Week 5 COPY Flashcards
(123 cards)
1
Q
What is the energy density of the following foods? Oil, peanuts, rice, ice cream, oranges, lettuce & mushrooms.
A
- Oil: 37kJ/g
- Peanuts: 24kJ/g
- Rice: 5.2kJ/g
- Ice cream: 3.8kJ/g
- Oranges: 1.5kJ/g
- Lettuce/mushrooms: –
2
Q
What is the energy density of fat, protein, carbohydrates, and alcohol?
A
- Fat: 37kJ/g
- Alcohol: 29kJ/g
- Protein: 17kJ/g
- Carbohydrates: 17kJ/g
3
Q
What percentage of body fat is pure fat?
A
87%
4
Q
What two tissue types are lost equally during starvation?
A
Fat and lean tissue.
5
Q
What is direct calorimetry and how is it performed?
A
Direct calorimetry involves continuous measurement of heat exchange in subjects confined in metabolic chambers. This very accurate method measures the amount of heat released to calculate energy expenditure. Individuals reside within the chamber for a period of 24 hours.
6
Q
What is indirect calorimetry and how is it performed?
A
Indirect calorimetry can be performed either at rest or during exercise, measures the rate of oxygen consumption and carbon dioxide production. This method can estimate the energy expended in a given situation, but is not a suitable representation of total daily energy expenditure.
7
Q
What are non-calorimetric methods of energy expenditure measurement, and why would they be chosen over other methods?
A
Indirect calorimetry can be performed either at rest or during exercise, and measures the rate of oxygen consumption and carbon dioxide production. This method can estimate the energy expended in a given situation, but is not a suitable representation of total daily energy expenditure. Common methods include heart rate, doubly labelled water, and the factorial method.
8
Q
What is the factorial method?
A
The factorial method is the most common and least invasive of the non-calorimetric measures used for estimating energy expenditure. It uses calculations and activity tables to estimate energy expenditure. The Schofield equation is used to predict basal metabolic rate.
9
Q
What is a physiological fuel value?
A
The number of kilojoules that the body derives from a food.
10
Q
What does the hypothalamus have to do with hunger and satiety?
A
The hypothalamus is the nerve centre for responding and controlling hunger and satiety responses through chemical messengers.
11
Q
Which part of the brain are active when looking at food images or eating food?
A
The visual cortex and the cerebellum (processes thinking and reasoning).
12
Q
What influences can trigger a hunger response?
A
- Presence of absence of nutrients in the bloodstream
- Size and composition of the preceding meal
- Customary eating patterns
- Climate (heat reduces food intake, cold increases it)
- Exercise
- Hormones
- Physical and mental illness
13
Q
How long does it take the stomach to process food completely?
A
four hours
14
Q
What is satiation, and what triggers it?
A
Satiation is the feeling of fullness after eating.
It is triggered by stretching of the stomach receptors and hormone release.
15
Q
What 3 influences can generate a hunger response?
A
- Physiological influences
- Empty stomach
- Gastric contractions
- Absence of nutrients in small intestine
- GI hormones
- Endorphines
- Sensory influences
- Thought, sight, smell, sound, taste of food
- Cognitive influences
- Presence of others, social stimulation
- Time of day
- Abundence of available food
16
Q
Which 2 macronutrients have the highest and lowest satiating effects?
A
- Protein has the highest satiety
- Fat has the lowest satiety
17
Q
What does fat trigger the release of once it enters the small intestine?
A
The hormone cholecystokinin, which triggers satiety and inhibits food intake.
18
Q
What is thermogenesis?
A
The generation of heat
19
Q
What are the 3 main categories of thermogenesis, and what is the 4th category sometimes involved?
A
- Basal metabolism
- Physical activity
- Food consumption
- (4th category sometimes involved): Adaptation
20
Q
What is the percentage breakdown of the 3 main components of energy expenditure?
