A A E 350 Exam #1
repletion
nutritional ______ results in the disappearance of decreased immunity that occurred during protein energy malnutrition
intra uterine growth retardation
occurs when a fetus does not grow sufficiently; usually due to inadequate maternal nutritional status before and during pregnancy or short maternal stature
night blindness
occurs when the reconversion and replenishing of rhodopsin does not occur; amount of rhodopsin is limited which makes it difficult to see in dim light
iron deficiency anemia
occurs when there is not enough hemoglobin produced due to lack of iron; no more iron stores are left
night blindness
often an early symptom of low levels of vitamin A
universal salt iodization
one of the most significant successes in the field of eliminating noncommunicable diseases such as iodine deficiency disorder
diarrhea
oral rehydration salts solution is the primary tool to treat _______
carbohydrate
overfeeding of ________ can result in high blood sugars and dehydration
fetal malnutrition
overnutrition following ____ _____ has also been linked to chronic disease risk in adulthood
affluent, low/middle
overweight and obesity used to be an ______ problem in 1975 but it is now also a problem for people with ________ socioeconomic status
hookworm
parasite that is acquired by walking barefoot over contaminated soil
vomiting, diarrhea
patients with marasmus cannot handle a large amount of food without ______ and having ______
bichat fat pads
patients with marasmus have sunken cheeks due to the loss of _____ ____ ___ which are among the last subcutaneous adipose depots to disappear
thyroid
people with goiter have a lack of ______ hormones which causes thyroid stimulating hormone to be produced in excess
cost, nutrient
the diets of the nutrition transition are lower in ______ but they are also lower in ______ quality
famine
the effect of malnutrition on pregnancy outcome has been studied in _______ situations
stunting
the failure of children to grow to a normal height for their age due to severe and chronic malnutrition; low height for age
overweight/obesity
the failure to adapt energy intakes to reduced energy expenditure leads to ________-
1000 days
the first ____ _____ of life is critical to break the cycle of malnutrition
childhood, holistic
the focus should be on preventing fetal and early _____ malnutrition, but the life cycle dynamics of cause and consequence demand a ____ inclusive approach
undernutrition, communicable diseases
the good part of the current nutrition transition is that there has been less _______ and ______ _______ due to an increase in food access
sacropenia
the gradual loss of muscle mass with age that is linked to age-related loss of strength, increased risks of morbidity, functional impairment, dependence, and mortality
kwashiorkor
the gut microbiota in persons with _____ have an altered metabolic profile that compromises efficient energy metabolism
5.5
the highest risk of undesirable outcomes is usually a birthweight found below ____ pounds
fatigability
the increased _______ and reduced strength of skeletal muscle during protein energy malnutrition may be explained by intracellular overhydration
emergency
the indicator of wasting is used extensively in _____ situations such as times of famine
first
the integrity of the epithelial barriers is the ______ to be compromised during vitamin A deficiency
goiter
the irregular growth of the thyroid gland caused by iodine deficiency disorder
ischaemic heart disease
the leading cause of death globally is _____ _____ which is a non-communicable disease
neonatal conditions
the leading cause of death in low-income countries is ______ _______
ischaemic heart disese
the leading cause of death in lower-middle income countries is ______ _____ _____ which is a non-communicable disease
vitamin A deficiency
the leading cause of preventable blindness in children and increases the risk of disease and death from severe infection
7.7-8.8
the lowest risk of undesirable outcomes is usually a birthweight in the range of ____-_____ pounds
decade of healthy aging
the main strategy to achieve and support actions to build a society for all ages; aims to improve the lives of older people, their families, and the communities in which they live
brain
the majority of _____ growth occurs during fetal period and first 18 months of life
heart
the malnourished _____ can easily be given a metabolic demand that is too high for it to supply during refeeding
4
the mean value of productivity losses due to iron deficiency is thought to be about $____ per capita
acute
wasting in children is usually due to _____ food shortage and/or severe disease
affluent
Western, ______ diets are high in fat and sugar, low in fiber, and have a lot of variety
red blood cells
___ ___ ____ will not use ketones at any point during starvation because they do not have any mitochondria; therefore they must use glucose
body weight
____ ____ decreased about 25% in the beginning of the Keyes study's semi-starvation period but it decreased progressively and nearly reached a plateau at the end of the period
total body, intracellular
____ ____ potassium is reduced during protein energy malnutrition due to decreased muscle proteins and loss of ______ potassium
meat factor
____ _____ also increases absorption of non-heme and heme iron
birth weight
____ ______ contributes to about half of the growth failure at age 2
food supplementation, growth hormones
____ ______ of the adolescent pregnant for the first time does not improve birth weight because ____ _____ favor growth of mother instead
open defecation
____ ______ results in the exposure of feces to the oral route of children which leads to further secondary malnutrition
milk, calcium
____ and ______ products can decrease the absorption of iron
fat, protein
____ cannot be broken down to produce glucose when carbohydrate is not available; therefore, _____ must be used instead
mild
____ food insecurity occurs when people worry about their ability to obtain food
iron
____ is part of many proteins involved in oxygen transport and oxidation/reduction reactions
serum
____ potassium levels stay stable during protein energy malnutrition because potassium leaves from inside cells
25
____% of heme iron is absorbed by the body
70
____% of older adults will be living in developing countries
linear growth
_____ ____ of adolescent girls has been shown to stop when they get pregnant
raised BMI
_____ _____ is a major risk factor for noncommunicable diseases such as cardiovascular diseases, diabetes, musculoskeletal disorders, and cancers
weight gain
_____ _____ is not a goal of the first of week refeeding; stabilization is the goal
weight loss
_____ _____ is observed in mice that received fecal microbiota from the kwashiorkor twin compared to the non-kwashiorkor twin
nutritional supplementation
_____ ______ improves birth weight in malnourished women but does not have an effect on the birth weight in marginally malnourished women
breast feeding, fed
_____ ______ is considered the best method of feeding infants but _____ is best
micronutrient supplementation
_____ _______ during pregnancy increases birth weight as well as balanced protein-energy supplements
reduced
_____ activity costs in the Keyes study participants was the main part of the energy savings and decreased basal metabolic rate
maternal
_____ deaths occur often due to severe iron deficiency anemia
iron
_____ deficiency in the first 1,000 days of life is suspected to have lasting effects on neural and behavioral development
neurologic, immune
_____ dysfunctions (ADD) and ______ function impairment also occur in intra uterine growth retardation newborns
IV
_____ feeds in malnourished children should not be used because they increase mortality
severe
