Nutrition in Medicine Flashcards
Undernutrition
Form of malnutrition from a reduced supply of food or from inability to digest, assimilate + utilise the necessary nutrients (macro + micro)
Hospital undernutrition epidemiology
On admission: 28-40% undernourished
In-patients: 2/3 lost weight during stay
Out-patients: 45-100% of undernutrition is unrecognised
Undernutrition
2-3 million ppl
5%
Most vulnerable groups undernutrition
Chronic diseases Elderly alone Recently discharged Low income Isolated
Undernutrition consequences in community
Falls
Depression
Infection risk
Dependency
Undernutrition consequences in hospital
Increased morbidity, length of stay, dependency, mortality, cost of care
Undernutrition causes
Reduced nutritional intake
Increased nutritional requirements
Increased nutritional losses
How long can u survive with no food, just water
63 days
Malnutrition Universal Screening Too (MUST) 5 steps
BMI score Weight loss score Acute disease effect score Overall risk of malnutrition Use management guidelines
Clinical investigations
Clinical Anthropometrics
Imaging procedures
Bioelectrical impedence analysis
Handgrip dyanomemtry
Total Energy Expenditure- made up of
Basal metabolic rate- energy required for basic bodily systems
Thermic effect of food- energy required to digest food
Physical activity
Stress Factors
How much protein per day
50g for 70kg
0.75g/kg/day
How much nitrogen/day
8.4g
Indications for Gastrotomy feeding
Reduced consciousness
Unsafe swallow
Pre-head + neck cancer surgery/radiotherapy
Special situations e.g. CF
Indication for Parenteral Nutrition
Intestinal failure Prevents infection- catheter doesn't enter vein until above clavicle- can be kept in for wks Prolonged postoperative ileus Intestinal obstruction Short bowel Short bowel fistula Acute pancreatitis GI motility disorders
