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
the higher the significance of your results