_____ food insecurity occurs when people experience hunger because they run out of food
moderate
_____ food insecurity occurs when people have to compromise quality and variety of food and reduce quantities by skipping meals
breastfeeding
_____ fosters healthy growth early in life and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life
heme
_____ iron is part of hemoglobin and myoglobin and is obtained from meat of all types
zinc
_____ is also needed for retinol binding protein (RBA) which is needed for the storage/transport of vitamin A in the body
soap
_____ is an important factor in nutritional status because it provides for hand cleanliness and careful washing of vegetables
protein
_____ is broken down to produce glucose when carbohydrate is not available
protein
_____ is required for building cells that make up muscles, membranes, cartilage, and hair, carrying oxygen, nutrient transport, antibodies, and enzymes
oxygen
_____ is required in order to produce energy from fat sources
malnutrition
_____ leads to a lowered work capacity, a lowered income, a lowered amount of money for food, and _____ of the women and children
weight
_____ loss is more rapid during the first week of starvation due to the loss of water and salt
insulin; food
_____ release is stimulated by the presence of carbohydrate and protein in the gut; plays key role in the switch from using up body stores to using _____
short
_____ stature is often associated with an increased risk of coronary heart disease and stroke and to some extent diabetes
stunted
_____ women have small babies because these women are in general smaller
diarrhea
_____ worsens the malabsorption during protein energy malnutrition and can further decrease nutritional status
pulmonary edema
______ ____ may develop in some malnourished people during refeeding due to an increased water load
chronic disease
______ _____ prevention and control helps people to live longer and healthier lives
school feeding
______ _____ programs have been shown to improve school performance in both developing and industrialized countries
childhood obesity
______ ______ is associated with a higher change of obesity, premature death, and disability in adulthood
childhood obesity
______ _______ leads to breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance, and poor psychological effects
enzymes, electron carriers
______ and ____ ____ molecules in the energy metabolism pathway require iron
pregnancy
______ can increase the iron needs of a person because of the placental needs, fetal and maternal growth, and potential blood loss
neural
______ cells multiply mainly in utero and during the first 2 years of life
iodine
______ deficiency has been shown to lower IQ by 13.5 points
urban
______ environments and lifestyles are raising barriers to safe, healthy physical activity that could help reduce some of the risks of obesity
mixed
______ feeding with ART is better than no breastfeeding at all for mothers living with HIV
diarrheal
______ infection causes changes in intestinal absorptive cells that prevents the absorption of nutrients
proteins
______ involved in drug metabolism, the immune system, and protection against free radicals require iron
beta-carotene
______ is much less toxic in higher doses than is the preformed animal forms of vitamin A
chronic
______ low intake of food leads to child stunting
insulin
______ promotes the uptake of phosphorous in the liver and muscles
calories
______ provide the energy for breathing, blood circulation, digestion, maintaining muscle tone, body temperature, physical activity, mental activity, fighting disease, and growth
undernutrition, infection
_______ and _______ during childhood can result in mothers with short maternal stature which stunts the growth of their fetuses
retinoids
_______ are common in animal tissues and can serve vitamin A functions directly
exclusive
_______ breast feeding usually extends the time between children which is strongly related to infant and child survival
growth
_______ can increase the iron needs of a person because more blood cells need to be produced
governments
_______ have a central role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices
adolescent, first
_______ hormonal changes accelerate growth, making this time period the faster rate of growth besides the ____ year
thyroid
_______ hormones contain 3-4 atoms of iodine
beta-carotene
_______ is a precursor of vitamin A found in plant tissues; it is also an antioxidant
calcium
_______ is a special concern for undernourished girls who become pregnancy because bones of adolescents have not reached maximum density
vegetables
________ are the major source of pro-vitamin A in children where animal products are limited
technological
________ development has reduced cost significantly during the nutrition transition
urbanization
________ during the nutrition transition creates jobs that are not as physically demanding and energy requiring
non-heme
_________ iron is found in grains, leafy green vegetables, legumes, and meat
higher
a _____ proportion of boys than girls are stunted in all countries probably due to the increased time boys spend outside the home
wernicke's encephalopathy
a brain disorder caused by carbohydrate feeding in thiamine deficient-patients; can lead to muscle weakness, ataxia, and confusion
malnutrition
a broad term for a range of conditions that hinder food health, caused by inadequate or unbalanced food intake or from poor absorption of food consumed
semi-starvation
a class study by Keyes described physical and psychological changes during a period of ___________
underweight
a condition in which a person is less than the standard weight range for his or her age; low weight for age
micronutrient deficiency
a deficiency in iron, iodine, or vitamin A that is sometimes referred to as hidden malnutrition
hypothyroidism
a disorder caused by a thyroid gland that is slower and less productive than normal; due to iodine deficiency
birth control
breast feeding is not an effective method of _____ ______
food security
exists when all people at all times have both physical and economic access to sufficient, safe, and nutritious food that meets their dietary needs for an active and healthy life
iron deficiency anemia
clinical signs include fatigue, weakness, pallor, headaches, shortness of breath, and cold hands/feet
food insecurity
exists when people lack access to sufficient amounts of safe and nutritious food, and therefore are not consuming enough for an active and healthy lifestyle
tolerable upper level (UL)
dietary reference intake that represent the highest level of daily intake to pose no risk of adverse health effects
recommended dietary allowance (RDA)
dietary reference intake that represents the level of intake required to meet 97-98% of healthy people
estimated average requirement (EAR)
dietary reference intake that represents the level of intake to meet the needs of 50% of healthy people
famine
extreme shortage of food with underlying crop failure due to bad weather, war, and civil strife or both
Bitot's spots
drying out of the eye and appearance of hardened epithelial cells
carbon dioxide
due to the decreased ventilatory response to a lack of oxygen in the blood during protein energy malnutrition, ______ ______ levels increase
muscle
during kwashiorkor, _____ protein breakdown decreases which leads to decreased visceral protein synthesis
insulin
during kwashiorkor, fat breakdown decreases and the action of _____ is enhanced because inhibitory effects of free fatty acids are suppressed
glucose
during the first stages of starvation, _____ is produced from protein breakdown to provide energy
outside, processed
during the nutrition transition in urban area, there has been an increase in meals prepared ______ the home and in _____ foods
