Nutrition
Ways medications alter nutrient absorption
-change pH of GI tract -increase GI motility -damage the intestinal mucosa -bind with nutrients rendering them unavailable to the body
Ways alcohol influences nutritional metabolism
-impairing nutrient storage -increasing nutrient catabolism -increasing nutrient excretion
Other functions of fats in the body
-storage form for energy -padding in that fat surrounds vital organs -protects portions of our bony skeleton from shock -aids in insulation and temperature management -helps maintain cell membrane integrity
At least ____ to _____ grams are needed daily to prevent?
50-100; ketosis (an abnormal accumulation of ketone bodies that is frequently associated with acidosis)
Fat soluble vitamins
A, D, E, K
To be a candidate for a PEG tube what has to be intact and functional within the patient?
GI tract
Essential nutrients that supply energy and build tissues are referred to as?
Macronutrients
Waist circumference is a good indicator of?
abdominal fat
Transferrin
acts as an iron-transporting protein, but because it is related to iron, levels may not always be an accurate indicator of nutritional status
Bulimia
characterized by gorging followed by purging with self-induced vomiting, diuretics, and laxatives, also becomes more common in this age group
Creatinine levels
directly proportional to the body's muscle mass; a reduction in this value reflects severe malnutrition.
Because water soluble vitamins (B,C) are not stored, amounts consumed in excess of need are _____ into urine; ______ are not likely.
excreted; toxicities
Saturated fats
exist mostly as components of fats or other lipids of amino orgins -foods rich in saturated fatty acids: beef, lamb, pork, veal, whole milk products, most cheeses, and a few plant products such as cocoa butter, coconut oil, and palm oil.
If muscle or liver glycogen stores are deficient, glucose is converted to _____ and stored _____.
glycogen; glycogenolysis
Conversely, glycogen is broken down in time of need to supply a ready source of glucose which is called?
glycogenolysis
Serum Albumin
good indicator of a patient's nutritional status a few weeks prior to when the blood is drawn and can help identify chronic nutrition problems
How should you introduce fiber to someone who is not used to taking it?
gradually accompanied by lots of water intake
In long term feeding situations in which gastric problems exist, the _____ is an alternate method through which nutrition can be delivered
jejunostomy
Food also contains the essential fatty acids ______ and ______.
linoleic and linolenic acid
Vitamins and minerals are needed for _____ of ____ and do not provide _____.
metabolism; energy; calories
Negative nitrogen balance
more nitrogen is excreted than ingested, and indicates tissue is breaking down faster than being replaced.
Body mass index
more preferred method to establish ideal body weight for adults and children, and measurement of waist circumference for adults only.
The toxic effect of alcohol on the intestinal mucosa interferes with the?
normal nutrient absorption
Digestion
process by which the GI system breaks up food into particles small enough to pass into the cells and be used by the cells.
Adolescents tend to eat their food _____ leading to _____ before ____ is experienced.
rapidly; over-consumption, satiety
Most absorption of digested food and minerals and some absorption of water occurs through the walls of the ______?
small intestines
PEG tube insertion is often used because?
unlike traditional, surgically places gastronomy tube, it usually does not require general anesthesia.
Water is more ____ to life than ____ because it provides the fluid medium necessary for all chemical reactions.
vital; food
Carbohydrates
-Carbon, hydrogen, oxygen -main source of energy in the diet -each gram provides 4 Kcal/g of energy
Of the six class of nutrients, three supply energy and three are needed to regulate body processes
-Carbs -Protein -Lipids (fats) -Vitamins -minerals -water
Toddlers and Preschoolers
-Growth rate slows -Children in this age group often experience an inadequate intake of fruits and vegetables and/or excessive intake of sweetened fruit drinks. -appetite dramatically decreases and becomes erratic
Gender
-Men and women differ in nutritional needs due to body composition and reproductive functions -Men have larger muscle mass=higher caloric and protein requirements -Women proportionally for adipose tissue -women of child bearing age have higher iron requirements due to menstruation
Cholesterol
-a fatlike substance found only in animal products -not an essential nutrient -the body makes sufficient amounts -high serum levels are clearly associated with an increased risk for atherosclerosis (hardening and narrowing of the arteries, which silently and slowly blocks arteries, putting blood flow at risk
Ways nutrient metabolism can be altered by drugs
-act as nutrient antagonists -alter the enzyme systems that metabolize nutrients -alter nutrient degradation
Incomplete proteins
-are deficient in one or more essential amino acids.
Older adults
-decrease in BMR, physical activity + loss of lean body mass, energy expenditure decreases -Decrease in peristalsis -Loss of taste b/t sweet and salty -Caloric needs of the body decreases -Prone to dehydration -Dietary restriction
Lipids (fats)
-most calories dense nutrient -9 Kcal/g -composed of triglycerides and fatty acids
Proteins
-naturally occurring substances that consist of amino acids, the simplest form of protein -hydrogen, oxygen, carbon, nitrogen -Critical component of muscle function, tissues of the human body -4 Kcal per gram -Classified as essential or non-essential or complete or incomplete
Vitamins
-organic compounds needed by the body in small amounts -needed for metabolism
Dietary fiber
-polysaccharide carbohydrate -contributes to disease prevention especially in the GI tract and cardiovascular system
Water
-present in every body cell -accounts for 50%-60% of adults total weight -About 2/3 of the body's water is contained within the cells (intracellular fluid) and the remainder is extracellular fluid
Adolescents
-rapid physical, emotional, social, and sexual maturation -Childhood nutrition problems often worsen during adolescence
The decision to advance a patient's diet is based on?
