Nutrition Exam 2 Cards Flashcards
(148 cards)
1
Q
A1c level for diabetes
A
6.5%
2
Q
Fasting plasma glucose (8 hours) for diabetes
A
126 mg/dL
3
Q
2-hour Oral Glucose Tolerance Test value for diabetes
A
200+mg/dL
4
Q
“Type 3 Diabetes”
A
Insulin resistance and insufficiency in the brain that plays a role in the development of alzheimers
5
Q
Thresholds for prediabetes
A
Fasting glucose 100-125
OGTT 140-199
A1c 5.7-6.4
6
Q
4 lifestyle interventions for DM
A
Healthy eating (high fiber, low carb)
Physical Activity
Quality sleep
Tobacco avoidance
7
Q
Carbohydrates for DM patients
A
High in fiber - 30g/day
8
Q
Recommended protein intake for DM patients
A
0.8 g/kg/day
9
Q
Nuts and diabetes
A
Mostly beneficial to the cardiovascular system - can still eat too many
10
Q
Ethanol and diabetes
A
Can interfere with hepatic gluconeogenesis causing hypoglycemia - highest risk in those taking drugs that stimulate insulin release
11
Q
Caffeine and diabetes
A
Long term abstinence may help with A1c but the data is limited
12
Q
Chromium and diabetes
A
Supplumentation up to 8mcg/day is safe and may help with insulin receptor activation
13
Q
Vanadium and diabetes
A
Insulin cofactor that we usually consume in small amounts - causes GI side effects
14
Q
Fish oil and diabetes
A
Not recommended - may help with elevated triglyceride levels
15
Q
Chocolate and diabetes
A
Dark is healthier, still a calorie dense food
16
Q
Cinnamon and diabetes
A
Not likely to be harmful but not much benefit that it helps either
17
Q
How fructose metabolism differs from sucrose metabolism
A
It is directly converted to fat and does not provoke the same insulin response
18
Q
alternative sweetener with the lowest glycemic index
A
Agave
19
Q
Effects of sugar alcohols
A
GI symptoms are a major side effect (think of the haribo gummy bears)
Erythritol recently linked to blood clots
21
Q
Pro/Con of non-nutritive sweeteners
A
Can be good, generally not found to be carcinogenic but aren’t always associated with weight loss or better health
21
Q
Ischemia
A
Not enough blood flow
22
Q
Infarction
A
No blood flow
23
Q
LDL level at which lifestyle changes should be considered for those with over 20% risk
A
Over 100 mg/dL
24
Q
LDL level at which lifestyle changes should be considered if risk is under 20%
A
130 for those with 2+ risk factors
160 for those with 0 or 1 risk factor
25
Fat intake recommendation for cardiovascular disease
Keep fat as low as possible while still getting adequate nutrition - 20-35% of total calories
26
Where do US women and children get most of there saturated fats?
From dairy (milk) and processed foods
27
Polyunsaturated fats and heart disease
May have some benefit in those who already have heart disease by preventing LV remodeling
28
Monounsaturated fats and CV disease
Linked to better heart health as part of a mediterranean diet
29
Ketogenic diet and CV disease
May worsen arterial endothelial function and promote atherosclerosis
30
Atherosclerosis and carbohydrates
Fruits/Vegetables are better sources of carbohydrates generally
31
Protein sources and CV from best to worst
Plant based
Poultry/Fish
Dairy
Unprocessed red meat
Eggs
Processed red meat
32
Atherosclerosis and antioxidants
Reduce cell damage and therefor help slow growth of plaques
33
Atherosclerosis and B vitamins
May not cause harm but also not much evidence for benefit
34
Coenzyme Q10
Supplement that may help patients with heart failure, found in plant based foods
35
Atherosclerosis and alcohol
Small amounts may have some benefit, although this may not be due to ethanol itself
36
Nuts and atherosclerosis
Consistently positive association - walnuts and almonds are the best - mind caloric intake
37
Plant stanols/sterols
Interfere with cholesterol absorption may be helpful for CV disease
38
Garlic and CV disease
May help lower blood pressure, not strongly associated with reduced mortality
39
Red Yeast Rice
Statin like supplement - questionable efficacy
40
Magnesium and CV disease
Found in leafy greens - low levels beneficial although dietary consumption is preferred
41
Concerning BP threshold
Over 120/80
42
Elevated systolic BP
120-129
43
Stage 1 hypertensive BP
130-139 over 80-89
44
Stage 2 hypertensive BP
140+/90+
45
Hypertensive crisis BP
180+/120+
46
Populations with higher BPs
Black patients and high BMI patients
47
DASH Diet
Focus on fruits and vegetables rather than salt and animal products
48
Dietary elements with positive BP effects (4)
Calcium, Magnesium, Fiber, Potassium
49
3 Dietary elements with negative effects on BP
Sodium, Alcohol, Caffeine
50
Metabolism difference of AKI patients
Faster protein metabolism - at risk for cachexia
51
Top two causes and one contributing cause of CKD in the US