leisure
during the nutrition transition, ______ activities are not as physically demanding and usually require technology
socioeconomic statuses
during the nutrition transition, the trends seen are happening for people of all _____ ______
chronic disease
during the nutrition transition, there are decreased activity levels which results in an increase in obesity and overweight which are risk factors for _____ _____
vegetables
during the nutrition transition, there has been a lower intake of _______
oil
during the nutrition transition, there has been an associated increase in edible ______ consumption
animal
during the nutrition transition, there has been an increased demand for ______ source foods
heart failure
during the rehabilitation phase of excess calories, a child must be monitored frequently for ____ ____ as it is possible that the cardiac output is not high enough to meet new demands
fat
during the second stage of starvation, ____ is broken down and metabolism provides ketones for all tissues except CNS, WBC, and RBC
appetite
during vitamin A deficiency, , there is a _____ in appetite which causes poor growth
keratinized
during vitamin A deficiency, ________ cells in the outer layer of skin replace normal epithelial cells in the underlying skin layers
bumpy
during vitamin A deficiency, skin has a _____ appearance because hair follicles become plugged with keratin
bacterial, vitamin A
during xeropthalmia, deterioration of the eye results from _____ invasion; ____ ____ usually provides resistance to infection
mucus
during xeropthalmia, the ____ forming cells deteriorate and are no longer able to synthesize lubrication for the body
cessation
early breastfeeding ______ was associated with reduced HIV transmission but also with increased risk of morbidity and child mortality in infants born to HIV-infected mothers
decreased
early life protein energy malnutrition leads to _____ brain growth, nerve myelination, neurotransmitter production, and velocity of nervous conduction
first
effects of improved nutritional intake on growth are greatest in the ______ year of life with significant effects into the second and third year
thiamin
electrolyte that functions as a cofactor in intermediary carbohydrate metabolism; feeding carbohydrates without this electrolyte can lead to deficiency symptoms
magnesium, cofactor
electrolyte that goes into the cell from the blood with refeeding in order for new tissue synthesis; important _____ in many enzyme systems involving energy storage and utilization and protein synthesis
potassium
electrolyte that moves into the cells from the blood in order to rebuild proteins during refeeding
balance
energy intake should be in _____ with energy expenditure to avoid unhealthy weight gain
infections
environmental enteropathy results in low-grade ______ that require large amounts of energy to fight; leaves fewer nutrients for growth
glucose
excess carbon dioxide production and increased oxygen consumption can result from giving too much _____ during refeeding
overnutrition
excessive food intake in relation to energy requirements; too many calories and not enough exercise leading to obesity, diabetes, hypertension, and cardiovascular disease
water
exclusive breastfeeding for 6 months also excludes ______ because it could be a source of contamination so it is not necessary
HIV transmission
exclusive breastfeeding for up to 6 months was associated with a 3-4 fold decreased risk of _____ _______ compared to non-exclusive breastfeeding
acute
famine results in _____ undernutrition
iodine
fetal deficiency of _____ can lead to increased rates of spontaneous abortion, stillbirths, congenital anomalies, and cretinism
iron
fiber, phytate, tannins, and oxalate found in plant foods can prevent the absorption of ______
complementary
field studies show no advantage in growth or development when _______ foods are introduced between 4 and 6 months
innocenti declaration
focuses on the need to protect, promote, and support breastfeeding; aims for the universal implementation of the ten steps to successful breastfeeding
5
intra uterine growth retardation in newborns of industrialized countries partially catchy up to controls during the first 2 years of life but are usually about ____ cm shorter and kg lighter in adulthood
fat
insufficient dietary _____ intake limits the absorption of vitamin A
sodium, fluid
insulin release during refeeding stops the excretion of _______ which causes ______ retention in the first few days of refeeding
fat, glucose
insulin release during refeeding stops the release of _____ from stores and the production of ______ from protein
complementary
interventions to improve intake of _______ foods can result in improved infant and child growth among populations at risk of undernutrition
increase
intracellular sodium levels ______ during protein energy malnutrition because the Na-K-ATP pump is not functioning properly
seawater
iodine is available in abundance in ______ making seafood and seaweed good sources of iodine
replication, brain
iodine plays a key role in cell ________ which is especially relevant for the ______
cognitive, brain, neurotransmitters
iron deficiency anemia can cause ______ defects in children due to not enough oxygen to the ______ or a decreased amount of ______
productivity
iron deficiency anemia can cause decreased ________ that leads to lowered effectiveness of money spent on education
pregnant
iron deficiency anemia is most common in ______ women in developing countries
mucosal
iron is stored in the _____ cells that will eventually slough off; this prevents excessive intake of iron
caloric
it is rare to have a protein deficiency without a _____ deficiency as well due to the nature of the food supplies ; exception with cassava and plantain as staples
second
it is recommended that breastfeeding continues in the _______ year of life and beyond
6
it is recommended that breastfeeding with complementary feedings starts at ____ months of age
6
it is recommended that infants receive exclusive breastfeeding for ____ months
1 week
it may take refeeding patients __ ______ to adapt to the increase oxygen demand so feedings should begin slowly
33 weeks
it took most participants in the Keyes study ___ ____ to fully recover from the semi-starvation period
salt
keeping _____ intake to less than 5 grams per day helps to prevent hypertension and reduces the risk of heart disease and stroke in the adult population
water clearance and ability to concentrate and acidify urine
kidney function that is NOT impaired during protein energy malnutrition
mid-upper arm circumference, medical, appetite
measurement taken by a community health worker to identify if a child can be treated for severe acute malnutrition with home-based treatment; child must have no ____ complications and still have an _____
anemia
maternal ______ associated with low birth weight and then low/no stores of iron for the infant
mortality
maternal anemia results in increased maternal ______ rate by up to 20% in developing countries
volume, energy nutrients
maternal malnutrition results in a lower ________ of milk produced with ______ ______ in the same concentration
quantity
maternal malnutrition results in breastmilk with the same quality but diminished _______
anthropometric assessment
measurement of body weight and the lengths, circumferences, and thicknesses of parts of the body; does not just focus on BMI
1.) 12 weeks of baseline diet ad lib 2.) 24 weeks of semi-starvation diet 3.) 12 weeks of rehabilitation (normal diet)
3 stages of the Keyes study
1.) clinical assessment (physical signs) 2.) biochemical assessment (lab measurements) 3.) dietary assessment (dietary recall)
3 ways that we determine nutritional status
