Nutrition Exam 2
What are the six things that can alter someone's fluid requirements? Be able to describe each to the level covered in the lecture.
-Surrounding environment like temperature and altitudes -activity level -functional losses -age and metabolic need -caffeine/ medication
calcium metabolic functions
-absorption of b12 -activation of lipase activation of protein-splitting enzymes -secretion of insulin -regulation of cell membrane permeability
how does potassium effect metabolic reactions
-converts glucose into glycogen -store nitrogen -released insulin
What are the tips provided for helping to relieve nausea and vomiting during pregnancy (used to be called morning sickness)?
-eat small frequent meals/snacks -Fluid intake between meals also prevent an empty stomach -Avoid strong odors and foods that trigger nausea -Try ginger or vitamin B6 supplements -Hyperemesis gravidarum-Report to clinician
sx of water intoxication
-low Na+ -Edema -lung congestion -muscle weakness -Decreased mental alertness -sleepiness -loss of appetite -Poor motor coordination -Confusion
ACE inhibitors
-pril; prevents ace enzymes, reverses the process of the RAA and ADH system and lowers BP
which role does magnesium have in the body
-secretion on thyroxine -nerve impulses -cofactor in activating amino acids -essential constituent of cell proteins
WHO growth charts cover what ages
0-2 years
water requirements of 0-6months
0.7l
How much protein do adults younger than 65 years old need?
0.8 per kg/day
water requirements of 1-12 month
0.8l
How much protein do adults ≥ 65 years old need daily
1-1.5 per kg/day
average wt gain recommended during 1st trimester
1-5lbs
failure to thrive usually affects those ages:
1-5yrs
vegetarians need ____ more iron due to lower bioavailability of iron form plant sources
1.8x
UI of fluoride
10mg/day to avoid fluorosis
average wt gain recommended during 2nd and 3rd trimester based on obese bmi
11-20 lbs
Premature infants have energy needs between
110 and 130 kcal/kg/day.
UL iodine
1100mcg
RDI for zinc
11mg/day for men 8mg/day for women
How long is recommended to exclusively breastfeed?
12 months
women between 50-70 require how much calcium
1200mg
An absolute minimum requirement of _____ of carbs per day for children and adults is recommended and necessary for normal brain function.
130g
average wt gain recommended during 2nd and 3rd trimester based on overweight bmi
15-25 lbs
What are the recommended U.S. physical activity guidelines for reducing risk of chronic disease later in life?
150-300 mins moderate activity/week or 75-150 mins vigorous activity/week
DRI for vit d for lactating mothers
15mcg/day
iron rda increases during pregnancy from
18 to 27mg/day
RDI of sodum
19-50 years: 1.5 g 51-70 years: 1.3 g 71+ years: 1.2 g
how many pounds per week should you gain in 2-3 trimesters
1lb/week
outpatient wt recommended wt gain for anorexia
1lb/week
inpatient wt recommended wt gain for anorexia
2-3lbs/week
What are the average daily water requirements for sedentary women
2.7L(91oz)
How much of peak bone mass is deposited as a fetus and depends on the mother's diet?
20-40%
DRI chloride
2300 mg or 2.3 g
Sodium UL
2300 mg/day
When does gestational diabetes get screened
24-28 wks, second trimester or symptomatically
average wt gain for healthy bmi
25-35lbs
how many elements are essential minerals in human life
25/118
average wt gain recommended during 2nd and 3rd trimester based on underweight bmi
28-40 lbs
What are the average daily water requirements for sedentary men
3.7L(125oz)
According to MyPlate.gov, __ % of a child's plate should be vegetables.
30
At what age does a gradual loss of functioning cells result in body composition changes such as increased muscle mass loss?
30
calorie prescription for treating anorexia
30-40 kcal/kg/day
What percentage of daily calories are recommended to come from fat for 1-3 years olds?
30-40% cals from fat
what is the additional daily calorie needs during the second trimester
340 kcal/day
extracellular water comprises
35%
what is the daily fluid requirement for a woman who is breastfeeding
3L/day
when is the last day gestational age can be determined for neonates over the age of 26 weeks
4 days of birth
when should you start introducing solid foods
4-6 months
RDI potassium
4.7 g/day
what percentage of ault peak bone mineral density is depostied during adolescene
40
upper limit of zinc
40 mg/day
When does a more rapid decline in basal metabolic rate start in life for men?
40 yrs
how much of peak bone mass is deposited as an adolescent
40%
1. When should you start providing an infant with Vitamin D supplementation and when can you stop giving the Vitamin D supplementation?
400 IU vit D daily at hospital discharge until drinking 16oz of vit d fortified milk
magnesium requirements
400-420 mg/d for males, 310-320 mg/d for females
UI for vitamin d
4000 IU/day
how much daily folic acid should women take who are capable of becoming pregnant
400mcg/day
when does menopause occur
45-55
what is the additional daily calorie needs during the third trimester
450 kcal/day
the national standards for nutrition needs for older adults are based on which estimated percentage decrease in metabolic activity during the middle and older years
5%
How much fluid do athletes need to hydrate with prior to exercise?
5-10ml/kg of body wt 2 hours prior
How much fluid do athletes need to hydrate with after exercise
5-7mL water/kg body wt at least 4 hours before working out
When does a more rapid decline in basal metabolic rate start in life for women?