A
- Thermic effect of food: 5-10%
- Physical activity: 25-50%
- Basal metabolism: 50-65%
21
Q
What is a quick and easy estimate value for basal energy needs for men and women?
A
- For men: 4-5kJ/min, or 100kJ/kg/day
- For women: 3-4.5kJ/min, or 95kJ/kg/day
22
Q
What effect does increased body weight have on basal metabolic rate?
A
The more a person weighs, the more total energy is expended on BMR, but the amount of energy per kg may be lower.
23
Q
What is basal metabolism?
A
The rate at which the body expends energy to maintain basic functions.
24
Q
What is adaptive thermogenesis?
A
Energy used to build tissues and produce the enzymes and hormones needed to adapt to changes in the environment such as physical conditioning, extreme cold or heat, overfeeding, starvation, trauma, or other types of stress.
25
Which macronutrient has the highest relative thermic effect of food?
Protein
26
What factors increase basal metabolic rate (BMR)?
* Height: tall, thin people expend more energy to stay warm
* Growth: Growth requires energy
* Lean body tissue: Lean tissue is more metabolically active
* Fever: Immune processes creating fever use energy
* Stresses: Physiological stress response increases energy expenditure
* Environmental temperature: Adaptive thermogenesis
* Smoking: Nicotine increases energy expenditure
* Caffeine: Increases energy expenditure
* Resistance training exercise: lean tissue expends more energy
27
What factors decrease basal metabolic rate (BMR)?
* Ageing: Due to reduced lean body mass
* Fasting/starvation: Lowers the BMR to conserve energy
* Malnutrition: Lowers the BMR to conserve energy
* Energy restrictive diet: Lowers the BMR to conserve energy
* Sleep: Energy expenditure is lowest while sleeping
* Sedentary activity: Lower activity level reduces lean body mass
28
What percentage of effect can thyroid hormone activity have on the rate of metabolism?
Thyroid hormone activity can speed up or slow down the rate of metabolism by up to 50%.
29
What is the equation used to calculate BMR in kJ per day?
| If typing answer, use the format "xxxx kJ/day"
30
How is the physical activity level (PAL) applied to energy calculations?
| If typing answer, use the format "xxxx kJ/day"
By using the appropriate value from the table.
31
What estimated energy requirement range do most people fall within?
* For men: +/- 840kJ
* For women: +/- 670kJ
32
How do you determine the estimated energy requirement (EER)?
1. Calculate the BMR using the BMR calc table
2. Calculate the physical activity level.
3. Combine the 2 values.
33
Which does neuropeptide Y trigger?
* Carbohydrate cravings
* Initiates eating
* Decreased energy expenditure
* Increased fat storage
34
What foods have been found to have the highest satiation value for minimal kilojoules?
Broccoli, carrots, tomatoes, lettuce, cucumber, and rice cakes.
35
What three factors does the amount of energy needed for an activity depend on?
* Muscle mass
* Body weight
* Type of activity
36
How do you calculate the kilojoules spent per minute doing an activity for your own body weight?
Multiply the value of kJ/kg/min for the activity from the table by your weight and then multiply that number by the number of minutes spent in the activity.
## Footnote
For example, if you weigh 65 kilograms and want to know how many kilojoules you spent doing 30 minutes of vigorous aerobics: 0.571 x 65 = 37.1 kilojoules per minute; 37.1 x 30 minutes = 1113 total kilojoules expended.
37
What is the thermic effect of food?
The acceleration of GI tract muscular activity that occurs when eating, which requires energy and produces heat.
38
What is the thermal effect of food proportional to?
The thermic effect of food is proportional to the food energy taken in, and is generally estimated at 10% of intake.
39
What are the thermic effect percentages of the 4 main food energy sources?
* Carbohydrate: 5-10%
* Fat: 0-5%
* Protein: 20-30%
* Alcohol: 15-20%
40
Why should the thermic effect of food be ignored for most purposes?
Because its contribution to total energy output is smaller than the probable errors involved in estimating overall energy intake and output.