low/middle
3/4 of deaths due to chronic disease occur in ______ income countries
1.) growth 2.) activity 3.) productivity 4.) chronic disease prevention
4 factors of good nutrition that must be met in order for a diet to meet the requirements for an active, healthy life
1.) chickpea 2.) soy 3.) peanut 4.) banana
4 foods that help the microbiome mature
cardiovascular disease, cancer, chronic respiratory disease, diabetes
4 major chronic diseases that account for 82% of all non-communicable disease deaths
1.) unhealthy diet 2.) physical inactivity 3.) tobacco use 4.) harmful alcohol use
4 modifiable risk factors of the double burden of malnutrition
low, middle
4 out of 5 chronic disease deaths are in ____ and _____ income countries
1.) pitting edema 2.) dry skin with lesions 3.) brittle hair 4.) straight and hypopigmented hair
4 physical signs of kwashiorkor
1.) fatigue (decreased heart rate) 2.) muscle soreness (decreased muscle tone) 3.) irritability (depressed, moody) 4.) hunger pains 5.) lack of ambition (poor concentration) 6.) inability to laugh or sneeze or tolerate heat
4 physical signs that the Keyes study participants showed after 3 months of starvation
1.) low protein-to-energy ratio 2.) hypoalbuminemia 3.) fatty liver 4.) edema
4 signs of kwashiorkor
1.) night blindness 2.) impaired immune function 3.) dry, hard skin 4.) dry cornea and eventual blindness
4 symptoms of vitamin A deficiency
1.) loss of appetite 2.) changes in normal metabolism increasing nutritional requirements (i.e. infections) 3.) prevention of nutrient absorption (i.e. diarrhea) 4.) diversion of nutrients to parasitic agents themselves 5.) environmental enteropathy
5 causative conditions of secondary malnutrition
1.) wasted appearance 2.) marked growth failure 3.) sparse, thin, and dry hair 4.) dry, thin skin 5.) apathetic patients with anxiety
5 signs of marasmus
thyroid
chronically high intakes of iodine can also cause impaired ______ function
1.) income 2.) food prices 3.) individual preferences 4.) cultural traditions 5.) geography and environment
5 social and economic factors that interact in a complex manner to shape dietary patterns
ART
WHO now recommends ______ for everyone from the time when any adult or child is first diagnosed with HIV infection
6, 12
WHO recommends that women who breastfeed and receive ARVs should exclusively breastfeed their infants for ____ months and continue breastfeeding until ____ months of age and only then consider stopping
fats, sugars, meat
Western diets tend to be high in _____, ____, and ____ products
fiber
Western diets tend to be low in _____ due to a lower intake of fruits and vegetables
sedentary
Western diets tend to go hand in hand with a rise in ______ lifestyles
processed
Western diets tend to include highly _______ foods
ready to use therapeutic food (RUFT)
a food given to refeeding children that is usually a paste in packets that does not need to be mixed with water; peanut butter mixed with dried skimmed milk and vitamins and minerals
noncommunicable diseases (NCDs)
a healthy diet helps to protect against malnutrition in all its forms, as well as ________ ______ including diabetes, heart disease, stroke, and cancer
thyroid stimulating hormone
a hormone that is constantly produced in iodine deficient people who develop goiter; this puts the thyroid gland in overdrive which enlarges it
iodine
a lack of ______ can cause goiter which is the enlargement of the thyroid gland
cost-effective, inexpensive
a large number of interventions for chronic diseases are very __________ for all regions of the world and _____ to implement
nutrition transition
a model used to describe the shifts in diets, physical activity, and causes of disease that accompany changes in economic development, lifestyle, urbanization, and demography
respiratory muscle
a person with malnutrition-induced ______ ______ wasting can get short of breath during refeeding because they cannot sustain an increased ventilatory drive
ferritin
a protein in the mucosal lining of the intestine and liver that iron attaches to in order to be stored
transferrin
a protein that transports iron through the blood
cretinism
a severe cognitive ability due to a maternal iodine deficiency
pelvic
a smaller _____ area also results in higher incidence of difficult births leading to higher infant and maternal mortality
dietary reference intake (DRI)
a system of nutrition recommendations that are used to promote good nutrition by the general public and health professionals; developed originally to prevent deficiencies but now health outcomes are also consideredno
food apartheid
a term coined by food justice advocates to describe the social inequalities that make healthy, culturally appropriate food inaccessible to certain communities
protein energy malnutrition
a term used synonymously with malnutrition that develops gradually in weeks or months and allows for a a series of metabolic and behavioral adjustments to occur as the body gets smaller
vitamin A, iron
antihelminthics given in conjunction with _____ ___ and ______ supplementation show better outcomes on children's health
rhodopsin
as part of _______, retinol binds with the protein opsin
conjunctival xerosis
abnormal dryness of the lining of the eyelids and the outer surface of the eyeball
90
about ____% of pre-formed vitamin A is absorbed
half
about _______ (or less) of non-heme iron is absorbed by the body than heme iron
right
access to nutritionally adequate and safe food is a basic individual ______
brush border, pancreatic
activity of the ____ ______ enzymes and ______ enzyme secretion return to normal with refeeding
diarrhea
adequate nutrition mitigates the negative effect of _____ seen in these first few years on linear growth
mortality
adult _____ rates increase when BMI is less than 18.5 or indicate obesity
noncommunicable disease
affluent diets are nutritionally adequate but imprudent which leads to an increased risk of _______ _____ such as coronary heart disease, diabetes, and hypertension
urine output
after 1 week of starvation, ____ _____ drops in most people to 100-700 ml/day
hunger
after 2-3 days of starvation, _____ subsides
defecation
after 3-4 days of starvation, ______ ceases
slows
after the first week of starvation, weight loss _____ in order to prevent the loss of lean body mass
microbiome
all microbes (and their genes) that are associated with humans, living on the outside, and inside of the human body
hunger
alleviating ______ helps children perform better and concentrate easier on complex tasks
prematurely
almost half of chronic disease death occur ______ in people under 70 years of age
macroeconmic
along with creating individual poverty, chronic diseases can also hinder the ______ development of many countries
food desert
an area characterized by a lack of affordable, fresh and nutritious food; suggests it's a natural occurrence but it's not
sodium
an electrolyte that must be given carefully to refeeding patients in order to prevent the overexpansion of the extracellular fluid
work
anemia in mother also results in decreased ______ capacity
cardiovascular disease, diabetes, and high blood pressure
babies programmed for a life of scarcity and then confronted with a world of plenty will see increases in _______ _______, _______, and _____ ____ ______
breast feed
babies who _____ ____ usually have better nutritional status than those who do not because the infant does not compete for food, it is clean, and has immunologic benefits
menarche, premearcheal
better nourished girls reach _____ earlier and have higher _____ growth velocity
mental
birth weight also influences _____ development and its accentuated in lower socioeconomic groups
phosphorous, phosphorylated