50 yrs
normal milestones of growth length by one year
50%
What was the reference population used to develop the WHO charts specifically
6 different countries
solid food introduction
6 months
which infant would require vit d supplementation
6 months being breastfed
Commodity Supplemental Food Program
60+ for socioeconomically disadvantaged, provides food packages to supplement a diet with foods that are high in nutrition
what is the recommended dietary allowance for vitamin d
600 IU/day but we really are only consuming 188IU
dri of vit d for <80yrs
600IU
intracellular water comprises
65%
What does the pH of a body fluid tell us? What is the blood pH compatible with life?
7 .35-7.45 (blood) is neutral
how does iron contribute to hemoglobin synthesis
70% of iron is found in hemoglobin in RBCs also found in myoglobin in muscles
children need between ______________ to ensure normal growth and development.
80 and 120 kcal/kg per day
During the first 3 years of life, the child's energy needs are between
80 and 120 kcal/kg/day.
dri of vit d for >80yrs
800IU
rda for copper
900mcg/day, found in meat
what is considered low vit d
<30 nmol/l
food sources of sulfur
Animal protein foods such as meat, eggs, milk, and cheese, also found in legumes and nuts.
Hemachromatosis
Autosomal recessive disorder that results in iron overload, even though iron intake is within the normal range
why does an infant need iron-fortified foods introduced at ~ 6 months of age
Because they need more iron after six months, breast milk doesn't cover it
what medical conditions result in failure to thrive
CNS disorders Endocrine disorders Congenital defects Partial intestinal obstructions
chemical name for vitamin d
Calciferol
nutrition requirements for adolescents female
Calories: 2200 kcal/day Protein: 45 grams/day Calcium: 1300 mg/day
nutrition requirements for adolescents male
Calories: 2500-2900 kcal/day Protein: 45-59 grams/day Calcium: 1300 mg/day
functions of magnesium
Cofactor for over 300 enzyme systems (catalysis of reactions that produce energy) protein synthesis (nutrient transport) muscle action basal energy expenditure
What are four social programs that exist in the U.S. to help older adults have access to nutritious foods?
Congregate nutrition services home delivered nutrition SNAP seniors farmers market program
What type of fat specifically are children and adolescents under consuming?
EPA and DHA
functions of copperzinc
Energy production Hemoglobin synthesis Iron absorption and transport Nerve and immune system function
clinical manifestations of IDA
Fatigue Cool extremities Dyspnea Activity intolerance Cold intolerance Tachycardia Tachypnea Pallor
eating attitudes
Food aversions Safe, risky, and forbidden foods "Magical thinking" (i.e., irrational thoughts and beliefs) Binge trigger foods Ideas about portion sizes Refusal to eat a food lacking a nutrition label
molybdenum
Functional catalytic component in several cell enzymes Involved in oxidation-reduction reactions
why are infants susceptible to water loss
Greater fluid requirements (due to high metabolic rate) Higher evaporative losses (due to a higher ratio of surface area to volume) Inability to communicate thirst or seek fluid
selenium toxicity sx
Hair loss Joint pain Nail discoloration GI upset
risk factors of BED
Hypothalamic dysfunction Genetic mutation causing food addiction Low levels of serotonin sexual abuse in childhood, frequent comments about wt
Decrease in HGH alone can result in:
Increased fat mass (especially centrally located) Decreased lean muscle mass Diminished muscle strength Decrease physical energy and stamina
eating habits
Intake pattern: the number of meals and snacks eaten and how they are consumed (sitting, standing, in front of a computer, etc.), time of day when eating or restricting intake, duration of meals and snacks, eating environment and company Food group avoidance, especially foods with higher energy density Diet variety from all food groups Fluid consumption: restricted versus excessive, types (caloric, noncaloric, water as beverage)
how does magnesium contribute to protein synthesis
Magnesium is a cofactor for enzymes that activate amino acids for protein synthesis. It also assists in the synthesis and maintenance of DNA
what are the defining characteristics of vitamins
Must be a vital, organic substance (that is not a macronutrient) and is necessary to perform a specific metabolic function or prevent a deficiency disease. 2. The body cannot manufacture it insufficient quantities to sustain life, so the diet must provide it.
food sources of molybdenum
Organ meats Milk Whole grains Leafy vegetables Legumes
what protects a tocopherol
PUFAs
Neuromotor Problems associated with failure to thrive
Poor sucking reflex Abnormal muscle tone Eating, chewing, and swallowing problems
night eating syndrome
Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. causes significant distress and/or impairment in functioning.
Vitamin A aka
Retinol
active form of vitamin a
Retinol
eating behaviors
Ritualistic behaviors Unusual food combinations Atypical use of condiments and seasonings Atypical use of utensils or use of utensils to consume a finger food Excessive use of artificial sweeteners
clinical signs of bulimia
Scars and calluses on hands/knuckles Dental enamel erosion Peripheral edema palpitations edema gerd
primary extracellular cation; regulated nutrient transport
Sodium
disulfide bonds
Strong chemical side bonds that are essential to collagen and connective tissue formation
vitamin E chemical name
Tocopherol
ballard scale
Used to determine gestational age POSTNATALLY(after birth)
ergocalciferol is
Vitamin D2
Cholecalciferol is
Vitamin D3
if the solute concentration outside the cell increases, what will happen to the movement of water between the compartments
Water will move from the cell into the extracellular space.
