RD Exam

order point=

(average daily use)(lead time)+ safety stock lead time is the number of days from placing the order unil delivery

inventory turnover rate=

(cost of sales(food costs))/average inventory costs *meausres how often an inventory is consumed and replenished

FTE/day equation

(labor hours worked per day)/8 hr normal work load

formula for nitrogen balance

(protein intake in grams/6.25)- (urinary urea nitrogen+4)

edible protion=

(raw purchased cost AP)/cooked edible weight

hemodialysis MNT

-1.2 g pro/kg SBW, at least 50% HBV -<60 years= 35 kcal/kg >60 yr or obese= 30-35 kcal/kg -25-35% fat -<7% saturated fat -<200 mg cholesterol ->1 liter fluid output: 2-4 g Na and 2 L fluid <1 liter fluid output: 2 g Na and 1-1.5 L fluid -Anuria: 2 g Na and 1 liter fluid -40 mg/kg IBW (2-3grams) K -calcium: individualized max of 2 g elemental -800-1000mg Phos -vitamins C, B6, folate, B12 supplements -Zinc DRI 8-11mg/day

peritoneal dialysis MNT

-1.2-1.3 g pro/kg SBW, >=50% HBV -<60 years: 35 kcal ->60 years: 30-35 kcal -2-3 g Na -K generally unrestricted -<-2000 mg total elemental calcium -800-100 mg Phos or 10-15mg Phos -1-3 L fluid depending on output/cardia status

MNT for renal calculi

-1.5-2L fluid/day needed to dilute urine -for calcium oxalate stones: make sure adequate calcium intake to bind oxalate and low oxalate (40-50mg) diet -alkaline ask/acid ash diets

MNT for CKD

-23-35 kcal/kg, adjust for weight loss/gain -<2400 mg/day sodium -protein restriction when GFR mL/min falls -fluid generally restriction -K not restricted unless serum level is elevated and urine output is <1 liter per day -Phos stage 1 and 2: to maintain normal serum levels -Phos stage 3 and 4: 800-1000 mg/day or 10-12 mg/g pro

when should you screen a pregnant women for GDM

-24-28 weeks of gestation, screen with 50 g oral glucose load

alcoholic liver disease

-3 stages -hepatic steatosis, alcohol hepatitis, cirrhosis -liver injury due to alcohol and metabolic derangements it causes

MNT for GDM

-40-45% CHo, 3 small-medium sized meals with 2-4 snacks -DRI for CHO pregnancy is 175 g/day -15-30 g CHO at breakfast (less well tolerated), rest divided evenly -increase risk of fetal macrosomia (LGA), fetal hypoglycemia at birth -overwieght/obese: moderate energy restriction to slow weight gain

protein in milk

-80% casein (forms soft curd) -whey is liquid drained from clotted milk

NSIP Nutrition Services Incentive Program

-AoA Administration on Aging -developed services to foster independent living; cash and commodities to state agencies

likely cause of anemia due to billroth procedures

-B12: lack of intrinsic factor and bacterial overgrowth in the look of intestine being bypassed interfere with B12 absorption (pernicious) -folate: needs B12 for transport inside the cell; also from poor folate intake and low serum iron (cofactor in folate metabolism)

altered neurotransmitter theory for ESLD

-BCAA decrease (used by muscles for energy) and AAA increase because damaged liver is unable to clear them, this abnormal ratio is though to bring on many of the symptoms of encephalopathy. MNT: is to add BCAA and fewer AAA to try to correct ration

expectancy theory

-Beer, Vroom -rewards serve as motivators only under certain circumstances -effective performance leads to certain rewards

summary of digestion in the mouth

-CHO--> with amylase--> takes starch to dextrin to maltose -FAT: mechanical -PRO: mechanical

summary of digestion in stomach

-CHO: continued breakdown to maltose -Fat: mechanical -Protein: proteolysis (protein digestion) *pepsinogen+HCL of stomach--> pepsin *pepsin acts on protein--> protease, peptones

summary of digestion in small intestine

-CHO: continued breakdown with pancreatic amylase *intestinal: + enzyme sucrase, sucrose--> glucose+fructose +maltase, maltose--> glucose+ glucose +lactase, lactose--> glucose+galactose -FAT *gallbladder +bile salts emulsify fats *pancreas +enzyme lipase, triglycerides--> FFA, glycerol +cholesterol esterase, cholesterol--> cholesterol esters +phospholipase, phospholipids--> lysolecithin, FFA -PROTEIN *pancreas +enzyme trypsin, protein, proteose, peptone--> polypeptide +chymotrypsin, proteose, peptone--> poly and di peptide *intestine +aminopeptidase, polypeptide--> peptide, amino acids

CMS Centers for Medicare and Medicaid Services

-DHHS

Headstart

-DHHS -helps low income children, ages 3-5 introduces food, teaches food food habits

Health Start

-DHHS -reduce infant mortality and improve health of low income women, infants, children, families -target high infant mortality rate areas

Prospective Payment System

-DRG-diagnostic related groupings -part of tax equality and fiscal responsibility act -patients classified on basis of the international classification of disease -hospitals paid a specific amount per patient based on diagnosis -LOS is NOT considered when determining payment

glucagon-like peptide-1 (GLP-1) agonist

-Exenatide (byetta) enhances insulin secretion, suppresses postprandial glucagon

international agency assistance programs

-FAO Food and Agricultural Organization (increase efficiency of production and distribution of food) -WHO World Health Organization (have RDA for developing countries)

dx of diabetes

-FBG >=126 mg/dL -GTT >= 200 mg/dL -symptoms of diabetes plus casual plasma glucose >200mg/dL HgA1C >= 6.5%

BRFSS Behavioral Risk Factor Surveillance System

-HHS -adults 18 yrs and older residing in households with telephones -telephone interviews collect info on height, weight, smoking, alcohol use, FFQ for fat, diabetes

YRBS Youth Risk Behavior Survey

-HHS -collects data on priority health risk behaviors -grades 9-12: smoking, alcohol use, weight control

PNSS Pregnancy Nutrition Surveillance System

-HHS -low income, high risk pregnant women -maternal weight gain, anemia, pregnancy behavioral risk-factors (smoking, alcohol) -counts # of women who breast-fed -goal is to identify and reduce pregnancy-related health risks

PedNSS Pediatric Nutrition Surveillance System

-Human Health Services -low income, high risk children, birth- 17 years -gain anthropometrics -monitor growth and nutritional status, infant-feeding practices

fever and infection MNT

-IV feedings of dextrose and water, then diet high in calories and fluids

USDA Food Safety and Inspection Service FSIS regulates

-Meat and Poultry Division -wholesome meat and poultry act: inspects all meat and poultry at time of slaughter and of processed products during production used in commerce -egg products inspection act: inspects processing plants; requires pasteurization of liquids eggs to be frozen or dried

NC 1.4 and NC 2.1 difference

-NC 1.4 is altered GI function, looks at problems inside the GI tract including exocrine functions with changes in digestion, absorption, and/or elimination -NC 2.1 is impaired nutrient utilization, refers to problems with metabolism of endocrine functions

National Cholesterol Education Program (NCEP)

-National Heart, Lung, and Blood Institute, endorsed by the American Heart Association (AHA) -offers general guidelines in treating high lipid levels

allergies

-Natural protection mechanisms, Ag-Ab reaction when antigen enters body, antibody reacts -immunoglobin E (IgE) mediatied reaction to normally harmless food protein

the four categories of menu items

-STAR: high profit, highly popular -DOG: low profit, low popularity -PUZZLE: high profit, low popularity -PLOWHORSE: high popularity, low profitability

starch use in dry heat

-Starch heated without water, temperature rises rapidly degrading the starch--> starch molecules break into fragments called dextrins (called dextrinization) -color change occurs (browning- Maillard reaction)

SMP Special Milk Program

-USDA -encourage milk consumption -subsidy for milk

SBP School Breakfast Program

-USDA -entitlement program, meals must meet dietary guidelines

WIC Special Supplemental Nutrition Program for Woman, Infats, and Children USDA

-USDA -for pregnant, postpartum, breast-fed, infants and children up to 5 -food for low income mothers at nutritional risk -health exam is required -must meet income standards -not an entitlement program: cap on amount of federal dollars allocated

SFMNP Senior Farmers Market Nutrition Program

-USDA -grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmers markets

FFVP Fresh Fruit and Vegetable Program

-USDA -introduce children to fruits and veggies -free to children nationwide in selected schools

SNAP Supplemental Nutrition Assistance Program

-USDA -largest food asssitnet program -entitlement -net income must be at or below certain % of the poverty level

Commodity Food Donation/Distribution Program

-USDA -provides foods to help meet nutritional needs of children and adults and strengthens agricultural market for products produced by American farmers *CSFP Commodity Supplemental Food Program *TEFAP The Emergency Food Assistance Program

EFNEP Expanded Food and Nutrition Education Program

-USDA -provides grants to universities that assist in community development -train nutrition aides to educate the public -home economists

ASP After School Program

-USDA -provides healthy snacks, schools receive cash subsidies for each snack served -same eligibility basis as NSLP

CACFP Child and Adult Care Food Programs

-USDA -support public and non-profit food service programs -reimburse operators for meal costs, provide commodity foods and nutrition education materials -meals must meet guidelines; must offer free or reduced-price to eligible -same eligibility standards as NSLP

NSLP National School Lunch Prgram

-USDA Food and Nutrition Service (FNS) -entitlement program to improve nutrition of children, especially from low income -gets cash grants and food donations; dollars reimburse schools on basis of number of meals served -implement dietary guidelines into lunch and breakfast -Team nutrition implements School Meals Initiatives for Healthy Children

SFSP Summer Food Service Program

-USDA Schhol Lunch -initiate, maintain or expand foodservice programs to children when school is out -administered by FNS, state educational agencies, public or private non-profit

NET Nutiriton Education Training Program

-USDA in 1977 -ammendment to School Lunch Act -provides nutrition education training to teachers and school foodservice personnel

healthy eating index

-USDAs overall measure of diet quality -measures how well Americans follow the Guidelines -5 food groups, 4 nutrients (fat, saturated fat, cholesterol, sodium), variety

economic order quantity EOQ

-a quantitative approach to ordering staple or regularly stocked items -find quantity that minimizes both purchasing and inventory costs

chromium properties

-absorption enhanced by vitamin C, niacin -ultra trace mineral

major issues with ileal resection

-absorption of B12, intrinsic factor, and bile salts -ileum absorbs a lot of fluid in GI tract, if resected need to drink at least 1 liter more water than their ostomy output daily to compensate for excessive losses in stool - if ileum cannot recycle bile salts and the liver can't produce enough to adequately emulsify lipids then will lead to malabsopriton of fat-soluble vitamins

alpha glucosidase inhibitors

-acarbose, precose -inhibit enzymes that digest CHO, delaying absorption

Steps in TCA (tricarboxylic acid cycle)/Krebs/citric acid cycle

-acetyl CoA

buttermilk

-add lactic acid bacteria to skimmed or partly skimmed milk -recipe: 1T vinegar or lemon juice or 1 3/4 tsp cream of tartar; add enough milk to make 1 cup

flexible budget

-adjusted to various levels of operation with varying levels of sales or revenues throughout the year (changes in patient or customer count) -ex. closing a floor for renovation

regional enteritis (Crohns disease)

-affects terminal ileum

chromium functions

-aids in insulin action -glucose metabolism

protein metabolism during exercise

-alanine is released from muscle protein and transported to liver for deamination to glucose -the oxidation of leucine (a BCAA) increases

symptoms of nephrosis

-albuminuria, edema, malnutrition, hyperlipidemia -increased synthesis and decrease clearance of VLDL

alcohols role in ALD

-alcohol is converted into acetaldehyde and excess hydrogen is released which disturbs liver metabolism -hydrogen replaces fat as fuel in the Krebs cycle, so fat accumulates in liver and in blood leaded to fatty liver and high triglycerides

durum wheat

-alimentary -high in gluten -bran and germ are removed, endosperm (starch) is ground to make semolina flour -products flexible after cooking due to gluten -noodles- also contain egg yolk and egg solids

liver function test includes which enzymes

-alkaline phosphatase ALP -lactic acid dehydrogenase LDH -aspartate amino transferase AST, SGOT -alanine aminotransferase, ALT, SGPT

HIPAA Health Insurance Profitability and Accountabilty Act 1996

-allows employees to transfer coverage of existing illness to a new employers insurance plan

HDP

-alpha -reverse cholesterol transport; moves cholesterol from cells to liver and excretion

types of energy reactions

-anabolism -catabolism

clostridium perfringens

-anaerobic -onset: 8-18 hours -symptoms: nausea, vomiting, abd pain, diarrhea -sources: improperly cooked and reheated, cooled slowly and reheated foods, cafeteria bug, meats, soups, gravies, stews, casseroles

clostridium botulinum

-anaerobic; rare and more deadly; usually heat resistant -found in soil, water, plants, intestinal tract -spores produce toxins under anaerobic conditions -spores destroyed by acid -onset: 4-36 hours -symptoms: weakness, double vision, fatigue, diarrhea, affects CNS, paralysis, slurred speech, fatal if not treated -sources: spoiled low acid foods, improperly canned foods, vacuum packed and tightly wrapped foods, smoked and salted fish, cooked root vegetables held at warm temps too long -honey is a source: don't give to infants

manifestations of renal disease

-anemia due to decreased production of erythropoietin -upset in blood pressure -decreased activation of vitamin D

chronic kidney disease

-anorexia, weakness, weight loss, nausea, vomiting -anemia due to deficient production of hormone erythropoeitin by kidney

dx of marasmus

-anthropometric: sever fat and muscle wasting, starved appearance, decreased tricep skin fold and arm muscle circumference -normal serum albumin -no edema

MNT for epilepsy

-anticonvulsants phenobarbital and phenytoin interfere with calcium absorption -take 1 mg folate daily with drug -may need supplement of vitamin D, calcium, thiamin -provide phenytoin separate from meals or other supplements -EN feedings decrease bioavailabilty of phenytoin so hold tube feedings >= 2 hrs -ketogenic diet

St johns wort use and potential interaction

-antidepressive -reduces effect of warfain, avoid with antihypertensives, oral contraceptives, antipsychotics, some statins

ginger uses and potential interactions

-antiemetic -avoid use with drugs that affect bleeding

ESLD signs/symptoms

-apathy, drowsiness, confusion, coma (portal systemic encephalopathy), asterisix (flapping, involuntary jerking motions)

Family and Medical Leave Act 1993

-applies to public agencies and private agencies employing >50 workers -up to 12 workweeks of unpaid, job-protected leave during any 12 months for: birth or placement of a child for adoption, to care for an immediate family member, or medical leave for a serious health condition -when you leave you are guaranteed an equal job, but not the same job

ESRD

-associated with BUN>100mg/dL and Cr 10-12mg/dL -retention of nitrogen metabolites -use Giovanetti diet: restrict protein to 20 grams (HBV), increase calories, control edema, prevent deficiencies

cost/effectiveness analysis

-assumes that the goal of the project is worthwhile -resolves the question" which method of intervention is the most effective in achieving the goal" -compare costs of alternative strategies -shows what works bets, considers cost, patient outcomes, used to predict level of outcome that can be expected

MNT for AKI

-at first: IV glucose, lipids, protein -1-1.3g/kg if non catabolic without dialysis if GFR returns to normal -1.2-1.5 if catabolic and/or initiation of dialysis -20-30 cals/kg, BEE* stress factor (1.2-1.3) during hyper metabolic conditions -low sodium (2-3 g), replace losses in diuretic phase -8-15 mg/kd phosphorus, may need binders -2-3 grams K based on output, serum potassium, dialysis -replace fluid output from previous day plus 500mL

non-spastic form cerebral palsy

-athetoid form -involuntary wormlike movement, constant irregular motions leading to weight loss MNT: high calorie, high protein diet, finger foods

adrenal cortex insufficiency (addisons disease)

-atrophy of adrenal cortex; symptoms due to absence of adrenal hormones -decrease in cortisol, aldosterone, androgenic

alzeimers disease MNT

-avoid distractions (no TV during meals), regular consistent mealtimes, encourage self-feeding, offer one course at a time, lower saturated fats, calming background music, finger foods may be helpful, avoid dehydration, may need verbal cues to chew and swallow

stomatitis MNT

-avoid very hot, very cold foods, spices, sour/tart foods -rinse with lukewarm water after meals

tropical sprue

-bacterial, viral, parasitic infetion -chronic GI disease, intestinal lesions, may also not affect stomach

Taft Hartley Labor Act- Labor Management Relations Act 1947

-balanced powers of labor and management; amended Wagner act -outlawed the closed shop -specified unfair labor practices of the union

supplements for lactose free

-calcium and riboflavin

valerian root use and potential interaction

-calms nerves -avoid with liver disease

intake nutriton diagnostic domain

-caloric energy balance -oral or nutrition support intake -fluid intake balance -bioactive substances (supplements, alcohol, functional foods) -nutrient balance (intake of nutrients compared to desired levels)

catering

-can become a profit center for any foodservice operation -relabel past records are essential -records must be complete and accurate

neoplastic disease

-cancer

sorbitol

-carbohydrate -alcohol from glucose; absorbed more slowly than glucose by passive diffusion; converted into fructose; excess may cause diarrhea

passive diffusion

-carrier facilitated -water soluble nutrients attach to carriers to cross cell membrane -higher to lower concentration -no energy required

accounting methods to record transactions

-cash basis -accrual basis

Escherichia coli

-cause bloddy diarrhea, severe cramping -slow onset of 3-8 days after ingestion, lasts 5-10 days -sources: rare or raw ground beed, uncooked fruits of vegetables, raw milk, unpasteurized apple juice -can survive freezing, high acidity, can grow at refrigerator temperature

non-tropical sprue

-celiac disease, gluten-induced enteropathy -reaction to gliadin (affects jejunum and ileum) leads to malabsorption, macrocytic anemia, weight loss, diarrhea, steatorrhea, iron deficiency anemia

properties and uses of gelatin

-changes liquid into an elastic solid -acts as foaming agent- marshmallows -keeps sugar and ice crystals small in candy and ice cream by interfering with the union of small crystals to make larger ones

functions of vitamin C

-changes proline into hydroxyproline into collagen which strengthens intercellular substances -wound healing -aids iron absorption

hormones role in the body

-chemical messengers that trigger enzymes

chemotherapy effect on diet

-chemical reagents which have toxic effect -nausea, vomiting, malabsorption, anorexia -stomatitis: cracks in skin at mouth corners, riboflavin deficiency -methotrexate: anti-foalte drug

gallbladder disease

-cholecystitis: inflammation of the gallbladder -usual cause is from an infection that causes excess water to be absorbed causing cholesterol to precipitate out leading to gallstones

vitamin D properties

-cholesterol is a precurser -fat soluble -UV light

Prader Willi Syndrome

-chromosome 15 depletion -congenital disorder, subnormal LBM ,supranormal body fat, obesity, FTT -ghrelin levels elevated which stimulates growth hormone secretion, appetite, intake, and fat mass deposition -dont sense satiety, decreased energy requirements -obesity at 2-3 years of age, hypogonadism, muscle hypotonia, short stature -best treatment is to control food intake/access

irritable bowel syndrome

-chronic abdominal discomfort, altered intestinal motility, bloating

ulcerative colitis can cause

-chronic bloody diarrhea, weight loss, anorexia, electrolyte (Na, K) disturbance, dehydration, anemia, fever, negative nitrogen balance

cirrhosis

-chronic state -damaged liver tissue is replaced by bands of connective and nonfunctional tissue which divides liver into clumps and reroute many of the veins and capillaries. Blood flow through liver is disrupted. Poor food intake leads to deficiencies. -protein deficiencies lead to ascites, fatty liver, impaired blood clotting

concentric model of organization

-circular -improves representation of dynamics of personnel relationships because functions are centered around individuals, not above or below them -organization without loose ends

RBP retinol-binding protein

-circulates with pre albumin -shortest half life of 12 hours -binds and transports retinol

DSHEA: Dietary Supplement Health and Education Act

-clarifies marketing regulations for botanicals and reclassifies them as dietary supplements -plant extracts, enzymes, vitamins, minerals, hormonal products available without prescriptions, may carry "structure/function" claims -the physiological effect can be noted, but no claims about prevention or cure of specific conditions can be made

requirements for bariatric treatment

-class 3 obesity with BMI of 40 or more -BMI of 35 or greater with comorbidities

three domains of nutrition diagnostic labels

-clinical NC -intake NI -behavioral NB

eggs used for

-coagulation, leavening, emulsification -can be used to bind, gives firmness, stability, coats food, browns, clarifies liquids

pantothenic acid functions

-coenzyme A- energy -synthesis of fatty acids

functions of B12

-coenzyme in protein synthesis -forms RBC

malabsorbed fats after an ileal resection

-combine with Ca, Zn, Mg leading to "soaps" -colonic absorption of oxalate increases forming renal oxalate stones -increased fluid and electrolyte secretion; increased colonic motility

steps upon glucose entering cell aided by insulin

-combines with phosphorus in presence of magnesium to form glucose-6-phosphate -proceeds ot pyretic acid

campylobacter jejuni

-common cause of gastroenteritis -abd pain, bloody diarrhea -onset: 3-5 days, lasts 2-10 days -sources: raw or undercooked meat or poultry, raw milk, raw vegetables

conflict resolution

-conflict is inevitable, necessary for the organization to survive, often leads to solutions -there are different conflict resolution methods

steatorrhea

-consequence of malabsorption ->7 gram is indicative of malabsorption -determine cause and treat

prime cost method

-considers raw food cost and direct labor cost invoked in making the item

goitrogens

-contain goitrin which inhibits synthesis of thyroid hormone -foods of the cabbage family, like brussel sprouts

properties of B12

-contains cobalt -bound by intrinsic factor in gastric juice

NADPH

-contains niacin -is essential for the synthesis of gatt acids

role of kidneys in acid base balance

-control bicarbonate (base) HCO3 -regulate hydrogen ion secretion and bicarbonate reabsoprtion

role of lungs in acid base balance

-control supply of carbonic acid (carbon dioxide, water) -amount altered by rate and depth of breathing

selenium properties

-cooperates with vitamin E -trace mineral

sections of leadership grid

-country club management: employee centered (1, 9) -impoverished management: low concern for people and production- exert minimum effort to get work done (1,1) -authority, obedience: focus on production (9,1) -team management: high concern for people and production (9,9)

American with Disabilities Act 1992

-covers employers with 15 or more employees -must provide "reasonable accommodations"

when evaluating information, ask questions based on CARS checklist

-credibility: check credentials of author -accuracy: is info current, factual -reasonableness: is info fair, balanced -support: supporting documentation cited

protein catabolism steps

-deamination (splitting off of NH2 by hydrolysis in liver) -NH2 converted into ammonia NH3 which is toxic -most of the ammonia is converted into urea and excreted by kidneys -some is converted into purines and some used to make the nonessential amino acids through transamination -the remaining carbon chain is a ketoacid (it can be oxidized for energy)

lab tests for renal disease

-decrease GFR, creatinine clearance rate decreased (urine tests_ -increased serum creatinien and BUN (blood tests)

esophagitis MNT

-decrease gastric acidity, reflux -diet: small, low fat, bland, low fiber, weight reduction (?)

glycogen storage disease

-deficiency of glucose-6-phosphatase in liver; impairs gluconeogensis and glycogenolysis -liver can't convert glycogen into glucose which leads to hypoglycemia

hypothyroidism

-deficiency of thyroid hormone -T4 low, T3 low or normal -decreased BMR leading to weight gain -MNT: weight reduction

management by objectives MBO

-democratic management that provides control from within -establish performance goals with employees: higher incentive value, control achieved through self-control, management stresses accomplishments -participative leadership

SOPP Standards of Professional Performance

-describes a competent level of behavior in the professional role

SOP Standards of Practice in Nutrition Care

-describes in general terms a competent level of nutrition care practice as shown by the NCP

descriptive research

-describes state of nature at one point in time, generates hypothesis, provides baseline data and monitors change over time -establish associations, but DOES NOT allow casual relationships to be determined

payback period

-determine the length of time it will take for the ash inflows from a project to equal cash outlay -how much time it will take for an investment to pay back the organization for the investment

cost/benefit analysis

-determines whether the goal of the intervention is worthwhile in terms of cost -benefit of nutrition outcome must outweigh cost of services -calculate benefits: direct and indirect -calculate total costs of program -calculate benefit/cost ratio