blood levels of _______ may decrease in the first few days of refeeding as it moves into cells from the blood because of the need to make _______ compounds in the cell
decreases
body temperature ______ in prolonged starvation
velocity
boys have a higher and longer ______ of growth spurt than for girls
equally
chronic diseases affect women and men almost ______ including heart disease
intellectual, chronic diseases, breast cancer
breastfeeding is linked to stronger _______ development of the child, reduced risk of cancer, obesity, and several _____ _____, and later reduced risk of _____ _____
economic
chronic diseases are a major cost and a profound ______ burden to individuals, their families, health systems, and societies
individual
chronic diseases are not always due to _____ responsibility because there is not always equitable access to a healthy life
older
chronic diseases are not just diseases for people of _______ age groups
F-100
catch-up formula that may be made using fresh cow's milk for refeeding children
iron deficiency
caused by insufficient intake to cover normal needs or to meet the increased needs for blood loss, growth, or pregnancy
spleen, lymph nodes
cells from the T lymphocyte regions of the ____ and ____ ____ are depleted during protein energy malnutrition
lowers
changes in the sympathetic nervous system and metabolism of thyroid hormone _____ the basal metabolic rate during starvation
capital
child stunting is now accepted as one of the best indicators of the quality of future human _______
parenteral, intravenous antibiotics
children admitted with severe acute malnutrition and medical complications should be given _______ or ______ _____
oral antibiotic
children admitted with severe acute malnutrition and with no apparent signs of infection and no medical complications should be given an _____ _____
antibiotics
children who are undernourished but who do not have severe acute malnutrition should not routinely receive _______ unless they show signs of clinical infection
oral antiobiotics
children with uncomplicated severe acute malnutrition, not requiring to be admitted and who are managed as outpatients, should be given a course of ____ ______
poverty
chronic disease cause significant financial burden and can push individuals and households into ______
calorie, nutrient, healthy
combating malnutrition has been an evolving movement in the world; first needed to meet _____ needs, then needed to meet _______ adequacy, now the emphasis is on ensuring a ______ diet
culturally
complementary food must also be easy to prepare and _____ appropriate
second
complementary foods are required in the ______ 6 months of life to provide adequate nutrition and stimulate development
energy, micronutrients
complementary foods must be adequately dense in _____ and _____ to meet the requirements of infants and young children
diarrhea
complementary foods must be prepared, stored, and fed in hygienic conditions to prevent _________
antihelminthics
compounds that kill parasitic worms without damaging the host; can improve the health status of children
vitamin c
concurrent intake of _______ ___ can enhance absorption of nonheme iron up to 6 fold (25 mg per meal)
xerophthalmia
condition of dry eye
double burden
countries that have both undernutrition and chronic diseases experience a ____ ____ with not enough resources to treat both issues
6
current U.S. infant mortality rate
zinc
current evidence shows that ____ supplementation reduces the length of time of diarrhea and reduces stool volume
activity
decreased ______ during the nutrition transition leads to decreases in energy needs
ATP
decreased amounts of _____ due to decreased energy substrates probably changes cellular exchange of sodium and potassium during protein energy malnutrition
stunting
defined as less than 2 standard deviations from the median of international growth for height for age (severe is greater than 3)
wasting
defined as less than 2 standard deviations from the median of weight for height (severe if greater than 3)
care
defined as the behaviors and practices of caregivers to provide the food, health care, stimulation, and emotional support necessary for children's health growth and development
infant mortality rate
defined as the number of children per 1,000 live births who die before their 1st birthday; key indicator of malnutrition
refeeding syndrome
describes the adverse clinical and biochemical problems that may result from feeding malnourished patients
carbohydrate, adapted
during kwashiorkor, the increase in ______ intake stimulates insulin production and a reduction in the production of epinephrine and cortisol; this breaks down the normal ____ system to severe lack of food
proteins, albumin, edema
during kwashiorkor, there is a decreased synthesis of plasma _____ in the liver, particularly ______ which reduces intravascular oncotic pressure and leads to ______
increased
during kwashiorkor, there is an _____ fat production in the liver from the excess carbohydrate which impairs fat break down and causes the enlargement of the liver
T lymphocytes
during protein energy malnutrition, ____ ______ that kill foreign invaders become defected and infection rate increases
B lymphocytes, antibody
during protein energy malnutrition, ____ _______ are relatively normal but there be defects in ______ production that predispose people to infection and otherwise less important infectious diseases
central
during protein energy malnutrition, ______ circulation takes precedence over peripheral circulation in order to allow the heart to function in setting of reduced oxygen consumption
catabolism
during protein energy malnutrition, ______ of cardiac cells/proteins occurs that make contractile fibers for pumping less effective
diarrhea
during protein energy malnutrition, ______ upon feeding may occur due to the impairments in gastrointestinal function
decrease
during protein energy malnutrition, cardiac output, heart, and blood pressure ______ so that less blood is pumped out of heart
catabolized, reduction
during protein energy malnutrition, expiratory and inspiratory muscles are ________ and there is a ______ in diaphragmatic mass
reduces
during protein energy malnutrition, heart muscle ________ in size in parallel with loss of lean body mass
lowers
during protein energy malnutrition, heat production and oxygen consumption _______
low, thyroxine
during protein energy malnutrition, insulin levels become _____ and leads to hormonal changes that affect ________
decreases, oxygen
during protein energy malnutrition, red blood cell production ______ due to decreased ________ demands due to a lowered amount of lean body mass (muscle)
decreases
during protein energy malnutrition, the basal metabolic rate and non-vital hormonal secretion ________
bacterial sepsis
during protein energy malnutrition, the deficiency of the immune system's functions of phagocytosis, chemotaxis, and intracellular killings lead to a high susceptibility to ____ ____
decrease
during protein energy malnutrition, there is a _____ in gastric, pancreatic, and bile production which impairs dietary fat breakdown
decreased
during protein energy malnutrition, there is a _____ respiratory muscle strength, maximum voluntary ventilation, vital capacity, and maximum inspiratory pressure
surfactant
during protein energy malnutrition, there is a decreased ________ synthesis, storage and secretion
emphysema
during protein energy malnutrition, there is a deterioration of lung function that causes _______ like changes
thymus
during protein energy malnutrition, there is a marked depletion of lymphocytes from the _____ gland because it is atrophied
increase, decrease
during protein energy malnutrition, there is an _____ in infections due to a _____ in immune function and a reduced ability to clear secretions from impaired muscle function