chromium food sources
Whole grains Cereal products Brewer's yeast
how does phosphorous contribute to acid-base balance
a chemical buffer that helps maintain ph homeostasis of body fluids
wilson disease
a congenital disorder that causes a person to retain excess copper. can result in liver and nerve damage that leads to death, if not treated.
menkes disease
a genetic disorder of copper transport that creates a copper deficiency and results in brittle hair, poor muscle tone, poor feeding, low temp
which factors increase intestinal absorption of minerals
a healthy GI tract eating foods from animal sources
how are fat-soluble vitamins transported and absorbed
absorbed by intestinal cells, along with dietary fat, as micelles. Incorporated into chylomicrons inside intestinal cells. Chylomicrons then enter the lymphatic system, and eventually the bloodstream.
how does calcium contribute to metabolic reactions
absorption of b12 and secretion fo insulin by pancreas
what will kidneys do if blood pH is too acidic
accept more hydrogen ions from blood in exchange for a sodium ion (which are more basic) to balance high acidity
in which metabolic process in phosphorus involved
acid base balance energy metabolism tooth formation
which effect on health is caused by a very low calorie diet
acidosis and electrolyte imbalance
calcitriol
active form of vitamin d; maintains calcium balance in the body
carbonic acid buffer system
adds or removes H+ compensating for either excess or shortage of H (h20 or co2)
the renin-angiotensin-aldosterone system causes what hormone to be released from the pituitary gland
adh
signs/symptoms of vitamin b2 riboflavin deficiency
affects areas of rapid cell generation cracked lips and corners of mouth swollen tongue burning and itchy eyes scaly greasy dermatitis
what are the recommendations for preventing food allergies when introducing solid foods?
after age two, slowly incorporate foods one at a time, every 3-5 days
when do sx of water dehydration become apparent
after loss of 1-2% of normal body wt
factors that influence water content
age (greater in infancy) gender M>F ratio of muscle to fat (muscle contains more water than fat
active form of vitamin e
alpha-tocopherol
How much additional protein is needed during pregnancy?
an additional 25 g, equals about 71g/day
when would you recommend someone rehydrates with both fluid and electrolytes (sodium and chloride) versus with only plain water?
an endurance athlete who is exercising longer than 90 minutes, especially in hot weather
iron deficiency
anemia; 33% of world population
food sources of phosphorus
animal foods, meat, fish, poultry, eggs, milk, plants (decreased ability to be absorbed due to oxalic acid)
phylloquinone
antidote used for excessive anticoagulant drug doses
selenium functions
antioxidant enzyme fucntion protects the lipids in the cell membrane
two main functions of vitamin e
antioxidant action and collagen formation
potential roles of phytochemicals
antioxidant, anti-inflammatory, hormonal actions, interactions w/ enzymes, dna replication, antibacterial effects
in which forms do minerals exist in the body
as part of vitamins, as charged molecules, and molecularly bound to other minerals
chemical name of vitamin c
ascorbic acid
how does calcium help blood clotting
assist in the formation of fibrin, which forms the protein matrix of blood blots
Acrodermatitis enteropathica
autosomal recessive zinc absorption impaired diarrhea, dermatitis, alopecia in infants
what two vitamins need to be increased during pregnancy
b9(folate) and vitamin D
why do infants receive a vitamin k injection at birth
because they don't have the hut bacteria that helps produce vit k
signs/symptoms of vitamin b1 thiamin deficiency
beri beri( i cant, i cant), wernike encephalopathy (alcohol induces deficiency causes debilitating brain disorder
during chloride shift, which ions move out of RBC and into the plasma as chloride moves into RBC
bicarb
what does transferrin do
binds and carries iron throughout the body
phytochemicals
bioactive organic molecules found in plants
Inadequate zinc intake leads to
birth defects, poor cognitive development after birth, poor wound healing, compromised immune system, dermal and epidermal tissue breakdown
Vitamin A deficiency can cause
blindness/ocular diseases risk factor for death from measles and diarrhea
vitamin k functions
blood clotting and bone development
four key functions of calcium
bone and tooth formation blood clotting muscle and nerve action metabolic reactions
Phosphoruous functions
bone and tooth formation energy metabolism acid-base balance
hypophosphatemia results in
bone loss, which is characterized by muscle weakness, loss of appetite, fatigue and pain
Vitamin A toxicity
bone pain, dry kin, fatigue, anorexia, hair loss
what does phosphorus toxicity cause
bone reabsorption
selenium food sources
brazil nuts, fish, meat, eggs, whole wheat bread
which food has the highest water content
broccoli
which substance directly controls calciums intestinal absorption and its use
calcitonin, vit d and parathyroid hormone
active form of vitamin D
calcitriol
which mineral supplement is recommended for mothers expecting multiple births
calcium
what two minerals need to be increased during pregnancy
calcium and iron
functions of vitamin d
calcium and phosphorous homeostasis and bone mineralization
examples of functional foods
calcium fortified orange juice, folate enriched bread, soy based foods
muscle contraction and relaxation require what for stimulation
calcium ions
How does vitamin a cause liver injury
can cause liver injury due to portal hypertension and ascites
what does the body do to b carotene
can convert half of it to active form, retinol.
what is the preferred energy source for infants, children, and adolescents?
