRI)
40
What are two examples of Benzodiazepines?
-Alprazolam -Clonazepam
41
What are food-drug interactions with Benzodiazepines?
-Avoid concurrent ingestion of alcohol -Limit/avoid caffeine
42
What are two examples of selective serotonin reuptake inhibitors (SSRIs)?
-Sertraline -Fluoxetine
43
What are food-drug interactions with selective serotonin reuptake inhibitors (SSRIs)?
-May increase appetite and weight -May cause dry mouth -Avoid St. John's Wort -Avoid alcohol
44
What is one example of a serotonin and norepinephrine reuptake inhibitor (SNRI)?
Duloxetine
45
What are food-drug interactions with serotonin and norepinephrine reuptake inhibitors (SNRIs)?
-Avoid St. John's Wort -Avoid alcohol
46
MNT for management of anxiety:
-Eat regularly schedules meals with protein and low glycemic carbohydrates to promote stable blood glucose -Eliminating caffeine for 3-4 weeks to see if anxiety decreases -Consider MVI with minerals if dietary intake does not meet the DRI for folate, B12, zinc, magnesium, and vitamin D -Include dietary sources of omega-3 fatty acids -Encourage physical activity
47
Major depressive disorder (MDD) affects ___% of Americans
6.7
48
What gender is more commonly affected by major depressive disorder?
Women
49
No definitive ___ of major depressive disorder has been identified
Cause
50
About ____ of people do not respond adequately to treatment for depression
1/3
51
What are contributing factors to the development of major depressive disorder?
-Genetics -Nutrition -Environmental stressors -Hormonal disruption (especially in the hypothalamic-pituitary-adrenal axis) -Alterations in neurotransmitter biology and function (monoamine deficiency theory)
52
The ___ ____ theory states that deficiency of serotonin, dopamine, and norepinephrine, or altered receptor function, is the main pathophysiologic factor of depression
Monoamine deficiency
53
What 3 classes of drugs are used for medical management of depression?
-SSRIs -SNRI -Norepinephrine-dopamine reuptake inhibitors
54
What SSRIs are used for treating depression?
-Fluoxetine -Paroxetine -Sertaline
55
What SNRIs are used for treating depression?
-Duloxetine -Venlafaxine
56
What is one example of a norepinephrine-dopamine reuptake inhibitor?
-Bupropion
57
Food-drug interactions with norepinephrine-dopamine reuptake inhibitors:
-May cause increased or decrease appetite and weight -May cause dry mouth -May cause taste change -May cause stomatitis -N/V -Take with food to decrease GI irritation -Limit/avoid alcohol -Avoid St. John's Wort
58
MNT for depression:
-Mediterranean dietary pattern may protect against the development of depressive symptoms later in life and decrease risk of Major Depressive Disorder -Encourage regular meals and snacks that help maintain blood glucose levels -Ensure adequate folate, vitamin B12, vitamin D, and omega-3 fatty acid intake (treat deficiencies of B12 or folate) -Social eating if possible -Recommend exercise -Curcumin may be beneficial due to anti-inflammatory effects -Zinc deficiency may play a role in depression, so treat deficiencies -Monitor for weight changes -Assess for food-drug interactions -Caution must be used if treating depression with St. John's Wort
59
Zinc may reduce depressive symptoms by...
-Decreasing dopamine reuptake -Increasing conversion of thyroid hormone T4 to T3 -Promoting excitatory neurotransmitter function
60
Why should we use caution if someone is using St. John's Wort to treat depression?
-Food-drug interactions -Increases risk of triggering "serotonin syndrome" if patient is taking a SSRI or SNRI
61
____ ____ causes episodes of an elevated or agitated mood known as mania alternating with episodes of depression
Bipolar disorder
62
The average age of onset of bipolar disorder is ___ years old
25
63
There is a genetic component to the development of bipolar disorder, but other factors that trigger the illness include...
-Hormones -Neurotransmitter abnormalities -Stress
64
Medical management of bipolar disease is done with ____
Lithium
65
Food drug interactions with Lithium:
-A stable, moderate amount of sodium is needed to stabilize lithium levels -Drink 2-3 liters of fluid/day -Limit caffeine -Monitor for weight gain -Can cause N/V/D
66
____ is a severe mental disorder that presents as psychosis, often with paranoia and delusions
Schizophrenia
67
Diagnosis of Schizophrenia requires at least one of the following three symptoms:
-Delusions -Hallucinations -Disorganized speech
68
Symptoms typically appear in ____ during their late teens to early 20s, and in ____ during their 20s to early 30s
Males; females
69
The ____ of Schizophrenia is poorly understood, but could be a heterogenous disorder generated by a combination of biochemical, genetic, structural, nutritional, and environmental factors, including infections and toxins
Pathophysiology
70
Medical management of Schizophrenia is a combination of...
-Dopamine-blocking antipsychotic medications -Antidepressants -Tranquilizers
71
What are two examples of dopamine-blocking antipsychotic medications?
-Haloperidol -Risperidone
72
Side effects of antipsychotics:
-Dry mouth -Constipation -Increased appetite -Weight gain
73
Schizophrenia is associated with altered ____
Metabolism
74
Schizophrenia ____ energy needs
Reduces
75
Schizophrenia ____ visceral fat
Increases
76
We should monitor weight in people with Schizophrenia; a weight gain of ___% should trigger assessment for metabolic syndrome
7
77
We should refer those with schizophrenia to ___ ___ ___ programs as needed
Behavioral weight management
78
MNT for schizophrenia:
-Recommend regular meal pattern and trial of a low-glycemic, dairy free, Mediterranean diet -Recommend sources of EPA and DHA (omega 3) -Rx screening for celiac disease -Assess for vitamin D and folate deficiency (associated with worse symptoms) -Assess for food-drug interactions -Avoid alcohol
79
We should caution against including ____ in the diet for someone with schizophrenia and it can cause increased blood levels of certain antipsychotic medications
Grapefruit
80
Addiction involves numerous _____
Neurotransmitters
81
The production of ____ produces a sense of pleasure
Dopamine
82
Production of dopamine is triggered by use of...
-Heroin -Amphetamines -Marijuana -Alcohol -Nicotine -Cocaine
83
___ and ____ are also involved in addiction
Serotonin and glutamate
84
Effects of addiction on nutrition status:
-Poor appetite -Craving for sugar and sweets -Constipation -Lack of motivation to prepare meals -Malnutrition
85
Malnutrition in someone with addiction may be due to...
-Insufficient food or nutrient intake -Alterations in absorption, digestion, metabolism, or excretion of nutrients
86
____ million people age 12 and up have alcohol use disorder (5.3% of this age group)
14.5
87
What screening tool is used to identify people at risk for alcohol use disorders?
AUDIT
88
MNT for alcohol use disorder:
-Assess dietary intake, GI function, risk of malnutrition, and for potential micronutrient deficiencies -Prescribe biochemical assessment of thiamin, folic acid, magnesium, and selenium -Rx multivitamin with minerals for 6 months -Provide nutrition education
89
In addition to a multivitamin with minerals, what additional supplementation should be given to those with alcohol use disorder?
-Thiamin: 50-100 mg -Folic acid: 1 mg daily
90
We should recommend a nutritionally adequate diet with ___-___% of kcal from high quality protein for those with alcohol use disorder
25-30
91
For those with alcohol use disorder, we should prescribe an omega-3 fatty acid supplement of ___-___ mg/day
800-1000

Advanced Medical Nutrition Therapy (14 decks)

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