-return of GI function -the absence of symptoms related to a particular disease process -the resolution of whatever prompted the dietary restriction
Classification of carbohydrates
-simple (monosaccharide and disaccharide) sugars -complex (polysaccharide) sugars
Complete proteins
-sufficient amounts of all the essential amino acids to support growth
Infants
-the period from birth to one year of age is the most rapid period of growth -Nutritional needs per unit of body weight are greater than at any other time in the life cycle. -Breastfeeding 6-12 mo -Solid food one at a time over 5-7 days @ 6 mo of age -Cow's milk not recommended under 1 year of age
School-Aged Children
-uneven, individualized, sometimes erratic growth pattern -nutritional implications focus on health promotion
BMR women
0.9 cal/kg of body weight per hr
How much % should protein intake contribute to total caloric intake for adults?
10-35%
A person with a BMI below ____ is underweight
18.5
a BMI of _____ to _____ is a healthy weight
18.5-24.9
BMR men
1cal/kg of body weight per hr
The Dietary guidelines for Americans 2010 recommends that fat intake be no more than between ____ and ____ of total caloric intake, with less than ____ of fat calories from saturated fats and less than ____ mg/day of cholesterol.
20%-35%; 10%; 300
A BMI of ____ or greater indicates obesity, a BMI of ____ or greater indicates extreme obesity.
30;40
1 lb of body fat equals?
3500 cal
The dietary guidelines of American 2010 (USDA)recommends that carbohydrates provide _____ to _____ of total calories for adults, mostly in the form of _____ carbohydrates.
45% to 65%; complex
Some fat is essential for digestion, absorption, and transportation of the fat-soluble vitamins?
A, D, E, K
Dysphagia is associated with an increased risk for what?
Aspiration
What vitamins are needed because they are used to metabolize alcohol?
B
Dietary proteins may be labeled as?
Complete (high quality) Incomplete (low quality)
Example of complete and incomplete proteins
Complete: animal products Incomplete: Plant proteins
The body's protein tissues are in a constant state of?
Flux
For short-term nutritional support (of less than 4 wks) what is used?
NG tube
Full liquid diets contain liquids that can be poured at?
Room temp
Excessive intake particularly of vitamins A and D is ____.
Toxic
Water soluble vitamins
Vitamin C and the B-complex vitamins
Nitrogen balance
a comparison between catabolism and anabolism, can be measured by comparing nitrogen intake (protein intake) and nitrogen excretion (nitrogen lost in urine, urea, feces, hair, nails, skin)
Blood glucose
blood cholesterol, and blood trigylcerides are additional laboratory tests related to nutritional status
The number of molecules within the structure determines the?
classification of carbohydrates
Parenteral
denoting any medication route other than the alimentary canal, such a intravenous, subcutaneous, intramuscular, or mucosal
Feedings into the intestine are always continuous to avoid triggering?
dumping syndrome
As with fatty acids, essential amino acids are those that body cannot supply, so they must be?
eaten
Primary role of linoleic and linolenic acid
formation of prostaglandins
What are not easily dislodged
gastronomy (jejunostomy)
Once ingested and metabolized, carbohydrates are converted primarily into?
glucose
What does the liver store?
glucose
Adults
growth ceases, nutritional needs level off, and fewer calories are required because of the decline of BMR with each decade of age
Factors increasing BMR
growth, infections, fever, extreme environmental temperatures, elevated levels of hormones, emotional tensions
Prealbumin levels
indicate short-term nutritional status, can be used to detect daily changes in a patient's protein status, and are excellent marker for malnutrition
Minerals
inorganic elements found in all body fluids ans tissues in the form of salts or combined with organic compounds
What two hormones are responsible for keeping serum glucose levels fairly constant with feasting and fasting?
insulin and glucagon
Overhydration levels can cause ____ albumin levels and dehydration may cause a very ______ albumin level
low; high
Anthropometrics data
measurements used to determine body dimensions; in children to assess growth rate; in adults an indirect measurement of fat
Hemoglobin and hematocrit
measures of plasma protein that also reflect a person's iron status
Protein status
measuring serum albumin and transferrin levels and by a total lymphocyte count
Triglycerides
most abundant fats allowing for approx. 90-95% of fats consumed -composed of fatty acids and are classified based on their length -further defined according to the levels of saturation and whether they are essential or non-essential.
Positive nitrogen balance
nitrogen intake is greater than excretion and indicates tissue grown (during childhood, pregnancy, lactation, and recovery from illness)
Enteral nutrition
patient is fed an appropriate formula through a tube passed into the stomach or duodenum from the nasal passage via a NG or nasoduodenal tube.
The total lymphocyte count
reflects immune status and is directly affected by impaired nutritional states
Prostaglandins
responsible for muscle activity, blood vessel response, blood clotting, and the immune system response of inflammation.
Trans fat raises?
serum cholesterol
What is an exception plant protein that is considered a complete protein?
soy
Micronutrients
such as vitamins and minerals, are required in much small amounts to regulate and control body processes
What is added to foods that supply calories but little to no nutrients?
sugars
All ____ must be converted to glucose because glucose is the only molecule body cells can use to make _____ which transports energy in cells
sugars; ATP
Basal metabolism
the energy required to carry on the involuntary activities of the body at rest---the enerygy needed to sustain the metabolic activities of cells and tissues
The BMI is a reliable indicator of?
total body fat stores in the general population
Unlike protein and fat, glucose is burned efficiently and completely and does not leave a _____ product for the kidneys to excrete?
toxic
The body converts excess carbohydrates and protein into fat and stores them as?
triglycerides
When glycogen stores are adequate, the body converts excess glucose to fat and stores it as ____ in _______.
triglycerides; adipose tissue
T or F: The BMI does not differentiate according to gender
true
Neutral nitrogen balance
when catabolism and anabolism are occurring at the same rate