41
What are some tips for accepting a healthy body weight?
* Value yourself and others for human attributes other than body weight. Realise that pre-judging people based on weight is as harmful as pre-judging them by race, religion or gender
* Use positive, non-judgemental descriptions of your body
* Accept positive comments from others
* Focus on your whole self, including your intelligence, social grace and professional and scholastic achievements
* Accept that no magic diet exists
* Stop dieting to lose weight. Adopt a lifestyle of healthy eating and physical activity permanently
* Follow the Australian Guide to Healthy Eating. Never restrict food intake below the minimum levels that meet nutrient needs
* Become physically active, not because it will help you get thin but because it will make you feel good and enhance your health
* Seek support from loved ones. Tell them of your plan for a healthy life in the body you have
* Seek professional counselling – not from a weight-loss counsellor, but from someone who can help you make gains in self-esteem without weight as a factor
* Appreciate body weight for its influence on health, not appearance
42
How is the body mass index (BMI) calculated?
BMI = 2weight (kg)/height (m)^2
43
What does the BMI reflect?
BMI reflects height and weight measures and not body composition.
44
What do BMI values reflect, fat or weight?
BMI values measure weight in relation to hight. The BMI does not reflect body fat.
45
What is the healthy BMI range?
18.5 - 24.9
46
What are 5 functions of fat in the body?
* Provides energy
* Insulates against temperature extremes
* Protects against physical shock
* Forms cell membranes
* Makes compounds such as hormones, vitamin D, and bile
47
When is visceral fat more common?
In men and to a lesser extent, women past menopause.
48
What is waist circumference the most practical indicator of?
Fat distribution and central obesity
49
What waist circumference values indicate a high risk of central obesity related health problems?
* For men: higher than 102cm
* For women: higher than 88cm
50
What is the correlation between body weight/body fat and disease risks/life expectancy?
There is a greater likelihood of developing chronic diseases and shortening life expectancy for those with a higher BMI and waist circumference.
51
What are health risks of being underweight?
infertility, menstrual irregularities, inability to preserve lean tissue if suffering from a wasting disease (cancer, digestive disorder). exacerbated struggle with medical stresses, osteoporosis and bone fractures.
52
What weight conditions are linked to higher mortality rates?
Both underweight and obesity.
53
What health risks are associated with obesity?
Insulin resistance, type 2 diabetes, chronic inflammation, sleep apnoea, osteoarthritis, some cancers, high LDL cholesterol, low HDL cholesterol, hypertension, stroke.
54
What effect does a weight gain of 4.5kg after the age of 18 years have on diabetes?
The risk of developing type 2 diabetes doubles.
55
What is ectopic fat, and how does it contribute to obesity associated diseases?
Ectopic fat is fat that accumulates outside of adipose tissue, and disrupts normal metabolism.
56
What health risks does the combination of obesity-induced inflammation and ectopic fat result in?
A cluster of symptoms known as metabolic syndrome: Insulin resistance (and high blood glucose), hypertension, high blood triglycerides, low HDL cholesterol, high waist circumference.
57
What conditions does metabolic syndrom synergistically increase the risk for?
Diabetes, hypertension, fatty liver disease, and atherosclerosis.
58
Is the body mass index (BMI) a good measure of body composition?
No
59
What factors can increase the desire to eat?
Boredom, stress, the time of day, sight of food, social situations, hunger.
60
What is the largest component of energy use by the body?
Basal metabolism
61
Which type of fat in our body is most highly associated with the risk of diseases like diabetes and cardiovascular disease?
Abdominal fat
62
What is a nutrition assessment?
A nutrition assessment evaluates a person’s health from a nutrition perspective.
63
What sources are used to gather information for a nutrition assessment?
* Historical information
* Anthropomorphic measurements
* Physical examination
* Biochemical analyses (lab tests).
64
What is a strategic compromise that can be made when collecting detailed patient information?