carbohydrates
what happens if iron toxicity is left untreated
causes free radical damage that cannot be adequately neutralized by antioxidants
menopause results in
cessation of estrogen and progesterone
water is required for which actives in the body
chemical reactions distribution of heat transportation of solutes
risk factors of bulimia
childhood sexual abuse, childhood physical abuse, or post-traumatic stress, recent sexual assault childhood obesity
sodium deficiency can also lead to
chloride deficiency
name the anions
chloride, bicarbonate, phosphorus and sulfate
When teaching patients with diabetes, which trace mineral should the nurse include as being important for its effect on insulin?
chromium
Kashin-Beck disease
chronic arthritis and joint deformity cause by selenium deficiency
what two conditions lead to vit k deficiency
chrons disease and chronic antibiotic use
food sources of vitamin c
citrus fruits and veggies, pineapples bell pepper oranges lemons
food sources of vitamin b12
clams, eggs, tuna, salmon, milk
foods that impair iron absorption
coffee, tea, dairy, soy, eggs
what are the negative consequences of not consuming enough of EPA and DHA essential fats early in development?
cognitive development and learning delays
which cue is associated with general symptoms used to help diagnose an eating disorder
cold intolerance, fatigue
functions of vitamin c
collagen synthesis and blood vessel wall regulation, iron redutant, antioxidant
how to help sodium deficiency from strenuous exercise
commercial sports drinks which supplement sodium and glucose
which are functions of phosphorus in the body
component of DNA ph balance calcification of bones and teeth stores energy as ATP
iodine
component of thyroxine T4, a hormone made by the thyroid gland that helps control the BMR.
cretinism
condition of congenital hypothyroidism in children that results in a lack of mental development and dwarfed physical stature; the thyroid gland is either congenitally absent or imperfectly developed
how does magnesium contribute to muscle action
conduction of nerve impulse for cardiac and muscle contraction
poor zinc intake in pregnancy can result in
congenital malformations
which meal program is most appropriate for a physically active older adult who is socioeconomically stable
congregate nutrition services
how can you enhance absorption of iron
consuming vitamin c and eating moderate amounts of lean meats, fish, and poultry in the same meal.
how does calcium contribute to bone and tooth formation
contains 99% of the body's calcium
why should you wait until 1 year to introduce cows milk
contains high amounts of calcium which inhibits iron absorption
excessive zinc leads to
copper deficiency
The renin-angiotensin-aldosterone-system
corrects hypovolemia by slowly increasing blood volume by reabsorbing sodium in the kidneys, which leads to water retention and vasoconstriction which increases blood pressure
which medication may increase water intake requirements
corticosteroid, anticholinergic, snri
food sources for riboflavin (b2)
cows milk
hindmilk
creamy, high in fat and other nutrients
what must happen for the active form a vitamin d to be made
d2 and d3 must be activated in two successive hydroxylation reactions
Severe hypomagnesemia can cause
death through cardiac arrhythmia
Why might Vitamin B12 supplementation need to be provided to older adults by subcutaneous injection?
decrease in digestive juices to be able to absorb vitamin d, injections will bypass GI tract for better absorption
Why are older adults at risk for dehydration?
decreased kidney function thirst response is blunted changes in hypothalamus
reduction of thirst in elderly is caused by
decreased production of ADH by the hypothalamus
hypocalcemia
deficient calcium in the blood that can result in muscle spasms, tetany that can progress to seizures and dementia
hypokalemia
deficient potassium in the blood; often due to prolonged diarrhea/vomiting, severe malnutrition, misuse of laxatives or surgery.
what can cause chloride toxicity
dehydration
iodine deficiency in childhood can lead to
delayed growth and onset of puberty
What is the leading cause of unintentional weight loss for older adults?
depression
what is first line treatment for GDM
diet and exercise
which clinical assessment finding leads the nurse to believe that a patient has hypokalemia
difficulty breathing, bloating and irregular heart beat
decreased secretion of digestive juices results in
diminished absorption and bioavailability of nutrients
normal milestones of growth length by 4 years
double birth length
normal milestones of growth weight by 6 months
double birth weight
albumin
draws water inside blood vessels to maintain equilibrium of the solute concentration between the fluid compartments
xerostomia
dry mouth
why do woman require extra iron
due to menstration
why do people who smoke or vape need additional vitamin c
due to oxidative stress from free radicals damage from the smoke, an additional 35mg of vit c is recommended to stabilize free radicals
What are two interventions an individual can do to decrease the amount of skeletal muscle mass loss at this age?
eating an adequate amount of protein, regular exercise
binge eating disorder
eating large amounts of food in a short amount of time. -no food control -secretly eat -guilt and shame The constant dieting and weight gain place these people at risk for alcohol and drug abuse.
food sources of folate
edamame, fortified breakfast cereals
sodium toxicity
edema, acute hypertension
good sources of vitamin a
eggs, milk, carrots, sweet potatoes, cantaloupe (orange foods), spinach, broccoli
who is most at risk for dehydration
elderly due to associated changes in hypothalamus and kidneys
What are the two particles that control water balance in the body?
electrolytes and plasma proteins
decline in insulin production and sensitivity in older age can cause
elevated blood glucose and DM
rhodopsin
enables the eye to adjust to different amounts of available light; retinal is part of this
sulfer makes high energy bonds that make metabolic reactions
energetically favorable
People particularly susceptible to dehydration include those who
engaging in intense exercise, those who have severe cutaneous compromise, infants, and older adults.