HALS: HIV assocaited lipodystrophy syndrome

-developed from HIV therapy -high cholesterol, high triglycerides, insulin resistance, changes in body fat distribution

health behavior model

-developed to explain why people fail to participate in programs designed to detect or prevent disease -person must perceive the threat for the threat to be behavior-motivating factor -susceptibility, perceived impact, perceived advantage of change, appraisal of barriers, self-efficacy

community food security initaitive

-development of sustainable, community-based strategies to ensure that all have access to culturally acceptable, nutritionally adequate food at all times

queue- queuing theory

-develops the relationships involved in waiting in line -analyze flow of customers in a cafeteria -balance cost of waiting lines with the cost of preventing waiting lines through increased service/expanding facilities

waist to hip ratio WHR

-differentiates between android and gynoid obesity

MNT for heart failure

-digitalis increase strength of heart condition -diuretics: nutirent loss, glucose intolerance, increased serum uric acid -diet of low sodium (2-3grams), DASH diet, fluid restriction if needed -1.2 g pro/kg; >1.37g/kg if depleted -evaluate thiamin status (with loop diuretics)-without thiamin pyruvate isn't converted to acetyl CoA for energy so hurt muscle is deprived -DRI for folate, Mg, MV with B12

cystic fibrosis

-disease of exocrine glands -secreiton of thick mucis that obstructs glands and ducts -results in chronic pulmonary disease, pancreatic enzyme deficiency, high perspiration electrolyte levels, and malabsorption

achalasia

-disorder of lower esophageal sphincter motility, does not relax and open upon swallowing -causes dysphagia

anorexia nervosa

-distorted body image, dramatic weight loss, preoccupation with food and weight gain -immediate concern: correct electrolyte imbalance -re-feed slowly -recommended initial daily calorie range from 1000-1600kcal (30-40kcal/kg)

conflict resolution methods

-dominance and suppression: forcing, smoothing, avoidance, resolve conflict by majority vote -compromise: find middle ground -integrative problem-solving: conflict conerted into a joint problem solving situation, openly try to find a solution to accept

lactose intolerance

-due to lactase deficiency -lactose remains intact, exerting hyperosmolar pressure so water is drawn into the intestine to dilute the load causing distention, cramps, diarrhea -bacteria then ferments the undigested lactose, releasing carbon dioxide gas

RYGB MNT

-dumping syndrome may occur -potential anemia -potential deficiencies of potassium, Mg, folate, and vitamin B12 needs supplements

black cohosh use and potential interaction

-ease menopause symptoms -may cause clotting

types of COPD

-emphysema -chronic bronchitis

positive reinforcement

-encourages repetition of a given behavior -should be specific and immediate' meaningful attention from superiors

function of carbohydrates

-energy -protein sparing action (allows most of protein to be used for tissue synthesis -regulation of fat metabolism (carbohydrate restriction leads to ketosis) *carbs needed in diet so fat metabolism can occur normally

MNT for UC/Crohns

-energy needs according to current BMI -limit fat only if steatorrhea -water soluble and fat soluble vitamins -iron, folate -assess Ca, Mg, Zn -MCT oil -watch lactose -frequent feedings -high fat may improve energy balance -when IBD is in remission or under control, high fiber to stimulate peristalsis

MNT for paralysis

-energy needs at 10% below predicted -at least 1.5 L fluid /day -watch for pressure ulcers

yohimbe use and potential interaction

-erectile dysfunction -elevates blood pressure

Ulcer

-eroded mucosal lesion

hyperthyroidism

-excess secretion of thyroid hormone -elevated T3 and T4 -increased BMR leading to weight loss -MNT: increase kcal

MNT for hyperkinesis

-experimental treatment: Feingold diet: no salicylates, artificial colors, artificial flavors--> efficacy not proven -behavior improves with special attention (mind over body) -sugar does not cause hyperactivity

BEE is affected by

-extremes in environmental temperatures -caffeine, alcohol, nicotine stimulate metabolic rate (7-15%)

vitamin E properties

-fat soluble -tocopherol -one of the least toxic vitamins

vitamin K properties

-fat-soluble -synthesized by bacteria in lower intestinal tract -no toxicity symptoms

Maternal and Child Health Block Grant DHHS

-federal program -under title V of the social security act -fosters public health nutrition programs at the state and local levels -provides training, consultation, funding -meet state eligibility requirement

examples of modified functional foods

-fermented dairy products have probiotics to help GI health -fortified margarines have plant sterols and stanol esters which reduce total and LDL cholesterol -calcium fortified orange juice -iodized salt -folate-enriched breads

renal functions

-filtration: of RBC, proteins -absorption: 100% glucose, amino acids: 85% water, sodium, potassium -excretion: wastes, urea, excess ketones -secretion: secretes hormones that control blood pressure, blood components; secretes ions that maintain acid-base balance

calories during lactation

-first 6 months +330 -6-12 months +400

dumping syndrome

-follows a gastrectomy (billiroth 1, 2) -food dumped from blood into intestine -when a rapidly hydrolyzed carbohydrate enters the jejunum, water is drawn to achieve osmotic balance. This causes a rapid decrease in the vascular fluid compartment and a decrease in peripheral vascular resistance. BP drops and signs of cardiac insufficiency appear -about two hours later, CHO digest and absorbed rapidly- blood sugar rises, stimulating an overproduction of insulin, causing reactive or alimentary hypoglycemia

operating budget

-forecast of revenues, expenses, and profit for a specific period of time *first forecast sales then budget expenditures

function of vitamin K

-forms prothrombin in the liver--> aids blood clotting -given pre-surgery -aids in calcium metabolism

bacillus cereus

-forms spores -aerobic -symptoms: emetic, diarrheal -onset: 30 mi to 6 hours (emetic), 6-15 hours (diarrheal) -sources: emetic--> rice products, starchy foods like pasta or potatoes, food mixtures like casseroles or sauces diarrheal--> meats, milk, vegetables, fish

staphylococcus aureus

-found in humans -enters through handling or contact with contaminated surface -no destroyed by cooking -in reheated foods, meat, poultry, eggs, milk products, stuffing, prepared salads, high protein foods -onset: 1-7 hours after ingestion -symptoms: nausea, vomiting, pain, diarrhea, no fever

diet therapy for dumping/ to avoid dumping

-frequent small, dry feedings, fluids before or after meals (to slow passage), restrict hypertonic concentrated sweets, give 50-60% complex CHO, protein at each meal, moderate fat, B12 injections may be needed, lactose may be poly tolerated due to rapid transport

Therapeutic Lifestyle Change (TLC)

-from Adult Treatment Panel -up to 35% calories from total fat; <7% from saturated, 5-10% from PUFA, up to 20% MUFA -<200mg cholesterol -25-30 grams fiber (1/2 soluble) -stanols and sterols inhibit cholesterol absorption (2-3 g/day) -maintain desirable body weight, prevent weight fain -increase physical activity to at least 30 minutes moderate intensity most days *endorsed by AHA

downward channel of communication

-from department head down through the ranks of workers -works with memos/handouts, manuals, policy statements

vasopressin (ADH)

-from hypothalamus, stored in pituitary -exerts pressor effect; elevates blood pressure -increases water reabsorption from distal and collecting tubules

vibrio parahaemolyticus, vibrio vulnificus

-from raw or undercooked seafood -onset 16 hours, lasts 48 hours -fever, vomiting, cramps, diarrhea

upward channel of communication

-from workers up to department head -suggestion boxes, grievance procedures

clinical nutrition diagnostic domain

-functional balance: physical or mechanical change that interfere/ prevents desired nutritional results -biochemical balance: change in capacity to metabolize nutrients -weight balance: chronic or changed weight status

GERD MNT

-gastro-esophageal reflux disorder -can be caused by esophagitis -avoid eating before bed, soda, caffeine, acidic foods -small, low fat meals, liquids

blind check receiving method

-give clerk blind invoice or PO listing incoming merchandise but omitting quantities or weights

tissue stores of energy

-glycogen from muscle and liver -fat from adipose tissue -cellular mass (protein stores)

MNT for postprandial or reactive hypoglycemia

-goal is to prevent marked rise in blood glucose that would stimulate more insulin -avoid simple sugar, 5-6 small meals/day, spread intake of CHO throughout the day, protein at RDA levels

MNT for irritable bowel syndrome

-goal to provide adequate nutrient intake and tailor pattern to specific GI issues -avoid large meals, excess caffeine, sugar, and alcohol -use food diary to trace intake, emotions, environment, and associated symptoms -identify food allergies and hypersensitivities -work with client to alleviate stress during eating

hormones involved in lipolysis

-growth hormone, glucagon (insulin antagonists) -glucocorticoids, thyroixine, epinephrine, ACTH (increase rate of fat mobilization)

examples of non-crystalline sugar candies

-hard candies: sour balls, butterscotch -brittles: peanut brittle -chewy candy: taffy, caramel -gummy candies: marshmelllows, jellies, gumdrops

potato pigmentation

-have phenolic compounds which cause color changes in raw, peeled, or bruised potatoes -green color under skin is due to chlorophyll that developed when potato is exposed to light during storage (may be accompanied by solanine, a natural toxicant)

functions of copper

-hemoglobin synthesis -aids iron absorption

pulmonary specialized formula

-high fat, low carbohydrate -nutre, pulmocare, prespalor

homogenized milk

-high pressure breaks fat globules -more susceptible to action of lipase, but pasteurization destroys lipase

MNT for cirrhosis

-high protein (.8-1 g/kg); in stress at least 1.5 g/kg -high calorie: 25-35 kcal/kg or 1.2-1.5*BEE -moderate to low fat: 25-40% calories, MCT if needed, <40 g fat if malabsorpiton. fat is preferred fuel in cirrhosis. Include omega 3. Decrease LCT if steatorrhea develops -low fiber if varicose present -low sodium if edema or ascites -with hyponatremia, fluid restriction of 1-1.5 L/day depending on severity, and moderate sodium intake -B complex vitamins, C, K, Zn, Mg; monitor need for A and D -zinc is involved in conversion of ammonia to urea, increased loss in urine

pedicatric HIV MNT

-high protein, high calorie with supplements needed for weight gain -MVI/minerals at doses 1-2* RDA or DRI -lactose restriction if intolerant -significant loss of LBM can be obscured by edema and HALS

post-mortem changes and aging of meat

-hold in cold storage to age and ripen (about 10 days) -aging increases tenderness

glucocorticoids

-hormone -protein--> glucose (through gluconeogenesis)

epinephrine

-hormone from the adrenal medulla -stimulates sympathetic nervous system -stimulates liver and muscle glycohenolysis -decreases release of insulin from pancreas during catabolic stress, blood glucose rises

glucagon

-hormone produced in alpha cells of pancreas -induces glycogenolysis -increase BG

functional properties of liquid in baked mixtures

-hydrates gluten and starts development -starts action of chemical leavening agent -dissolve sugar, salt, gelatinizes starch

hyperkinesis

-hyperactivty, ADHD Attention Deicit Hyperactivity Disorder

acute ketoacidosis

-hyperglycemia due to insulin deficiency or excess carbohydrate intake, dehydration due to polyuria, increased pulse, fruity odor of ketones -treatment: insulin, rehydration

thyroid disorders

-hyperthyroidism -hypothyroidism

DBPCFC double blind placebo controlled food challenges

-identify food-induced symptoms -gold standard for diagnosis

organizing functions

-identify tasks and activities, dived tasks into positions -establish relationships among all other functions of management

MNT for ESLD

-if not comatose: moderate to high levels of protein (increase up to 1-1.5 gram pro/kg as tolerated) and provide enough kcal CHO/fat to minimize muscle catabolism -30-35 kcal/kg (30-35% calories as fat with MCT if needed) -low sodium if ascites -vitamin/mineral supplementation -altered neurotransmitter theory

how are disciplinary action/grievances handled

-if unionized, grievances are settled informally by employee and supervisor -if unionized, the contract states a written formal grievance procedure

ginseng uses and potential interaction

-immunity, endurance -high blood pressure, avoid with warfarin

phospholipids

-in cell membranes -control passage of compounds in and out of the cell; most are lecithins which contain choline (lipotropic factor) -helps prevent fat accumulation in the liver -functions in the transport and utilization of fatty acids and cholesterol through the enzyme LCAT (lecithin-cholesterol acyltransferase)

galactosemia

-inborn error of metabolism -due to missing enzyme that would have converted galactose -1-PO4 into glucose-1-PO4

NNMRRP National Nutrition Monitoring and Related Research Program

-includes all data collection and analysis activities of the federal government related to measuring the health and nutritional status, food consumption, attitudes about diet and health -jointly run by DHHS and USDA

MNT for acute viral hepatitis

-increase fluids to prevent dehydration -50-55% CHO to replenish liver glycogen and spare protein -acute hepatitis: 1-1.2 g pro/kg for cell regeneration, provide lipo tropic agents to convert fat into lipoproteins for removal from liver (high protein intake will help prevent fatty liver) -moderate to liberal fat intake if tolerated; limit fat if steatorrhea -small, frequent feedings because of anorexia -encourage coffee -MVI with B complex, C, K, zinc

components of a budget

-indirect (fixed) costs -direct, variable, flexible costs -semi-variable costs -sunk costs -differential costs

gastritis

-inflammation of stomach

pancreatitis

-inflammation with edema, cellular exudate and fat necrosis -may be due to blockage or reflux of ductal system causing premature activation of enzymes within pancreas which leads to autodigestion

acute viral hepatitis

-inflammation, necrosis, jaundice, anorexia, nausea, fatigue *jaundice occurs when bile ducts are blocked

TQM Total Quality Management

-involves continuous improvement of organization processes, resulting in high quality products and services -has three elements -PDCA cycle: plan, do, check, act or PDSA: plan, do, study, act

group or co-op pirchasing

-involves union of separate units (hospitals), not related to a single management, for joint purchasing -economic advantage of large volume purchasing

renal calculi

-kidney stone, most common is calcium stone- calcium oxalate stones

behavioral nutriton diagnostic domain

-knowledge and beliefs -physical activity balance and function -food safety and access

standard treatment for ESLD associated encephalopathy

-lactulose: hyperosmotic laxative that removes nitrogen -neomycin: antibiotic that destroys bacterial blare that produce ammonia

stages of a bill

-legislation enters as a bill or a resolution -bill is sent to committee which schedule public hearings where testimony is taken from bill sponsors *nutritionist can present views here or in earlier planning stages* -committee revises bill during a markup session and put into final form -if approved it is sent to rules committee for debate -it needs approval from both Houses and the President -Differences between the two houses are worked out in a Joint House Senate Conference Committee, ultimately passing a reconciliation bill

2015 Dietary guidelines changes

-limit calories from added sugars (<10%), saturated fats <10%, trans fats <1%, reduce sodium <2300mg -adults need 30min/day or 150 minutes moderate intensity exercise each week

specific MNT for ideal resection

-limit fat, use MCT (does not require bile salts and needs less intestinal surface area) -supplement fat soluble vitamins, Ca, Mg, Zn, parenteral B12 followed by monthly injections may be needed

hepatic failure (ESLD)

-liver function decreased to 25% or less -liver cannot convert ammonia (NH3) into urea so you get ammonia accumulation in the blood

strategic marketing

-long term overall view of marketing in the organization in which resources are allocated and objectives are set after defining the market -selection and analysis of a target market; creation and maintenance of an appropriate marketing mix

Strong Heart Diet Study

-looked at Native American incidence of cardiovascular disease and diabetes -something other than intake, perhaps genetic, low physical activity -consumed 12% fewer calories than average US

what happens to eggs when they are stored in the refrigerator too long?

-loss of CO2 makes eggs more alkaline (base) -whites become watery; yolks flatten -odors are obsorbed

radiation effect on diet

-loss of taste -xerostomia (dry mouth-- moisten foods) -esophagitis -diarrhea -malabsorption -mucositits: inflammation of mucosal lining -avoid fresh, raw, uncooked foods, offer cold and soft food

markers indicative of thiamin deficiencies

-low erythrocyte transketolase -high plasma pyruvate

MNT for cholecystitis

-low fat diet: acute 30-45 grams and chronic 25-30% of calories -cholecystectomy

MNT for gout

-low purine may not be effective (because body makes purines) -may need weight reduction -moderate protein, liberal CHO, low to moderate fat, decrease alcohol, liberal fluid -avoid high purine foods -medications (irate eliminant, colchicine) may induce loss of nutrients

oxaloacetic acid

-main CHO fuel -formed from pyretic acid and some amino acids (biotin is needed to form) -it reacts with acetyl CoA to form citric acid which starts the cycle

goals for diabetics

-maintain normal blood glucose (average preprandial 70-130mg/dL, peak post prandial average <180) -optimal lipid levels -blood pressure goals -prevent and treat chronic complications

MNT for COPD

-maintain stable weight, replete not overfeed -1-1.5 g/kg protein (15-20% kcal) -30-45% as fat (oxidation of fat consumes less oxygen than oxidation of CHO) -40-55% as CHO -small, frequent mini meals, nutrient dense

serum albumin

-maintains collodial osmotic pressure -hypoalbuminemia associated with edema, surgery -levels above normal range likely due to dehydration -long half-life, does not reflect current protein intake

AI for fiber daily

-male: 38 gram -female: 25 g

enzymes for CHO digestion are available when

-maltase, sucrase: 30th week gestation -lactase: birth -pancreatic amylase: until 6 months after birth

likert

-management of conflict -four basic systems of organizational leadership: exploitive/autocratic, benevolent/autocratic, consultative, participative -participative is the most effective

factor pricing method (traditional method, markup method)

-mark up is difference between the cost and the selling price

CRP c-reactive protein

-marker of inflammatory stress -as it declines, indicates when nutritional therapy would be beneficial -when elevated CRP decreases, PAB increases

Fair Labor Standards Act 938

-may be called Minimum Wage or Wage Hour Law; set minimum wage -for overtime work bust pay time and one-half -amendment Equal Pay Act: prohibits discrimination on basis of sex -donated time must be paid -child labor laws regulate work hours and duties of children

arm muscle area AMA

-measures skeletal muscle mass (somatic protein) -to determine use TSF and AC -important to measure in growing children

roasting details

-meat will continue to cook when recommend from oven "carry over cooking" -allow roast to stand 30 minutes before carving

ARDS MNT

-meet basic nutrition needs, stable weight, facilitate weaning, preserve LBM -avoid excess non-protein calories -EN containing EPA and GLA (gamma-linoleic acid), and enhanced levels of antioxidant vitamins -1.5-2 g pro/kg BW to maintain lead body mass

how to make a white sauce

-melt fat, add flour (roux) -remove from heat, add liquid at 170-180F; add salt -add an acid when cooking is complete

complementary and alternative medicine CAM

-mind/body medicine, alternative medical systems like acupuncture, biologically based therapies like herbs, chiropractic medicine, lifestyle and disease prevention

alkaline/acid ash diets

-minerals not oxidized leave an ash residue in urine -change composition of diet to change pH of ash in urine -to prevent acidic stones create alkaline ash -to prevent alkaline stones create acidic ash

MNT for nephrosis

-mod. protein restriction (0.8-1 g/kg) 50% from HBV- excess protein will be catabolized to urea and excreted -restrict fat <30%, low saturated fat diet, 200 mg cholesterol -35 kcal/kg/day -sodium restriction (2-3g.day) depending on hypertension, edema -calcium 1-1.5 g/day, supplement with vitamin D -may need fluid restriction with edema -abnormalities in iron, copper, zinc, and calcium related to protein loss

managerial informational role

-monitor: search for information to become more effective -disseminator: transmits information to subordinates -spokesman: transmits information to people inside and outside

calcium properties

-most abundant mineral -regulated by parathyroid hormone -vitamin D, acid, and lactose aid absorption

vitamin C properties

-most easily destroyed -structure like glucose -antioxidant -needs acid pH -destroyed by heat, alkaline pH, oxidation

food costs

-most readily controlled item, subject to greatest fluctuation

educational readiness assessment assess

-motivational level -educational level -situational assessment

fluorosis

-mottled teeth -with excessive fluoride

dawn phenomenon

-natural increase in early morning blood glucose and insulin requirements due to increased glucose production in liver after overnight fast -increased need for insulin at dawn

nephrosis

-nephrotic syndrome -primary defect in capillary basement membrane of glomerulus which permits escape of large amounts of proteins into the filtrate moving through the tubules

long term consequences of uncontrolled DM

-neuropathy: peripheral and autonomic; gastroparesis -retinopathy: leads to blindness -nephropathy: leads to decreased kidney function

homocystinurias MNT

-newly diagnosed receive increased doses of folate, pyridoxine (B6), and B12 -if they don't respond: low protein, low methionine diet

chronic nonspecific infantile diarrhea

-no significant malabsorption -consider ratio of fat to CHO calories, volume of ingested liquids -some are inadvertently placed on a low fat diet or consume too many fluids or too many calories -give 40% calories as fat, balanced with limited fluids, restrict or dilute fruit juices with high osmolar loads (apple, grape)

MNT for SLE

-no specific dietary guidelines, tailor to needs -medications used affect nutrient metabolism, needs and excretion -may have dietary deficiencies of iron, folate, calcium, fiber, and B12 -may have anemia but associated with inflammation (not iron intake) -may show symptoms of celiac disease

food intolerance

-non-IgE -abnormal physiologic response, GI, cutaneous, respiratory symptoms, but NO antibody production

specific MNT for jejunal resection

-normal balance of CHO, PRO, fat -avoid lactose, oxalates, large amounts of concentrated sweets, vitamin, and mineral supplements

indirect (fixed) costs

-not affected by sales volume or number of people served -not directly evident in day to day activities ex. rent, taxes, interest on debt, insurance, depreciation

hair analysis

-not for nutritional measurement -useful in measuring intake of toxic metals

zero based budget ZBB

-not this years expenses plus an inflation factor -begin at 0. Must justify expense -PPBS Planning, Programming, Budgeting System -planning oriented

difference between medical and nutrition diagnosis

-nutrition diagnosis changes as the patients response changes -medical diagnosis does not change as the condition exists

planning includes

-objectives (serve as motivators, provide direction) -policies -procedures

esophageal varices

-occur when blood can't enter the liver -caused when connective tissue overgrowth causes resistance to blood entering the portal vein. The increased pressure forces blood back into collateral veins that offer less resistance (causing portal hypertension) -esophageal, abdominal, collateral veins enlarge, increasing blood pressure in these small veins and these vessels are fragile and form outpouching called varices, they can burst open or can be torn apart from a diet high in roughage

retrogradation

-occurs in starches with a high proportion of amylose -starch after cooled or chilled, may become less soluble and recrystallize to form a solid or rigid gel- it retrogrades back to the insoluble form on freezing or aging -hydrogen bonds that hold the gel together break and reform in an orderly crystalline fashion -reduces the quality of food -greatly accelerated by freezing: when a starch gel is thawed, water is lost because it is unable to rebind to the fragile spongy mass -so want to prepare frozen products with a starch or flour from a waxy cereal (like waxy corn, sorghum, and rice)

symptoms of AKI

-olgiuria (<500mL urine) -azotemia (increased urea in blood)

OAA Older Americans Act Nutrition Program (formerly ENP) DHHS 3

-one hot meal each day for 5 days a week, provide 1/3 recommended intake -eligibilty: all aged 60 and older plus spouse, regardless of income -congregate meals (ambulatory) -home delivered -counseling services

PES

-one problem (altered, impaired, increased, risk of) *related to* -one etiology (cause/contributing factors) *as evidenced by* -assessment of signs and symptoms -always want to select the most important and urgent problem to be addressed

NHANES National Health and Nutrition Examination Survey

-ongoing (repeated) survey to obtain info on health of American people -evaluates clinical, chemical, antrhopometric, nutritional data of Americans -NHANES 3: oversampling of adults>=65 with no upper age limit -WWEIA

listeria monocytogenes

-onset: 2-30 days -grows 34-113F, slightly alkaline or neutral, resists freezing, drying, and heat sources: hot dogs, luncheon meats, cold cuts, coleslaw, raw milk, soft cheese

salmonella

-onset: 6-48 hours -symptoms: fever, nausea, vomting, chills, headache lasts 2-3 days -sources: low acid foods at body or room temp, raw or undercooked meat and poultry, eggs, raw dairy, seafood, melons -destroyed by pasteurization

the business plan

-organizing the planning process -diagnose the situation -set goals and objectives -develop operating plan -develop a financial plan -write the document

postprandial or reactive hypoglycemia

-overstimulation of pancreas or increased insulin sensitivity -experience weak, trembling, extreme hunger -blood glucose falls below normal 2-5 hours after eating (50m/dL)

function of thiamin

-oxidation of CHO -so if increase CHO, increase thiamin need -metabolism of pyruvate

TEFAP The Emergency Food Assistance Program

-par tof USDA Commodity Food Donation -quaterly distributions of commodity foods to local, public, or private nonprofit agencies

