Nutrition in Health and Disease

Question 1

What is the definition of diet?

Answer 1

sum total of all foods ingested

Question 2

What are fixed components of demand?

Answer 2

Basal requirements (membrane function)
Mechanical work (cellular and tissue level)
Substrate turnover

Question 3

What are the variable components of demand?

Answer 3

Cost of processing dietary intake
Cost of physical activity
Cost of maintaining body temperature

Question 4

What is basal metabolic rate?

Answer 4

Minimum to get away with and still being alive
Can be measured by direct colorimetry
Calculated depending on lean body mass + factors for activity and illness

Question 5

What is nutritional failure?

Answer 5

Failure to meet the nutritional requirements of the individual
Development of deficiencies
Weight loss or excess

Question 6

What is the definition of malnutrition?

Answer 6

A state of nutrition in which a deficiency or excess of energy, protein ad other nutrients causes measurable adverse effects on tissue/body form, body function and clinical outcome

Question 7

How is BMI calculated?

Answer 7

Weight (kg)/Height(^2) (m)

Question 8

What are the metabolic syndromes associated with obesity?

Answer 8

Hypertension
CVD
Type 2 diabetes mellitus
Fatty liver
NASH
Cirrhosis

Question 9

What cancers are most associated with obesity?

Answer 9

Breast

Bowel

Question 10

What is the current UK economic estimate cost of obesity?

Answer 10

£5 billion p.a

Question 11

What BMI range is classed as underweight?

Answer 11

<20

Question 12

What BMI range would suggest physical impairment?

Answer 12

<18

Question 13

What BMI range would suggest increasingly severe consequences?

Answer 13

<16

Question 14

How is undernutrition screened?

Answer 14

Malnutrition Universal Screening Tool

Question 15

What is the malnutrition universal screening tool?

Answer 15

Picks up patients at risk of malnutrition
Validated in the community and hospital
Can be carried out by people without special training

Question 16

What is the BMI for score 0?

Answer 16

> 20

Question 17

What is the BMI for score 1?

Answer 17

18.5 - 20

Question 18

What is the BMI for score 2?

Answer 18

<18.5

Question 19

What is the weight loss score?

Answer 19

Unplanned weight loss score in past 3-6 months

Question 20

What is score 0 on weight loss score?

Answer 20

<5%

Question 21

What is score 1 on weight loss score?

Answer 21

5-10%

Question 22

What is score 2 on weight loss score?

Answer 22

> 10%

Question 23

What is the acute disease score?

Answer 23

If the patient is acutely ill and there has been or is likely to be no nutritional intake for more than 5 days = automatic score 2

Question 24

What makes up the MUST score?

Answer 24

BMI + Weight loss score + Acute disease score

Question 25

What is a MUST score >2?

Answer 25

Suggests risk of undernutrition

Question 26

What is a MUST score 1?

Answer 26

Supplements and observation required

Question 27

What is a MUST score 0?

Answer 27

Monitoring required

Question 28

What does malnutrition associate with?

Answer 28

Illness Social isolation Age Socially vulnerable groups

Question 29

What are the clinical consequences of malnutrition?

Answer 29

``` Impaired immune response Reduced muscle strength Impaired wound healing Impaired psychosocial function Impaired recovery from illness/surgery Poorer clinical outcomes ```

Question 30

What is the estimated cost of undernutrition in the UK?

Answer 30

£13 billion p.a

Question 31

What factors are considered when calculating energy requirements?

Answer 31

``` Age Weight Sex Disease Activity ```

Question 32

What are the causes of undernutrition?

Answer 32

Appetite failure Access failure Intestinal failure

Question 33

What is appetite failure?

Answer 33

Eating disorders e.g. anorexia nervosa | Disease related

Question 34

What is access failure?

Answer 34

False teeth Strokes Cancer of head and neck Head injury (unconscious)

Question 35

What is intestinal failure?

Answer 35

Reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption of nutrients Consequences of surgery