manganese functions
enzyme used for CHO amino acid and cholesterol metabolism formation of bone and cartilage as well as wound healing associated with serum ferritin concentrations
sulfur functions
essential element in protein structure
MNA
evaluates risk for malnutrition
hyperkalemia
excessive potassium in the blood due to excessive intake or IV administration of potassium; can lead heart to weaken to the point of cardiac arrest
dietary requirements of vitamin D vary due to
exposure to sunlight, latitude of residency, melanin concentration
where is chloride found in the body
extracellular fluidmagn
anorexia
extreme aversion to food, Severe weight loss Decreased basal metabolic rate. affects girls more than boys
Effects of hypothyroidism
fatigue, depression, weight gain, cold intolerance, infertility, thin and course dry hair and skin, low and husky voice
what is the back up energy source for infants, children, and adolescents?
fats
good food sources for vitamin d
fatty fish, fortified milk, plant milks, mushrooms, margarine
iron is stored as ___________ in the liver, spleen and other tissues
ferritin
foremilk
first breast milk received in a feeding, watery and low in cals.
anorexia risk factors
first degree relative with AN, BN, or depressive disorder, higher rates in monozygotic twins. obsessive traits in childhood
antidiuretic hormone (ADH)
first line of defense against hypovolemia; synthesized by hypothalamus and stores in pituitary gland, conserves water by telling kidneys nephrons to increase absorption of water and constrict blood vessels resulting in normal blood volume and osmotic pressure
chemical buffer system
first line of defense against pH shift; when strong acid added to a buffered solution, the base partner reacts with acid to form a weaker acid (acid+alkalline base)
during which two stages is growth the greatest
first six months and onset of puberty
food sources of fluoride
fish products, tea, crab, shrimp, raisins, grape juice, cream of wheat, grits, oatmeal
What are the best food sources of EPA and DHA
fish, seafood, egg yolks, and algae
What are the best food sources of EPA and DHA?
fish, seafood, egg yolks, and algae
if folate or folic acid found naturally in food
folate
Is folate or folic acid better absorbed?
folic acid
are foods fortified with vitamin b9 (like grains) fortified with folate or folic acid
folic acid
is folate or folic acid more easily absorbed
folic acid
which food should be avoided when taking monoamine oxidase inhibitor
foods containing tyramine like cheese, cured meats, and soy products
where is the active form of vitamin a found
foods of animal origin, eggs
what are functional foods
foods that have some kind of health benefit beyond basic nutrition. For example it might prevent some kind of disease
colloidal osmotic pressure
force for attracting water; low levels lead to water going where it shouldn't ; doesn't get drawn into cells resulting in edema
how does calcium contribute to blood clotting
formation of fibrin, a protein produced in response to bleeding to form blood clots
fluoride
forms strong bonds with calcium so accumulates in calcified body tissues, such as bone and teeth.
Where is intracellular fluid found in the body?
found inside of cells 2/3 total body water
two basic forms of minerals in body
free ions, covalently bound to another mineral or organic substance
how can vitamin d3 be made in the body
from a compound in the epidermis called precursor 7-dehydrocholesterol when it is exposed to ultraviolet light.
food sources of potassium
fruits and vegetables, potatoes, milk products, bananas and oranges
what food group is most important to consume while taking thiazide diuretics
fruits and veggies because diuretics can cause excess loss of minerals including potassium
What is the purpose of diuretic medications?
gets rid of excessive fluid and lowers blood pressure
iron is necessary for
glucose metabolism collagen and purine synthesis conversion of beta carotene to active vitamin a
Iodine deficiency
goiter and brain damage
toxicity of molybdenum can cause symptoms similar to
gout
What blood pH would indicate a state of alkalosis?
greater that 7.45
food sources for pyridoxine (b6)
grilled chicken, pistachios
the nurse knows that sulfur enhances the structure of which body part
hair skin and nails
calcium ions are vital for communication between what kind of cells
heart muscle and neurotransmitters
Sx of Hypokalemia
heart muscle weakness, possible cardiac arrest, respiratory muscle weakness causing sob, poor intestinal muscle tone with bloating
chloride functions
helps maintain water balance (follows sodium) helps with acid base balance and digestion (hydrochloric acid in stomach maintains ph)
how does fluoride protect teeth
helps resist erosion from bacteria
how do we screen iron deficiency
hematocrit, hemoglobin, serum iron, transferrin, ferritin
what are the two forms of iron
heme and nonheme
functions of irons
hemoglobin synthesis and general metabolism
> 98th percentile is _____ wt for length WHO
high
girls who mature earlier are at _______ risk for obesity
higher
potassium toxicity
hyperkalemia
Obesity can lead to gestational diabetes and increase the risk of the baby being born with
hypoglycemia and respiratory distress.
antihypertensive medications can cause
hypokalemia
potassium deficiency
hypokalemia
sodium deficiency
hyponatremia sodium loss due to heavy exercise
Why is hydrating with plain water only after prolonged exercise with significant sweating potentially dangerous?