MNT for SBS

-parenteral nutrition initially to restore and maintain nutrient status -enteral: start early to stimulate growth, increase over time; continuous drip -may take weeks or months to transition to food

CSFP Commodity Supplemental Food Program

-part of USDA commodity food donation -administered by state health agencies -monthly commodity canned or packed foods -for low income women (preg/post-partum), infants, and children up to 6 years, some elderly at nutritional risk

sulfur properties

-part of amino acids cysteine, cystine, methionine

magnesium properties

-part of chlorophyll -50% in bone, 50% in cells

soluble fibers

-pectins, gums -delay gastric emptying absorb water, form soft gel in small intestine- slows passage and delays or inhibits absorption of glucose and cholesterol

deficiency of niacin

-pellagra -beefy, bright, red tongue -symmetrical, pigmented rash in sunlight

dextrin

-polysaccharde -intermediate product of starch breakdown

glycogen

-polysaccharide -animal starch; from glucose; stored in muscle and liver

pectin

-polysaccharide -nondigestible; thickening quality, found in fruits

starch

-polysaccharide glucose chains; 50% of CHO intake, only yields glucose

cellulose

-polysaccharide resistant to digestive enzyme amylase, adds bulk, helps stimulate perstalsis

streptococcus

-poor hygiene -destroyed by cooking -sources: milk, eggs, potato salad, food belt at room temp for hours -onset 2-60 hours, causes fever and diarrhea

cause and effect (fish) diagram

-portait of a problem -focus on different causes of a problem; categorizes related factors to make their influence more observable -technique to increase worker involvement in decision-making -asks "what are the causes of the effect (results) you are seeking?"

indications for PPN

-post-surgery when EN is expected to resume within 5-7 days, mild to moderate malnutrition, as supplement to enteral

amylin agonist

-pramlintide (symlin) -decreases glucagon production

VLDL

-pre-beta -transports endogenous triglyceride from liver to adipose cell

IDL

-pre-beta to beta -LDL precursor; found in circulation secondary to catabolism of other lipoproteins

transtheoretical stages of change model

-precontemplation -contemplation -preparation -action -maintenance

MNT for AIDS

-preserve LBM, prevent weight loss, and wasting -BEE*1.3 for asymptomatic -protein: 0.8 to to 1.2-2.0 g/kg if wasted LBM -educate about food safety: neutropenic diet (avoid raw foods) -nutrition supplementation should not be routinely recommended and herbal supplementation discouraged

echinacea uses and potential interaction

-prevent, moderate cold symptoms -avoid taking >2 months

possible benefits of phytochemicals

-prevention or treatment of chronic diseases like cancer, heart disease -may detoxify drugs, toxins, carcinogens, mutagens -may act as blocking agents, preventing active carcinogen from reaching target tissue -may reduce risk of CHD by protecting LDL cholesterol from oxidation, reducing synthesis or absorption of cholesterol

cost of profit pricing

-price the product to ensure a predetermined percentage of profit -profit is established as a cost -method 1. add up all costs as percentages 2. to find the targeting food cost percentage, subtract the total from 100% 3. to determine the selling price of an item= total food cost/desired food cost percentage

erythropoietin EPO

-produced by kidney, stimulates bone marrow to produce RBC

marketing mix- 4 os of marketing

-product -place -price -promotion

NSI Nutrition Screening Initiative

-promote nutrition and improve nutritional care for the elderly to identify nutritional problems early *A. determine checklist: identifies factors placing people at nutritional risk (disease, tooth loss, economic hardship, involuntary weight loss/gain) *B. level 1: screen identifies those who need more comprehensive assessments *C level 2: screen provides more specific diagnostic info on nutritional status

ephedra uses and potential interactions

-promote weight loss -rapid heart rate, headaches, very likely hazardours

functions of magnesium

-protein and fatty acid synthesis -stabilizes structure of ATP

physical and chemical changes as meat cooks

-protein coagulates -collagen is hydrolyzed to gelatin and softens -surface browns due to breakdown of pigments -heat changes interior from red to pink to brown to gray -increase tenderness of meat by adding vinegar

diet for urea cycle defects

-protein restirction (1, 1.5, 2 g/kg based on tolerance, age) to lower ammonia; therapeutic formulas to adjust protein composition to limit ammonia production ex: OTC ornithine transcarbamylase deficinecy

types of insulin

-rapid-acting -shortacting -intermediate acting -long-acting

copper deficiency

-rare: microcytic anemia, neurtropenia -wilsons diease

creatinine height index

-ratio of creatinine excreted/24 hrs to heigh -estimates lean body mass- somatic protein -60-80% mild muscle depletion

roux-en-y gastric bypass

-reconstructs the small intestine to resemble the letter Y -creates a small gastric pouch connected directly to the jejunum

zinc decifiency

-reduced immune function -alopecia -poor wound healing -hypogeusia

inflammatory bowel disease (IBD) classifications

-regional enteritis (Crohn's disease) -chronic ulcerative colitis (UC)

short acting insulin

-regular -take 30-45 minutes before meal (burst of insulin to cover the meal about to be eaten) -one unit covers 10-15 grams CHO, duration 3-6 hours

common insulin regimens

-regular and NPH twice a day -multiple daily injections MDI: regular before meals, NPH 1-2X -Glargine (lantus) basal at bedtime; rapid acting as bolus for meals -insulin pump therapy provides basal or rapid acting or short acting insulin pumped continuously; boluses of insulin given before meals

acid base balance

-regulation of hydrogen concentration -acid releases hydrogen ions; base takes up hydrogen ions

serum creatinine

-related to muscle mass; measure somatic protein -may indicate renal disease, muscle wasting -released by muscle cells and excreted by kidneys with little reabsorption

BUN

-related to protein intake -indicator of renal disease

vender performance requirements

-reliability, willingness to handle emergencies -compare price, quality, service

kava use and potential interaction

-relieve anxiety -liver failure, very likely hazardous

saw palmetto use and potential interaction

-relieve symptoms of enlarged prostate -diuretic

adult diarrhea

-remove cause: bowel rest, replace lost fluids and electrolytes especially those high in sodium and potassium -when diarrhea stops, begin with low fiber foods, followed by protein foods, fat need not be limited -avoid lactose at first -foods or supplements that contain prebiotic components (pectin, fructose, oats, banana flakes) which favor friendly bacteria -probiotics

chronic pancreatitis MNT

-reoccurent attacks of epigastric pain of long duration -PERT: pancreatic enzymes orally with meals and snacks to minimize fat malabsorption from lack of pancreatic lipase. *MCT don't require lipase so use instead -promote weight fain and give maximum level of fat tolerated without an increase in steatorrhea or pain -if malabsobing fat soluble vitamins give water soluble forms: parenteral B12> -pancreatic bicarbonate secretion may be defective- ,ay need antacids so PERT will work -PN may be needed -to avoid pain, avoid large meals with fatty foods, avoid alcohol

goals of burn MNT

-replace fluid and electrolytes lost -increase calories and protein (adequate not excessive kcal) -1.5-3 g pro/kg, high calories -vitamin C for wound healing 500mg *2 -water soluble vitamins, 2*RDA -vitamin A 10000 IU -vitamin K if on antibiotics -zinc for wound healing if deficit, 220 mg zinc sulfate

Protein digestibility corrected amino acid score PDCAAS

-represents amino acid score after correcting for digestibility -protein coefficient of digestibility, estimates % of protein in each food category that is actually digested (ex. animal 97%, plant proteins 70-90%)

contingency or situational leader

-repsonds to external environment -management must identify which techniques will work in a particular situation at a particular time

inputs to productivity

-resources -labor, money, materials, facilities, energy

ARDS acute respiratory distress syndrome

-respiratory failure -lungs no longer able to exchange gases, hyper metabolism, increased energy needs

MSUD MNT

-restrict BCAA to 45-62 mg/day -provide adequate energy from CHO and fats to spare amino acids -include small amounts of milk to support growth; gelatin may be used -avoid eggs, meat, nuts, and other dairy products

MNT for PKU

-restrict substrate phenylalanine (PHE), supplement the product tyrosine -low phenylalanine, but provide enough to promote growth -avoid aspartame -need for PHE decreases with age and infection -low protein, high CHO intakes may lead to increased dental caries

too much sugar

-results in coarse cells, thick walls, a shiny crust and a crumbly product

alpha linolenic acid needed for/effect

-retinal function and brain development -decreases hepatic production of triglycerides (inhibits VLDL synthesis) -little effect on total cholesterol levels

dietary guidelines for americans

-revised every five years -designed to prevent chronic disease -written by USDA and HHS

5 sources of power

-reward power: incentives, praise to reinforce certain behaviors -coercive power: negative side of reward power, punish for not carrying out requirement, ineffective in motivating -position (legitimate) power: subordinate acknowledgement that the influencer has the right to exert influence due to position -expert power: belief that influencer has some relevant expertise that the subordinate does not; provides credibility -referent power: personality, based on desire to identify with or imitate the influencer, how well you are liked

mediterranean diet

-rich in alpha linolenic acid, high in monounsaturated fats -includes: olive, canola, soybean oils; walnut, almonds, pecans, peanuts, pistachios, fish, poultry, eggs rather than beef, breads, fruits and vegetables in abundance, beans, legumes, yogurt, cheese -resveratrol: in skin of red grapes, may help lower blood pressure

vitamin D deficiencies

-rickets: soft bones -osteomalacia: adult rickets

phosphorus properties

-second most abundant mineral -part of DNA, RNA, ATP

what happens when food bypasses the duodenum

-secretion of secretin and pancreozymin by the duodenum is reduced -those hormones typically stimulate the pancreas, so now there is little pancreatic secretion which can lead to steatorrhea -calcium (most rapid absorption in duodenum) and iron (need acid) absorptions are affected

epilepsy

-seizures, altered consciousness

serum transferrin

-serum level controlled by iron storage pool -rises with iron deficiency -can be determined from TIBC: total iron binding capacity -transfer protein for production of hemoglobin -shorter 1/2 life -when iron stores low, transferrin pool high (diagnose anemia)

factors of BMI

-sex -age -body composition -endocrine glands-thyroid

Prealbumun/transthyretin

-short half life; picks up changes in protein status quickly -during inflammation, liver synthesizes CRP at expense of PAB

asset management, turnover rates

-shows current effectiveness of inventory control; are you efficiently using the assets to produce more income? -inventory turnover rate

PERT Program Evaluation and Review Technique/ CPM Critical Path Method

-shows relationships among phases of a project -shows what activities must await completion of other tasks and which activities can be performed concurrently -can calculate total amount of time to complete -critcal path: longest pathway through, determines the minimum time for completion

pentose shunt

-side channeling of glucose -does not require ATP -ribose (part of RNA) is produced -NADPH is products

ileal resection

-significant resection can produce major complications

shor bowel syndrome (SBS)

-significant resections of the small intestine -severeity reflects length and location of resection, age of patient, and health of the remaining tract -malabsorption, malnutrition, fluid, and electrolyte imbalances, weight loss

types of fat

-simple -compoind -derived

blooms taxonomy

-simple tasks to progress, objectives at lower level must be mastered before more complex learning can take place

classification of proteins

-simple: amino acids -conjugated: simple plus non-protein substance like lipoprotein -derived: fragments from simple and conjugated (peptide)

gastric banding

-small gastric pouch created using a fluid-filled inflatable band -adjusted to alter size of the opening -will not require folic acid, iron, or B12 replacements

peripheral parenteral nutrition

-small surface veins -short term therapy with minimum effect on nutritional status

active transport

-sodium pump *needs energy from ATP; and sodium plays active role

simple diffusion

-some water and electrolytes -higher to lower concentration: intestine to blood to lymph

constipation

-sometimes due to an atonic colon (weakened muscles) -high fluid, high fiber diet, exercise

comfrey use and potential interaction

-sooths nerves -irreversible liver disease

forms of cerebral palsy

-spasitc form -non-spastic

EN formulas

-standard -elemental -specialized

FDA mandatory standards for products shipped across state lines

-standard of identity: what a product must be to be called -standard of quality: minimum quality below which foods must not fall -standard of fill of containers: protects against deception

standard EN formulas

-standard polymeric -normal GI function -provide 1-1.5 cal/cc -lecithin may be added as an emulsifier -least expensive: intact protein and isotonic (osmolality close to blood)

starch use in moist heat

-starch molucles dont dissolve in cold water, will form a suspension -when heated--> molecules swell, thicken, and become translucent due to gelatinization

stomach digestion

-start of proteolysis by protease pepsin and HCL (protein digestion) -continuation of starch hydrolysis by salivary amylase

TANF Temporary Assistance to Needy Families

-state food and nutrition assistance program -states determine the eligibility of needy families and the benefits and services those families will receive

leavening can be caused by

-steam expands the hollow shell -air expands when heated before proteins coagulate and resin it -carbon dioxide production (through action or yeast on sugar or the action of acid on baking soda)

functions of the liver

-stores and releases blood, filters toxic elements, metabolizes and stores nutrients, regulates fluid and electrolytes

paralysis

-stroke due to barin embolism, may be undernourished or overweight -immobilization decreases ability to absorb calcium and increases nitrogen loss in urine -spinal cord injury

formal, competitive bid buying purchasing

-submit written specifications and quantity needs to vendors who then submit a price -bids are opened together; place order with lowest bid price

tyramine nutrition interaction

-substance found naturally in food -hypertension if taken with MAOI (monoamine oxidase inhibitor) -want to eliminate dopamine and restrict tyramine (monoamines), restrict age fermented, dried, pickled, smoked, and spoiled foods -avoid hard, aged cheese (cheddar, swiss), sauerkraut, some sausage, lunch meats, tofu, miso, chianti wine -Limit sour cream, yogurt, buttermilk -OK to eat cottage cheese, cream cheese -GOOD to buy, cook, and eat fresh foods

AKI, acute kidney injury/acute renal failure

-sudden shutdown with previously adequate capacity: decreased GFR, inadequate pre-renal perfusion -can be caused by trauma: burns, accident, obstruction, severe dehydration

flavor of vegetables provided by

-sugars in peas and corn -glutamic acid found in young vegetables -sulfur

BUN: creatine ratio of <10:1

-suggests reduced BUN reabsorption due to renal damage (may need dialysis)

biotin properties

-synthesized by intestinal bacteria -inactivated bu avidin (protein in raw egg white)

liver lipogenesis

-synthesizes fat, but does not store fat

systems apporach

-system is an organized whole composed of interdependent parts -two parts of theory: an open system interacts with external forces and impact of changes within an organization (a change in one part affects other parts)

MNT for CAD, CVD, IHD

-thiazide diuretics may induce hypolakemia -salt restriction <=2400 mg Na (6 g) -decrease weight if needed -DASH diet

functions of protein

-tissue synthesis, maintains growth, regulates body processes -insuffiecient energy source- nitrogen has to be removed first

USDA Nationwide Food Consumption Surveys (NFCS)

-to obtain info on food intake of individuals and total households from entire US -evaluates 7 nutrients- protein, calclium, iron, thiamin, riboflavin, vitamins C, A -diets rated good if intakes equaled or surpassed RDA: rated poor if less than 2/3 of RDA for 1 or more nutrients

iron properties

-trace ineral -part of hemoglobin

copper properties

-trace mineral -attached to protein ceruloplasmin

zinc properties

-trace mineral -excess leads to copper or iron deficiency

iodine properties

-trace mineral -part of thyroxine

homocystinurias

-treatable disorder of amino acid metabolism -characterized by severe elevations of methionine and homocysteine in plasma and excessive excretion of homocystine in urine -associated with low levels of folate, B6, B12

MNT for galactosemia

-treated solely by diet -galactose and lactose free -no organ meets, MSG extenders, milk, lactose, galactose, whey, casein, dry milk solids, curds, calcium, or sodium casein ate, dates, bell peppers

niacin properties

-tryptophan (an essential amino acid) is the precursor -essential in all cells for energy production and metabolism

MNT for alcoholic liver disease

-typically associated with malnutrition -alcohol replaces food in diet -alcohol causes inflammation of GI tract and interferes with absorption of thiamin, B12, vitamin C, and folic acid -alcohol interfere with vitamin activation -increases need for B vitamins to metabolize alcohol -increase need for Mg; excreted after alcohol consumption -malnutriton increases alcohols destructive effects -folate and protein deficiencies (most responsible for malabsorption) -thiamin dieficiency (can cause Wernicke-Korsakoff Syndrome)

chronic ulcerative colitis (UC)

-ulcerative disease of the colon, begins in rectum

licorice root use and potential interaction

-ulcers -avoid combinations with spironolactone, thiazide and loop diuretics, hypertensives

CHIP Childrens Health Insurance Program

-under social security act, partnership between federal and state government -expands health coverage to uninsured children

cardiac cachexia

-unintended weight loss -blood backs up into liver and intestines causing nausea and decreased appetite -arginine and glutamine may help -lower saturated fat, low cholesterol, low trans fat -<2 g Na -high calorie

outputs to produvctiviy

-units of service -meals, patient days, consults

job enrichment

-upgrades job by adding motivating factors -increases number of tasks and control the employee has over the job -maslow and herzberg both classified job enrichment as a motivator

MNT for cystic fibrosis

-use age appropriate BMI to assess height and weight -PERT- pancreatic enzyme replacement with meals and snacks -high protein, high calorie, unrestricted fat, liberal in salt -if growing normal and steatorrhea is controlled: calories to cover RDA for age and sex but if fails to grow may need 110-200% of normal energy needs -protein: 15-20% of calories-malabsorption due to pancreatic deficiency -carbohydrate: 45-55% of total calories -liberal fat to compensate for high energy needs (35-40% of calories) -additional 2-4 grams salt/day in hot weather with heavy perspiration -age appropriate dosage of water-soluble vitamins and minerals -supplement water soluble forms of fat soluble vitamins (A and E)

boiling vegetables

-use covered pan unless otherwise indicated -boil in small amount of water for a short time to preserve nutrients

Fish cookery

-use dry or moist heat -store at lower temperatures

delphi

-use of focus group, group decision better than individual

peripherally inserted central catheter

-used for short or operate term infusion

qualitative/ subjective food quality criteria

-uses organoleptic measurements -color, odor, taste, texture

direct costs

-variable, varies directly with the changes in sales (revenue), directly involved in service to customer ex. china, silver, food, uniforms, laundry, repairs

renin

-vasoconstrictor, elevates BP -formed in kidneys, secreted by glomerulus when blood volume decreases -stimulates aldosterone to increase sodium absorption and return blood pressure to normal

ginkgo biloba uses and potential interaction

-vasodilation -avoid use with warfarin

hormones involved in renal function

-vasopressin -renin -erythropoietin

acquired immune deficiency syndrome (AIDS)

-virus debilitates immune system by attaching lymphocytes -results in diarrhea, malabsorption, nausea, vomiting, weight loss

non-governmental agency assistance programs

-voluntary: pricate, non-profit, ex. American Heart Association -professional organizations: Academy of Nutrition and Dietetics -Foundations, business, industy

cheese production

-warm milk--> add lactic acid producing bacteria--> add enzyme rennet to coagulate casein forming the curd, separate curd from whey (liquid)

folate properties

-water soluble -PABA is a precursor

thiamin properties

-water-soluble -lost as temp or pH rises -heat stable in acid

etiology of heart failure

-weakened heart fails to maintain adequate output resulting in diminished blood flow so fluid is held in tissues and have dyspnea

Crohns can cause

-weight loss, anorexia, diarrhea -can develop B12 deficiency which can lead to megaloblastic anemia or iron deficiency anemia due to blood loss and decreased absorption

MNT for athritis

-well balanced diet with vitamin intake to at least DRI -bed rest, aspirin, reduce overweight status to decrease stress -anti-inflammatory diet may help with osteoarthritis: fresh fruits, vegetables, resembles mediterranean diet

hawthorne studies

-western electric -if you involve people in the process, they become more productive -placebo effect- special attention improves behavior

informal, open market purchasing

-when a small amount is needed quickly -buyer requests quotes on specific items for specific amounts and qualities from one or more sources of supply

when should you increase gelatin and decrease liquid

-when making a large mold -when it will stand at room temperature for a long time -when acid content is high -when making a whip

TVP benefits

-when mixed with ground meats can extend the number of servings, lowering its costs -soy protein adds juiciness because of water content

scientific management

-work centered: workers working at maximum efficiency -minimize motivation needed by supervisor -find the best way of performing tasks -focus on physical aspects of job, not human aspects

BMI/Quetelet index formula

-wt in kg/ by ht^2 -(wt in lb/ht^2)*703

sources of vitamin A

-yellow, orange fruits -dark green leafy vegetables -cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato

low fat milk has how much fat?

.5-2%

diet requirements for protein

.8g/kg body weight -10-15% of total energy intake

highest BMR at age

0-2years old

AST, SGOT aspartate amino transferase normal range

0-35 U/L

length parameters for infants

0-6 mo: 24" 7-12 mo: 28"

weight parameters for infants

0-6 mo: 6kg, 13lb 7-12 mo: 9kg, 20lb

water needs for infant

0-6mo: 125-155 ml/kg 7-12 mo: 1.5 mL/kcal

protein needs for infant

0-6mo: 9.1 g 7-12 mo: 11g

very weak r

0.0-0.2

weak, low r

0.2-0.4

moderate r

0.4-0.7

protein restriction for CKD stage 3 and 4

0.6-0.8 g/kg

serum creatinine normal values

0.6-1.4 mg/dL

strong, high r

0.7-0.9

protein restriction for CKD stage 1 and 2

0.8-1.4 g pro/kg

very strong, very high r

0.9-1.0

Valance of K

1

valence of Na

1

ratio of baking powder to flour

1 1/2 tsp baking powder to 1 cup flour

gel formation recipe

1 T gelatin will gel 1 pint liquid -mix with cold water to soften; add hot water to disperse

steps of collective bargaining

1. bargaining between union steward and management -then if that fails: mediation- neutral person helps settle differences; decision not binding -then if that fails: arbitration- hearing to dissolve a dispute during an impasse; decision is usually binding (final step)

list the steps in research

1. identify a relevent and improtant topic 2. develop well-considered research question (who, what, how) 3. research question leads to a hypothesis 4. prepare research protocol: methodology to solve the problem 5. organize methods and materials 6. collect and analyze data 7. study results and make decisions

female needs of riboflavin

1.1mg

female needs of thiamin

1.1mg

sedentary activity factor

1.2

needs for males of B6

1.2-1.7mg

male needs of thiamin

1.2mg

active activity factor

1.3

2002 DRI for alpha linolenic acid for lactation

1.3 g/day

male needs of riboflavin

1.3 mg

needs for females of B6

1.3-1.5mg

sodium AI for men and women 19-50

1.5 g /day; 3.8 g NaCl

%milk fat of dried skim milk

1.5% fat -keeps well

2% milk has how much fat?

1.5-2.25%

normal range of magnesium

1.5-2.5 mEq

relief workers

1.55 employees necessary for everyday coverage of full-time positions

meal criteria for SBP

1/4 daily recommendation of protein, calcium, iron, vitamin A, vitamin C

highest concentration of dextrose used in peripheral nutrition

10%

thermic effect of food is what % of our energy expenditure

10%

what is a hidden cost

10% may be added to food cost to cover unproductive costs -losses in preparation, cooking, serving, unavoidable waste

toxicity level of vitamin A

10,000 IU

newborn initial 6% weight loss should be regained by

10-14 days

serum ferritin normal values

10-150ng/mL for female 12-300ng/mL for male *indicates size of iron storage pool

normal BUN:creatinine ratio

10-15:1

BUN blood urea nitrogen normal range

10-20mg/dL

AGA appropriate for gestational age

10-90th %ile

PT prothrombin time range

11-12.5 seconds; 85-100% normal -anticoagulants prolong PT -evaluates clotting adequacy; change in vitamin K intake will alter rate of clotting

male needs of zinc

11mg

school foodservice staffing pattern

13-15 meals/labor hour

calcium AI for males and females ages 9-13

1300mg AI

normal range of sodium

136-145 mEq/L

female needs of niacin

14 NE

impaired glucose tolerance 2 hr PG

140-199

safe minimum internal temperature for beef/steaks

145F

safe minimum internal temperature for fish

145F

safe minimum internal temperature for veal/lamb

145F

needs of vitamin E

15mg

male needs of niacin

16 NE

how much water should be drank for every 1 lb body weight lost?

16 oz

% nitrogen in protein

16%

amputation subtractions for entire leg when determining desirable body weight

16%

TTHY transthyretin, PAB prealbumin normal level

16-40 mg/dL visceral protein

safe minimum internal temperature for chicken

165F

safe minimum internal temperature for duck

165F

safe minimum internal temperature for turkey

165F

% composition of protein of egg yolk

17.5%

personal zone distance

18"-4', when giving instructions or working closely

light or thin cream % fat

18-30%

coffee should be brewed at what temperature?