DM and HTN
Atherosclerosis
52
General protein recommendations for CKD and why
Plant proteins are preferred due to lower phosphate content - may need B12 supplement
53
Recommended protein intake for CKD 1-2
.8g/kg/day
54
Recommended protein intake for CKD 3-5
.6-.8g/kg/day
55
Recommended protein intake for stage 5 and dialysis
Actually needs INCREASED protein intake 1-1.3 (1.3 for Peritoneal dialysis) per kg/day
56
General dietary guidelines for all CKD adults
Plant Dominant, Low Protein diet (PLADO)
50%+ protein from plants
Under 4 g of sodium daily (3 if edema)
High fiber
30-35 cal/kg/day unless trying to loose weight for medical reasons
57
3 things you might want to supplement in a CKD diet
Iron, C and B12 (any water soluble vitamin really)
58
Protein intake for a very low protein diet
.28-.43g/kg/day
Must have various supplements (Keto acids, amino acids, B12)`
59
Energy intake recommendation for CKD
30-35calories/kg/day
60
Fat intake for CKD
Avoid saturated fats as atherosclerosis can be an aggravating factor
61
Dietary fiber intake for CKD
25-30 g/day - Long known to help with kidney disease due to anti-inflammatory properties
62
Sodium recommendation for CKD
3-4 g or less per day depending on whether edema is present
63
Fluid intake recommendation for CKD patients
1.5 L/day
1.0 L/day if complications such as fluid overload or hyponatremia
64
2 ways to help CKD patients avoid potassium in fruits and vegetables
Give them a list of things that don't have potassium
Have them boil fruits/vegetables first
65
Potassium recommendation for CKD
Under 3g/day in later stages
66
Animal based food with high acid content
Hard cheeses and Egg yolks
67
PRAL
Potential Renal Acid Load
68
2 ways to reduce acid levels in CKD
Supplement with bicarbonate or eat 2-4 cups of fruits/vegetables daily
69
Organic v Inorganic Phosphorus
Organic is harder to absorbed - naturally occuring
Inorganic is easier to absorb - in dark sodas and processed foods
70
Dietary phosphorus recommendation for CKD
800mg/day
71
3 things to eleminate from beverages for a CKD diet
CO2, Caffeine, Sugar
72
Vitamin D and CKD
Always supplement - will generally cause calcium increase
73
What do we do if we have to choose between calcium and Vitamin D
Choose calcium b/c the heart needs it
74
Carnitine
Supplement that may help with lipid levels
75
2 minerals deficient in CKD that are not recommended for supplementation
Zinc and Selenium
76
2 medications that contain aluminum that should be avoided with CKD
Antacids and Immune boosters
77
Eosinophilic esophagitis
Chronic allergic inflammatory condition with infiltration of esophageal lining - can lead to scarring and strictures
Like squeezing a toothpaste tube with the cap on
78
Dietary modifications for eosinophilic esophagitis
Remove allergy causing foods
Six food elimination diet
Elemental diet (formula)
79
Presentation of eosinophilic esophagitis
Trachealized esophagus
80
8 Major allergens
Milk, Wheat, Eggs, Soy, Peanuts/Treenuts, fish/shellfish
81
Prognosis for six food elimination diet
Symptom response in 87% of patients
Histologic response in 69% of patients
82
Prognosis of elemental diet in Eosinophilic esophagitis
100% symptomatic response
95% histologic response
83
Elemental diet
Nutrient rich amino acid formulas used to replace ALL foods
84
Dyspepsia
Chronic, recurring upper abdominal discomfort
85
Peptic ulcer disease
Characterized by open sores on the mucosal membrane of the stomach or duodenum
86
Macros for GERD dyspepsia and PUD
Decrease simple carbs and increase fiber
High fat fried foods may trigger symptoms
No guidelines for specific proteins
87
3 acidic foods that can trigger GERD
Tomato based, Citrus, Carbonated beverages
88
5 other foods that can trigger gerd
Spicy, Coffee, alcohol, peppermint, chocolate
89
Alcohol and stomach problems
THought to cause peptic ulcers
90
Dairy and stomach problems
Associated with lower PUD risk
91
3 herbs that MAY help with dyspepsia and GERD
Curcumin, Ginger, Peppermint/Caraway oil
92
Lifestyle modifications for GERD
Small meals
Weight loss
Loose clothing
HOB elevation
Quitting alcohol, tobacco, caffeine
93
Prebiotics
Food high in non-digestible fiber that promotes the growth of beneficial gut bacteria
94
6 foods with prebiotics
Apple, Asparagus, Garlic, Onion, Banana, Oats
95
Probiotics
Food containing live organisms with associated health benefits
96
4 common probiotic strains
Bifidobacterium, Sacchromyces, Lactobacillus, E. coli (non-pathogenic)
97
Consipation
Infrequent, hard stools that are difficult to pass
98
Dietary treatment of constipation
30g/day fiber
Fruits and vegetables - dried fruits are especially helpful
Whole grain also an option