absorption
during protein energy malnutrition, there is decreased _______ due to the decreased height of the villi and decreased production of enterocytes
decreased
during severe protein energy malnutrition, there is a _______ rate of glucose absorption because villi are damaged
impaired
during severe protein energy malnutrition, there is an _______ intestinal absorption of fat and carbohydrates
nausea
during starvation, ____ occurs in about 1/3 people from ketone production from body fat breakdown
blood glucose
during starvation, _____ _____ levels drop to 35-65 mg/dl without clinical signs of low blood sugar (they might appear normal)
serum electrolytes
during starvation, _____ ______ do not change because kidney conservation occurs promptly; low potassium is rarely seen
stay the same
during starvation, plasma cortisol and growth hormone _____ __ ____
increases
during starvation, plasma glucagon _______ in order to stimulate glucose production
decreases
during starvation, plasma insulin ______ in order to mobilize and use fat stores for energy
normal
during starvation, serum albumin is ______ until late in starvation
increase
during starvation, serum fatty acids levels _______
glucose
during starvation, skeletal muscle is broken down to produce _____ for the central nervous system, red blood cells, white blood cells, and your brain
decrease
during starvation, there is a _____ in the size of body comparments
scarring
during the end of xeropthalmia, corneal ulcerations and keratomalacia results in ________
negative
during the first 5-7 days of starvation, there is a ____ nitrogen balance characterized by the break down of skeletal muscle to produce glucose
retirement
for many poor older people in developing countries, ______ is not an option due to lack of pensions, poverty, and death of younger people
adequate intake
from birth to 6 months of age, ____ _____ is used to recommend iron intake instead of recommended dietary allowances
liver
glucose is stored in the ____ to be available to the blood and brain during an overnight fast
muscle
glucose stored in the _____ can only be used by that specific tissue because it does not mix in the bloodstream to be used during starvation
iodine
goiter develops when _____ is lacking
longer
growth of boys before growth spurt occurs for a _____ time than for girls
more
heme iron is taken into the cells ______ efficiently than non-heme iron
baby friendly hospital initiative
hospital designation where it has agreed not to accept free or low-cost breastmilk substitutes, feeding bottle and teats, and to implement practices that promote and support breastfeeding
nasogastric
if a child's intake of food does not reach 80 kcal/kg/day despite frequent feeds, coaxing and re-offering, the remaining feed should be given by _______ tube
muscle
if protein is not available in the diet, ____ will begin to be broken down
patterns
in any population, there will be a certain number of people who do not demonstrate the typical ______ seen in the vast majority
stunted
in developing countries, the overfeeding of _______ populations should be avoided
2/3
in ideal scenarios, _____ of body iron content is being used
cigarette smoking
in industrialized countries, _____ ______ is the most important determinant of intra uterine growth retardation
middle-aged
in low and middle income countries, ______ people are especially vulnerable to chronic diseases because they develop the disease younger, suffer longer, and die sooner than those in high income countries
carbohydrate
in order for fat to be turned into energy, a small amount of _______ must be available
maternity leave
in order to promote exclusive breastfeeding, we must enact 6 months of mandatory paid _____ ______ as well as policies that encourage women to breastfeed in the workplace and in public
hyperplasia
increase in the number of brain cells
iron
increased blood volume in pregnancy results in increased ______ needs
sugars
limiting intake of free ______ to less than 10% of total energy intake is part of a healthy diet
infectious, chronic
low and middle income countries need to deal with ______ diseases but they also are seeing a rapid increase in ______ disease risk factors and death
mortality, mental, disease
low birthweight results in a higher ______ rate, impaired _____ function, and increased risk of adult ________
magnesium
low blood _____ levels may cause irregular heart rhythm, hypocalcemia, muscle weakness, and neurologic symptoms
potassium
low blood ______ levels may result in irregular heart rhythms during refeeding
edema
low blood protein levels leads to intestinal _____ which decreases luminal absorption which leads to diarrhea
depression
malnourished adults increases the risk of _____ which leads to frailness and lack of ability to care for self independently
low; energy
malnourished mothers typically have children with ____ birth weight; also have less ______ to care for their children and future grandchildren
stimulated
malnutrition during the first 1000 days of a child's life indirectly affects mental development because it makes children less active and therefore their brains are less ______
decreased
malnutrition during the first 1000 days of a child's life results in a ______ mental capacity and amount of brain cells
double burden of malnutriton
malnutrition plus rapid upsurge of risk factors for chronic disease such as overweight and obesity leads to this
secondary malnutrition
malnutrition that is not directly caused by the diet; results from a condition that prevents proper ingestion, digestion, or absorption, and metabolism; could accompany other types of malnutrition and make them worse
blood loss
menses, GI tumors, and parasites can lead to ____ ____ that can cause iron deficiency
oxygen
metabolism that uses _____ is more efficient at producing ATP; requires glucose, protein, and fat
iodine
micronutrient needed for the synthesis of thyroid hormones
iodine
micronutrient needed to regulate the metabolic activities of all cells
iron
micronutrient that must be present for red blood cell and hemoglobin production
iron
micronutrient that only becomes important for later rehabilitation of a refeeding child because it is important to avoid hypocalcemia
microbiota
microorganisms living in a particular environment, or site
measles
mortality and severity of ______ worsens with vitamin A deficiency,
preventable
most chronic diseases are ______ and the risk factors can be eliminated
built environment
most of the declines in the risk factors for global disease burden center on changes to the _____ _____
HIV
mothers living with ______ should breastfeed for at least 12 months and may continue for 24 months or beyond while being fully supported for ART adherence
first trimester
mothers should be reached prior to or in the _____ _____ for greatest effect of supplementation because many pregnancies are unplanned
bigger
multiple micronutrient supplements yield a _____ increase than just iron and folate supplements alone
90
neither ____% of the global population is consuming salt with iodine
absorbed
non-meat sources of iron (non-heme iron) are not as easily _______ iron stores as heme iron
declining
number of children stunting is ________ worldwide except for Africa
F-100
plumpy-nut (RUTF) is similar in nutrient composition to _____ formula
illnesses
poor nutrition also increases nutrition-related ______ which causes children to miss more days of school which affects their learning
more
poor people are much _______ likely than the wealthy to develop chronic disease and die as a result
2
potential for catch-up growth in stunted children is limited after the age of ____ especially if they are born with low birth birth weight or severe stunting in infancy