hyponatremia, not replenishing the loss of sodium from sweat
clinical signs of anorexia
hypotension, bradycardia, cols, fatigue, hypercholesterolemia, hypoglycemia, menstrual irregularities, abdominal pain and bloating
defiency or tocity of iodine can lead to
hypothyroidism; greatly reduces BMR
which foods will provide a good source of calcium
ice cream, collard greens, and calcium fortified orange juice
zinc
immune system mineral
chromium deficiency can result in
impaired glucose metabolism
where can you find b carotene (vit a)
in yellow, orange, and dark green foods
causes of iron deficiency anemia
inadequate intake excessive blood loss loss of HCI which frees iron for GI absorption presence of inhibitors or iron medical conditions that affect GI lining
sx of menopause
increase of body fat, decrease of lean muscle tissue and increases risk of heart disease and osteoporosis
during pregnancy, is iodine needs increased or decreased
increased
midmilk
increased fat content
what happens if you introduce solid foods before four months
increased infant adiposity and childhood obesity
how do fats change during pregnancy
increased requirement of essential fatty acidsfla
hyperventilation balances pH by
increasing the release of CO2 (an acid) combating acidosis
cause of manganese toxicity
industrial occupations inhaling it, and over nutrition in parenteral nutrition
Do children need more or fewer daily calories coming from fat than adults
infants needs higher amounts of fat than adults
who is at risk for water intoxication
infants, athletes, and pateints with polydipsia
which risk is associated with lipectomy procedures
infection, large disfiguring skin depressions, blood clots, circulatory problems
electrolytes
inorganic, single mineral elements that carry electrical charges (cations and anions) that help maintain the body's fluid balance
water forms the basis of which type of body fluid that is also composed of sodium and chloride
interstitial fluid
how does potassium contribute to water balance
intracellular electrolyte holds water inside cells and counterbalances osmotic effect of sodium
water forms the basis of which type of body fluid that is also composed of potassium and phosphates
intracellular fluid
hydroxylation
introduces a hydroxyl group into an organic compound
what is the most common deficiency causing preventable brain damage during pregnancy
iodine
how does sodium contribute to maintain water balance
ionized sodium is the major electrolyte in extracellular fluid, variations in sodium control the movement of water across the membrane by osmosis
Why can pregnant women who are otherwise healthy develop a normal physiologic type of anemia related to pregnancy?
iron deficiency
minor minerals
iron, iodine, zinc, fluoride
dietary needs during lactation
kcals/day increase to 330 kcals/day during the first six months and 400 kcals/day in the second six months of lactation Fluid 3L Increased of vit D, b12, and zinc
what usually causes hyperkalemia
kidney dysfunction not appropriately wasting
chronic dehydration results in
kidney infections, kidney stones, gallstones, and constipation
vit d toxicity
kidney stones, calcification of soft tissues, fragile bones
how does the urinary system help balance pH
kidneys can adapt to secrete either more or less hydrogen ions
why is the cleaning your plate method problematic
kids appetites will vary in childhood, they often don't need any many cals as parents think they do. This can lead to bad relationships with food and overeating/binge eating.
iron toxicity
leading cause of poisoning of children in the u.s.
good food sources of vit k
leafy greens
more or less iodine is required for infants and children
less
what do minor minerals mean
less of these in the body than major; less than 100mg/day
What blood pH would indicate a state of acidosis?
less that 7.35
if you have more melanin do you get less or more vitamin d
less; acts as a sunscreen to not absorb ultra violet rays that activate vit d
which food has a water content of 90% or higher
lettuce, cantelope or squash
What are the five lifestyle interventions listed on the lecture slide that can prevent chronic diseases as you get older
limiting/stopping smoking increased intake of fruits/veg lower diet of sat fat and sodium regular exercise limit alcohol intake
What is colostrum, when is it produced, and what are the benefits to the baby?
liquid gold, first lactation, includes nutrients, antibodies, growth factors, proteins, yellow color due to vitamin A, provides first immune boost and laxative to remove meconium. contains about 20% protein
water intake
liquids consumed food consumed end product of cell oxidation
where does the hydroxylation reactions occur for vitamin d production
liver and kidneys
the highest concentration of selenium found in the body are
liver, kidneys, heart and spleen
which medications if fda approved for us in patients who are obese/and or have type 2 diabetes
lorcaserin, phentermine/topiramate
when does dehydration require medical attention
loss of 10-11% body weight
sx of hypophosphatemia
loss of appetite, fatigue, pain
What does sarcopenia mean?
loss of lean muscle mass associated with aging
<2nd percentile is ____ wt for length WHO
low
what are some potential adverse effects of diuretics related to water and electrolyte balance?
low blood pressure, dehydration, and hypernatremia
Hypovolemia
low blood volume
Hyponatrimia
low sodium in the blood causes acid-base imbalances causing muscle cramps, nausea/vomiting, confusion, coma and death
the more hydrogen ions a solution has, the _________ the pH
lower
zinc toxicity can can alter
lymphocyte function and cause nausea, vomiting and epigastric pain
excess calcium interfers with the absorption of
magnesium, zinc, and iron
plasma proteins
mainly albumin and globulin, organic large molecules that are to large to diffuse so they stay in the blood to regulate solute concentration
where is vitamin a stored
mainly liver, found in eyes, lungs, skin, spleen and testes
manganese is mostly found in
mainly plant sources, also cereals tea and whole grains
functions of sodium
maintain water balance muscle action nutrient absorption
MNA less than 7
malnourished
bulimia
manifests as gorging on large quantities of food, followed by compensatory mechanisms to purge. Alternating binging and dieting. Dieting and inappropriately compensating by: -Vomiting what they have eaten -Using laxatives and diuretics -Fasting -Performing extreme exercises
greatest source of zinc
meat such as beef. low fat millk, peanut butter and oysters
RDA for iron
men and woman 8mg/day woman 19-50 18mg/day
intestinal bacteria form of vitamin k
menaquinone
how does magnesium contribute to basal energy expenditure
mgATP involved in the secretion of thyroxine to maintain a normal metabolic rate and adapt to cold temps
food sources of calcium
milk and milk products, calcium fortified soy products, bokchoy, collard greens and kale
What is a commonly used assessment tool to screen for malnutrition in older adults in a clinical setting? Is this used to diagnose malnutrition?