185-203F

needs of iron for female

18mg

needs of iron for male

18mg

RDA of protein for 4-8 yr old

19 g

The National Dysphagia Diet

1: pureed, moderate to severe avoid: gelatin, fruited yogurt, ice cream 2: mechanically altered, mild to moderate moist foods easily formed into bolus, soft cooked avoid: bread, rice, cheese cubes 3: advanced avoid: hard, sticky, crunchy foods, hard fruits and vegetables, nuts, seeds

water needed/calorie ingested

1cc

leftovers should be cooled from 135 to 70 within

2 hours and cool from 70-42 within an additional 4 hours

normal stool fat

2-5gram

amputation subtractions for forearm with hand when determining desirable body weight

2.3%

signs of edema is seen with albumin levels at

2.8

what % of observations lie within 1 SD of the mean?

2/3 (68%) - range is called M+1 SD of the mean

human milk kcal/ounce

20 calories/ounce

infant formula

20 calories/ounce

cows milk composition

20% pro, 30%CHO, 50% fat

# servings of #10 case

20-25 servings

weight gain for normal weight female

25-35lb

chromium needs

25-35ug

normal birth weight

2500-4000g

%milk fat of dried whole milk

26% fat -does not keep well

normal MCH

27-32 pg

weight gain for underweight female

28-40lb

triglyceride structure

3 fatty acids, 1 glycerol

low fat label

3 grams or less per serving

needs for females of fluoride

3 mg

storage time for fresh eggs in shell

3-5 weeks

RBP retinol binding protein normal level

3-6mg/dL

normal range of potation

3.5-5 mEq/L

serum albumin level

3.5-5.0 g/dL visceral protein

ferrous sulfate supplementation during pregnancy

30 mg during 2nd and 3rd trimesters (between meals, not with tea, milk, or coffee)

ALP alkaline phosphatase normal range

30-120 U/L

class 1 obesity BMI

30-34.9

medium cream % fat

30-36%

MNT for pressure ulcers

30-40kcal/kg -Stage 1 and 2: 1.2-1.5 g/pro/kg -Stage 3 and 4: 1.5-2 g/pro/kg -normal intake of calcium, adequate fluids -supplement vitamin C stage 3 and 4 500-1000mgs -supplement zinc stage 3 and 4 220mg zinc sulfate for 2-3 weeks -daily dietary source of vitamin A

whipped cream % fat

35%

class 2 obesity BMI

35-39.9

introduce nuts and fish when to infants

36 months

full oxidation of 1 molecule of glucose yields how many ATP?

38

AW of K

39

gelatin nutritive value

4 calories per gram -incomplete protein

open system hang time

4 hrs

needs for males of fluoride

4 mg

social zone distance

4'-12" most business interaction

ALT, SGPT alanine aminotransferase normal range

4-36 U/L

maximum rate of dextrose infusion should not exceed

4-5 mg/kg/minute -to prevent hyperglycemia and other complications

CAPD continuous ambulatory peritoneal dialysis

4-5 times per day

normal range of Ca

4.5-5.5 mEq/L

AW of Ca

40

sodium chloride is what % Na

40%

needs of folate

400ug

calorie increase during 3rd trimester

452

female needs of selenium

45ug

to prevent EFAD give

500cc of 10% fat emulsion 1-2times/week

muscle glycogen is depleted in 2-3 hours of continuous exercise at what %

60-80%

CKD stage 2 GFR

60-89

MNA should be used for those

65 years and older

young old age

65-74

grain

75% starch, partially complete protein, 2% fat -contains vitamin E (germ), thiamin (scutellum), riboflavin, phosphorous

aged age

75-84

needs of vitamin C

75-90mg

1.5 cal/cc formulas are what % water

76-78%

butter milk fat %

80

nutritive value of eggs

80 calories, 6 g protein, 5 grams fat, vitamins A, D, riboflavin

CHI- creatinine height index normal value

80%

margarine fat %

80% vegetable oil or animal fat

1 cal/cc formulas are what % water

80-86%

osmolarity of peripheral parenteral nutrition limited to

800-900 mOsm

female needs of zinc

8mg

reading level of materials for the general public should be at what grade level?

8th

needs of vitamin K for females

90 ug

TCA cycle produces

90% of bodes energy as ATP, CO2, and water

male needs of vitamin A

900 ug RE

needs of copper

900ug

normal range of Cl

96-106 mEq

what % of observations lie within 2 SD of either side of the mean?

98%

normal temperature

98.6F

high risk pregnancies classified as

<16, >=30, or <12 months between pregnancies

free foods

<20 calories <5 g CHO per serving

desirable totoal cholesterol level

<200

low cholesterol label

<20mg/serving

VLBW

<3.3lb (<1500g)

fresh fish should arrive at what temperature

<41F

LBW

<5.5lb or <2500g

normal A1C range

<5.7% -over 65 years <7% in health -over 8% in frail elderly

HA1C goal for diabetics

<7.0%

AI for calcium during pregnancy and lactation

<=18 its 1300mg, >18 1000mg

sour cream % fat

>18%

serum transferrin normal level

>200mg/dL visceral protein

TLC total lymphocyte count normal range

>2700 cells/cu mm

heavy or thick cream % fat

>36%

class 3 obesity BMI

>40

smoke point temperature should be

>400F

GRV that indicates to hold feeding

>500mL

CKD stage 1 GFR

>90

LGA

>90th %ile

protein % of protein isolates

>= 90%

hyperglycemia fasting

>=100mg/dL

protein % of protein concentrates

>=70%

milk whole fat exchange

CHO: 12 Pro:8 Fat: 8 Kcal: 160

sweets, desserts, other CHO exchange

CHO: 15 Pro, fat, kcal varies

fruit exchange

CHO: 15 Pro: 0 Fat: O Kcal:60

starch/bread exchange

CHO: 15 Pro: 3 Fat: 1 kcal: 80

alcohol exhange

CHO: varies Kcal: 100

protein medium fat exchange

CHO:0 Pro: 7 Fat: 5 kcal: 75

protein high fat exchange

CHO:0 Pro: 7 Fat: 8 kcal: 100

milk reduced fat exchange

CHO:12 Pro: 8 Fat:5 Kcal: 120

non-starchy vegetable CHO

CHO:5 Pro: 2 kcal: 25

a high fiber diet may increase need for

Ca, Mg, P, Cu, Se, Zn, Fe

function of vitamin D

Calcium and phosphorus metabolism

medical functional food examples

PKU formulas free of phenylalanine

order of predominance of fat in margarine

PUFA, MUFA, SAT

hemicellulose and lignins are

a non-CHO substance not significantly softened by cooking

conceptual skills

ability to see organization as a whole; importance increases at higher ranks of management

human skills

ability to work effective as a group member; important at all levels but imperative at lower levels of management

components of research report

abstract, into, review of literature, methodology, results, discussion, implications

food security

access by all people at all times to sufficient food for an active and healthy life

monitoring of financial status

accounting methods, general ledger, profit and loss statements, balance sheet, financial ratios

ascites

accumulation in the peritoneal cavity of fluid and sodium it carries

types of SCFA

acetate, butyrate, propionate, lactate

ketone bodies produced by normal fat metabolism

acetoacetic acid, acetone, beta-hydroxybutyric acid -acetoacetic and beta-hydroxybutyric acid enter into the blood and are taken to the peripheral tissues, converted back to acetyl CoA and oxidized as fuel

if there is not enough oxaloacetic acid coming in from CHO to maintain cycle efficienctly

acetyl CoA coming in from fat cannot be handled properly and is diverted to form ketone bodies

PBI protein bound iodine measures

activity of thyroid gland- measures T4 and T3, measures energy metabolism/level of thyroxine produced -not a nutritional assessment parameter

hamwi equation for large frame

add 10%

how do you prevent milk rom curdling during food preparation?

add an acid slowly and agitate -an acid precipitates casein

budget projections

add the increase in cost to the current cost -total all costs

to determine the payback peroid

add up the costs of the service add up the costs saved by using the new service dived costs of service by dollars saved

cured

additional whey removed, salt added, ripened

functional properties of salt in baked mixtures

adds flavor, keeps yeast from sticking -too much salt interferes with growth of yeast

functional properties of fat in baked mixtures

adds tenderness by coating gluten particles, keeping them from becoming one big mass

AI

adequate intake -when insufficient evidence exists for EAR, RDA

workmans compensation

administered by state -insurance covering employees liability for the costs of any accident incurred by an employee in connection with their job -must furnish a safe place to work, competent supervision

what age do most dietary deficiencies occur?

adolescene

hormones which stimulate protein catabolism/ gluconeogenesis

adrenal steriods (glucocorticoids)

osteomalacia

adult rickets -bone disease due to vitamin D deficiency- lack of sunlight or diet intake -reduction in bone density- demineralization

whole cows milk should not be given to an infant until

after 1 year of life (12 months)

thermic effect of food is greater

after consumption of carb or protein than after fat

period of growth spurt in childhood

age 4-6

acute diarrhea

aggressive and immediate rehydration; replace fluids and electrolytes lost in stool -reintroduce oral intake within 24 hours

absorption of non-heme iron

aided by gastric juice, vitamin Cm calcium helps if oxalates are present

milling

air classification is a separation method that improves baking qualities by separating large flour particles from fine particles

MAP, modified atmosphere packaging

air is removed and replaced with gases (carbon dioxide and nitrogen)

emphysema

air sacs (alveoli) lose elasticity; thin, chachectic, have difficulty exhaling

which amino acid is the most glucogenic

alanine -catabolized to pyruvate or to Krebs cycle

cause of edema/anasarca (extreme edema)

albumin exerts pressure on blood vessel wall to keep water within, when albumin drops, pressure drops so fluid leaks out. Water moves from extracellular plasma to interstitial space (between and around cells) which leads to edema and ascites

what reabsorbs sodium

aldosterone

complete protein

all essential amino acids in sufficient quality and ratio to maintain body tissue and promote growth

conventional production system

all preparation done on premix where meals are served

agency shop

all workers must pay agency fee, but not required to join union

sunk costs

already incurred and cannot be recouped by a new decision or alternative; cost involved in studying merits of a new computer

indication for TPN

altered GI function, impaired nutrient utilization -malabsorption, diffuse peritonitis, intestinal obstruction, SBS, hyper metabolic states, FI disorders, fistulas, critical care patients if NPO is expected to last more than 4-5 days and EN is not possible

RAST

alternative skin test -serum is mixed with food on paper disk; measures specific IgE antivodies

nutrients absorbed in the jejunum

amino acids, fatty acids, glycerol, simple sugar, minerals, vitamins

starch is composed of

amlylose and amlyopectin molecures

color of yolk depends on

amount and type of pigment in hens diet

DNA deoxyribose nucleic acid

amount of DNA in cell indicates the number of cells per organ, and helps determine stages of growth

finish of fat

amount of fat cover on the carcus

differential costs

amount of increase or decrease in cost when you compare alternative choices; differences in costs between two delivery systems

precision reliability

amount of variation that occurs randomly, measure of reliability of test

% yeild

amount provided by 1 lb of the item

what component of starch is responsible for gelation

amylose

union steward

an employee who represents fellow employees as the union representative -the steward does not get extra pay for serving

waist circumference is

an independent factor for disease when out of proportion to goal body fat

heme iron

animal sources ferrous +2 absorbable

gastritis can cause

anorexia, nausea, vomiting, diarrhea

treatments for ulcer

antacids, antibiotics to eradication bacteria, rest, diet therapy

anticoagulant (warfarin sodium) nutrition interaction

antagonizes vitamin K -avoid Ginkgo biloba extract, garlic, ginger (may increase bleeding) -consistent vitamin K intake -avoid high dose vitamin A, E

flavonoids

anthocyanins and anthoxanthins/flavones

treatment for tropical sprue

antibiotics, high calories, high protein, IM B12 and oral folate supplements

function of vitamin E

antioxidant, resists hemolysis of RBC

selenium functions

antioxidant, tissue respiration

cohort

any group whose members have something in common

Delaney Clause

anything causing cancer in animals or humans must be removed from market

megestrol acetate nutrition interaction

appetite stimulant

low potassium sources

apple, cranberry, blueberry, carrot, corn

high homocystein levels

are independent risk factor for CHD

net worth ratios

assess ability to meet long term debt

what does the benefit cost ratio do?

assess if economically efficient program

profit center

assigned both expense and revenue responsibilities

cofactor

assists enzymes -example: mineaks

gastroparesis

associated with delayed gastric emptying -can be caused by surgery, diabetes, viral infections, obstructions -bezoar formation may be due to undigested food or medications- treatment includes enzyme of endoscopic therapy

causal model forcasting

assumption that a relationship exists between the item being forecast and other factors (like selling price) -medium and long term forecasts, expensive to develop

Wholeness Meat Act of 1967

assures consumer that the animal was healthy at the time of slaughter and the meat is fit for human consumption -shown w/ round purple stamp "USDA Inspected and Passed"

when do fetal iron stores start to decrease

at 3-4 months -need additional iron from formula or supplemented foods

when should you add solids to infant diet?

at 4-6 months, when sitting posture an be sustained and extrusion reflex diminishes -begin with iron-fortifed cereals, then strained fruits or vegetables

MacGregor

attitude of manager toward employees has an impact on job performance -theory X -theory Y

scalar principle

authority and responsibility flow in a direct line vertically from the highest to lowest -duties should be delegated to the lowest capable

which fruit are best stored at room temperature?

avocados, bananas, pears, and tomatoes

grant

award of financial or dirt assistance -anyone can apply -usually lasts over a few years

t-bone cut of meat is from

back and ribs

concern of TPN

bacterial translocation, not utilizing GI -GALT gut associated lymphoid tissue compromised

objectives for the hierarchy of learning

based on blooms taxonomy

collagen in heat...

becomes hydrolyzed to gelatin and becomes tender

meat thermometers should be inserted

before cooking

compensatory benefits

benefits or pay for time not worked

thiamin deficiencies

berberi, muscle weakness, foot drop, memory loss, tachycardia

which fruits/vegetables should be washed right before serving and why

berries and mushrooms, they are very perishable and will absorb water and fall apart

horizontal channel of communication

between departments or between prediction and services

where does the pancreas lie?

between the duodenum and the stomach

what neutralizes acidic chyme as it enters the duodenum?

bicarbonate ions from the pancrease

what aids absorption of vitamin D

bile salts, acidity of chyme, accompanies Ca, P absorption

what aids absorption of E, K

bile salts, fat

what aids absorption of vitamin A

bile salts, pancreatic lipase, fat

Landrum-Griffin, Labor Management Reporting and Disclosure Act 1959

bill of rights for union members; regulates internal union affairs

BV

biological value -determine fraction of absorbed nitrogen retained for growth and maintenance

phytochemical definition

biologically active, naturally occurring chemical compounds in plant foods, act as natural defense for the plant

what is needed to make oxaloacetic acid?

biotin

neonate

birth to 1 month -can absorb whole, in tat protein

processed

blend of several natural cheeses (american) -emulsifier added (disodium phosphate) -high moisture content (41-50%)

histogram

block diagram whose blocks are proportional in are to the frequency in each class or group -summarizes data from a process that has been collected over time

functions of calcium

blood clotting, cardiac function, nerve transmission, smooth muscle contractility

CAP-FEIA

blood test specific in identifying children with milk, egg, fish, peanut allergy

cooking methods

boil, steam, pressure cooking, bake, stir fry, dried, frozen

blanching

boiling than submerging in cold water

types of feeds

bolus, continous drip (cyclic), intermittent

third space fluid

both extraecellular and extravascular

semi-variable costs

both fixed and variable -portion of the cost will remain fixed regardless of changes in sales volume ex. labor, maintenance, utilities ex. certain number of employees for basic service with added workers as need increases

for acute Crohns flare ups

bowel rest, parenteral nutrition or minimal residue

moist heat methods

braising, simmer, steam, stewing

types of moist heat methods

braising, simmer, steam, stewing, proteolytic enzyme

which part of the grain is removed for white grain

bran and germ

catabolism

breakdown; uses and releases energy; creates a constant energy deficit, which must be supplied by food

conclusion

brief summary of results

chlorophyll when heated in alkaline becomes

bright green, chlorophyllin -mushy, hemicellulose is broken down, water soluble vitamins are lost

chinese yang foods

bright, hot, hot soup from chicken

high purine foods

broths, anchovies, sardines, organ meats, sweetbreads, herring, mackerel

avoid both pheophytin and chlorophyllin

by cooking vegetable for short time and cooking quickly

bureaucratic leadership style

by the book, follows procedures to the letter

teeth assessment that is missing, loose, loss of enamel

calcium deficiency, poor intake

nutritional value of milk

calcium, phosphorus, riboflavin, vitamins A and D, niacin

prohibited foods of muslim

called haram= pork, alcohol, gelatin, congealed salad -fasting sunup to sundown during ramadan

macronutrient needs as we age

calorie needs decrease, protein needs remain the same

egg storage

can be maintained for 6 months in cold storage (29-32) with grade A eggs -fresh egg will sink

energy

capacity to do work

RQ of 1

carbohydrate alone # of CO2 produced is the same as the # of O molecules utilized

fat components

carbon, hydrogen, oxygen

protein components

carbon, hydrogen, oxygen, nitrogen -sulfur: found in cysteine, cystine, methionine

major buffers

carbonic acid (H2CO3) and sodium bicarbonate (NaHCO3)

precursor for vitamin A

carotene -provitamin (nutrient chanced into vitamin) -converted in intestinal mucosal cells

yellow/orange pigment

carotenoids -least affected by pH

stabilizer additives

carrageenan, pectin, cellulose, gelatin, vegetable proteins

what can be found in infant formula that does not have lactose?

casein hydrolysate

ADH following burn trauma

causes renal water reabsoption

measuring of central tendency data distribution

center of any mass of data

functions of manganese

central nervous system

direct benefits

change in diet or food habits as a result of counseling, change in functioning of body due to altered diet intake -value is determined by measuring the cost of treatment alternatives needed due to absence of improved food habits (ex. benefit of high fiber diet, no laxatives needed)

variables

characteristics that may have different values from observation to observation

ripening process occurs due to

chemical changes due to enzymes -starch changed to sugar

chemical modification of modified starch

chemical modification done by acids and enzymes to change viscosity and ability to gel

modified starch

chemical modification or physical modification -changes viscosity and ability to gel -used to stabilize frozen gravies: waxy maize, modified cornstarch

elemental EN formulas

chemically defined, used with malabsorption -pre-digested protein or amino acids, glucose or sucrose, small fat, vitamins, minerals, electrolytes -absorbed in proximal intestine, low to no residue, don't need pancreatic enzymes, high osmolality, poor taste -used with compromised GI function, inability to digest and absorb

green pigment

chlorophyll

two important minerals for glucose metabolism

chromium and zinc

COPD

chronic obstructive pulmonary disease, persistent obstruction of airflow through the lungs -symptoms include weight loss, emaciation, anorexia

drug therapy for ulcer

cimetidine, rantidine-H2 blocjer -prevent binding of histamine to receptor, decreases acid secretion

sources of vitamin C

citrus fruits, potatoes, papaya, dark green, yellow vegetables

transactional leader

clarifies roles and responsibilities; uses rewards and punishments to achieve goals -engage in bargaining relationship with their followers -leader and follower have separate but related purposes

diet for gastritis

clear liquids, advance as tolerated, avoid gastric irritants

diet for diverticulitis

clear liquids, low-rsidue or elemental, gradual return to high fiber diet

implementation messages should be

clear, complete, concise, concrete, correct

indicators

clearly defined markers that can be observed and measured -they are used to monitor and evaluate progress towards nutrition outcomes

yogurt

coagulated product; fermentation of milk sugars by lactic acid bacteria

order of predominance of substances containing saturated fat:

coconut oil, palm kernel, cocoa butter, butter, beef tallow, palm oil

functions of B6

coenzyme in amino acid metabolism: deamination, transamination -so increase protein need to increase pyridoxine

functions of biotin

coenzyme in fatty acid synthesis, converts pyruvate to oxaloacetate in gluconeogensis

domains of learning

cognitive, affective, psychomotor

irradiation

cold-sterilization -prevent off flavors in meats -approved by FDA for spices, beef, lamb, pork, poultry, wheat, potatoes

two connective tissue proteins

collagen and elastin

acetyl CoA comes from

comes from pyretic acid (CHO), oxidation of fatty acids and degradation of carbon skeleton of certain amino acids

benchmarking

compar satisfaction levels to those of other facilities which are considered "best in class"

rate based indicator

comparative rate indicator -what will happen with the BEST care

glycemic index

compares blood glucose response of a food to standard glucose load -afected by cooing methods and processing of starch -as particle size decreases, the index increases -foods with low index produce greater satiety

specific gravity measures

compares lightness of products, ratio of the density of a food to that of water, weight of a given volume of sample divided by weight of same volume of water

role of sugar in gelatinization

competes with starch for the water needed for gelatinization -increases translucency, reduces viscosity, and gel strength -if too much sugar is used, consistency is thin (water needed to dissolve excess sugar is not available for the gelatinization of starch, decreases swelling of starch granules)

choline properties

component of lecithin

functions of sulfur

components of organic molecules

abstract

condensation of final report, has purpose of study, questions asked, scope and method, summary of conclusions

legislative branch

congress, senators, representatives

hair assessment that is thin, sparse, duo dry brittle, easily pluck able assessment

consider vitamin C, protein deficiency

reliability

consistency or reproducibility of test results

nutritional surveillance

continous collection of data -identifies problem, sets baseline, sets priorities, detects changes in trends -use height, weight, hematocrit, hemoglobin,serum cholesterol -on-going system linked to active health program: WIC, CDC -data identifies needs and kind of intervention needed

systolic pressure measures

contraction, greatest pressure

gluconeogesis

conversion of non-carbohydrate sources into glucose (from glycerol and amino acids)

preparation suggestion for cauliflower

cook for a short time, covered

broccoli preparation suggestion

cook in microwave, less time, same flavor, retains color slightly better, better retention of vitamin C, no large difference in eating quality

ready-prepared production system

cook-chill, cook-freeze foods are prepared on site then frozen, chilled for late use -requires blast chiller or freezer, adequate storage

what starch should you use to get a clear, shiny, translucent sauce

corn starch

what is okay on a gluten restricted diet

corn, potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flax

which oils are winterized

corn, soy, cottonseed oils

cost of sales

cost of raw food and beverages sold

cost/benefit studies

cost/benefit of nutrition eduction and intervention -cost/benefit analysis -cost/effectiveness analysis