Screening patients by collecting preliminary data, such as hight-weight and haematocrit.
65
What does nutrition screening help identify?
Patients who will require additional nutrition assessment.
66
What types of historical information can be gathered?
* Medical history
* Personal and social history
* Medication and supplements history
* Food and nutrition history
67
What is discussed when taking medical history information?
Current and previous mental, emotional, and physical health problems, treatments, and surgeries; chronic disease risks; and family medical history that affect nutrient needs, nutrition status, or the need for intervention to prevent or alleviate health problems.
68
What does medical history information help identify?
Conditions and treatments that might interfere with food intake or require dietary adjustments.
69
What information might also be gathered as part of the medical history information that may reveal genetic susceptibilities?
Family medical history. This will allow for attempted prevention of genetically susceptible diseases through dietary and other lifestyle changes.
70
What is discussed when taking personal and social history?
Cognitive, educational, family, religious, cultural, financial, and environmental influences on food intake, nutrient needs and diet therapy options.
71
What is discussed when taking medication and supplements history?
Medications (prescription and over-the-counter), illicit drugs, dietary supplements, and alternative therapies that affect nutrition status.
72
What is discussed when taking food and nutrition history?
Food intake and availability, recent weight changes, dietary restrictions, food allergies or intolerances, physical activity habits, nutrition and health knowledge.
73
What medical conditions are associated with malnutrition?
* Acquired immune deficiency syndrome (AIDS)
* Alcoholism
* Anorexia nervosa or bulimia nervosa
* Burns (extensive or severe)
* Cancer and cancer treatments
* Coeliac disease
* Chewing or swallowing difficulties (including poorly fitted dentures, dental caries, missing teeth, and mouth ulcers)
* Decubitus ulcers (pressure sores)
* Dementia or other mental illness
* Diabetes mellitus
* Feeding disabilities
* Infections
* Inflammatory bowel diseases
* Kidney disease
* Liver disease
* Malabsorption
* Surgery (recent or major)
* Vomiting (prolonged or severe)
74
What effect can financial concerns have on food choices?
Financial concerns may restrict access to nutritious food and health care.
In general, the quality of the diet declines as income falls.
An inadequate income puts an adequate diet out of reach when the ability to purchase the foods required to meet nutrient needs is lost.
Low income affects not only the power to purchase foods but also the ability to shop for, store, and cook them.
75
What 3 substances may interfere with good health and nutrition status?
* Alcohol
* Tobacco
* Illicit drugs
76
What information should be recorded if a person is found to be taking any medication or supplement?
* Name
* Dose
* frequency and duration of intake
* Reason for taking it
* Any adverse effect signs
77
What is the definition of a drug?
Any substance that modifies one or more of the body's functions.
78
Under what circumstances are adverse nutrient-drug interactions most likely?
* If drugs are taken over long periods
* If several drugs are taken concurrently
* If nutrition status is poor or deteriorating
79
In what ways may nutrients and medications interact?
* Drugs can alter food intake and the absorption, metabolism and excretion of nutrients.
* Foods and nutrients can alter the absorption, metabolism and excretion of drugs.
80
What information is discussed when gathering food and nutrition history information?
Information about food intake and availability, recent weight changes, dietary restrictions, lifestyle and physical activity habits, food allergies or intolerances, nutrition and health knowlege or beliefs, recent food intake, usual food choices.
81
What information can discussing food and nutrition history provide besides identifying possible nutrient imbalances?
Information about what and how a person eats, providing the background about how a person will accept diet changes should they be necessary.
82
What is the 24-hr dietary recall dietary assessment method?
24-hour dietary recall allows you to identify what you have consumed over the past 24 hours. This method is usually assisted by an interviewer and conducted face-to-face or by telephone. Interviewers ask participants what they have consumed the previous day with questions about specific foods and fluids consumed including the amount, type and preparation methods.
83
What are the advantages of the 24-hr dietary recall dietary assessment?
