Nutrition

Ways medications alter nutrient absorption

-change pH of GI tract -increase GI motility -damage the intestinal mucosa -bind with nutrients rendering them unavailable to the body

Ways alcohol influences nutritional metabolism

-impairing nutrient storage -increasing nutrient catabolism -increasing nutrient excretion

Other functions of fats in the body

-storage form for energy -padding in that fat surrounds vital organs -protects portions of our bony skeleton from shock -aids in insulation and temperature management -helps maintain cell membrane integrity

At least ____ to _____ grams are needed daily to prevent?

50-100; ketosis (an abnormal accumulation of ketone bodies that is frequently associated with acidosis)

Fat soluble vitamins

A, D, E, K

To be a candidate for a PEG tube what has to be intact and functional within the patient?

GI tract

Essential nutrients that supply energy and build tissues are referred to as?

Macronutrients

Waist circumference is a good indicator of?

abdominal fat

Transferrin

acts as an iron-transporting protein, but because it is related to iron, levels may not always be an accurate indicator of nutritional status

Bulimia

characterized by gorging followed by purging with self-induced vomiting, diuretics, and laxatives, also becomes more common in this age group

Creatinine levels

directly proportional to the body's muscle mass; a reduction in this value reflects severe malnutrition.

Because water soluble vitamins (B,C) are not stored, amounts consumed in excess of need are _____ into urine; ______ are not likely.

excreted; toxicities

Saturated fats

exist mostly as components of fats or other lipids of amino orgins -foods rich in saturated fatty acids: beef, lamb, pork, veal, whole milk products, most cheeses, and a few plant products such as cocoa butter, coconut oil, and palm oil.

If muscle or liver glycogen stores are deficient, glucose is converted to _____ and stored _____.

glycogen; glycogenolysis

Conversely, glycogen is broken down in time of need to supply a ready source of glucose which is called?

glycogenolysis

Serum Albumin

good indicator of a patient's nutritional status a few weeks prior to when the blood is drawn and can help identify chronic nutrition problems

How should you introduce fiber to someone who is not used to taking it?

gradually accompanied by lots of water intake

In long term feeding situations in which gastric problems exist, the _____ is an alternate method through which nutrition can be delivered

jejunostomy

Food also contains the essential fatty acids ______ and ______.

linoleic and linolenic acid

Vitamins and minerals are needed for _____ of ____ and do not provide _____.

metabolism; energy; calories

Negative nitrogen balance

more nitrogen is excreted than ingested, and indicates tissue is breaking down faster than being replaced.

Body mass index

more preferred method to establish ideal body weight for adults and children, and measurement of waist circumference for adults only.

The toxic effect of alcohol on the intestinal mucosa interferes with the?

normal nutrient absorption

Digestion

process by which the GI system breaks up food into particles small enough to pass into the cells and be used by the cells.

Adolescents tend to eat their food _____ leading to _____ before ____ is experienced.

rapidly; over-consumption, satiety

Most absorption of digested food and minerals and some absorption of water occurs through the walls of the ______?

small intestines

PEG tube insertion is often used because?

unlike traditional, surgically places gastronomy tube, it usually does not require general anesthesia.

Water is more ____ to life than ____ because it provides the fluid medium necessary for all chemical reactions.

vital; food

Carbohydrates

-Carbon, hydrogen, oxygen -main source of energy in the diet -each gram provides 4 Kcal/g of energy

Of the six class of nutrients, three supply energy and three are needed to regulate body processes

-Carbs -Protein -Lipids (fats) -Vitamins -minerals -water

Toddlers and Preschoolers

-Growth rate slows -Children in this age group often experience an inadequate intake of fruits and vegetables and/or excessive intake of sweetened fruit drinks. -appetite dramatically decreases and becomes erratic

Gender

-Men and women differ in nutritional needs due to body composition and reproductive functions -Men have larger muscle mass=higher caloric and protein requirements -Women proportionally for adipose tissue -women of child bearing age have higher iron requirements due to menstruation

Cholesterol

-a fatlike substance found only in animal products -not an essential nutrient -the body makes sufficient amounts -high serum levels are clearly associated with an increased risk for atherosclerosis (hardening and narrowing of the arteries, which silently and slowly blocks arteries, putting blood flow at risk

Ways nutrient metabolism can be altered by drugs

-act as nutrient antagonists -alter the enzyme systems that metabolize nutrients -alter nutrient degradation

Incomplete proteins

-are deficient in one or more essential amino acids.

Older adults

-decrease in BMR, physical activity + loss of lean body mass, energy expenditure decreases -Decrease in peristalsis -Loss of taste b/t sweet and salty -Caloric needs of the body decreases -Prone to dehydration -Dietary restriction

Lipids (fats)

-most calories dense nutrient -9 Kcal/g -composed of triglycerides and fatty acids

Proteins

-naturally occurring substances that consist of amino acids, the simplest form of protein -hydrogen, oxygen, carbon, nitrogen -Critical component of muscle function, tissues of the human body -4 Kcal per gram -Classified as essential or non-essential or complete or incomplete

Vitamins

-organic compounds needed by the body in small amounts -needed for metabolism

Dietary fiber

-polysaccharide carbohydrate -contributes to disease prevention especially in the GI tract and cardiovascular system

Water

-present in every body cell -accounts for 50%-60% of adults total weight -About 2/3 of the body's water is contained within the cells (intracellular fluid) and the remainder is extracellular fluid

Adolescents

-rapid physical, emotional, social, and sexual maturation -Childhood nutrition problems often worsen during adolescence

The decision to advance a patient's diet is based on?