% moisture content high to low of cheeses

cottage cheese, cream cheese, mozzarella, camembert, bleu, swiss, cheddar, gorgonzola, parmesan

injunction

court order to prevent someone from doing something

symptoms of dumping syndome

cramps, rapid pulse, weakness, perspiration, dizziness

linoleic deficiency

creates eczema, poor growth rate, petechiae (red, purple skin spots)

lipogenesis

creation of adipose tissue

glycogenesis

creation of glycogen in muscle and liver

types of candies

crystalline sugar, non-crystalline sugar

elements of total quality management

customers/clients: judges of quality culture: environment created that establishes quality as a top priority counting: measurement of what constitutes a high quality service or product and what needs improvement

methods of cooking is determined by

cut of meat

B12

cyanocobalamin

methionine is converted to

cysteine

oxalate containing foods

dark leafy greens, chocolate, strawberries, nuts, beets, tea

six sigma

data driven approach for improving quality by removing defects and their causes -determine errors that occur in a process and you can systematically determine how to eliminate them and get as closet to zero as possible

numerical discrete variables

data with numbers

oral contraceptives nutrition interaction

decrease folate, B6, and C

anemia

decrease in total red cell mass due to fewer red blood cells or to smaller cells with less hemoglobin

thiazide diuretics nutrition interaction

decrease potassium and magnesium, absorb calcium (enhance renal absorption)

oat bran and soluble fibers

decrease serum cholesterol by binding bile acids converting more cholesterol into bile

elderly needs assessment

decreased attention span (want short sessions), audience participation to maintain interest; carefully control questions to stay on topic, prefer written material to control rate of input

adding bran to flour

decreased volume of end product, since bran is heavy -need to increase flour and liquid to compensate; to provide more gluten and to hydrate the flour

vitamin B6 and protein nutrient nutrition interaction

decreases effectiveness of L-dopa (levodopa) which controls symptoms of parkinsons disease. -so want to take drug in the morning with limited protein (competes with drug for absorption sites)

methotrexate (chemotherapuetic) nutrition interaction

decreases folate

older adults and BMR

decreases, less activity which means less lean body mass, and more body fat which decreases BMR

ischemia

deficiency of blood due to obstruction (like thrombosis)

hypernatremia is associated with

dehydration

loop diuretics (furosemide, lasix) nutrition interaction

deplete thiamin, potassium, magnesium, calcium, sodium, chloride

isoniazid (treats TB) nutrition interaction

depletes pyridoxine which can cause peripheral neuropathy -dont take with food -interferes with vitamin D, calcium, phosphorus

pellagra disease characterized by

dermatitis, diarrhea, dementia

population of interes

describes group about which the observations are made

formularies

descriptions of approved products that an organization would like all personnel to use

broad types of research

descriptive analytical

summative evaluation

designed at planning stage but conducted at the end -considered final -example: post-test

survey research

designed to describe and quantify characteristics of a defined population

mallows hierarchy of needs

determinants of behavior, motivated by the desire to satisfy specific needs when basic needs are met, the higher needs become motivators -basic needs: physiological (survival needs) and security and safety -higher human needs: social then self-realization then advanced training then job enrichment

stings of change model of counseling

determines your clients current stage, behavior change more effective

tropical sprue can cause

diarrhea, malnutrition, deficiencies of B12 and folate due to decreased HCL and intrinsic factor

range

difference between the lowest and highest values in the distribution -subtract lower from higher value

transactional vs. transformational leadership

difference on how leaders and followers influence each other

gout

disorder of purine metabolism -causes increased serum uric acid; which deposit in joints causing pain, swelling

to determine the number of ounces in a scoop

dived the scoop number into 32

when is low fat and non-fat milk inappropriate during infancy

during first two years of life

mayo is an example of an

emulsification stabilized by egg yolk

examples of additives

emulsifiers, humectants, stabilizers, anti-caking agents, inhibitors of mold (preservative), inhibitive of spores, appearance enhancers

elderly and vitamins

encourage folate-rich foods; supplements of B6 and B12 may be needed due to atrophic gastritis

participative leadership style

encourage workers to participate in decision-making

textured protein products (TVP)

end product to produce fibers from protein, soybeans are used

outcome oriented evaluations

end result or consequence of program, change in attitude, knowledge, ultimate indicator of quality measuring the actual health status of the client, or skills of an employee

end products of metabolism

energy (ATP), carbon dioxide, water

function of fat

energy, insulation, padding, depresses gastric secretion so delays emptying -has less oxygen, more carbon than carbohydrate so provides more nervy (more carbon atoms for oxidation)

FDA

ensures safety of some domestic and imported food products, and nutrition label content

graham, whole wheat flour characteristics

entre grain, use freshly ground, spoils quickly due to fat in germ

coenzymes

enzyme activators -includes some vitamins (mainly B vitamins)

bromelin

enzyme in pineapple that breaks down protein and prevents gelation

types of responses to cliends

evaluation (judgemnt-leads to offering advise, no helpful) hostile reassuring probing understanding

concentrated milk types

evaporated, sweetened condensed milk, dried whole milk, dried skim milk

what may cause fallen center of cakes

excess sugar, excess fat, excess baking powder

marketing channel

exchange of ownership: producer, processor, distributor, supplier, customer

breastfeeding recommendations

exclusive breastfeeding for 4-6 mo, then supplemented by weaning foods for at lease 12 monhts

occupations exempt from minimum wage and overtime requirements

executive, administrative, professional, outside salespersons

TVP, textured vegetable protein

fabricated into simulated meat products ex. imitation bacon bits

pregnancy weight gain thats at risk

failure to gain alb/month in last half of pregnancy

FTT

failure to thrive, may result from acute or chronic illness, restricted diet, poor appetite, lack of fiber leading to chronic consitpation, diminished intake

fresh produce grades

fancy, extra #1, #1, combination, #2

derived fat

fat substance derived from a simple or compound fat hydrolysis or enzymatic breakdown; fatty acid, glycerol, steriod

cholesterol

fat that is found in all cells, important in cell striation -some absorbed with bile salts -most absorbed with cholesterol esterase; converted into cholesterol esters -excreted by liver as bile

vitamin A is a

fat-soluble vitamin

exercise physiology: at rest and during normal activities what is the primary energy source

fats (80-90%) -carbs: 5-18% -protein: 2-5%

calorie needs for infant 0-6 months

female: 520 male: 570

calorie needs for infant 7-12 months

female: 676 male: 743

kefir

fermented by lactobacillus kefir; adds carbon dioxide; about 3% alcohol

macrocytic, megaloblastic anemia

few large cells, filled with hemoglobin -due to deficiency of folate or B12 -schilling test for pernicious anemia

myofibrils

fibers muscles are composed of

main source of alpha linolenic acid

fish oils (EPA and DHA), walnuts, flaxseed, canola

calcium content is high in

fish with canned bones, oysters, and shrimp

crystalline sugar candies

fixed orderly pattern of molecules or atoms -large crystals (rock candy) -small crystals (fondant, fudge)

osmosis

fluid moves from less to more concentrated side of membrane

flow phase

follows fluid resuscitation and return of oxygen transport -increases

chyme

food bolus and gastric juice

food cost per meal=

food cost per month/# meals per month

daily food cost report

food cost percentage -tells you what percent of the income was spent on the food sold

soluble fiber is found in

fruits, vegetables, legumes, oats, barley, carrots, apples, citrus fruits, strawberries, bananas

sources of phytochemicals

fruits, vegetables, legumes, whole grains, nuts, seeds, herbs, spices

dry heat methods

frying, broiling, roasting

how come fudge has smaller crystals than rock candy?

fudge has more ingredients that interfere with crystallization; milk, chocolate, corn syrup

procurement

function of acquiring material for production

prospective

future oriented

cholelithiasis

gallstones

which hormone stimulates gastric secretions and motility

gastrin

billroth 1

gastroduodenostomy -attaches the remaining stomach to the duodenum

billroth 2

gastrojejunostomy -attaches the remaining stomach to the jejunum

atopy

genetic predisposition to produce excessive IgE antibodies in response to an allergen

lactose composition

glucose and galactose

energy metabolism

glucose in cell is oxidized to produce energy, carbon dioxide, and water

nutrients that use active transport as mechanism for absorption

glucose, amino acids, Na, K, Mg, Ca, Fe

diet therapy for non-tropical sprue

gluten free restricted diet -no wheat, rye, oats, barley, bran, graham, malt, bulgur, couscous, durum, orzo, thickening agents

special dietary use functional foods

gluten-free, weight loss foods

what is stored in the liver

glycogen

decrease in cortisol causes

glycogen depletion, hypoglycemia

bulimia

gorging and vomiting syndrome -usually close to normal weight -damage teeth, throat, esophagus, rectal bleeding, bruised knuckles, low potassium and chloride blood levels

grades of canned fruits and vegetables

grade A: desserts, salads (fancy) grade B: processed (choice) grade C: puddings, pies (standards)

conventional (whole) functional foods

grape juice, red wine, fatty fish, tomatoes

public zone distance

greater than 12", formal

properties of anthocyanins

greatly affected by changes in pH, soluble in water, bright red in acid, bluish in alkaline

product mix

group of items you will offer

weight for age chart marker of

growth -affected by acute nutritional stress or illness -not used to salsify under/over weight -cannot distinguish between stunting and wasting because it does not include height

deficiencies of riboflavin

growth failure, cheilosis (cracked lips), angular stomatitis (mouth corner cracks, sore throat), magenta tongue

National Labor Relations Act-Wagner Act 1935

guaranteed right to organize and join labor unions -gave union the right to be the bargaining agent -created the National Labor Relations Board NLRB

what affects the stability of swollen starch granules in a paste?

heat, acid, and agitation

anasarca is associated with

heat, liver, renal failure, and extreme protein/calorie malnutrition

convection

heated air movement with fan

motivational interviewing

helps clients recognize and begin to resolve their concerns and problems

CPM Critical Path Method

helps plan and control an operation, project analysis -identifies the most critical activities, how to best allocate limited resources

lecithin

helps yolk act as an emulsifier

deficiencies of vitamin E

hemolytic anemia

deficiencies of vitamin K

hemorrhage

liver specialized formula

hepatic aid 2, nutrihep

which duct from the liver joins with the cystic duct from the gallbladder?

hepatic duct

AST, SGOT aspartate amino transferase is increased with

hepatitis

LDH lactic acid dehydrogenase is increased with

hepatitis, myocardial infarction, muscle malignancies

HBV

high biological value

which foods slow gastric emptying

high fat foods and complex carbs, especially soluble fibers

ketogenic diet

high fat, very low carbohydrate -4 grams fat: 1 gram non-fat -ketone bodies behave as inhibitory neurotransmitters; mild dehydration needed to prevent dilution of ketones -needs supplementations of Ca, D, folate, B6, B12 -MCTs are more ketogenic, more rapid metabolism and absorption

diet for diverticulosis

high fiber diet- increases volume and weight of residue, provides rapid transit

what will increase needs of magnesium

high protein, calcium, or vitamin D

MNT for adrenal cortex insufficiency/ Addison's disease

high protein, frequent feedings, high salt -hormonal replacement

MNT for steatorrhea

high protein, high complex CHO, fat as tolerated, vitamins (especially fat-soluble), minerals, MCT (rapidly hydrolyzed in GI tract)

low cariogenic potential foods

high protein, moderate fat, minimal concentration of fermentable CHO -strong buffer; high mineral content Ca, P, Ph>6, stimulates saliva ex. cheddar cheese, nuts, meats

desired property of fat used in frying is

high smoke point

dyslipidemia

high triglyceride and low HDL

deeper the dark pigments of vitamin A

higher amounts of vitamin A

which hormones are released from intestine in presence of gluose and fat?

hormone glucagon-like peptide 1 (GLP-1) and hormone glucose-dependent insullinotropic polypeptide (GIP)

cellular oxidation

how energy is created

frequence of acceptance

how often they would be willing to eat an item

paralinguistic

how the clients message is delivered -ex if they are hesitant/stuttering may mean sensitivity or anxiety

measures of dispersion

how values are distributed about the mean -range, standard deviation

results of physiologic trauma

hyperglycemia, hyperinsulinemia, hypovalemia, drop in body temperature, little or no ketosis, increased glucagon -fluid and sodium retention, potassium excretion, loss of nitrogen, sulfur, zinc, and phosphorus

cyclosporine (immunosuppressant) nutrition interaction

hyperlipidemia, hyperglycemia, hyperkalemia, hypertension

risk factors of atherosclerosis

hypertension, obesity, smoking, elevated blood lipids, heredity

calcium deficinecy

hypocalcemia leads to tetany (irregular muscle contractions)

what is the central regulation of food intake?

hypothalamus gland

ebb phase

hypovomelia, shock, tissue hypoxia -decreases

first step in marketing process and plan is to

identify a need that is not being filled, market niche

what aids absorption of B12

ileum, stomach secretions (need HCL, intrinsic factor)

right to work laws

illegal to fire an employee who refuses to join a union even if contract has a union shop clause

pareto charts

illustrate the relative importance of problems through bar charts -work on the tallest bar or problem that occurs most frequently; correcting the "vital few" problems will have the greatest impact on quality -use the 80-20 rule: 80% of a given outcome results from 20% of an input

burns BMR

immediate shock period-catabolism rises 50-100%

ABC inventory classification system

importance of each inventory item is measured by activity level A items: 15-20% of total # of items in stock constitute 75-80% of total annual value C items: 60-65% of inventory compromise 5-10% of value

where does most digestion in the bowel take place?

in the first 100cm of intestine (in duodenum, and upper jejunum) -what remains is small amounts of sugar, starches, fiber, and lipids

abnormal fat metabolism

inaqequate CHO results in incomplete fat oxidation and buildup of ketones -tissues can't oxidize high amounts of ketone bodies, results in ketosis

to prevent alkaline stones create acidic ash

increase anions, Cl, Ph, Su, by adding meat, fish, fowl, eggs, shellfish, cheese, corn, oats, rye

to prevent acidic stones create alkaline ash

increase cations, Ca, Na, K, Mg, by adding vegetables, fruits, brown sugar, molasses

to lower RQ

increase fat intake

as fruits and vegetables age

increase in hemicellulose and lignin

if using buttermilk in replace of regular milk in a recipe

increase the baking soda

changes in enzymes of meat during aging

increase the water holding capacity of the muscle

lithium carbonate (antidepressant) nutrition interaction

increased appetite, weight gain, maintain consistent sodium and caffeine intake to stabilize levels. if sodium or caffeine are restricted, lithium excretion decreases, leading to toxicity

high temperatures when cooking meat

increases shrinkage, toughen meat

type of flours that don't need to be sifted

instant blending, agglomerated, instantized

endemic goiter

insufficiency of hormone production due to inadequate iodine intake MNT: iodized salt, free of goitrogens

hormones involved in lipogenesis

insulin (anabolic)

acute hypoglycemia

insulin reaction (shock); due to insulin excess or lack of eating; slow pulse, cool, clammy skin, hungry, weak, shakiness, sweating

chromium deficiency

insulin resistance

oral glucose lowering medicines

insulin secretagogues, biguanieds, thiazolidinediones, alpha glucosidase inhibitors, glucagon-like peptide-1 agonist, amylin agonist

unemployment compensation

insurance against loss of income -employers pay tac on payroll for this

service marketing characteristics

intangibility, perishability, heterogeneity, inseparability -services must be intangible and produced and consumed at the same time

legislative process

interaction between the legislative, executive, and judiciary branches -legislative branch may introduce and enact a law and can override a veto by the executive branch -the executive branch may veto or sign into law -judiciary may discard a law if it considers it in violation of a persons basic rights and freedoms

lower income adult needs assessment

interest focus on costs and traditional food habits; oriented toward present and towards solving current problems

nutrition informatics

intersection between nutrition, information, and technology

milk is low in

iron (unless fortified)

heterogeneity of service

is concerned with the variation and lack of uniformity in the performance of people

metabolic acidosis

kidneys either produce or retain too much hydrogen leading to an increase in production of carbonic acid OR kidneys may excrete too much base to compensate, respiration increase to remove carbon dioxide to decrease carbonic acid

forms of nonverbal communication

kinesics, paralinguistics, proxemics

FTE/year equation

labor hours worked that year/ 2080

end product of anaerobic glycolysis

lactate

cori cycle

lactate is released from tissue, transported to liver, and converted back to pyruvate

shortened cakes

larger amount of fat, uses chemical leavening -pound cake -rich cake -gold cake -white cake -yellow cake

avoidance learning modification

learn to escape from unpleasant consequences -avoid future criticism by improving future performances

cake (soft wheat)

least and weakest gluten, more starch, 7.5% protein

free rein leadership style

least control, allows group to lead and make decision, workers operate with minimal direction/control

licensure

legal recognition, defines a scope of practice

if kidneys retain bicarbonate

level of base increases

p value is

levels of significance -shows how strong or eek the evidence is in support of a hypothesis

FCC Federal Communications Commission

licenses radio and TV

supplementary benefits

life and health insurance

high turnover ratio indicate

limited inventory is kept

pour batter proportion

liquid 1 to flour 1 example: waffles

drop batter proportion

liquid 1 to flour 2 example: muffins

soft dough proportion

liquid 1 to flour 3 example: bread

stiff dough proportion

liquid 1 to flour 4 example: pie crust

gastroplasty MNT

liquids to pureed to soft to regular small meals and snacks

NLRB National Labor Relations Board

listens to claims of unfair labor practice

vitamin A is stored in the

liver

where is bile produced?

liver

ALP alkaline phosphatase is increased with

liver and bone disease

ALT, SGPT alanine amino transferase is increased with

liver disease

foods high in iron

liver, kidney, beed, dired fruits, dried peas and beans, nuts, leafy greens, fortified whole grain products

sources of biotin

liver, kidney, egg yolk, yeast

sources of riboflavin

liver, kidney, meat, milk

sources of copper

liver, kidney, shellfish

sources of B12

liver, meat, milk, kidney, eggs, fish, cheese * pure dietary deficiency is rare

respiratory alkolosis

loss of carbonic acid (increased ventilation), to compensate kidneys excrete additional base

arteriosclerosis

loss of elasticity of blood vessel walls

wilsons disease

low serum copper, genetic absence of liver enzyme

vinegar added to meat when cooking

lowers pH and increases water holding capacity of muscles -hence why marinades have vinegar

calcitonin

lowers serum calcium by inhibiting bone resorption

what happens when starch is not mixed enough into a moist heat cooking method?

lumps form which decrease thickening, granules on the outside swell as they take up water -those on the inside remain dry, decreasing thickening process

concentration of electrolytes is expressed in

mEg milliequivalents

B12 deficiencies

macrocytic megaloblastic anemia or pernicious anemia after gastrectomy or removal of ileum (due to lack of intrinsic factor)

formative evaluation

made during course of education -allows for revision of plans, methods -client must be involved; focus group, pre-test -feedback guides the rest of the educational process

waist circumferene standard measurements

male >40 female>35

AI for alpha linolenic acid for adults

male: 1.6 female: 1.1

standard TSF measurments

male: 12.5mm female: 16.5 mm

AI for linoleic acid for adults

male: 17 female: 12

standard AMA measurements

male: 25.3cm female: 23.2 cm

RDA protein needs for adulthood >=19

males: 56 females: 46

causes of osteoporosis

malnutrition (especially protein), lack of exercise, decline in estrogen

organizational change theory

managers serves as catalysts for change -leader recognizes there is a need for a change, helps followers recognize this need by raising their level of dissatisfaction and change to a new state

grading is based on

maturity of animal, marbeling of fat, color and texture of lean

MCH measures

mean corpuscular hemoglobin, color

MCV measures

mean corpuscular volume, size

unionization

means of collective bargaining

meal equivalent

measure of productivity defined as the amount of all food sales divided by the average cost of a typical meal

continuous scores

measure on a continuous scale

controlling/evaluating

measure present performance against standard performance -ongoing process to determine whether goals have been reached -shows strengths and weaknesses, solves problems

high potassium sources

meat, fruits, vegetables -banana, orange, tomato, potato, cantaloupe

sources of zinc

meat, liver, eggs, fish

phosphorous sources

meat, milk, poultry, eggs, fish, cheese

sources of vitamin B6

meat, wheat, corn, yeast, pro, liver, ready-to eat cereals

informal channel of communication

meets social needs of group -from employee to employee

HCT hematocrit normal values

men: 42-52% women: 35-47% pregnant women: 33%

hemoglobin normal values

men:14-17 gm/dL women: 12-15 gm/dL pregnant: <=11

du jour

menu of the day, uses leftovers and food bargain

factors affecting food cost

menu planning (most important factor) type of service purchasing methods receiving control storage and production control standardize portions to control costs

function of niacin

metabolism of CHO, protein, and fat

alcohol metabolism

metabolized as a fat -7 calories/gram

biguanides

metformin (glucophage) -enhance insulin action, suppress hepatic glucose production

cysteine can be synthesized from

methionine

limiting amino acid of soybeans

methionine

limiting amino acids in legumes

methionine, cystine, and tryptophan

focus group

method of attaining information about a target group; small group who talk about the beliefs, opinions, and problems; contributes attitudinal data

most digestion occurs in the

middle of the jejunum

diagonal channel of communication

minimizes time and effort expanded in organizations

absolute FTE

minimum number of employees needed to staff the facility: counts productive hours

fat needs for infant

minimum of 30 grams per day

modular formulas

mix individual components, adds flexibility in tailoring formulas

how to prevent lumps when cooking with starch

mix starch with fat, cold liquid, or sugar

baking powder

mixture of baking soda, a dry acid, and cornstarch -types: tartrate, phosphate, combination

dispersion systems

mixture of solids, liquids, gases

gastroparesis can cause

moderate to severe hyperglycemia and have a detrimental effect on gastric nerves

microorganisms

molds, yeast, bacteria

FTC Federal Trade Commission

monitor internet, TV, radio, bogus weight loss claims

end products of fat digestion

monoglycerides, diglycerides, glycerol, fatty acids

emulsifier additives

monoglycerides, diglycerides, lecithin, disodium phosphate

which fats combine with bile salts to form micelles

monoglycerides, diglycerides, long chained fatty acids

types of carbohydrates

monosaccaride, disaccaharide, polysaccharide

adipose lipogenesis

most active site -fatty acids+ glycerol--> triglycerides *needs NADPH from pentose shunt

profit margin

most commonly used assessment of overall financial efficiency -reflects the portion of sales volume remaining after paying all expenses

sources of magnesium

most foods, milk, bread

mode

most frequently occurring value; prediction most likely to be right

standard deviation

most significant measure of dispersion, indicates the degree of dispersion about the mean value of distribution

work simplification procedure examples

motion economy, work sampling, pathway chart/flow, operation charts, process charts, cross charts

operation charts

movements of hands, reduces transportation and replan work areas

oxytocin

moves milk through ducts

deficiencies of biotin

muscle pain, dermatitis, glossitis

marbling of fat is around

muscles

pie chart

must always add up to 100%

closed shop

must be member of union first before hiring *illegal in public employment

union shop

must join union after being hired *illegal in public employment

bacteria optimal growth

need moisture, neutral foods, 68-113F can be aerobic or anaerobic -destroyed by pasteurization

profit margin=

net profit (profit after all expenses have been paid)/ sales dollars (revenue)

NPU

net protein utilizartion -measures the amount of protein actually used

additive that fixes color, inhibits clostridium botulinum

nitrites

do creatine supplements enhance endurance?

no

do sugar alcohols (sorbitol, xylitol, mannitol) promote tooth decay?

no

should growth charts to assess children with down syndrome be used?

no

Federal Register

notices of public hearings, proposed and final rules, agency decisions, published weekly -lists changes in USDA food programs

NRTI drugs

nucleotide nucleoside reverse transciptase inhibitors (retrovir, zidovudine) -HIV meds that can lead to anemia, loss of appetite, low vitamin B12, copper, zinc, carntitine

BE in sales volume

number of $ you need to bring in to break even

meals per labor hour=

number of meals produced/number of hours worked

meat specifications

numbering system for oder wholesale cuts -IMPS -NAMP

substitute label

nutritionally equal or superior in some ways and superior in others

imitation label

nutritionally inferior; may cost less, taste the same

what is a major factor in cause of coronary artery disease (CAD), cardiovascular disease (CVD), and ischemic heart disease (IHD)?

obesity

formal evaluation strategies

objective test (right or wrong) performance test

introduction

objectives, definitions, background, limitations, order of presentaiton

work sampling

observe random samples to determine percentage of time working or idle

carry over cooking

occurs for about 10 minutes when meat is removed from oven, internal meat temperature will rise 15-25F

which oil is not winterized

olive oil

order of predominance of substances containing monounsaturated fat

olive, canola, peanut, sunflower

alpah linolenic acid

omega 3

fatty fish as a functional food

omega 3 fatty acids reduce TG levels

linoleic acid

omega 6

monounsaturated

one double bond

function of iron

oxygen transport

very, very significal, reliable p value

p<0.0001

very significant difference, more reliable p value

p<0.01

significant difference, results are reliable p value

p<=0.5

not significant difference, not reliable results

p>0.05

examples of coenzymes needed for energy production

pantothenic acid, thiamin, riboflavin, niacin

proteolytic enzyme

papain (papaya), bromeliad (pineapple) will tenderize meat

transpyloric feeding

passed by pyloric valve in stomach; used in comatose patients or ones with no gag reflex

third party reimbursment

payment by a third party for service rendered by a health care provider to patient ex. Blue Cross, Medicare

statutiry benefits

payment required by law ti ensure income in event of unemployment, injury or death

common allergies

peanuts, eggs, milk, soy, wheat, shellfish

glucose-6-phosphate also proceeds through the

pentose shunt

theory X

people inherently dislike work and will avoid it if possible; authoritarian, work-centered; workers prefer to be controlled and directed by pressure -motivation through fear, autocratic

steam cooking method

perforated container, covered, over boiling water

food code

person in charge must be able to identify food allergens and associated symtoms

tyrosine can be synthesized from

phenylalanine

what aids absorption of riboflavin

phosphorus

kinesics

physical communication/behaviors -such as direct eye contact, attentiveness, arms folded across chest, clenched fists

physical modification of modified starch

physical modification done by pre-gelatinized starch used in instant puddings

what decrease absorption of zinc

phytates and copper

thiols

phytochemical found in cruciferious vegetables (contain sulfur), helps with detoxification of carcinogens

