Nutrition in Healthcare Flashcards
(89 cards)
1
Q
What is the Hamilton Family Health team?
A
- services approx 300, 000 pt in hamilton area
- 166 physicians
- nurses, NPs, dietitians, pharmacists, physician assistants etc.
- “our mission is better care, together”
2
Q
what can RD’s support management for?
A
diabetes, HTN, dyslipidemia, GI issues, IBS, celiac, anemia, eating disorders, bariatric surgery
3
Q
what factors are included in preventative care with RD’s?
A
- food security
- prenatal nutrition
- infant feeding
- diabetes prevention, heart health, depression
- seniors fragility, malnutrition and healthy aging
4
Q
what do RD’s tackle on a daily basis?
A
nutrition misinformation
- some are evidence based an some are not
- goal is to “do no harm”
5
Q
what percentage of woman in Canada want to reduce their body wt?
A
70
6
Q
teens who self report dieting, end up developing what 2 things?
A
- become overweight
- develop an eating disorder
7
Q
self dieting and restriction can lead to:
A
- metabolic changes
- mental health impacts (binge, eating, feelings of guilt, shame)
- weight cycling (wt loss, wt gain, repeat)
8
Q
what is optimized nutrition?
A
- meeting nutrient needs
- flexibility in food choices
- enjoyment in food
9
Q
what is disordered eating?
A
- restricting/limiting
- food rules
- lack of enjoyment
- feelings of shame/guilt
10
Q
what is eating disorder?
A
- ++ time spent in eating disorder behaviours
- impact on function wellness, health
- self eval based on weight, shape
11
Q
what is the most common eating disorder?
A
binge eating disorder
12
Q
what does the HFHT eating disorder toolkit for early detection an intervention include?
A
screening, assessment, lab Rqn, resources, referrals. registry
13
Q
what physical changes can put someone at risk for eating disorder?
A
- early puberty
- abnormal growth
- activities that emphasize body, wt, shape
- low BMI, wt suppression
- T1D
- amenorrhea
- fam hx of eating disorders
14
Q
what populations are at risk for eating disorders?
A
- racilized persons
- gay men/trans
- ppl with ADHD, autism an women with disbilities
- ppl in larger bodies
- wt stigma
15
Q
what are the impacts of weight bias on mental and emotional health?
A
- stress, depression, anxiety, psychiatric diagnosis, suicidal thoughts
- poor body image
16
Q
what are the impacts of weight bias on physical health?
A
- avoid physical activity
- unhealthy eating practices
- delay/avoid seeking healthcare
- increased BP, pain substance use and stress
17
Q
what are the impacts of weight bias on social health?
A
- bullying and harassment
- social isolation
- difficulties with relationships
18
Q
what are the impacts of weight bias on monetary?
A
- discrimination in education and workplace settings
- lower performance
19
Q
can you tell how healthy someone is by looking at them?
A
no
20
Q
what is “health”?
A
state of complete physical, mental and social well being endnote merely the absence of disease or infirmity (WHO)
21
Q
what are the 4 M’s in an assessment?
A
mechanical, metabolic, mental, monetary health
22
Q
what are the 5 A’s in an assessment?
A
ask, assess, advise, agree and assist
23
Q
what are the tx options to becoming healthier?
A
- lifestyle
- meds
- bariatric surgery
24
Q
intuitive eaters tend too;
A
- enjoy food
- less likely to binge eat or show eating disorder symptomology
25
what factors can influence wt gain or inadequate nutrition?
mental health, dieting, meds, chromic stress, behaviours, physical activity, sleep, metabolism, culture, gut microbiome, environment
26
what are the main hormones in our appetite control system?
- ghrenlin
- leptin
- pancreatic peptides
- cortisol
27
the body is designed to defend against what?
weight loss
28
high stress levels increasing cortisol can override what?
our appetite (hypothalamus)
29
what is the HFHT bariatric toolkit?
ongoing follow up and pre surgical support to help pt achieve their health goals and reduce complications
30
what are some long term complications of bariatric surgery?
- weight regain
- nutritional deficiencies
- high suicide rates an depression
- relapse of diabetes an HTN
- coping after surgery
31
what is a main common post op complication of bariatric surgery?
hair loss, 1 year post op
32
what should be assessed and completed for a pt recovery bariatric surgery?
- assess for deficiencies in protein, fatty acids, iron, zinc
- annual bloodwork
- treat deficiencoes
- ensure taking adequate supplementation
33
what meds can be poorly absorbed after bariatric surgery?
- SSRI
- levothyroxine
- antibiotics
- BC pills
34
when should you watch for signs of rapid wt gain or loss?
- pregnancy
- infancy/children
- teens
- menopause
- older adults
35
at 1 year of age, what do infants eating patterns usually look like?
infants diet often mimics the unhealthy eating patterns seen in older children and adults
36
9-18 months is critical time for nutrition and adequate diets. t or f
t
37
how many extra cals should be consumed in first trimester?
none
38
how many extra cals should be consumed in second trimester?
350
39
how many extra cals should be consumed in third trimester?
450
40
how much wt gain should there be in first trimester?
1-2 kg
41
when a womens pre pregnancy BMI is over 30, it is highly linked with increased risk for what?