mini nutritional assessment short form; for screening not diagnosis
Does the amount of carbohydrates needed daily stay the same, increase, or decrease during pregnancy?
minimum increases to 175g/day
hemolytic anemia
more blood cells being broken down than are being made
what do major minerals mean
more of these found in the body than trace; more than 100mg/day
heme iron
most efficently absorbed; found in 40% of animal foods, no plant foods
What are the other signs of readiness for solid foods other than age
motor skills, opening mouth in anticipation for food, baby itself is large enough, can actually process swallowing foods(not pooling in front of mouth)
how does calcium contribute to muscle and nerve action
muscle contraction and release of neurotransmitters from neuron synapses
which change in a toddler most requires an adequate dietary supply of protein, minerals and vitamins
muscle development
sx of mag deficiency
muscle weakness tetany Ventricular arrhythmia growth failure (in children)
Keshan disease
myocardial disease caused from selenium deficiency that primary affects young children and women of child bearing age
food sources of sodium
naturally occurs in food, table salt, processed foods
clinical manifestations of iron toxicity
nausea, irritability, vomiting, diarrhea GI bleeding damage to liver
toxicity of magnesium
nausea, vomiting, diarrhea
how does phosphorous contribute to energy metabolism
necessary for controlled oxidation of carbs, fats, and proteins to release energy
a preterm infant who consumes breast milk from a milk bank is exposed to which risk
necrotizing enterocolitis
how does vitamin k help bone development
needs vit k for osteocalcin to bind to calcium to form bone crystals
anions
negatively charged ions
manganese toxicity
nervous system disorders
signs/symptoms of folate deficiency
neural tube defects
does the fda regulate or recognize functional foods
no
MNA +12
no malnutrition
Can you be diagnosed with gestational diabetes in the first trimester of pregnancy
no, if you are it is most likely undiagnosed type 2 dm
what is the additional daily calorie needs during the first trimester
none
food sources of magnesium
nuts, soybeans, legumes, milk, bananas, cocoa, lots of veggies and unrefined grains, hard water
≥ 95th percentile for BMI-for-age CDC growth chart places individual in the
obesity category
calcium supplements best absorbed in doses ...
of 500mg or less and taken with food
how does the fda recommend supplements
only supplement if you can't meet it in your diet
which food choices are rich sources of potassium
oranges cooked halibut, roasted soybeans
chromium functions
organic complex glucose tolerance factor, which stimulates the action of insulin.
calcitrol maintains bone mineralization which lowers the risk and progression of
osteoporosis
toxicity of phosphorus can result in
osteoporosis
Calcium deficiency
osteoporosis hypocalcemia rickets tetany
Where is extracellular fluid found?
outside of the cells in body water, blood plasma, lymphatic fluid, and interstitial fluid
>= 85th and <95th percentile for BMI-for-age CDC growth chart places individual in the
overweight category
risk factors of GDM
overweight, bmi greater that 26, 30+ years old, pre disposing factors
what prevents the absorption of calcium in plants esp spinach and rheubarb
oxalic acid
what happens when there are too many free radicals
oxidative stress
food sources for niacin (b3)
peanuts, yellowfin tuna
signs/symptoms of vitamin b3 niacin deficiency
pellagra; dermatitis diarrhea dementia death
signs/symptoms of vitamin b12 deficiency
pernicious anemia, peripheral neuropathy, and glossitis
what mineral deficiency can occur from consuming significant amounts of antacids containing aluminum hydroxide
phosphorus deficiency
major form of dietary vitamin k is
phylloquinone
what prevents the absorption of calcium in grains
phytate
Where are phytochemicals found?
plant derived foods
What are the other potential causes of malnutrition in older adults?
poor food habits poor oral hygiene GI problems
decrease of melatonin leads to
poor sleep, insomnia
people with selenium deficiency usually live in geographic areas with
poor soil content of selenium
food sources for thiamin b1
pork, macadamia nuts
cations
positively charged ions
primary intracellular cation; regulated entry of another important electrolyte
potassium
what major mineral stimulates beta cells to release insulin
potassium
how does potassium effect blood pressure
potassium intake increased sodium intake to balance out blood pressure and be normotensive
food jag occurs during
pre school age children
vulnerable population for iron deficiency
pre-school age children, pregnant women
Food preferences come from parents in
preschool-aged children
D vitamins are known as
pro hormones
where is adh produced and stored
produced in the hypothalamus and stored in the pituitary
sulfur deficiency is related to
protein malnutrition
which solutes can influence the movement of water across a membrane
proteins, sodium and glucose
congregate nutrition services
provides adults who are +60 and their spouses nutritionally sound meals in senior centers and other public or private facilities
where is fluoride most commonly found
public water and toothpaste
which water soluble vitamin is involved in protein metabolism
pyridoxine (b6)
What are the symptoms of hyponatremia
rapid pulse, shallow breathing, confusion, headache, seizures, increased urine output, hyperactive bowel.