9-12 month infant grasp

pincer grasp (thumb and forefinger)

we get maternal hormones from

pituitary

hormones which stimulate protein anabolism

pituitary growth hormone, thyroid hormone, insulin, testosterone

functions of management

plan, organize, direct, control, evaluate

non-heme iron

plant sources, cereal -ferric +3

breakeven point

point at which sales revenue (income) will exactly cover fixed and variable costs -breakeven in number of units sold -breakeven in sales volume

menu mix

popularity -calculated by dividing the number sold of a particular item, by the total number of all items sold

eggs shell

porous, exchanges moisture and gases; covered with bloom that prevents excessive loss and protects contents

clarification response

pose a question after an ambiguous client message; used to make previous message explicit

behavior modification methods

positive reinforcements, avoidance learning, extinction

order of effective starch thickeners

potato, waxy corn, waxy rice, waxy sorghum, tapioca, wheat **wheat flour less effective than wheat starch because of the protein content **pastry and cake flour have more starch and less gluten so thicken better

McClellands achievement

power-affiliation theory -all people have three needs: need to achieve, need for power, and a need for affiliation -achievement: do something better/more efficiently -affiliation: desire to be liked -power: enjoy competition/seek confrontation

Mifflin St. Jeor

predicts RMR, within 10% of indirect calorimetry -use normal weight and obese individuals

fixed budget

prepared at one level of sales or revenue (no expected major change in patient or customer count during the year)

Age Discrimination in Employment Act 1967

prevents discrimination due to age, protects older worker too

Equal Employment Opportunity Act 1972

prevents discrimination in employment based on race, color, religion, sex, national origin, political affiliation -overseen by EEOC

Civil Rights Act 1964

prevents discrimination on basis of race, color, national origin, prohibits sexual harassment -overseen by the EEOC Equal Employment Opportunity Commission

program intervention types

primary (health promotion), secondary (risk reduction), tertiary (rehabilitation efforts)

which grade has the most marbling

prime

grades of meat

prime, choice, select, standard -determined at slaughter

nutrition diagnostic reference sheet: four components

problem or nutrition diagnosis label, definition of the label to differentiate a discrete problem area, etiology, and signs/symptoms

dextrinization

process during dry heating of starch where starch molecules break into fragments called dextrins

hydrogenation

process f adding hydrogen (at the double bond) to unsaturated fast to increase saturation and stability

marketing

process of identifying a need, assisting potential clients in recognizing that need, and filling that need

value analysis

process of investigating all aspects of a service with the goal of discovering and eliminating unnecessary costs without interfering with the effectiveness of the service

best cheese for cooking

processed, because of emulsifier fat will not separate out

not adding enough fat in ice cream will

produce a grainy ice cream with large crystals

mastication

produces bolus

4 P of marketing

product, place, price, promotion

marketing mix for goods

product, place, price, promotion

types of control

production, quality, quantity

net profit

profit shown after all expenses have been deducted from sales

gross profit

profit shown after deducing raw food and beverage (cost of sales) from sales (revenue)

contribution margin

profitability -calculated by subtracting a menu items food cost from its selling price

peter principle

promote someone to a level of incompetence

preservative/mold inhibitor additives

proprionate

RQ of 0.82

protein alone

marasmus

protein and calorie starvation

eggs as emulsifiers

protein in egg forms a thin film around droplets of oil; stabilizes emulsion

sources of niacin

protein, peanuts, ready-to-eat cereals, chicken, rice, yeast, milk

iatrogenic malnutrition

protein-calorie malnutrition -brought on by treatment, hospitals, medications

neoplastic MNT

protein-eneryg malnutrition, malabsorption, fluid-electrolyte imbalance -altered taste acuity- add flavor /seasongins -may have meat aversions- avoid red meat -thrush from oral infections so avoid spicy, acidic, strongly flavored foods (want bland liquids, soft foods, chilled or frozen) -throat of neck cancer: use PEG -cancer cachexia: generalized wasting contacted to cytokines and the tumor-necrosis factor (TNF)

ripening process stages

protopectin converted to pectin (ripe) then converted to pectic acid (overripe)

hiatial hernia

protrusion of a portion of the stomach above the diaphragm into the chest -symptom: heartburn

limited choice menu

provide choices for some items

MNT for glycogen storage disease

provide consistent supply of exogenous glucose with raw cornstarch at regular intervals, a high carb and low fat diet

function foods definition

provide more benefits than the basic nutritional benefits -conventional whole foods, modified, medical foods, special dietary use

state and local food protections

provides for grading, sizing, and labeling of eggs; inspection of dairy and seafood products

major function of fiber

provides indigestible bulk, promotes intestinal function

functional properties of egg in baked mixtures

provides stability, retains leavening agent, distributes shortening by emulsification, introduce air, adds color and flavor

6 domains of professionalism of SOPP

provision of services, application of research, communication an application of knowledge, utilization and management of respires, quality in practice, competency and accountability

promotion tools

publicity, direct mail packages, paid ads, personal visits, public visibility, communication with those in your referral network, run a contest

future contracts purchasing

purchase goods at a specific price to be shipped later

first control in receiving process

purchase order

methods to determine the value of inventory

purchase price, weighted purchase price, FIFO, LIFO

just-in-time purchasing

purchase products as needed for production and immediate consumption by customer -without having to store and record it in the inventory

surimi

purified and frozen minced fish with a preservative, used in analogs, may have egg white or starch added to create desired structure

glycolysis

purpose is to produce pyruvate for the krebs cycle by breaking down glucose, with or without oxygen, into pyruvate or lactate

acute pancreatitis MNT

put pancreas at rest, withhold all feedings, maintain hydration -progress as tolerated to easily digested foods with low fat content -elemental (pre-digested) EN into jejunum may be tolerated

what does the protein to glucose reaction require that is stimulated by glucocortioids?

pyridoxine (B6)

what vitamin is needed for the transport of amino acids?

pyridoxine (B6)

catabolism involves which amino acid

pyridoxine (vit B6)

during prolonged exercise reliance on carbohydrate to provide _____ is needed for continued lipid oxidation

pyruvate

pyruvic forming lactic acid

pyruvic acid can proceed to form lactic acid (used for muscle contractions) when energy needs exceed supply of oxygen -only a small amount of lactic acid is produced -cori cycle

types of descriptive research

qualitative, case report, surveys

grades are based on

quality, firmness, color, maturity, freedom from defects, uniform size and shape -graded by USDA

phos deficiency

rare

pantothenic acid deficiency

rare -paresthesia in feet (tingling)

magnesium deficincy

rare-tremors

error of central tendency

rate everyone as average

leniency of error

rate everyone higher then they deserve

mortality

rate of death

Quasi governmental agencies

receive both federal and private funds and can provide nutrition assistance -american red cross -national research council- Food and Nutrition Board

accrual basis

recognizes revenues when earned and expenses when incurred (regardless of when the actual cash is received or dispersed)

RDA

recommended dietary alllowance

general ledger

records and reports transactions categorized by account numbers -summary of all expenses and revenues for the month by category (meat, fruit, dairy)

anthocyanins

red, blue, and purple

changes of color of myoglobin due to interaction with oxygen

red-->brown-->green

motion economy

reduce motions and time required

extinction modification

reduced undesired behavior -absence of reinforcement, following undesired behavior

myocardial infarction

reduction of coronary flow to myocardium due to blood clot blocking a narrowed coronary artery

effectiveness of management

refers to the degree to which we achieve our objectives (producing positive results)

efficiency of management

refers to the minimization of resources that we must expend to achieve the objectives (producing positive results at the lower cost)

job description

reflects required skills and responsibilities -matches applicants to jobs, orientation and training, employee appraisal/evaluation

osteoblasts

reform bone

distal tuble

regulates acid-base balance

FTC Federal Trade Commission

regulates content of food ads; enforces grunt-in labeling; challenges product claims when product crosses state lines

thyroxine

regulates metabolism and rate of oxidation -influences physical and mental growth -stimulates liver glycogenolysis, gluconeogenesis -raises blood sugar

loop of henle

regulates water and sodium balance

grape juice/red wine as functional food

resveratrol lower platelet aggregation

pressure cooking

retains color, flavor, cut small

hypoventilation

retention of acid (carbonic acid)

commissary production system

satellite, centralizes procurement and production; food production and service areas are in separate facilities - big disadvantage: has 9 critical control points

indirect benefitd

saving of physicians time and other resources due to the prevention or reduction in severity of disease

pilot study

scaled down version of the larger investigation; practice implementation, determine whether clinical trial, as planned, is feasible; are goals realistic and attainable?

choice menu

selective -better please clientele

hyperemesis gravidarum

sever nausea, vomiting, acidosis, weight loss MNT: bed rest, small amounts of frequent carbohydrates

time span types

short range or operational planning (1 year or less) long range planning (up to a 5 year cycle) strategic planning (decisions, not plans, continuous and systematic)

time series forecasting

short term forecasts moving average- uniformly weighs past observations OR exponential smoothing-uses software to forecast usage, gives more recent values more weight, does not uniformly weigh past observations

very poor class needs assessment

short term planners

frozen foods cooking method

shorter cooking time than fresh because they are bleached and freezing made them tender

dyspnea

shortness of breath

medium tender meats come from the

shoulder (chuck)

balance sheet

shows financial condition as of a particular date -lists assests: cash, inventory, accounts receivable -lists liabilities: amounts owed to you

line graph

shows frequency on vertical scale; method of classification on horizontal scale

bar charts

shows measurement only on vertical axis -bars arranged horizontally or vertically in ascending or descending order

profit and loss statement (income statement or revenue and expense statement)

shows operating results over a period of time -presents the income, expenses and profit over the course of the budget period

tube bore for ready prepared formulas

small #8 -more comfortable

what is essential for smooth ice cream?

small crystals

complete digestion and absorption of food takes place in the

small intestine (duodenum, jejunum, ileum)

diet for hiatial herna

small, bland feedings: avoid late nigh snacks, caffeine, chili powder, black pepper

diet therapy for gastroparesis

small, frequent meals, pureed foods, avoid fiber, avoid high fat (liquid fat may be better tolerated)

microcytic, hypochromic anemia

small, pale cells -due to iron deficiency -associated with chronic infections, malignancies, renal disease

cooking of fruits and vegetables

softens cellulose, increases keeping quality, and cooks starch

sources of fluoride

soil, water

properties of anthoxanthins/flavones

soluble in water, colorless in acid, yellow in alkalizes -ex. onions turn yellow when cooked in aluminum pan

results

specific lab, clinical, objective, or subjective findings

SMART objectives

specific, measurable, achievable, relevant, time frame

sources of vitamin K

spinach, kale, broccoli, green leafy vegetables

deamination

splitting off of NH2 by hydrolysis in liver

liquid consistencies

spoon thick, honey-like, nectar-like thin: all beverages: water, ice milk, juices, coffee, tea, gelatin

EOQ=

square root of (2 FS/CP) F=fixed costs of making an order S= sales or usage in units/yr C= carrying costs of inventory, holding cost P= purchase price per unit

equation for the standard deviation

square root of the sum of the squared deviations of each value from the mean, divided by the number of observations -curve of normal distribution as it falls away from its peak on either side

re-feeding syndrome

starved cells take up nutrients, potassium and phosphorus shift into intracellular compartments -leads to hypokalemia, hypophosphatemia, and hypomagnesemia

morbidity

state of disease

homeostasis

state of equilibrium of the internal environment of the body

methodology

statement of hypothesis, discussion of methods used

process charts

steps involved in processing using symbols

disciplinary action

steps taken to correct undesirable behavior -oral warning--> written warning--> suspension --> dismissal

what retains sodium

steriods

gluten refers to

storage proteins; prolamins -gliadin in wheat -secalin in rye -hordein in barley -avenin in oats

structure of fatty acids

straight hydrocarbon chains terminating a carboxyl group at one end and a methyl group (CH3) at the other -classified by the number of carbons in the chain, the position of the first double bond, and the number of double bonds

bread (hard wheat) characteristics

strong gluten, 11.8% protein

collagen

structural part of tendon that surrounds muscle

job analysis

studies all aspects of job, done by worker and their supervisor -conducted first to collect info for job description

which vein for PN minimizes risk of phlebitis

subclavian

substrate

substance upon which an enzyme works

hamwi equation for small frame

subtract 10%

disaccharide examples

sucrose, lactose, maltose

what beside acid can stabilize an egg white foam?

sugar

insulin secretagogues

sulfonylureas, meglitinides (glucotrol) -promote insulin secretion

descriptive statistics

summarizes and describes aspects of a set of data

until age two how should length be measured?

supine length

cholecystectomy

surgical removal of gallbladder -bile now secreted from liver directly into intestine

HRA Health Risk Appraisal

survey categorizing a populations general health status (used in worksites, government agencies as a health education or screening tool) -consists of questionnaire, calculations that predict risk of disease, educational message to the participant

SIADH

syndrome of inappropriate antidiuretic hormone -hyponatremia caused by hemodilution, treated with fluid restriction

anabolism

synthesis of more complex substances

hypertenstion is characterized by

systolic >140 or diastolic >90 or both

adjusted FTE

takes into account the benefit days and days off

functions of fluoride

teeth, bones

smoke point

temperature to which fat can be heated before puffs of smoke occur

dry heat cooking methods used for

tender cuts, near the backbone (loin, sirloin) -there is less collagen so need less time to soften

acid (vinegar) and salt increase during aging in meat

tenderness by increasing water holding capacity of the muscle

penetrometer measures

tenderness, firmness; baked custards

analytical research

tests hypotheses concerning the effects of specific factors of interest and allows causal associations to be determined -includes clinical trials, follow-up studies, case control studies

t test

tests significance between the means of two different populations -tests null against alternative hypothesis -null rejected if this probability value is equal to less than the level set for significance

external validity

tests whether or not a generalization can be made from a study to a larger population (applied to external environment)

chi square X test

tests whether or not there is a real difference between categories -used with attributes that have more that 2 categories -compares the frequency with which wed expect certain observations to occur with the frequency that actually occured

internal validity

tests whether the difference between two groups is real

linear correlation coefficient (r)

the degree of the linear relationship -the closer the points are to the line, the stronger the degree of linear relationship or r

acetly CoA

the intermediate breakdown product of carbohydrate, protein, and fat

custard sag

the larger the %sag, the more tender the gel (objective measure of quality)

diverticulosis

the presence of diverticula- small mucosal sacs that protrude through the intestinal wall due to structural weakness -related to constipation and life-long intra colonic pressures

what is required for the Kreb cycle

thiamin (TDP), niacin (NAD), riboflavin (FAD), pantothenic acid (CoA), magnesium, lipoic acid

as enery expenditure increase the need for what vitamins increase

thiamin, niacin, riboflavin, and pantothenic acid

main vitamins and minerals in meat, fish, poulty

thiamin, niacin, riboflavin, iron, copper, trace minerals

flours can be enriched with

thiamin, riboflavin, niacin, iron, folic acid

examples of phytochemicals

thiols, soy foods, terpenes, carotenoids, lycopene, limonoids, phenols, flavonoids, isoflavones, phytoestrogens, thiols, indols, lignans

decreas in androgenic causes

tissue wasting, weight loss

what may cause poor volume of cake

too little baking powder, improper level of sugar or fat

what may cause coarse texture of cake

too much baking powder or sugar, oven temp too low, inadequate mixing

what may cause tough, dry crumb of cake

too much flour or egg, to much mixing, too little fat or sugar, over-baking

what nutrients are listed on a nutrition facts label

total fat, sat fat, trans fat, cholesterol, sodium, total carb, fiber, soul/ins, sugar, protein

fluoride properties

trace mineral

manganese properties

trace mineral

methods to establish line items within budget

traditional (incremental), zero-based budget (ZBB), fixed budget, flexible budget, performance budget

transamination

transfer of amino group to a ketoacid to form a new amino acid

simple triglyceride structure

triglyceride (most food fat is triglyceride)

cross-sectional study

type of analytical research -one time data collection -prevelance study, all cases of a specific disease among a group of people in a specific time -a snap-shot look at one point in time, describes current, not past or future

quasi-experimental design

type of analytical research -time series: series of measurements at periodic intervals before the program behind and after the program ends

qualitative research

type of descriptive research -purpose to explore a phenomenon of interest as a prelude to theory development -data collected through interviews, observations, questionnaires

case report

type of descriptive research -report of observations on one subject or more than one subject -describes quantitatively the experiences of a group of cases with a disease or condition in common -helps identify variables important to the etiology, care, or outcomes of a particular condition

phenylalanine is converted to

tyrosine

Dietary refernece intakes DRI

umbrella of nuteint guidelines RDA,EAR,AI,UL

AST, SGOT aspartate amino transferase is decreased with

uncontrolled diabetes with acidosis

experimental model research

use experimental and control groups -target populations are randomly chosen to be in either group -experiemental group receives the program/treatment -conrol does not receive treatment or may receive placebo -compute differences between two groups

traits of a manager

use of authority, power, and influence

induction

use of electrical magnetic vibrations to excite the molecules of metal cooking surfaces

financial ratios

use of formulas to analyze an organizations financial position -formulas use data from financial statements ; compare organization with similar ones and compares ratios with those projected o with preceding ratios -liquidity ratios: assess ability to meet short term debt -asset management, turnover ratios -net worth ratios -daily food cost report -food cost per meal -meals per labor hour -profit margin -payback period -budget projections

social marketing

use of marketing principles to advance to a social cause, idea, or behavior

prime vending purchasing

use single vendor for majority of purchases

stir fry cooking method

use tender vegetables, high in moisture, don't drain

gantt progress chart

used to schedule and control work -concerned with time of production, not cost -brackets indicate opening and closing -carat V shows current time in the project

subjective model forcasting

used when relevant data is scarce or when relationships between data do not tend to persist over time- rely on opinions of others -delphi technique

affective food quality test

used with untrained panelists; determine preference or opinions -hedonic, paired preference, ranking

labor turnover rate

uses # of new employees at end of period

foam cake

uses air as leavening, dependent on egg foam for volume -angel cake -sponge cake -chiffon cake

traditional (incremental)

uses existing budget as a base and projects changes for the ensuing year in relation to the current budget -usually begins with this years expenses plus an inflation factor -control oriented

gastroplasty

uses staples to create a small gastric pouch, leaving only a small opening into the distal stomach

DFAP descriptive flavor analysis profile

uses trained panel for flavor profile

incaparina

vegetable engineered food -made of maize, sorghum, cottonseed flour

sources of vitamin E

vegetable oils, whole grains, green vegetables, almonds

eye assessment that is pale, dry, poor vision assessment

vitamin A, zinc, or riboflavin deficiencies

foods low in what vitamin darken rapidly when cut due to enzymatic action

vitamin C -acid prevents enzymatic oxudation

gums assessment that is sore, red, swollen, bleeding

vitamin C deficiny

MNT for osteomalacia

vitamin D and calcium supplements

which vitamin is typically fortified in infant milk

vitamin D and mineral=iron

vitamins synthesized by bacteria

vitamin K, B12, thiamin, ribofllavin

tongue assessment that is smooth, slick, purple, white coating

vitamin or iron deficiencies

hematocrit measures

volume of packed cells in whole blood

congressional index

weekly update; identifies bill with sponsor and committee

syneresis

weeping, liquid released from a coagulated product

coffee at higher temps

will be bitter, tannin extracted

healthy people with high protein intake

will excrete excess nitrogen and be at ) balance

vinegar and salt on a poached or coddled egg

will improve shape by hastening coagulation

theory Y

work is as natural as play or rest; management should arrange conditions so workers can achieve goals by directing own efforts, positive, participative

vitamin K is affected by

mineral oil, antibiotics, anticoagulants

job enlargement

more similar taste to alleviate bordeom

alpha ketoglutaric acid (created from amino acids through gluconeogenesis) needs what

needs thiamin for decarboxylation

renal specialized formula

nepro, novasource renal

deficiency of alpha linolenic acid

neurological changes; numbness, blurred vision

hemoglobin for infants

newborn: 16.25-19.5 6-23 mo: 10+

unstructered (non-directed) interviews

no definite checklist; more participation from applicant, may be able to get more information

low calorie label

no more than 40 calories

null hypothesis

no relationship in population of data, often has equal to expressed

limiting amino acid in gelatin

no tryptophan, and low in methionine and lysine

cerebral palsy

non-hereditary, brain damage, inadequate control over voluntary muscles leading to spasms

nominal variables

non-ordered, fit into a category with no specific order -gender, race, marital status

dietary fiber

nondigestible CHOs and lignin -binds water, increases fecal bulk

PPFPs Prepared and Perishable Food Programs

nonprofit programs that link sources of unused, cooked and fresh foods with social service agencies that serve the hungry

no choice menu

nonselective, either cycle or single use -permits accurate forecasting, greater control

size of eggs

not a part of grading, size classified by weight per dozen

respiratory acidosis

retention of carbon dioxide by lungs (decreased ventilation), to compensate kidneys increase absorption of base

peristalsis

rhythmic movements of small intestine, pushes chyme through GI tract

vitamin B2

riboflavin

lips assessment that is swollen, red, dry, cracked

riboflavin, pyridoxine (B6), niacin

which food is least likely to cause allergy

rice

meals per labor hour equation

# of meals produced/# of hours worked

to determine popularity index=

#servings of an item/ total number of servings of all items in that category that day

equation to determine proof

%alcohol *2

labor turnover rate equation

((number of employees terminated and replaced)/(total positions in department)) * 100

% weight change formula

((usual wt-actual wt)/usual wt)*100

equation to determine calories from alcohol

(.8)(proof)(ounces)

net protein utilization equation

(N intake- Noutput)/N intake

mEq equation

(mg/atomic wt)* valance

Department of Health and Human Services DHHS regulates

***PHS Public Health Service -concerned with infections and contagious diseases transmitted through shellfish, milk, vending machines, and restaurants -contaminated shellfish transmit hepatitis -pastureization of milk: Milk Ordinance Code ***Centers for Disease Control CDC -investigates and repots cases of food borne illness ***FDA Center for Food Safety and Applied Nutriiton CFSAN -Food, dug, cosmetic act

lactose intolderance is detected

*by breath hydrogen test *lactose tolerance test

value of r is always between

-1 and 1

nutritive value of meat, fish, poultry

-16-23% protein -carbohydrate-glycogen in liver, glucose in blood -vitamins and minerals

treatment for osteoporosis

-HRT hormone replacement therapy, weight bearing exercise -vitamin D (400-800mg) -calcium (>=1200 mg, dont exceed 500-600 mg at one time) -adequate protein -moderate to low sodium -5 servings fruits and vegetables

systemic lupus erythematosus (SLE)

-autoimmune disease

cobalt properties

-exist with B12 -store in the liver

acid

0-7

ratio for cooking rice

1 cup of rice, use 2 cups of water

TPN solutions protein ratio for anabolism

1 gram nitrogen/150 calories -1-1.5 g pro/kg/day

low saturated fat label

1 gram or less /serving

recommended weight gain during first three months

1 lb/month

recommended weight gain after three months

1 lb/wk

ladles

1 ounce= 1/8 cup

storage time for poultry, ground meat, fresh fish, shellfish in fridge

1-2 days

steps of control process

1. establish qualitative and quantitative standards 2. measure performance 3. compare to standard 4. take corrective action

2002 DRI for alpha linolenic acid for pregnant

1.4 g /day (300mgDHA)

stressed activity factor

1.5

safe minimum internal temperature for ground beef, ground veal, ground lamb

160F

transport hot food at what temp

165-170F

valance of Ca

2

infant formula need

2 1/2 oz/lb/day

desirable turnover rate

2-4 times per month is often desirable

2 cals/cc formulas are what % water

69-71%

net weight of #10 can

6lbs, 9 oz

typical american diet contains how many mg iron per 1000 calories

6mg

reading level for audience of lower literaracy should be at

6th grade

vitamin D

7 dehydroholesterol--> D3 cholecalciferol--> D2

what % increase in BMR for each degree rise in temperature?

7%

human milk composition

7% pro, 38% CHO, 55% fat -more lactalbumin

skim milk has how much fat?

<.5%

supplement fluorine at age 6 months if level in water supply is

<0.3ppm

optimal LDL-C level

<100

ELBW

<1000g

SGA

<10th% ile for gestational age

optimal BP with respect to cardiovascular risk

<120/80 mmHg

normal TG level

<150

grades of eggs

AA, A, B

pantothenic acid needs

AI 5 mg

needs for vitamin D

AI 5-15 ug

for analysis of variance use

ANOVA- tool to evaluate validity

states are federally graded by

Agricultural Marketing Service of the USDA

examples of elemental formulas

Alitraq, peptamen, vivonex

rapid acting insulin

Aspart (Novolog) and Lispro (humalog) -take 5-15 minutes before eating, usually duration of 4 hours

BE in graph

BE is where the total cost line crosses the revenue (sales) line

when dieter reaches plateau

BMR has dropped to reflect loss

linoleic acid chemical name

C18:2omega6 -indicates that there are 18 carbons, two double bonds, the first double bond on the 6th carbon

alpha linolenic acid chemical name

C18:3omega3 -indicates there are 18 carbons, three double bonds, the first at the third carbon

which hormone contracts gallbladder, releasing bile and stimulates pancreas?