99
Lifestyle modifications for constipation
Hydrate
Physical activity may help with peristalsis
100
Diarrhea definition
3 or more loose watery stools per day
101
Chronic diarrhea definition
Greater than 4 weeks of symptoms
102
Nutrition and acute diarrhea
Usually an infectious etiology - BRATY diet
103
Why are prunes a good laxative
they contain sorbitol
104
BRAT(Y) diet
Banana, Rice, Applesauce, Toast +/- Yogurt
105
Nutrition for chronic diarrhea
low-FODMAP diet, elimination with reintroduction
106
FODMAP
Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, Polyols
107
3 low FODMAP veggies
Cucumbers, Carrots, Lettuce
108
3 high FODMAP veggies
Garlic, Beans, Onion
109
3 low FODMAP fruits
Pineapple, Strawberries, Grapes
110
3 high FODMAP fruits
Blackberries, Watermelon Peaches
111
3 Low FODMAP starches cereals and grains
Potatoes, Chips, Popcorn
112
3 Low FODMAP proteins
Chicken eggs tofu
113
3 high FODMAP Proteins
Sausage, Beer battered fish, Breaded meat
114
3 high FODMAP starches cereals and grains
Beans, Bread Muffins
115
Prevalence of food allergies
10-11% of the US population
116
Manifestation of food allergies
Have a rapid and potentially severe onset - Immunologic symptoms that are often life-threatening
117
Manifestation of a food intolerance
Usually severity correlates with the dose (unlike allergies) Symptoms focus around the GI tract and are usually non-life threatening
118
Number of possible food additive allergens
160+
119
Common food intolerance foods
High FODMAP, Gluten, Fructose, Caffeine, Lactose
120
Ninth common allergen
Sesame
121
Imperfection of food allergen labeling
Milk=cow milk
Eggs=Chicken eggs
122
Newer children allergen guidlines
Delay of exposure to allergens NOT recommended - only delay in HIGH risk babies
123
Early indirect allergen exposure
Mother eats allergenic foods while breastfeeding or pregnant
124
5 symptoms of IgE mediated food allergy
Uticaria (hives), Angioedema, Dyspnea, Sense of impending doom, tachycardia
125
Acute management of an IgE mediated allergic response
Administration of epinephrijne ASAP may use steroids, antihistamines or beta agonists as well
126
Oral allergy syndrome
Foods cause lip tingling and mouth itching - most common in adults with hx of seasonal allergies
127
Distinguishing factors of Oral allergy syndrome
Presents within a few minutes and is usually exclusive to RAW foods not cooked ones
128
Management of oral allergy syndrome
self limiting - Antihistamines can help - work up if systemic symptoms are present
129
Diagnosis of lactose intolerance
Stool studies for osmotic gap, Hydrogen breath test, small bowel biopsy
130
Percent of americans with actual celiac disease and percent with non-celiac sensitivity
13% non-celiac
1% true celiac
131
Symptoms of gluten intolerance
Bloat flatulence and borborygmy accompanied by malabsoption and B and D vitamin deficiencies
132
Celiac skin lesions
Dermatitis Herpetiformis
133
3 diagnostics for celiac disease
Exclusion test, Serum antibody assay, Small bowel biopsy
134
What to animal and plant products tend to turn into in the body
Animal - Acid
Plant - Base
135
Seitan
Plant based meat product made from vital wheat gluten
136
What happens to B12 absorption as we age
It gets less efficient around 50
137
Vegetarian friendly sources of B12
Fortified cereals, plant based milks, dairy and eggs - often still need supplementation
138
2 types of B12 supplements
Cyanobobalamin
Methylcobalamin - more natural but not much better nutritionally
139
Plant based sources of VItamin A
Orange, yellow, red, and some green vegetables that contain carotenoids
Vegetarians can usually get enough
140
High risk for iodine deficiency
Vegans that eat non-iodized salt
Can eat seaweed
141
Calcium rich vegetables with low oxalate
Cauliflower, chives, cucumbers, cabbage
142
Iron and vegetarian diets
Eat with vitamin C for better absorption whole grains and nuts can be good sources - but less easy to absorb than iron in meat!
143
4 vegetarian foods with zinc
Nuts, seeds, legumes, whole grains
144
What limits zinc absorption
Phytates - can be removed via soaking
145
Fatty acid supplementation for vegetarin diets
Need to add chia seeds, flax seeds, hemp seeds, walnuts or seaweed to get enough ALA to convert to DHA/EPA
Supplemetation often recommended esp. if pregnant or breastfeeding
146
Vegeterian complete protein sources and higher risk determination
Higher risk if no iodized salt
Quinoa, soybeans, chia, buckwheat
147
4 risks of a plant based diet
Poor bone health
Anemia
Childhood malnutrition
Pregnancy and lactation difficulties
148
4 benefits of a plant based diet
Decreased mortality
Decreased T2DM
Decreased CV disease
Decreased cancer