less
pro-vitamin A is _____easily absorbed than pre-formed vitamin A
increased
protein energy malnutrition early in pregnancy resulted in _______ rate of fetal loss and malformations
low
protein energy malnutrition late in pregnancy resulted in ______ birth weight babies
the code
provides guidelines for the marketing of breast milk substitutes, bottles, and teats and aims to restrict practices that make infant feeding decisions responsive to market pressures
data was needed in order to figure out how to provide food relief to people who became starved during WWII
purpose of the Keyes study
increases
refeeding _______ the heart rate, blood pressure, oxygen consumption, and cardiac output
plasma
refeeding causes an ______ of plasma volume
nutrition transtion
the dietary change in ______ ______ is to high-sugar, high-fat, high-salt, energy dense, and micronutrient low foods
congestive heart failure
refeeding may result in _______ _____ _____ which is the inability for the cardiac output to increase enough to meet the needs from the increased plasma volume, increased oxygen consumption, and increases in blood pressure and heart rate
gastrointestinal
refeeding requires a period of readaptation to food to minimize ________ complaints such as diarrhea, nausea, and vomiting
extracellular
refeeding results in the expansion of the ______ space and fluid must be given carefully during the first few days to weeks of refeeding
nutrition transition
refers to the change from traditional diets towards "Western" diets
visual
rhodopsin absorbs light which signals the _____ cortex of the brain
traditional
rural, ______ diets are low in fat and sugar, high in fiber, and have little variety
waste disposal, clean water
sanitary ____ _____ and ____ ____ are important in reducing secondary malnutrition and preventing transmission of parasites and diarrheal diseases
stimulation, emotional
sensory _____ and _____ support are also a part of the refeeding therapy of a malnourished child
heart rate
since cardiac output and stroke volume decrease during protein energy malnutrition, the only compensatory mechanism for increased oxygen needs is an increased ____ ____
environmental enteropathy
small intestinal disorder triggered by constant ingestion of feces via contaminated food and water; results in leak of bacteria through intestinal walls into blood stream
healthy
snacks high in sugar, fat, and salt are marketed aggressively and more easily available and cheaper than ____ alternatives
oral rehydration salts solution
solution responsible for saving children's lives; gives solution of sodium and glucose to treat acute diarrhea
carbohyrate
some _____ is needed for energy production
iron depletion
stage of iron deficiency caused by a decrease in iron stores (ferritin)
iron deficiency hematopoiesis
stage of iron deficiency that occurs when iron stores are depleted with insufficient absorption to counteract normal losses; leads to decreased hemoglobin production
F-75
starter formula that may be made with fresh cow's milk for refeeding children
Barkers fetal origins of disease hypothesis
states that nutritional insults during critical periods of gestation and early infancy followed by relative affluence increase the risks of chronic diseases in adulthood
chronic diseases
studies of children and health risk found that in the thinnest children, the more obese they became as adults, the greater was their risk of developing _____ ______
low birth weight
stunted children lead to stunted adults which leads to ___ ____ ____ infants
cognitive
stunting at age 2 is associated significantly with later deficits in _______ ability
epidemiologic
the U.S. originally refused to believe WHO reports on the prevention of chronic diseases through nutrition because they focused on ________ evidence versus clinical trials ("wrong kind of science")
energy, intake
the Western diet is _____ dense and its dietary variety and palatability are associated with increased ______
gut microbiota
the ____ _____ influences the growth and differentiation of gut epithelial cells and plays pivotal nutritive, metabolic, immunological, and protective functions
eye
the _____ especially needs mucus to keep the surface moist and to wash away dirt and other particles that settle on the eye
cost
the _____ of a healthy diet is 60% higher than that of a nutrient adequate diet and 5 times that of an energy sufficient diet
indigenous
the ______ diet is usually high in whole grains and starchy roots but it is now being replaced with foods higher in fat, animal food sources, and sugars
iron deficiency
the absence of iron stores combined with signs of iron-deficient red blood cell production implying an insufficient supply of iron to various tissues; diet does not provide enough to meet needs
hypotension, decreased
the altered cardiovascular reflexes during protein energy malnutrition can cause postural _______ and _____ venous return
basal metabolic rate
the amount of calories required for basic life fuunctions
preformed vitamin A
the amount of vitamin A in the body may become toxic when there is excess consumption of _____ _____ ___
obesity, chronic disease
the bad part of the current nutrition transition is that there has been a higher risk of ______ and _____ ______
school
the best predictors of ______ outcomes is weight gain during the first two years of life followed by birth weight
18
the best way to improve birth weight is to delay pregnancy until at least age _____
low birth weight
the best way to prevent stunting in children is to prevent _____ _____ _____
ketones
the brain will eventually use ____ when starvation is prolonged and glucose is no longer available
carbohydrate
the citric acid cycle requires some _____ to keep it turning
formula
the code has had a major impact on the way ________ is advertised and marketed
health care system
the code urges there to be no donations of free or subsidized supplies of breastmilk substitutes to any part of the ____ ____ ____
cell proliferation
the continuous development of cells in tissue formation that requires vitamin A
decreased
the decreased cardiac output that occurs as a result of protein energy malnutrition causes _____ renal plasma flow and glomerular filtration rate
slow
the negative nitrogen balance seen during starvation will _____ around 1 month because skeletal muscle breakdown decreases significantly for only cells that have to have glucose
higher
the nutrition transition has resulted in a ______ intake of fat, sugars, and energy
functional
the nutritional status of older adults is related to their _____ abilities to carry out activities of daily living independently
lean body mass
the participants in the Keyes study had a relatively high loss of ____ ____ ___
everyday activities
the participants in the Keyes study were expected to maintain ____ _____ such as maintenance tasks, laboratory assistance, shop duty, desk work, educational programs, and walking
lower
the potential for catch-up growth for stunted children is worse for those children who are of ______ socio-economic status
developing
the prevalence of iron deficiency anemia is higher in children in _____ countries
hemoglobin
the protein of red blood cells that carries oxygen molecules that requires iron
myoglobin
the protein similar to hemoglobin found in the cytoplasm of muscle cells that requires iron
undernutrition
the result of prolonged low levels of food intake and/or low absorption of food consumed; can apply to energy or vitamin deficiencies
appetite
the return of the _____ of a malnourished child is the sign for entering the rehabilitation phase of refeeding
diabetes
the rise in _____ in U.S. adults corresponds to the rise in overweight and obese adults in the U.S.