* Cheap, easy, quick
* Low respondent burden
* May also represent usual diet
* May be more objective and reliable than a diet history
* Interviewer is able to prompt
84
What are the disadvantages of the 24-hr dietary recall dietary assessment?
* May not represent usual intake
* Does not capture daily or seasonal variations in eating patterns
* May not provide enough data for the intended purpose
* May be limited by poor memory or ‘selective forgetting’
* Individuals have a tendency to report an ‘ideal’, average or expected diet
85
What are the uses for the 24-hr dietary recall dietary assessment?
* Establish a recent food pattern.
* Research situations where the mean intake of a large group is required.
86
What is the diet history dietary assessment method?
Diet history is an interviewer-assisted method that aims to identify an individual’s usual dietary intake. In addition to asking about usual eating patterns, checklists and food diaries may be used to gain a more comprehensive picture of one’s overall intake.
87
What are the advantages of the Diet history dietary recall dietary assessment?
* Assesses usual intake
* Includes normal variation such as weekends and seasonal changes
* More complete data enables assessment of all nutrients
88
What are the disadvantages of the Diet history recall dietary assessment?
* Interviewer needs training
* Hard to standardise (may be done differently with different individuals)
* May be limited by poor memory or ‘selective forgetting’
* Takes time to administer (can be 60 minutes or more)
* High administrative burden and cost
89
What are the uses for the diet history dietary assessment?
It is used with adults
90
What is the food frequency questionnaire dietary assessment method?
The food frequency questionnaire is a questionnaire based on food lists. The foods included in the lists are those that contribute significantly to nutrient and energy intake in the population of interest. The questionnaires may or may not ask about the actual amount of food consumed. Food frequency questionnaires may be either self or interview administered.
91
What are the advantages of the food frequency questionnaire dietary assessment?
* Cheap, quick
* Good for population surveys
* Enables focus on specific foods or nutrients
* Can be quickly analysed by computer
92
What are the disadvantages of the food frequency questionnaire dietary assessment?
* May receive incomplete responses
* Foods may be inappropriate for the population of interest
* May not be representative of all foods available
* Difficult to estimate overall total intake
* May take a long time or a lot of effort for respondents to complete
* Needs computer software to analyse
93
Where is the food frequency questionnaire dietary assessment usually used?
Generally conducted in a research situation to ascertain the mean nutrient intake of a group
94
What is the Food records (or diaries) dietary assessment method?
Food records (or diaries) are provided to individuals who then record all foods that they consume over the next one to seven days. They include types and amounts of all food and beverages consumed using weighed measures (scales), household measures (measuring cups) or other estimates.
95
What are the advantages of the Food records (or diaries) dietary assessment?
* Do not rely on the individual’s memory
* Accurate description of food consumed over a period of time
96
What are the disadvantages of the Food records (or diaries) dietary assessment?
* Time consuming
* High burden on the individual
* Poor compliance – major limitation of showing only the actual intake, which may be different from the usual intake (conscious or unconscious changes in eating habits)
97
In what setting is the Food records (or diaries) dietary assessment usually used?
Generally only used in research
98
What is the duplicate portion analysis dietary assessment method?
Duplicate portion analysis involves collecting a duplicate portion of the foods and beverages consumed and then undertaking a chemical analysis of nutrient content of those foods/beverages.
99
What are the advantages of the duplicate portion analysis dietary assessment?
* Accurate for research
* Good for unusual or experimental foods
100
What are the limitations of the duplicate portion analysis dietary assessment?
* Respondents may alter their intake
* High burden for both the respondent and the administrator
* Cost of additional food and lab tests
101
What is the direct observation dietary assessment method?
Observation of food consumption can be done by either video cameras or trained observers. This can especially be done in facilities that serve meals.
102
What are the advantages of the direct observation dietary assessment method?
* Low respondent burden
* Accurate; precise details can be obtained
* Can be done overtly (respondent aware) or covertly (respondent unaware)
* Can reveal a person’s food preferences, changes in appetite, and any problems with a prescribed diet.
