Nutrition Flashcards

Question

Define the RNI

Answer 1

The RNI is the amount of a nutrient that is enough to ensure that the needs of nearly all a group (97.5%) are being met. For most vitamins and minerals, DRVs are given as Reference Nutrient Intakes (RNI). Most vitamins and minerals also have Lower Reference Nutrient Intakes

Answer 2

The LRNI is the amount of a nutrient that is enough for only a small number of people in a group who have low requirements (2.5%) i.e. the majority need more.

Answer 3

The Safe intake is used where there is insufficient evidence to set an EAR, RNI or LRNI. The safe intake is the amount judged to be enough for almost everyone, but below a level that could have undesirable effects.

Answer 4

During pregnancy – its recommended women of child bearing age take 400μg folic acid supplement daily until 12th week of pregnancy. This prevents birth defects of the central nervous system (aka neural tube defects) including spina bifida

Answer 5

If family history of neural tube defects - higher dose of 5mg of folic acid daily recommended. Women with diabetes and those taking anti-epileptic medicines may also need to take a higher dose of folic acid

Answer 6

Advised to take vitamin D, folic acid and vitamin C | Avoid excess vitamin A as can be teratogenic.

Answer 7

 Breastfed babies (birth to one year of age) - daily supplement containing 8.5 - 10μg of vitamin D  Babies fed infant formula – not required until receiving less than 500ml of infant formula a day  Children aged 1 to 4 years old - daily supplement containing 10μg of vitamin D Who needs extra vitamin A and C  Children aged six months to five years – daily supplement of vitamins A and C (often combined with vitamin D)  Precautionary measure - ensure requirements are met (difficult to be certain diet provides a reliable source)  Babies fed infant formula – not required until receiving less than 500ml of infant formula a day

Answer 8

Those living in the UK, including people at increased risk of vitamin D deficiency, should consider a daily supplement containing 10μg (400 IU) of vitamin D People at higher risk of deficiency include those:  With limited sun exposure  With dark skin (for example African, African-Caribbean, or Asian or Middle-Eastern ethnic origin)

Answer 9

• Cover up their skin for cultural reasons (for example Muslim women) or for health reasons (for example people with skin photosensitivity or a history of skin cancer). • Spend very little time outdoors (for example those who are housebound or institutionalized). • Are at increased risk of nutritional deficiency, for example vegans and those who do not eat fish, or generally have a poor diet  Are at increased risk of nutritional deficiency  Are pregnant or breastfeeding  Are elderly (65 years and older)  Have certain conditions or are taking certain drugs  Are obese or have had gastric bypass surgery  Have a family history of vitamin D deficiency

Answer 10

Vitamin D deficiency caused by intestinal malabsorption or chronic liver disease usually requires vitamin D in pharmacological doses. Vitamin D requires hydroxylation by the kidney to its active form, therefore the hydroxylated derivatives alfacalcidol or calcitriol should be prescribed if patients with severe renal impairment require vitamin D therapy

Answer 11

* Some vegans * People in certain demographic groups – infants and children, adolescents (iron deficiency), pregnancy and breastfeeding, elderly, ethnic minorities * Chronic alcoholism - poor diet and poor GI absorption * Innate GI malabsorption e.g. coeliac, inflammatory bowel disease (IBD) * Chronic kidney disease (CKD) – vitamin D * If prescribed certain medications e.g. isoniazid

Answer 12

Addition of nutrients to appropriate food vehicles e.g. • Vitamin D fortified margarine • B vitamins and iron in cereals • White and brown flour fortified with calcium, iron, thiamine and niacin • Fluoride in drinking water

Answer 13

Products which contain vitamins, minerals and often other ingredients. Promoted on basis that taking additional vits and minerals will be beneficial. However the evidence for this in most cases is unsubstantiated. We have already discussed those for whom specific recommendations are in place.

Answer 14

* Toxicity and accumulation e.g. iron * Supplements are expensive * Cause complacency - bad diet * Legal status practically no control * Dose, claims quality control, availability * Not viewed as a medicine – thus difficult to offer advice * Interactions

Answer 15

• Methotrexate and folic acid – beneficial. Protect vs. side-effects of methotrexate • Iron and Vitamin C – beneficial. Vitamin C enhances iron absorption • Tetracyclines and metal salts e.g. iron or magnesium. Reduces absorption of antibiotic therefore take antibiotic at least 2 hours before or 6 hours after metal salt supplement • Calcium and corticosteroids. Corticosteroids reduce absorption of calcium from the GI tract, increasing risk of osteoporosis Good Practice – Always ask patients about any supplement they take

Answer 16

* Advice to public about healthy diet * Identification of patients who may benefit from additional supplementation * Aware of common symptoms of deficiency * Be able to recommend appropriate supplements * Prevent interactions

Nutrition Flashcards

(40 cards)