CCK cholecystokinin

fat exchange

CHO: 0 Pro: 0 Fat: 5 kcal: 45

protein lean exchange

CHO: 0 Pro: 7 Fat: 2 kcal: 45

milk fat free/low fat exchange

CHO: 12 Pro: 8 Fat: 0-3 kcal: 100

herbs, botamicals, and supplements are regulated by

DHEA: Dietary Supplement Health and Education Act of 1994

protein anabolism, synthesis

DNA forms RNA on ribosomes and RNA forms template mold which carries the plan to the cytoplasm

functions of folate

DNA synthesis, forms RBC (with bit B12) in bone marrow, prevents neural tube defects

amount to purchase=

EP/%yield

BE in number of units sold=

FC fixed costs/(SP selling price-VCvariable cost)

BE in sales volume=

FC fixed costs/(VC variable costs/sales)

Which government organization controls additives

FDA

Food Drug and Cosmetic Act

FDA -covers all interstate food except meat, fish, poultry, and eggs -does inspect egg substitutes and imitation eggs -monitors shipping of shellfish -prohibits adulteration and misbranding -regulates additives

Health and Diet Survey

FDA, HHS -telephone survey of randomly selected adults -tracks self-perception of relative nutrient intake levels, use of food labels, knowledge of fats, and prevalence of supplement use

which organizations monitor and investigate claims

FTC Federal Trade Commission and NCAHF National Council Against Health Fraud

GDM dx

Glucose >=140 mg/dL indicated need for further testing

PKU is detected with what test

Guthrie blood test

main cause of ulcer

H. pylori bacteria

gases created by bacterial digestion

H2, CO2, N, CH4

what aids absorption of iron

HCL, calcium (binds oxalates)

HIPPA guidelines

Health Insurance Portability and Accountability Act -permanet legal document; entries written in black pen or typed -complete, concise, clear, objective, legible, accurate -sign and date all entries -late entries should be identified as such -make sure corrections are done right

B6 antagonist

INH-isoniazid (drug for TB)

IMPS

Institutional Meat Purchasing Specifications

joint commission and nutrition risk

JC says must identify hospital patients nutritional risk within 24 hours of admission, but does not mandate a method of screening

intracellular electrolytes

K+, Mg++, P

enzyme that helps phospholipids in the function in the transport and utilization of fatty acids and cholesterol

LCAT, lecithin-cholesterol acyltransferase

if linoleic acid replaces CHO

LDL decrease, HDL increase

physical activity of animal will

NOT increase tenderness

intermediate acting insulin

NPH Humulin, Novolin -onset 2-4 hours, duration 10-16 hours

extracellular electrolytes

Na+, Ca++, Cl-, HCO3-(bicarb)

NAMP

National Associated of Meat Purveyors

Healthy people 2020

National Health Program and Disease Prevention Objectives -developed by DHHS -goals and objectives for improving health -2020 goals address nutrition and weight, physical activity, heart disease and stroke, diabetes, oral health, cancer, food safety, and health for seniors

Where can you get information on the composition of food

National Nutrient Data Bank, USDA

US Department of Commerce regulates

National marine Fisheries Service NMFS -inspects and certifies fishing vessels, seafood processing plants, retail facilities for federal sanitation standards -Grade A: met sanitation and quality standards

MI foundation skills

OARS -open-ended questions -affirmations: instill home, statements of appreciations of strength -reflective listening -summaries

pregnancy induced hypertention

PIH -eclampsia -hypertension, edema of face and hands, proteinuria, rapid weight gain after 20th week; may have convulsion -sodium destruction is NOT recommended for prevention or treatment

plant based exchange

Pro: 7 CHO, fat, kcal varies

lab values for macrocytic anemia

RBC: decreased hemoglobin: low hematocrit: low MCV: high, >95 MCH: high MCHC: normal, >31

lab values for microcytic hypochromic anemia

RBC: may be normal -hemoglobin: low -hematocrit: low MCV (mean corpuscular volume): low, <80 MCH (mean corpuscular hemoglobin): low MCHC (mean corpuscular hemoglobin concentration): low, <31

RMR vs BMR

RMR is more frequently used than BMI; usually greater than BMR by 10-20%

order of predominance of fat in butter

SAT, MUFA, PUFA

bacterial digestion converts malabsorbed CHO and fibers into

SCFA: short chain fatty acids

medium chain triglycerides (MCT)

SFAs between 6 and 12 carbons -naturally found in milk fat, coconut oil, and palm kernel oil

procedure for determining readibilty

SMOG index -finds average of polysyllabic words

examples of entitlement programs

SNAP, Medicare, NSLP, SFSP, SBP

types of screening tools

Subjective global assessment, mini nutritional assessment, nutrition screening initiative, geriatric nutritional risk index

hyperlipidemia

TG>=150 mg/dL

essential amino acids

TV TILL PMH threonine, valine, tryptophan, isoleucine, leucine, lysine, phenylalanine, methionine, histidine

respiratory quotients RQ equation

Vco2 carbon dioxide expired/Vo2 oxygen consumed

when sweetener is added to liquid of packing juice, the density of the syrup is expressed as

a % by weight of sucrose

lycopenes

a carotenoid found in tomatoes and watermelon and overtones in apricots, provides a red color -acts as antioxidant and phytochemical

power

ability to exert influence

relevance/validity

ability to measure phenomenon it intends to measure

what aids absorption of thiamin

acid

affective learning domain

acquisition of attitudes and values

physical inventory

actual count of all goods on hand

transformational leader

agents of change -inspire followers to become motivated to work towards organization goals rather than personal gain -employee acceptance of group mission -increased morale, team spirit

advocacy

agressive form of action; plead cause of a group

colonic salvage

anaerobic fermentation and absorption of end-products of carbohydrate, fiber, and amino acid breakdown

vacuum packing meat

anaerobic, oxygen-impermeable film, sous vide, extends storage life of meat

main question ANOVA answers

are there one or more significant differences anywhere among the samples?

types of measuring of central tendency

arithmetic mean, median, mode

diet for ulcer

as tolerated, well balanced, avoid late night snacks, avoid irritating stomach -omit: cayenne, black pepper, large amounts of chilli powder, excess caffeine and alcohol

vitamin C

ascorbic acid

consultative leadership style

asks for input, but makes final decision alone

ANOVA

asks whether the difference between samples is a reliable one that would be repeated, used when several products compete against one another, compares variance between groups with the variance within groups

frozen fruit should be stored at

at or near 0F

spot weight loss theory

belief that localized exercise reduces fat stores in the active area -research does not support this notion

heparin

blood clots

open shop

can join union or not

seat turnover=

customers per meal/number of seats

autocratic leadership style

demands obedience, most control

sources to assessment information to assess population/community

demographic, socioeconomic, morbidity, mortality rates, identify services available, cultural factors, geography, environment, school nutrition programs, education attainment, social welfare programs, transportation, anthropometric, biochemical, clinical, dietary intake data

fluoride deficiency

dental caries

dependent variables v independent variables

dependent are outcomes; indented are what you manipulate in the study

how to pasteurize milk

destroys bacteria -145F for 30 minutes or 160F for 15 seconds

performance budget

details what it costs to perform an activity ex. how much to supervise the cafeteria

fixed order quantity inventory system

determines the order poiint

process oriented evaluations

did the process produce desired results?

DASH diet

dietary approaches to stop hypertenstion -whole grains, fruits, vegetables, low fat dairy, poultry, fish, moderate sodium, eliminate alcohol decrease sweets, calcium to meet DRI

WWEIA What We Eat in America

dietary intake component of NHANES -two days of 24 hour dietary recall data

nonparametric test

does not depend on a normal distribution

food broker

does not own products; connects buyers and sellers -makes the deal

promotions pricing

done for a short time -sale or special price is done to increase sales during a slow period

starch uses in food preparation

dry heat, moist heat, in white sauces

ascorbic acid as an additive

enhances appearance by preventing browning

goiter

enlargement of thyroid gland due to insufficient thyroid hormone production

menu determines

equipment, food, space, and personnel needed

amputee equation

estimated IBW= (100-%amputation)/100*IBW for original height

EAR

estimated average requirements for 50% of populatiion

nutrition survey

examination of a population group at a particular point of time -considered cross-sectional exam; pin-points problems -determines prevalence of condition or characteristics at a specific time

CDC Steps

example of a major federal level grant, steps to a healthier US focused on community based health initiatives

chronic bronchitis

excess mucus production, chronic productive cough

types of analytical research

experimental model, quasi-experimental design, cohort studies, case control studies, cross sectional studies

pregnant adolescent needs

extra iron, calcium, and zinc

RQ of 0.7

fat alone

sources of choline

fat in eggs, milk, liver, soybeans

during low to moderate intensity aerobic activity

fat is a significant energy source -its long duration, steady pass, endurance training

ketosis

fat metabolism

Medicaid

federal law administered by states -payment for medical care for all eligible needy: all ages, blind, disabled, dependent children

business marketing

filling a customers needs or desires

FIFO

first in first out -stock rotation -rearrange merchandise so that older containers are in front and issued first

self rising flour contains

flour, baking powder, flour, salt

pastry ingredeints

flour, fat, liquid, salt

role of rhythmic contractions of esophagus

force food into stomach where it is mixed with gastric juice and reduced to chyme (acidic)

boiling

form of radiated heat

audit

formal study that retrospectively monitors performance

sources of folate

fortified dry creel, liver, kidney, green leafy vegetables, citrus fruits, lentils, beans

modified functional foods

fortified, enriched, enhanced

sulfur

found in onion, brussel sprouts, and cabbage -when cut, enzymes and sulfur are mixed

if need EN for more than 3-4 weeks

gastrostomy or jejunostomy feedings -PEG inserts tube into stomach through abdominal wall -use x-ray confirmation of tube tip location (NOT blue dye)

block grants

given from federal government to state or local communities for broad purposes as authorized by legislation -great flexibility

long-acting insulin

glargine (lantus), determir (levemir) -onset 2-4 hours, duration 20-24 hours

baby friendly hospital initiative

global effort to increase incidence and duration of breast-feeding -must implement ten steps to successful brews-feeding -requires multidisciplinary team

diabetes specialized formulas

glucerna, diabetisource

sucrose composition

glucose and fructose

maltose composition

glucose and glucose

needs assessment for middle and upper income adults

goal-oriented; consider activities they can't relate to as a waste of time

iodine deficiency

goiter

sources of thiamin

grains, wheat germ, pork, liver

acanthosis nigricans

gray-brown skin pigmentations in skin folds

obstacles to effective appraisals

halo effect, leniency of error, error of central tendency

CAD will have

hard, narrow arteries from plaque buildup in heart

quick cooking cereals additive

have disodium phosphate added -makes cereal alkaline so particles swell faster and cook more quickly -want to avoid on low sodium diets -proteins are split so lessen cooking time

tomatoes as a functional food

have lycopene which may reduce prostate risk

Medicare

health insurance program for people over 65; of any age with ESRD; employers and employees pay -part A: hospital insurance -part B: optional insurance for supplementary benefits

why heat changes meat color

heat denatures globin; iron is oxidized

conduction

heat moves from one particle to another by contact

work schedule

hour by hour, used in training, tasks and times

trans fatty acid

hydrogen are across from each other; pack as tightly as SFA in membranes

breath hydrogen test

hydrogen produced by colonic bacteria on lactose, absorbed into bloodstream and exhaled in 60-90 minutes

cis fatty acids

hydrogens on same side as the double bond; most natural fats and oils

undigested food and water pass through the ______ into the large intestine or colon

ileocecal valve

jejunal resection

ileum can adapt and take over jejunal functions

thiazolidinediones (actos)

improve peripheral insulin sensitivity

radiation

in fared waves coming from glowing heat -gas flame, charcoal, electrical element, toasting, broiling -microwake

glutamic acid is used

in form of salt (MSG)

myo-inositol properties

in plants as physic acid related to sugar contains phosphorus vitamin-like factor

where does most chemical/enzymative activity in digestion take place?

in small intestine

where is bile stored?

in the gallbladder

where does most digestion in the stomach occur?

in the pyloric (lower) region

grading of an egg does not

include the color of the shell or the size of the eggs

to produce smoother ice cream...

increase fat

performance specifcations

indicate quality by functioning characteristics of the product (pH level of detergents)

technical specifications

indicate quality by objective and impartial test results -graded food items

approved brand specifications

indicate quality by specifying a brand name or label

BUN:creatine ratio of >20:1

indicates "pre-renal state" in which BUN reabsorption is increased due to acute kidney damage (may be reversible and may not require dialysis)

FEP free erythrocyte protoporphyrin

indirect measure of toxic effects of lead on heme synthesis -increased in lead poisoning -lead depleted iron leading to anemia and displaces calcium in bone leading to a zinc deficiency

infant mortality rate

infant deaths under 1 year of age, expressed as the number of deaths per 1000 live births

difference between infant formula and breast milk

infant has more protein, more iron than human milk but lacks antibodies

managerial roles

informational, decision-making/problem solving, and conflict resolution

farina

inner portion of wheat kernel

germ

innermost -contains the 2% fat -will find B vitamins, vitamin E, minerals, and phytochemicals -contains scutellum

discussed

interpretation of results, comparison with other studies

inspection of meat

is mandatory, done by the USDA at slaughter

nutritional informatics

is the intersection between nutrition, information, and technology- technology use to spread nutrition information

gelatinization

is the swelling that occurs when starch is heated in water close to the boiling point

soy food phytochemicals

isoflavones which have been found to lower elevated cholesterol

loss leaders

items priced lower to draw people in in the hope that they will purchase other items at normal markups

halo effect

judge on most noticeable positive trait

why do you see a decreased activation of vitamin D with renal disease?

kidney produces active form of vitamin D which promotes efficiency absorption of calcium by the gut

Nutrition Labeling and Educaiton Act

label must identify form, weight, name, and address of manufacturer, ingredients in decreased order, size of serving

FTE/week equation

labor hours worked per week/ 40 hour normal work load

tube bore for blenderized whole foos

large #16

low turnover ratio indicate

large amounts of money are tied up in stock

round bone cut of meat is from

leg

low glycemic index foods

legumes, milk, nuts, pasta, ice cream, yogurt

dietary fiber is found in

legumes, wheat bran, fruits, vegetables, whole grains

labor costs

less controllable than food costs

fish v. meat

less fat and moisture than meat, fewer calories

all-purpose (blend of hard and soft) characteristics

less gluten, 10.5% protein

moist heat is used for

less tender cuts with more connective tissue (bottom round, chuck, brisket)

intimate zone distance

less than 18", for very close friends, business handshakes

calorie % from fat

less than 30%

very low sodium label

less than 35 mg/serving

a slow cooked roast yields

less waste

assets=

liabilities+ capital (equity)

essential fatty acids

linoleic and linolenic

what stables an egg emulsion?

lipoproteins stabilize by interacting at the surface of the oil droplets to form a layer

to prevent fat accumulation in liver

lipotropic factors (choline) produce lipoproteins which transfer fatty acids out of liver

pork chops comes from

loin

longitudinal

long period of time

stature vs length chart reflects

long term nutritional status, determines extent of stunting

hyperventilation

loss of acid (carbonic acid) H2Co3

osteoporosis

loss of bone tissue -reduction in amount of bone due to defective calcium absorption (deossification) -type 1: postmenopausal (within 15-20 years) -type 2: age associated >70 -white and asian omen more common that balck or hispanic

excess mixing of quick breads causes

loss of carbon dioxide, overdeveloped gluten, tunnels from top to bottom, tough, heavy product

which areas of an SBS are of major concern?

loss of ileum (especially distal 1/3), loss of ileocecal valve, loss of colon

properties of riboflavin

lost in UV light

homogenization of ice cream

makes it easier to beat in air during freezing, makes ice cream smooth

Fair employment Practice Law

makes it illegal to ask about a candidates race, religion, sex, national origin, age, marital status

WHR indicative of android obesity and an increased risk for obesity-related diseases

male: >1.0 women: >0.8

RDA protein 14-18 yr old

males: 52g females: 46 g

trans fatty acids found in

margarine, shortenings, frying fats as product of partial hydrogenation of PUFA

selling price=

mark-up factor X raw food cost

types work schedules

master, shift, production

five federal block grant areas

maternal and child health, community services, social services, preventative health services, primary care

direct calorimetry

measures heat produced in respiration chamber, limited usefullness

indirect calorimetry

measures oxygen consumed and carbon dioxide excreted using a machine

renal solute load

measures solutes in 1 L urine; daily fixed load of 600mOsm -mainly measures nitrogen (60%) and electrolytes (sodium)

line-spread test

measures viscosity of liquids or semi-solid foods that flow on a flat surface

vicosimeter

measures viscosity of liquids that flow on an incline plane or on a rotational basis

sources of sulfur

meat, fish, eggs, poultry, animal proteins

AI for total fiber for adults over 50 yrs

men: 30 female: 21

AI for total fiber for adults under 50 yrs

men: 38 female: 25

median

midpoint -value at midpoint

cabbage preparation suggestion

minimize the development of a strong flavor, cook for a short time, keep lid off initially to let acids escape, cook in large amounts of water

braising

moist heat method flour meat, brown, cover and simmer in liquid

selenium deficiencies

myalgia, cardiac myopathy

pigment thats the main contributor to meat color

myoglobin

dehydration can cause

nausea, dizziness, sunken eyes, fever, hyperventilation, excessive sweating, concentrated urine, dry inelastic skin, increase in solutes (BUN), tachycardia, headache, fatigue, decreased appetite, weigh t loss

half and half % fat

no less than 10.5%

may develop ___ with arthritis

normocytic anemia -not diet related (so not treated with iron), inflammation of arthritis prevents reuse of iron

egg yolk is a naturally

oil in water emulsion

chlorophyll when heated in acid becomes

olive green, pheophytin

tube bore

opening of tube -based on viscosity of feeding

types of budgets

operating, cash, capitol

lactose tolerance test

oral dose of lactose (up to 50 grams) after a fast -if intolerant of lactose, blood glucose will rise <25mg/dL above fasting (flat curve) -if tolerant of lactose, the rise would be above 25mg/dL (normal curve)

rank order variables

ordinal scale, observations compared with each other and put in order -best to worst, 1 to 4

enzymes in cellular oxidation

organic catalysts that control reaction -proteins

fat is deposited around

organs and muscles

sources of myo-inositol

outer husks of cereal grains, leafy green vegetables

bran

outer layer (hull)

hyponatremia is associated with

over-hydration

>95th on a weight for length/stature chart may indication

over-nutrition

what are the four modifiable factors in primary prevention and treatment of CAD, CVD, IHD?

overweight, high salt intake, alcohol consumption, physical inactivity

seventh day adventist diet

ovo-laco vegetarian, no caffeine, no alcohol

analytical food quality tests

paired compassion, triangle, ranking or scaling

iron deficiency

pale tongue, fatigue, anemia, spoon-shaped nails, pale conjunctivae

6-8 month infant grasp

palmar grasp

active or reflective listening

paraphrase or repeat back what was just said -focus on thoughts and feelings of other rathe than on their own personal reactions

diffusion

particles move from more to less concentrated side

candling

pass an egg in front of a bright light to view contents -judge thickness of white, location, and condition of yolk

sensitivity

proportion of afflicted individuals who test postve

specificity

proportion of non-afflicted identified as non-afflicted

prime cost=

raw food cost+ direct labor cost 1. determine price factor (markup) - add desired food cost percentage to percentage of direct labor cost -dived total into 100 2. selling price= prime cost X price factor ( or markup factor)

chinese yin foods

raw, cold fish, vegetables, and fruits

the more sugar, the more time needed to

reach the elevated coagulation temperature of gluten -as sugar increases, the volume of the cake increases up to the point where gluten is so weak that the strands snap and the cake falls in the center

cash basis

recognizes a transaction at the time the cash is taken in or released

adolescent needs assessment

relate to their interests; consider peer pressure and attitudes toward authority

cobalt deficiency

related to B12 deficeiny

diastolic measures

relaxation, least pressure

double blind study

removes bias from research; neither researcher nor the subject knows which group is receiving the treatment

dried fruit should be stored at

room temperature

diabetic curve after glucose tolerance test will be

rounded

perpetual inventory

running record of balance on hand -updated each time an item is placed in or removed

best source of linoleic acid

safflower

most polyunsaturated

safflower

order of predominance of substances containing polyunsaturated fat

safflower, corn, soybean, cottonseed, sunflower

winterized oil

salad dressing; won't crystallize when cold -oil chilled to 45 degrees; fatty acids with high melting points crystallize and are filtered out -winterized oil is clear, not cloudy

commercial operations

sale of food is primary activity, profit is desired

iron needs during childhood

same for both boys and girls up to age 10, at age 11 girls need more

fatty acids

saturated, unsaturated, hydrogenation

SAP

screen, assessment, plan

deficiencies of vitamin C

scurvy, poor wound healing, bleeding gums, petechiae (tiny purple spots on skin caused by bleeding)

ALP alkaline phosphatase is decreased with

scury and malnutrition

sources of iodine

seafoods, iodized salt

which hormone stimulates flow of pancreatic juice?

secretin

hormones

secretions from endocrine glands

proximal convoluted tuble

section for major nutrient reabsorption

Elavil (antidepressant) nutrition interaction

sedative effect, weight gain, increased appetite

vitamin B6 deficiencies

seizures, anemia, dermatitis, glossitits, peripheral neuropathy

examples of retrogradation

separation when a gravy thaws, old pudding, stale bread

sentinel event indicator

serious event that requires further investigation each time it occurs ex. 0% food poisoning, 100% of oncology patients are fed within 5 days

types of cakes

shortened, foam

decrease in aldosterone causes

sodium loss, potasium retention, dehydration

anti-caking additives

sodium stearate

sources of selenium

soil, grains, meat, fish, poultry, dairy

an example of a thick white sauce

souffle

type of acids used to product carbon dioxide

sour milk, cream of tartar, molasses

probiotics

sources of bacteria used to reestablish bacterial gut flora

okay on a galactosemia diet

soy, hydrolyzed casein, lactate, lactic acid, lactalbumin, pure MSG

which grade has the least marbling

standard

nutrition care process

standardized, consistent structure and framework used to provide nutrition care

why do old potatoes taste sweeter

starch changes to sugar during storage, old potatoes taste sweeter, cook to a darker brown (Maillard reaction) and are softer in texture

types of polysaccharides

starch, cellulose, pectin, glycogen, dextrin

GLP-1 and GIP

stimulate insulin synthesis and release

prolactin

stimulates milk production

mini-max stock

stock is allowed to deplete to safety level before new order is placed

carbohydrate loading

stores 2-3 times normal amount of muscle glycogen

types of managerial skills needed

technical, human, conceptual

inferential statistics

techniques that allow conclusions to extend beyond an immediate data set; what is the probability that the result can be applied to a larger group; what can you infer from the results of your study

food synergy definition

the additive influence of foods and constituents which, when eaten, have beneficial effect on health

the closer the r is to 1 or -1

the closer the points are to the line/ the stronger the degree of linear relationship

shape of the bone of meat identifies

the cut

check off

the deduction of union dues from pay of union members

standard deviation is also equal to

the distance between the mean and the point of inflection on either side

productivity

the efficiency with which a production or service activity converts inputs into outputs; excessed as ratios

an experimental model research is successful if

the experimental group has improved more than the control group

which double bond is designated the omega sign on a fatty acid

the first double bond, from the methyl end of the fatty acid

synergy

the groups product/decision is superior to what the most resourceful individual within the group could have produced working alone

meat cuts determine

the method of cooking

TCA takes place in

the mitochondria

the closer r is to 0

the more dispersed the points will be from the line

biochemical analysis is

the most accurate measure of nutrition status

least tender meats come from

the most used muscles (flank, brisket)

crispness or state of turgor in fruits and vegetables is due to

the osmotic pressure of water filled vacuoles

extracellular water is found in

the plasma, lymph, interstitial or intercellular

rancidity

the uptake of oxygen in an unsaturated fatty acid

r=0

there is no linear relationship

how should tough cuts be cooked

they should be cooked well done because they have more collagen which needs more time to soften

pork is a good source of

thiamin

vitamin B1

thiamin

metabolic syndrom

three of more of the following which are linked to insulin resistance which often increase risk of coronary events -hypertension -hyperlipidemia -hyperglycemia -waist measurement >=102cm (40")men and >=88cm (35") women -low HDL<40mg/dL in men and <50 mg/dL in women

long term central access via PN

through the cephalic, subclavian, or internal jugular vein into the superior vena cava

which hormone regulates metabolism and rate of oxidation?