- gestational diabetes
- pre eclampsia
- c sec
- pre term birth
42
meeting with an RD to improve OB outcomes can improve what factors in pregnancy?
- optimize dietary intake
- ensure appropriate supplementation
- slow down rate of wt gain
43
what infants are at high risk of anemia?
- pre term, low birth wt
- breast fed babies
- low socioeconomic status
- born to new immigrants
- insufficient iron rich foods at 6 months of age
- excessive milk consumption
44
in children an youth, wt loss of what percentage indicates malnutrition and is a medical emergency?
10-20%
45
<80-88% usual wt for children is an indication of what?
malnutrition and requires urgent assessment
46
vasomotor symptoms in menopause are associated with a higher incidence of CVD and depression. t or f
t
47
if menopausal hormone therapy started within first 10 years of menopause, risk of HD and dying of any cause is reduced by what percentage?
40%
48
what is a key factor in reducing menopausal symptoms and CVD risk?
optimized diet
49
what dietary pattern has been shown to reduce menopausal symptoms?
Mediterranean diet
50
what is the A, B, C, D, E, F, G lifestyle?
A- avoid caffeine, alcohol, excess Na an sugars, smoking
B-balanced healthy diet
C- calcium from foods to maintain bones an BP
D- D3 for bone health an immune function
E- exercise - 30 mins x 5 days = 150 min/week
F- chose foods rich in heart healthy fats
Fan- stay cool, dress in layers, stay hydrated
51
what are common foods challenges amongst seniors?
- food an drug interactions
- constipation
- dehydration
- cooking for one
- eating well on fixed income
52
what things may you notice about seniors eating habits?
- low appetite
- easily full
- fatigue (skip more meals, rely on processed food, settle for tea)
- trouble chewing, dry mouth, dentures, constipation
53
what amount of seniors are at risk for malnutrition?
1/3
54
what population is the most vulnerable and most at risk for malnutrition?
- older women
- socially isolated
- living with depression
- polypharmacy
- poor oral health
55
malnourished seniors are more likely to:
- more visits to doc
- more likely to have a fall
- admitted to hospital
- increased med use
- reduced quality of life
56
during hospital admission in malnourished seniors, what is the result?
- worsen during their stay
- stay 2-7 days longer
- high 30 day re admission rate
57
symptoms of hypoglycaemia:
headache, sweating, dizziness, hunger, blurred vision, fast HR, shaking, anxiety, tired, weakness, irritability
58
losing wt without trying increases risk of:
- muscle loss
- risk of malnutrition
- falling
- hospitalization an further decline
59
what is the EMR Tool - Screen?
looks at wt loss, changes in appetite, dysphagia, etc
- consists of 8 questions
60
what does DASH diet stand for?
dietary approaches to stop HTN
61
what does combination of Mediterranean and DASH diet reduce?
cognitive decline
62
Med diet reduces ____ by 28-30%.
CVD
63
1/3 of participants with depression in the SMILES study reported no symptoms of depression after following which diet?
Mediterranean diet
64
protein an carbs work tg to boost ____________ in the brain which helps with mood, sleep and feelings of joy.
Serotonin levels
65
lack of tryptophan an glucose can cause:
low mood, difficulty sleeping, lacking joy, pain inhibition
66
lack of tyrosine can cause:
lacking drive, motivation an or enthusiasm for life
67
lack of glutamine can cause:
anxiety, irritable, inability to relax
68
lack of glucose, methionine and folate can cause:
memory, learning, recall
69
how much protein should be consumed at each meal?
25g protein/meal
70
how can you prevent feeling hangry?
eat at reg times, q4-5 hours
71
is olive oil or coco nut oil better?
olive oil
72
benefits to olive oil:
- boost in HDL, lowers LDL
- anti inflammatory
-reduce impact of Alzheimers
- prevents stroke CVD
- antioxidant
73
benefits of coconut oil:
- boosts HDL but also LDL
- improve body composition
- handles heat well
74
DASH diet can lower sbp by how many points of mercury?
11
- this is = to 1 BP med
75
what is gas an bloating cause by?
swallowed air, certain foods, drinks, meds, supplements
76
what can gas an bloating indicate?
lack of fibre, an intolerance, or IBS
77
soluble fibre can lower LDL cholesterol by what percentage?
10
78
soluble fibre sources:
psyllium, barely, legumes, oats, ground flax an chia seeds and several fruits/veggies
79
what yogurt should you buy to reduce constipation?
a) danactive
b) yoptimal or logo
c) activia
activia
80
low levels of vitamin D3 are associated with what?
falls, depression an poor immune function
81
is vitamin D3 in a lot of our foods?
no it is limited (fish an milk)
82
who is at risk for vitamin B12?
1/3 of adults over age of 50
83
risk factors for low B12 status including:
- vegan diet
- med use
- older age
- heart burn
- other GI conditions
- gastric surgery
84
what is the #1 deficiency in the world?
iron
85
what populations are mostly deficient in iron?
infants, women and children
86
when should iron start to be given in life?
5-6 months of age
87
why should more fruits an veggies be added to meals when you are deficient in iron?
fruits an veggies as vit C can enhance iron absorption
88
what drink should be avoided when eating a meal (associated with low iron)?
avoid tea/coffee
89
in child bearing years, what should be tested for? (due to low levels of iron)
test CBC and ferritin