-return of GI function -the absence of symptoms related to a particular disease process -the resolution of whatever prompted the dietary restriction

Classification of carbohydrates

-simple (monosaccharide and disaccharide) sugars -complex (polysaccharide) sugars

Complete proteins

-sufficient amounts of all the essential amino acids to support growth

Infants

-the period from birth to one year of age is the most rapid period of growth -Nutritional needs per unit of body weight are greater than at any other time in the life cycle. -Breastfeeding 6-12 mo -Solid food one at a time over 5-7 days @ 6 mo of age -Cow's milk not recommended under 1 year of age

School-Aged Children

-uneven, individualized, sometimes erratic growth pattern -nutritional implications focus on health promotion

BMR women

0.9 cal/kg of body weight per hr

How much % should protein intake contribute to total caloric intake for adults?

10-35%

A person with a BMI below ____ is underweight

18.5

a BMI of _____ to _____ is a healthy weight

18.5-24.9

BMR men

1cal/kg of body weight per hr

The Dietary guidelines for Americans 2010 recommends that fat intake be no more than between ____ and ____ of total caloric intake, with less than ____ of fat calories from saturated fats and less than ____ mg/day of cholesterol.

20%-35%; 10%; 300

A BMI of ____ or greater indicates obesity, a BMI of ____ or greater indicates extreme obesity.

30;40

1 lb of body fat equals?

3500 cal

The dietary guidelines of American 2010 (USDA)recommends that carbohydrates provide _____ to _____ of total calories for adults, mostly in the form of _____ carbohydrates.

45% to 65%; complex

Some fat is essential for digestion, absorption, and transportation of the fat-soluble vitamins?

A, D, E, K

Dysphagia is associated with an increased risk for what?

Aspiration

What vitamins are needed because they are used to metabolize alcohol?

B

Dietary proteins may be labeled as?

Complete (high quality) Incomplete (low quality)

Example of complete and incomplete proteins

Complete: animal products Incomplete: Plant proteins

The body's protein tissues are in a constant state of?

Flux

For short-term nutritional support (of less than 4 wks) what is used?

NG tube

Full liquid diets contain liquids that can be poured at?

Room temp

Excessive intake particularly of vitamins A and D is ____.

Toxic

Water soluble vitamins

Vitamin C and the B-complex vitamins

Nitrogen balance

a comparison between catabolism and anabolism, can be measured by comparing nitrogen intake (protein intake) and nitrogen excretion (nitrogen lost in urine, urea, feces, hair, nails, skin)

Blood glucose

blood cholesterol, and blood trigylcerides are additional laboratory tests related to nutritional status

The number of molecules within the structure determines the?

classification of carbohydrates

Parenteral

denoting any medication route other than the alimentary canal, such a intravenous, subcutaneous, intramuscular, or mucosal

Feedings into the intestine are always continuous to avoid triggering?

dumping syndrome

As with fatty acids, essential amino acids are those that body cannot supply, so they must be?

eaten

Primary role of linoleic and linolenic acid

formation of prostaglandins

What are not easily dislodged

gastronomy (jejunostomy)

Once ingested and metabolized, carbohydrates are converted primarily into?

glucose

What does the liver store?

glucose

Adults

growth ceases, nutritional needs level off, and fewer calories are required because of the decline of BMR with each decade of age

Factors increasing BMR

growth, infections, fever, extreme environmental temperatures, elevated levels of hormones, emotional tensions

Prealbumin levels

indicate short-term nutritional status, can be used to detect daily changes in a patient's protein status, and are excellent marker for malnutrition

Minerals

inorganic elements found in all body fluids ans tissues in the form of salts or combined with organic compounds

What two hormones are responsible for keeping serum glucose levels fairly constant with feasting and fasting?

insulin and glucagon

Overhydration levels can cause ____ albumin levels and dehydration may cause a very ______ albumin level

low; high

Anthropometrics data

measurements used to determine body dimensions; in children to assess growth rate; in adults an indirect measurement of fat

Hemoglobin and hematocrit

measures of plasma protein that also reflect a person's iron status

Protein status

measuring serum albumin and transferrin levels and by a total lymphocyte count

Triglycerides

most abundant fats allowing for approx. 90-95% of fats consumed -composed of fatty acids and are classified based on their length -further defined according to the levels of saturation and whether they are essential or non-essential.

Positive nitrogen balance

nitrogen intake is greater than excretion and indicates tissue grown (during childhood, pregnancy, lactation, and recovery from illness)

Enteral nutrition

patient is fed an appropriate formula through a tube passed into the stomach or duodenum from the nasal passage via a NG or nasoduodenal tube.

The total lymphocyte count

reflects immune status and is directly affected by impaired nutritional states

Prostaglandins

responsible for muscle activity, blood vessel response, blood clotting, and the immune system response of inflammation.

Trans fat raises?

serum cholesterol

What is an exception plant protein that is considered a complete protein?

soy

Micronutrients

such as vitamins and minerals, are required in much small amounts to regulate and control body processes

What is added to foods that supply calories but little to no nutrients?

sugars

All ____ must be converted to glucose because glucose is the only molecule body cells can use to make _____ which transports energy in cells

sugars; ATP

Basal metabolism

the energy required to carry on the involuntary activities of the body at rest---the enerygy needed to sustain the metabolic activities of cells and tissues

The BMI is a reliable indicator of?

total body fat stores in the general population

Unlike protein and fat, glucose is burned efficiently and completely and does not leave a _____ product for the kidneys to excrete?

toxic

The body converts excess carbohydrates and protein into fat and stores them as?

triglycerides

When glycogen stores are adequate, the body converts excess glucose to fat and stores it as ____ in _______.

triglycerides; adipose tissue

T or F: The BMI does not differentiate according to gender

true

Neutral nitrogen balance

when catabolism and anabolism are occurring at the same rate