thyroxine

an increase in enzyme level in the blood indicates

tissue damage

if linoleic acid replaces saturated fat

total cholesterol decrease, HDL decrease

assembly serve production system

total convenience -purchase completely prepared individual portions; finish by thawing, heating on premise -no on-site food production, kitchen less kitchen

do not fry what cut of meats

tough cuts, like bottom round

chylomicron

transports dietary triglycerides from gut to adipose cells; synthesized in intestine from dietary fat; lowest density due to smallest amount of protein

functions of choline

transports lipids as acetylcholine

types of cheese

uncured, cured, processed

numerical continuous variables

underlying continuous scales

technical skills

understanding of and proficiency in a specific kind of activity; most important at lower levels of management

manganese deficiencies

unlikely

color of shell

unrelated to food value or quality

informal evaluation strategies

unstructured observation of food selection and behaviors

boiling acidic vegetables that need more time to cook

use more water, no lid

lean management approach

using less human effort, less space, less capital, and less time to make products exactly as the customers wants with few defects -ex. recognize workflows

work schedules

usually include an 8 hour work day, 30 minutes lunch break, and one or two 15 minute work breaks

examples of branched chain amino acids

valine, leuicine, isoleucine

CSM

vegetable engineered food -made of corn, soy, non-fat dry milk, vitamins, minerals

molds optimal growth

warm (77-86F), damp, dark conditions, grow best on acid, neutral sweet foods -boil to destroy

PRO Peer Review Organization

watchdog of DRG system; formal assessment by physicians of quality and efficiency of services provided

when to D/C PN when using as transitional feeding

when about 75% of needs are being meet via EN

r=1

when all points lie exactly on a straight line with a positive slope

r=-1

when all the points lie on a straight line with a negative slope

anthoxanthins/flavones

whites

non-crystalline sugar candies

without clearly defined shape, formless -crystallization prevented by adding inhibitors of increasing sugar concentration -corn syrup retards crystallization thus increasing viscosity and chewness

chromium sources

yeast, oysters, potatoes, liver

colostrum

yellowish transparent fluid secreted from the breast during first few dats -has more protein, less fat, less CHO than mature milk -has antibodies

chalazae

yolk anchors, hold yolk in the center

which part of the egg is ore concentrated?

yolk, more protein, fat, minerals, and vitamins by weight

mechanisms of absorption

-active transport -simple diffusion -passive diffusion

hypothalamus gland

-acts as a satiety and feeding center -has glucoreceptors that are though to regulate desire to eat -regulate body temperature

school lunch must provide what under NSLP

1/3 of the recommended intake for protein, vitamins A, C, iron, and calcium

dietary sources of carbohydrate of macronutrients

100% CHO 58% protein 10% fat (glycerol can be converted to glucose)

impaired fasting BG level

100-125

mark up factor=

100/food cost percentage

needs of calcium

1000-1200 mg

UL of vitamin E

1000mgs

for a renal patient you want to keep BUN under

100mg/dL

minimum recommended levels of hemoglobin during pregnancy

11 g/dl

% composition of protein of egg white

11%

weight gain for obese

11-20ob

weight fain for overweight female

15-25lb

CKD stage 4 GFR

15-29

needs of iodine

150ug

food should be reheated at what temp for how long

165F for 15 seconds within 2 hours

acute care conventional staffing pattern

17 minutes per meal or 3.5 meals/labor hour

CKD stage 3 GFR

30-59

normal MCHC

32-36%

meat, dairy, eggs in fridge should be at what temperature

32-40F

female needs for magnesium

320mg

roasting temperature

325F

minimum recommendation of hematocrit during pregnancy

33%

RDA of protein for 9-13 yr old

34 g

calorie increase during 2nd tirmester

340

suggested fluid for adults

35 ml/KG or 1 mL/kcal

HCV

blood to blood contact

good quality indicated by

by high proportion of thick white

brussel sprouts

cook uncovered with little water for best flavor (due to sulfur)

chemical properties of carbohydrates

carbon, hydrogen, oxygen

total energy expenditure includes

-basal energy expenditure -energy expended in physical activity (EEPA) -thermic effect of food

acute hypoglycemia treatment

-begin with 15g CHO glucose tables, fruit juice, sugar -wait 15 minutes; if still <70mg/dL, give another 15 grams -repeat and treat until BG is normal

LDL

-beta -transport cholesterol from diet and liver to all cells

functions of myo-inositol

-binds calcium, zinc, iron -membrane structure

what causes ascites?

-blood cannot leave the liver -that is due to connective tissue overgrowth which blocks blood flow lout of liver into vena cava. -the liver expands and when storage capacity is exceeded, pressure caused by increased blood volume forces fluid to sweat through the liver into the peritoneal cavity -this fluid is almost pure plasma with a high osmolar load, pulling more fluid in to dilute the load, leading to sodium and water retention -low serum albumin may be due to dilution factor

fat metabolism as a micelle

-bound to protein to form lipoproteins (chylomicron)- penetrate intestinal mucosa, travel through lymph, into the thoracic duct into the blood -includes some phospholipids

par stock inventory management method

-bring stock up to par level each time an order is placed regardless of the amount on hand

strategic planning concentrates on

-broad technological and competitive aspects -SWOT analysis: strength, weaknesses, opportunities, and threats to business

budget purpose

-gives manager basis for control: estimate of future needs -must be flexible and adjustable according to changes -usually reviewed monthly

components of a nephron

-glomerulus, proximal convoluted tubule, loops of hence, distal tubule

functional properties of flour in baked mixtures

-gluten: gives elastin properties, forms framework, holds in leavening agent, made from gliadin and gluten in through process of hydration and mixing -color from carotenoids; oxidation during storage and turn flour from creamy yellow to white (if oxidizing agent is added it is labeled "bleached") -strength of flour: refers to the capacity to retain leavening (depends on gluten quality)

what fat is directly absorbed into portal blood

-glycerol (water-soluble) -short chained fatty acids (<12 carbons) -some phospholipids

those infants who can't tolerate cow or soy products should use what formulas

casein hydrolysate (pregestimil)

hepatic glycogenolysis following trauma results from

catecholamines epinephrine and norepinephrine -release suppresses insulin

behavior modification is based on

cause and effect explanation of behavior

tannins

cause astringent feeling in mouth (underripe banana)

food borne infections

caused by large number of bacteria that is carried by food into the GI tract -salmonella, steptococcis, listeria, campylobacter, vibrio, shigella, e coli, norovirus

aldosterone following burn trauma

causes renal sodium retention and gluconeogenesis

production systems

conventional, commisary, read-prepared, assembly-serve

phenylalanine hydroxylase

converts phenylalanine into tyrosine

insulin

-hormone produced in beta cells of pancreas -increases cell permeability to glucose; fosters glycogenesis and lypogenesis -lowers BG

humectant additives

-humectants retain moister and increase firmness -glycerol monostearate

phenylketonuria PKU

-inborn error of metabolism -missing enzyme phenylalanine hydroxylase so phenylalanine and metabolites accumulate leading to poor intellectual function

urea cycle defects

-inborn error of metabolism -unable to synthesize urea from ammonia resulting in ammonia accumulation -will cause vomiting, lethargy, seizures, coma, anorexia, irratibilty

maple syrup urine disease MSUD

-inborn error of metabolism of the BCAAs leucine, isoleucine, valine

functions of zinc

-increase taste acuity -enhances insulin action -cell division

what is the intermediate breakdown product of CHO, protein, and fat?

acetly CoA

amino acid composition

amino group (NH2)=base and carboxyl group (COOH)=acid

what hormone increase excretion of potassium?

aldosterone

what may cause yellowing of cakes

alkaline batter, excess soda

saturated fatty acid

all available bonds of carbon chain are filled with hydrogen; solid and hard at room temperature -saturated with hydrogen

uncured cheese

cottage cheese, cream cheese

when is CCK cholecystokinin released?

from duodenum when fat enters

progesterone

hormone that develops placenta after implantation

diffusion of innovation

how behavior spreads -people are categorized -use components of knowledge, persuasion, decision, confirmation to tailor intervention to where they are in the process

overrun

increase in volume from freezing and whipping -determined by weight, should be 70-80%

goal of motivational interviewing

increase motivation so that clients are able to express the rationale for the changes that need to be made

RQ of 0.85

mixed intake

cured meats are pink due to

nitrites -which are added to inhibit botulism

unsaturated fatty acid

one or more double bonds

collective bargaining

one person represents a group of people to bargain with the employer

one dozen oranges yields

one quart juice

when should birth weight be tripled?

one year

quality improvement

ongoing process, controlling function of management -GOAL: to improve health care

dichotomous scores

only two events are possible -ex. heads or tails

non-commercial operations

onsite food service, food is secondary activity -ex. school, hospital, military

medications for gastroparesis

prokinetics (erythromycin, metoclopramide) to increase stomach contractility and shorten gastric emptying time

end product of aerobic glycolysis

pyruvate

what is the main substrate for energy production within the Kreb cycle

pyruvate

grading indicates

quality

ACTH adrenocorticotropic hormone following burn trauma

releases cortisol which mobilizes amino acids from muscle

normal fat metabolism

requires adequate carbohydrate for complete fat oxidation FA-->acetyl CoA-->taken to Krebs --> ATP, CO2, H2O all --> needs CHO *produces ketone bodies

entitlement programs

requires payment of benefits to all eligible people as established by law; for a specific population who meet certain income or other eligibility requirements; usually for a finite time-1 yr

elastin

resistant to heat, little change in cooking, found in ligaments, cartilage; yellow color

why does syneresis occur?

occurs when cooked at too high a temperature, or too low a temperature for too long a time -will create a tough, watery product

management concepts

philosophies about how an organization views customers, and the delivery of products or servides

compound fat example

phospholipid

EN ideal for

short term access: 3-4 weeks -normal GI function

the most tender meat cuts come from

the least used muscles ex: loin, backbone

glucose-6-phosphate can lead to

the synthesis of glycogen -liver glycogen releases glucose to blood to maintain normal blood glucose levels: this process requires glucose-6-phosphatase

theory Z

the value of the company is the people -everyone who will be affected by a decision is involved in making the decision (consensus decision making)

Acute viral hepatitis HBV

sexually transmitted

arithmetic mean

simple average -total and dived by number of observations

monosaccharide examples

simple sugars -glucose, fructose, galactose

sweet acidophilus milk

skim milk plus acidophilus bacteria reduces lactose

insensible losses

skin, breathing .8-.12 liters/day

function of vitamin A

skin, vision

if unable to tolerate gastric feeds

try nasoduodenal or nasojejunal

glomerulus

tuft of capillaries held closely by Bowmans capsule -produce ultra filtrate which then passes through rubles -capsule blocks passage of red blood cells and large molecules like protein

polyunsaturated

two or more double bonds

parallel forms reliability

two separate but similar forms of the same test at the same time, reliability determined by the degree to which the sets of scores coincide

gastric emptying of a meal usually takes between

two to six hours

cohort studies

type of analytical research -cohort of healthy people followed through time to see if they develop a specific deisease -also called incidence studies -longitudical and prospective study -retrospective cohort studies use existing data and look back for relationships between exposure factors and outcomes

case control study

type of analytical research -focus on specific disease -those with disease compared to those without

sources of vitamin D

sunlight, egg yolk, fortified milk, ergocalciferol

pastry (soft wheat)

weaker gluten, 7.9% protein

parenteral nutrition PN

-infusion of a hypertonic solution delivered through a central venous catheter -used to when patients unable to eat by mouth and EN not possible

categories of diffusion of innovation

-innovator: adopt readily -early adopters: opinion leaders -early majority: cautious in adopting -late majority: skeptical, adopt through peer pressure -laggards: last to adopt

carotenoid properties

-insoluble in water -little effect in acid or alkaline solution

growth hormone, ACTH (adrenocorticotropic)

-insulin antagonist

CQI Continuous Quality Improvement

-integral part of TQM -empasis on organization and systems rather than individuals -theory that something can always be better

hemoglobin Hgb

-iron containing pigment of red blood cells -erythrocytes are produced in bone marrow

early rapid weight loss during diet is due to

water -as liver glycogen is utilized as an energy source, water in which it is stores is released

loss of colon

water and electrolyte loss, loss of salvage absorption of CHO and other nutrients

SCFA stimulate

water and sodium absorption in the colon and provide substrates for energy production

when baking at high altitudes

water boils at lower temp, need to decrease the amount of baking powder and increase amount of liquid

yeasts optimal growth

water, energy, acid medium in oxygen, 77-86F -destroyed by boiling

large intestine absorbs

water, salts, and the vitamins synthesized by bacteria

which starches only have amylopectin

waxy starches (rice, corn, sorghum) -they are non-gelling; stable to freezing and thawing, used in frozen foods

adverse effects of carb loading

weakness, bloating, dizziness, soreness

vitamin A deficiency

-night blindness, nyctalopia -xerophthalmia-corneal damage (not reversible) -bitots spots on conjunctiva -dry, scaly skin (hyper keratosis)

cash budget

-projects revenues and expenses, showing inflow and output of cash over time -purpose is to determine if funds will be available when needed

centralized pruchasing

-personnel in one office does all purchasing for all units in that organization -cost-effective and time saving

phosphorus functions

-phospholipids transport fat through lymph and blood -bone, teeth

Illegal Immiagration Reform and Immigrant Responsibilty Act 1996

-places limitations on persons who remain in the US longer than permitted by their visa and/or who violate their nonimmigrant status

PDCA cycle

-plan, do, check, act or PDSA plan, do, study, act -problem solving technique for TQM

capital budget

-plant facilities, equipment, cost of improvements and repairs (service, maintenance contracts), expansions, replacements, computers, software -includes expenditures whose returns are expected to last beyond one year

leadership grid

-plots leaders concern for people (employees) vs their concern for production -scale of 1 to 9; 1 is low concern, 9 is high concern

delphi technique

-problem solving/decision making -designed to probe expert minds in a series of written interviews from which some consensus is sought -participants do not meet

nominal group techniques

-problem solving/decision making -more structured and controlled than ordinary brainstorming group -has leader who controls interactions, rigid enforced procedures, and controls responses by leaders -items are ranked in priority order; vote for final decision -yields more brainstorming ideas than traditional brainstorming

glycemic load

weighted average of the glycemic indexes of all foods eaten

micelles

wetting agents composed of fat and bile salt -needed for absorption

variable of interest

what researchers are observing

job breakdown

what to do and how to do it, no time limits

when should you add an acid when cooking

when complete because acid breaks down starch and will give a runny product -will break down starch and cause runny product

diverticulitis

when diverticula become inflamed as a result of food and residue accumulation and bacterial action

egg whites at room temperature will

whip more quickly and yield a larger volume due to lower surface tension

blenderized formulas

whole food, large bore tube, thick intact protein, high residue

sources of manganese

whole grains, legumes, nuts

needs of manganese

1.8-2.3ug

eggs have BV of

100%

urinary creatinine clearance normal value

115 +- 20ml/min

operating costs

12-18% of budget utilities, electricity, laundry, cleaning

needs of vitamin K for males

120 ug

blood glucose range for endurance athletes during activity

120-180mg/dL

measure of #10 case

13 cups

RDA of protein for 1-3 yr old

13 g

safe minimum internal temperature for pork

145F

safe minimum internal temperature for roast

145F

normal range or phosohprus

3-4.5 mEq

traditional cafeterias serve

3-4/minute

storage time of steaks, chops, roast in fridge

3-5 days

fresh fruits and vegetables in the fridge should be at what temp

40-45F

folic acid supplementation during pregnancy

400 mcg (get about 200 from food) so total 600 mcg

breast fed infant supplements needed

400IU vit D from birth .25 mg fluoride.day after 6 months if water contains inadequate flouride

danger zone for bacteria

41-135F

male needs for magnesium

420mg

needs of sulfur

425-550mg

recommended % of macronutrients for adults

45-65% CHO 20-35% FAT 10-35% PRO

hematocrit range for newborn

49-54%

when should birth weight be doubled?

4th-5th month

extended care facility staffing pattern

5 meals/labor hour

amputation subtractions for entire arm when determining desirable body weight

5%

cafeteria staffing pattern

5.5 meals/labor hour

humidity of storage should be

50-60%

male needs of selenium

55ug

what % of protein can be converted to glucose?

58%

% source of CHO from protein

58%- glucogenic amino acids -will yeild glucose following deamination

#10 can, #/case

6

cartons and bags on shelfs in storage should be how high off the floor?

6"

amputation subtractions for lower leg with foot when determining desirable body weight

6%

number of wet diapers that is normal per day

6-8

recommended minutes of physical activity of children daily

60 minutes

exercise about what % above maximal oxygen uptake uses carbohydrates as a fuel source

60-65%

alkaline/base

7-14

normal BG level

70-100 mg/dL 2hpost prandial <140mg/dL

ideal temp range for growth of pathogen

70-125

female needs of vitamin A

700 ug RE

needs of phosphorus

700mg

protein during second half of pregnancy and lactation

71 grams

lactose % in dried whey

73%

normal MCV

80-95 fL

oldest old age

85 and up

storage of fresh fruits and vegetables require what humidity?

85-90%

overweight BMI for age chart percentile

85th to 94th

composition of milk

87%water, 3.7% fat, 4.9% carbohydrate (lactose), 3.5% protein

angina pectoris

chest pain

diarrhea types

child acute child chronic adult diarrhea steatorrhea

acid effect on eggs as leaveners

acid stiffens an egg white foam by tenderizing the protein and allowing it to extend more easily

crystal size inhibitors

acid, fat, protein acid: cream of tartar, vinegar fat: chocolate, milk protein: milk, egg whites, gelatin

what aids absorption of calcium

acid, vitamin D, lactose

flavor of fruit due to

acids, sugar, aromatic compounds

cognitive learning domain

acquisition of knowledge or subject matter

psychomotor learning domain

acquisition of muscular skills (exercise, food preparation)

influence

action that will cause a change in behavior or attitude of another

what permits the greatest retention from a learner?

active involvement

<5th on a weight for length/stature chart may indicate

acute illness or wasting

propofol nutrition interaction

administered in oil, consider fat calories (1.1 cals/cc), want to check TG

food recovery and gleaning programs

collect excess wholesome foods that would otherwise be thrown away (cafeterias, restaurants) for delivery to hungry people

spastic form cerebral palsy

difficult, stiff movement; limited activity -results in obesity MNT: low calorie, high fluid, high fiber diet

to prevent enzymatic oxidation

dip in citris juice, add sugar before freezing, heat to boiling

outcome categories

direct nutrition, clinical and health status, patient-centered, health care use and cost

structured interviews

directed, use checklist or preplanned strategy, gives same information on all; minimizes personal biases

market segmentation

dived market into groups of people with similar product needs -includes demographic, geographic, psychographic, behavioristic

split halves reliability

divide the test in half, reliability is determined by degree of similarity of results

dry storage should be

dry, cool, dark, well-ventilated, clean -temperature= 50-70F

constipation in elderly

due to decrease gastric motility, decrease HCL secretion in stomach -often lack calcium and iron

where is secretin located

duodenum

job specification

duties involved, conditions, qualifications; written for each job, not each position -used in selection and placement of employees -does not have detailed information as to what to do or time involved

unity of command

each is accountable to only one superior

eggs as leaveners

effectiveness depends on amount of air beaten in and retained -egg is heated-> air expands-> egg white stretches and protein coagulates

cross charts

efficiency of equipment placement, studies work motions, shows number of movements between pieces of equipment

what yields a stiffer, more stable emulsion, egg white or yolk?

egg yolk because it has more protein by weight than white

what does not aid in iron absorption

eggs, tea, milk, cheese

for acute UC

elemental diet may be needed to minimize fecal volume

standing orders

eliminate the need to call in daily or weekly orders

cellular oxidation uses

enzymes, coenzymes, substrates, cofactors, hormones, energy reactions,

hyperglycemia is caused by what during burn trauma

epinephrine suppresses insulin, insulin resistance so decreased cell uptake and use

environmental protection agency EPA

establish and monitor water quality standards; determines safety and tolerance levels for pesticides

what gas accelerates the ripening of fruits during storage

ethylene gas

effect of protein on fluid balance

exerts colloidal osmotic pressure

incidence

(number of new cases of a disease over a period of time/total number of people at risk)* 100,000 -measure of risk of developing disease

prevalence

(total number of people with a disease during a period of time/average number of people)*100,000 -number of exciting cases of disease

milk thistle use and potential interaction

-may help protect liver

garlic uses and potential interactions

-may lower cholesterol and blood pressure -reduces clotting time, want to avoid use with warfarin

density of sucrose is

-measured in degrees Brix by a Brix hydrometer -expressed on label as extra light, light, heavy, extra heavy syrup

urinary creatinine clearance

-measures GFR, renal function -estimate include body surface area (ht and weight)

triceps skinfold thickness (TSF)

-measures body fat reserves; measures calorie reserves

total lymphocyte count

-measures immunocopentency -moderate depletion (900-1800), severe depletion (<900) -decreased in protein-energy malnutrition

folate deficiencies

-megaloblastic macrocytic anemia -diarrhea, fatigue

food cost is

food purchases plus foods removed from inventory OR beginning inventory minus ending inventory, plus food purchases -to determine: need # meals served, food purchases, foods removed from inventory

three major cost control factors

food, labor, and operating expenses

major costs

food, labor, operating

nutrition assessment indicators/categories

food/nutrition related history, anthropometrics, lab/medical tests, nutrition-focused physical findings, client history

hedonic scale

foods rated from extremely like to extremely dislike -can use facial scales with children

specialized formulas

for certain disease state

list sugars in order of sweetness

fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose

herzbergs two factor theory

-motivation and maintenance approach

food intoxications

illness caused by a toxin formed in the food prior to consumption -staph A, C bot, Clos perf, Bac cere

mellorine

imitation ice cream, butterfat is replaced by hydrogenated vegetable oil

aging is delayed in apples that are stored

in controlled atmosphere (reduced oxygen)

arthritis

inflammation of peripheral joints

stomatitis

inflammation of the mouth -associated with riboflavin defieicny

feedback

info client gives back to you as you are discussing and questioning

Congressional Record

information from the floor, no hearings lists bill with sponsors and action, issued daily when congress is in session

why do egg yolks turn green when overcooked?

iron from yolk and sulfur from the whole egg creates ferrous sulfide

nail assessment that is brittle, thin, spoon-shaped

iron or protein deficiency

skin assessment that is pale, dry, scaly

iron, folic acid, zinc deficiency

lead poisoning symptoms

irritability, lethargy, anorexia, vomitng, diarrhea, anemia

MSUD signs/symptoms

-poor sucking reflex, anorexia, FTT, irratibilty, sweet burnt maple syrup odor of sweat and urine

metabolic alkalosis

loss of hydrogen due to loss of acid or an increased retention of base to compensate, ventilation decreases to retain carbon dioxide to make carbonic acid

function of riboflavin

-energy release from protein -red cell production

MIS

an electronic system that manages infromation

BBTD

baby bottle tooth decay

food cost percentage=

daily food cost/daily income

sources of calcium

dairy, leafy vegetables, legumes

POMR

problem-oriented medical record

osteroclasts

resorb and remove bone

atherosclerosis

-progressive narrowing of arteries -accumulation of lipids in heart, brain, and legs: structural and compositional changes in the intimal layer of the large arteries

functional properties of sugar in baked mixtures

-adds sweetness and browning -hygroscopic: modifies texture by tenderizing (softens gluten and prevents gluten development by absorbing some of the water that gluten needs for development)

lipogenesis (synthesis/deposition) occurs in

-adipose -liver

diverticular disease

-diverticulosis -diverticulitis

treatment for Crohns/UC

-maintain fluid and electrolyte balance: antidiarrheal agent (sulfasalazine)

lipolysis

-occurs via oxidation -oxidation forms acetyl CoA which enters Krebs

types of interviews

-structured -unstructureed

needs of B12

2.4ug

AW of Na

23

full time employees usually available how many days per year

236 days -129 days off and benefit days

introduce eggs when to infants

24 months

closed systems hang time

24-48 hours

healthy BMI for most elderly

25-29

fluid recommendations of elderly

25-30ml/kg

sources of pantothenic acid

animal foods, grains, legumes

most unsaturated

canola

table dhote restaurant

complete meal at set price

orlistat nutrition interaction

decrease fat absorption by binding lipase

HAV

fecal-oral transmission

endosperm

inside area -rich in carbs and protein

if kidneys excrete excess bicarbonate

level of base decrease

vitamin B6

pyridoxine

carbohydrate

starches and sugars

the lower the p value