Nutritional Assessment

Question 1

Energy in humans

Answer 1

50% is lost as heat

45% is stored as energy in the body as ATP and 5% is required to convert energy to heat

Question 2

Define calorie

Answer 2

Amount of heat required to raise 1 g of water by 1 degree Celsius

Question 3

1000 calories =

Answer 3

1 kcal

Question 4

Water in adult males

Answer 4

50-60% of lean body mass

Question 5

Macronutrients

Answer 5

Water
Carbs
Protein
Lipids

Question 6

Micronutrients

Answer 6

Electrolytes
Vitamins
Trace Elements

Question 7

Carbohydrates

Answer 7

Simple (mono adn disaccharides)
Complex (oligo and polysaccharides
Monosaccharides (glucose, fructose, galactose)

Question 8

Glucose

Answer 8

Major source of fuel through glycolysis and oxidative phosphorylation

Question 9

Carbohydrates

Answer 9

Disacchardies (sucrose and lactose)

Polysaccharides are storage forms of energy

Question 10

Diet should be

Answer 10

60% starch, 30% sucrose and 10% lactose

Question 11

**All carbs provide

Answer 11

3.4 kcal/g of energy

Question 12

Proteins

Answer 12

Linear chains of amino acids
Function as enzymes, structures and function, stabilize blood, cell signaling and immune processes
2nd largest energy source to fat

Question 13

***All proteins provide

Answer 13

4 kcal/g of energy

Question 14

As metabolic rates rise,

Answer 14

more protein is converted to energy and lost for other function

Question 15

Lipids

Answer 15

Liquid at room temp are called oils

Lipids exist as solids at room temp are called fats

Question 16

Unsaturated fats

Answer 16

Avocados, nuts, vegetable oils (olive oil)

Question 17

***Each gram of fat contain

Answer 17

9 kcal/g of energy

Question 18

To prevent essential fatty acid deficiency any nutritional plan must contain

Answer 18

linoleic and alpha linolenic acid

Question 19

Define Malnutrition

Answer 19

An acute, subacute or chronic state of nutrition, in which varying degrees of overnutrition or undernutrition with or without inflammatory activity have led to a change in body composition and diminished function

Question 20

Types of malnutrition

Answer 20

Marasmus
Kwashiorkor
Mixed
Obesity

Question 21

Define Marasmus

Answer 21

• Prolonged inadequate intake or utilization of protein and calories
• Weight loss > 10% of usual body weight
  Protein and fat wasting but proteins are preserved

Question 22

Define Kwashiorkor

Answer 22

Inadequate protein and micronutrient intake
Preserved fat tissue but depletion of proteins
Severe hypoalbuminemia and edema can be seen

Question 23

Define Mixed Marasmus/Kwashiorkor

Answer 23

• Severe protein-calorie malnutrition
• Temporal wasting (head looks like a skull)
  Reduced visceral and somatic proteins and lipids
• Chronically ill, trauma, infxn and burns, immunocompromised or wound healing

Question 24

Obesity- Overnutrition

Answer 24

BMI greater than 25

Question 25

Define Nutrition Assessment

Answer 25

A comprehensive approach to diagnosing nutrition problems that uses a combination of the following: medical, nutrition and med history, physical exam, anthropometric measurements and lab data

Question 26

Nutrition Assessment Goals

Answer 26

- ID of the presence of factors associated with increased risk - Determine of risk of malnutrition complication - Establishment of estimated nutrition needs - Establishment of baseline nutrition status

Question 27

Weight Guidelines

Answer 27

If they are >120% of their IBW use adjusted | If they are less than 120% of IBW use actual body weight

Question 28

Measure for marasmus:

Answer 28

``` Muscle and fat wasting in temporal area Loss of fat/muscle in shoulders Loss of SC fat in hands Tricep skin-fold thickness using a nutrition caliper Mid-muscle circumference ```

Question 29

Factors that decrease albumin

Answer 29

``` Overhydration Edema Kidney dysfunction Poor dietary intake Burns Cirrhosis Trauma Sepsis ```

Question 30

Factors that increase albumin

Answer 30

Volume depletion Steroids Insulin

Question 31

Factors that decrease transferrin

Answer 31

Chronic infection, cirrhosis, burns, cortisone, testosterone

Question 32

Factors that increase transferrin

Answer 32

``` Iron deficiency Pregnancy Hypoxia Chronic blood loss Estrogens ```

Question 33

Transferrin Normal

Answer 33

250-300 | Half life: 8-9

Question 34

Albumin Normal

Answer 34

3.5-5 | Half-life 18-20

Question 35

Factors that decrease prealbumin

Answer 35

``` Cirrhosis Hepatitis Stress Hyperthyroidism CF Burns ```

Question 36

Factors that increase prealbumin

Answer 36

Kidney dysfunction

Question 37

Prealbumin normal

Answer 37

15-40 | Halflife 2-3 days

Question 38

Factors that decrease total lymphocyte count

Answer 38

Severe malnutrition wiht loss of immune function HIV TB

Question 39

Factors that increase total lymphocyte count

Answer 39

Volume depletion

Question 40

Total lymphocyte count normal

Answer 40

>1500

Question 41

TLC =

Answer 41

WBC X % Lymphocytes

Question 42

Estimating energy requirements:

Answer 42

Think about physical stress not emotional

Question 43

Indirect Calorimetry

Answer 43

RQ less than 0.7 = underfed | RQ > 1 = overfed

Question 44

Urinary Nitrogen Excretion

Answer 44

Used to monitor protein adequacy | Measures 85-90% of total nitrogen excretion from the body

Question 45

Other losses of nitrogen other than urinary?

Answer 45

Skin, fecal and respiratory

Question 46

1 g nitrogen =

Answer 46

6.25 g protein

Question 47

Adequate intake of alpha-linolenic acid for men and women

Answer 47

M: 1.6 g/day W: 1.1 g/day

Question 48

Adequate intake of linolenic acid for men and women

Answer 48

M: 14-17 g/day W: 12 g/day

Question 49

Fat should represent no more than

Answer 49

10-35% of calories

Question 50

Calculating Energy and Protein Requirements

Answer 50

Determine weight Estimate caloric requirements based on stress Estimate protein requirement based on stress Follow-up measurement to verify adequate energy and protein to avoid catabolism of proteins