103
What are the limitations of the direct observation dietary assessment method?
* High cost
* May be obtrusive
* Time consuming/labour intensive
* Not suitable for studying large populations
* Respondents may alter intake when observed
104
What is a retrospective dietary assessment?
One that involves measuring through recall of past intake.
105
What is a prospective dietary assessment?
One that involves measuring future intake.
106
What are several sources of errors that can affect the accuracy and usefulness of the data collected?
* Dietary records and recalls may lack sufficient detail about the type or amount of food consumed.
* Respondents may alter their intake on the day of recording/observation because it is easier to record, to please the observer, or because they are embarrassed by their usual intake.
* Respondents may have difficulty recalling their intake for retrospective methods and this is more commonly the case for individuals who do not prepare their own food.
* Respondents may also inaccurately estimate and record the portions of food they consume.
107
What are the 3 types of retrospective (past intake) dietary assessments?
* 24 hour recall
* Diet history
* Food frequency questionnaire
108
What are the 3 types of prospective (future intake) dietary assessments?
* Food records (or diaries)
* Duplicate portion analysis
* Observation
109
What are 2 methods of estimating nutrient intakes from collected food intake data?
* Food composition tables
* Diet analysis programs
110
What are 4 tools used to evaluate food intake?
* 24-hour recall
* The food record
* The food frequency questionairre
* Direct observation
111
What are 3 details the assessor will need to know?
* How the foods are prepared
* When the foods are eaten
* Beverage consumption inlcuding alcohol or caffeine
112
What is is the most effective approach for obtaining an accurate 24-hr recall?
The multiple-pass method
113
What is the multiple-pass method of 24-hour recall?
The interview includes four or five separate passes through the 24-hour period of interest.
* 1st pass: the person provides a ‘quick list’ of foods consumed without prompts
* 2nd pass: helps the person remember foods that are often forgotten, such as beverages, bread, additions to foods (e.g. butter on toast), savoury snacks and sweets.
* 2rd+4th passes: elicit additional details about the foods consumed, such as the amounts eaten, preparation methods, and places where foods were obtained or consumed.
* Final pass: provides an opportunity to recall foods and to probe for additional details.
114
What are anthropometrics?
Anthropometrics are physical measurements that reflect body composition and development.
115
What 3 purposes do anthropometrics serve?
1. To evaluate the progress of growth in women who are pregnant, infants, children and adolescents.
2. To detect undernutrition and overnutrition in all age groups.
3. To measure changes in body composition over time.
116
What do healthcare professionals compare anthropometric measurements to?
Population standards specific for gender and age, or with previous measures of the individual. This reveals changes in an individual's status.
117
What are the 5 main anthropometric measurements and what do they reflect?
* Abdominal girth measurement: Abdominial fluid retention and organ size.
* Height-weight: Over and undernutrition; growth in children.
* Head circumference: Brain growth and development in infants and children under 2yo.
* Skinfold: Subcutaneous and total body fat.
* Waist circumference: Body fat distribution, valuable indicator of abdominal fat.
118
What are the 2 most common and useful anthropometric measurements?
Height and weight are the most common and useful measurements.
119
What measurement is used primarily up to age 3? and for children over 3?
* Under age 3: length measurements.
* Over age 3: Height measurements.
120
What is the most useful anthropometric measurement used once adult height has been reached?
Changes in bodyweight.
121
What metrics do standard charts of growth compare?
* Weight to age
* Height to age
* Weight to height
122
What useful estimate and assessment do skinfold measures provide, and what is the reasoning for is this?
Skinfold measures provide a good estimate of total body fat and a fair assessment of the fat's location? Most body fat lies directly beneath the skin, and the thickness of this subcutaneous fat reflects total body fat.
123
What waist-to-hip ratio generally indicates an increased risk of heart disease and diabetes in men and women?
* Men: 0.90
* Women: 0.80