cancer
the risk of stroke and ______ mortality at several sites is increased if shorter children show an accelerated growth in height
European famine areas
the semi-starvation diet given to the participants in the Keyes study represented the types of foods available in ____ ____ _____ (higher carbs, lower proteins/fats)
undernourishment
the status of persons whose food intake regularly provides less than their minimum energy requirements; synonymous with chronic hunger
wasting
the tendency for children to be severely underweight for their height as a result of malnutrition; low weight for height
hunger
the uneasy or painful sensation caused by lack of food; synonymous with chronic malnutrition
last
the visual system is the _____ to be impaired during vitamin A deficiency
processed
the worldwide availability of ______ foods has soared since 2004
body weight
there appears to be a continuous gradient in work capacity and productivity that is linked to _____ _____
adolescent
there are higher maternal and infant mortality and pre-term delivery with _______ pregnancies
chronic disease
there are large increases in _____ ______ associated with obesity in both rural and urban areas
income
there is a rising amount of obesity seen in developing countries at all _____ levels
coronary heart disease
there is an association between low growth in the first year of a child's life and increased risk of ______ _____ _____; blood pressure is increased in those with retarded fetal growth and subsequent weight gain in infancy
cognition
there is an effect on infant _______ if a baby is born to a mother with low stores of iron
poor
there is growing evidence that shows the burden of obesity is becoming greater among the _____ than others
1.) anemia 2.) vitamin A deficiency 3.) loss of appetite
three consequences of the infestation of parasites causing secondary malnutrition
1.) central nervous system 2.) red blood cells 3.) white blood cells
three types of cells that have to use glucose and cannot use ketones
food systems
to achieve the healthy dietary patterns, large transformative changes in _____ ______ will be needed at all levels
decreases
total energy expenditure ________ in prolonged starvation due to less activity and more sleep
30
total fat should not exceed ____% of total energy intake
undernutrition, infection
traditional diets have inadequate energy and nutrients which leads to ______ and increased risk of ______
1.) changes in food system to higher fat, salt, and energy foods 2.) urban environments and lifestyels
two major causes of the double burden of malnutrition
kwashiorkor, marasmus
two types of protein energy malnutrition
protein energy malnutrition
type of malnutrition characterized by an extremely deficient intake of protein and calories; made worse by accompanying illness
micronutrient malnutrition
type of malnutrition characterized by dietary deficiencies of vitamin A, iodine, iron, zinc, vitamins D, C, and Bs
kwashiorkor
type of protein energy malnutrition characterized by moderate energy deficits and severe protein deficits; characterized by edema with some subcutaneous fat tissue maintenance
marasmus
type of protein energy malnutrition characterized by severe energy and protein deficit; characterized by skin and bones appearance with little or no subcutaneous fat tissue
pre-formed vitamin A
type of vitamin A that comes from animal sources
pro-vitamin A
type of vitamin A that comes from carotenoids from plants
smaller, competition
undernourished adolescent mothers tend to have _____ infants due to _________ for nutrients and poorer placental function
longer
undernourished girls grow for a ____ period of time, so they may not be finished growing before the first pregnancy
later
undernourished girls grow longer before a ____ menarche
double burden of malnutrition
undernutrition exists simultaneously with overweight and obesity (overnutrition) and diet related noncommunicable diseases
motorized
urbanization has resulted in the increased use of ________ transport which has decreased activity during the nutrition transition
phosphorous
very low levels of this electrolyte can lead to respiratory, cardiac, and nervous system dysfunction as well as red and white blood cell dysfunction
rhodopsin
visual pigment that is composed of vitamin A
infection
vitamin A deficiency is associated with decreased resistance to _______
soluble, lipids
vitamin A is a fat-________ vitamin and is absorbed and transported with _____
mucous
vitamin A is essential for the production of ______-forming cells in the lungs, trachea, skin, and GI tract
gene, epithelial
vitamin A is involved in _____ expression and the maintenance of ______ tissue
differentiation
vitamin A is involved in the regulation of growth and ______ of cells, including some cells of the immune system
epithelial
vitamin A is needed for the production, structure, and normal function of _____ cells in the lungs, trachea, skin, GI tract, etc.
liver
vitamin A is stored in the _____
intracellular overhydration
water follows sodium during protein energy malnutrition so there may be _____ ______
fluid retention
weight gain greater than 1 kg during the first week of refeeding is due to ____ ______
calcium, iron
when a mother is malnourished, the nutrients such as _____ and _____ in the breastmilk are taken from the maternal stores
ketones
when carbohydrates and glucose are not available in adequate amounts, _____ are made from fat instead of energy
vitamin A
when the pool of _____ __ is low, dark adaptation is slowed down
nutritious
while rich countries have managed to make calories cheap, they have neglected to also make _______ food cheap
vitamin A
without _____ ____, the ability to make enzymes and epithelial cells is compromised
14
work increased ____% for each one-gram increase in an adult's hemoglobin