magnesium deficiency
rare but can be a result of starvation DM kidney disease long term diuretic therapy malnutrition w/ alcoholism
Deficiency of Phosphorus
rare unless using large amounts of antacids containing aluminum hydroxide (binds w/ phosphate which inhibits absorption)
food sources of iron
red meat, organs such as liver, fish and poultry, lentils and other dired beans, dark leafy greens
vitamin d3 niacin toxicity
reddened, flushed skin, itching, burning and tingling
calcitonin
reduces calcium absorption and decreases blood calcium levels
how does calcium act as an iron reductant
reduces iron from ferrous state (3+) back to ferric state (2+)
how does potassium affect muscle action
regulated contraction of cardiac and skeletal muscle cells
how does vitamin k help blood clotting
regulates concentrations of four blood clotting factors.
IGR (intrauterine growth restriction)
results from malnutrition or poor weight gain. may be caused by the moms chronic disease or infection, or substance use or abuse
hypoventilation balances pH by
retaining more CO2 to alleviate alkalosis (retaining more acid)
chronic vit d deficiency in children
rickets
Vitamin D deficiency symptoms
rickets, muscle weakness, heart disease, tb, obesity, dm, alzheimers, parkinsons
MNA 8-11
risk of malnutrition
extreme vitamin C deficiency disease
scurvy
food sources of iodine
seafood, iodized salt, cranberries, navy beans and peanut butter
what is the criteria for diagnosing hyperemesis gravidarum
sever, prolonged, and persistent nausea/vomiting; usually requiring hospitalization
Vitamin A during pregnancy leads to
severe birth defects and miscarriage
chloride toxicity cause
severe dehydration when the concentration of chloride is too great
<2nd percentile for WHO length-for-age chart places individual in
short stature category
how does phosphorous contribute to bone and tooth formation
skeletal bone mineralization, 1/2 of hydroxyapitate
which major mineral creates a dependent glucose transporter than allows the passage of glucose and galactose from the intestinal lumen into the cell
sodium
which molecule is the primary base used in the chemical buffer system
sodium bicarb
how does sodium contribute to nutrient absoprtion
sodium dependent glucose transporters allow for passage of glucose and galactose from intestinal lumen into the intestinal cells
name the cations
sodium, potassium, calcium, magnesium
major minerals
sodium, potassium, calcium, phosphorus, magnesium, chloride, sulfur (salty potato chips pretty much contain salt
describe the four functions of water
solvent, transportation, thermoregulation, lubricant
antioxidant reaction
stabilizes free radicals so less cell damage occurs ; protects PUFAs
how does the parathyroid hormone control calcium
stimulated vitamin d to increase absorption of calcium in the GI tract and to increase blood calcium levels
Zinc deficiency symptoms
stunted growth hypogeusia hyposmia poor wound healing hair loss diarrhea skin irritation compromised immune function
sources of folic acid
supplements, enriched grains, turkey and chicken liver, greens
do phytochemical work better synergistically or as isolated compounds
synergistically
how do you get chloride in the diet
table salt
which b vitamin is needed for carbohydrate metabolism
thaimin (b1)
which rationale is accurate for reestablishing a normal weight and eating pattern as a priority in the treatment of an eating disorder
the neurochemistry returns to normal
How does the FDA regulate supplements?
they regulate it with foods for safety but not with medications so no clinical trials for efficacy
sulfur is a component of which vitamins which act as coenzymes in cell metabolism
thiamin and bitotin
Boys who mature earlier tend to be
thinner
initial sx of dehydration
thirst, headache, decreased urine output, dry mouth, dizziness, impaired concentration 2% of normal weight is lost
treatment for gestational hypertension with protein >300
three full glasses of milk every day
iodine toxicity
thyrotoxicosis or iodine-induced hyperthyroidism
non heme iron
tightly bound in foods (not as efficiently absorbed) found in 60% of animal foods and all plant foods
signs/symptoms of vitamin c deficiency
tissue bleeding, poor wound healing, bleeding gums, toothloss
Why is it recommended women take folate/folic (Vitamin B9) acid prior to becoming pregnant and during pregnancy?
to decrease neural tube defects, most important in the first 28 days of pregnancy; often too late
In which age group would the child master self-feeding?
toddlers
fluorosis
toxicity of fluoride, yellowing of teeth, white spots on teeth
what is the transport protein of iron
transferrin
normal milestones of growth weight by one year
triple birth weight
infants expected growth rate (wt and ht) by first year
triples birth wt and increases in length by 50%
<5th percentile for BMI-for-age CDC growth chart places individual in the
underweight
CDC chart
used to screen infants/children for potential health or nutrition related problems who fall outside of 5th-95th percentile
WHO charts
used to screen infants/children for potential health or nutrition related problems who fall outside the 2nd-98th percentile
good food sources of vitamin e
vegetable oils, sunflower, safflower and cottonseed oil, hazelnuts and spinach.
function of vitamin a
vision, tissue strength, and immunity
advanced sx of dehydration
visual impairment, hypotension, anorexia, muscle weakness, kidney failure and seizures 10% of body weight is lost
what vitamin deficiency can folate mask
vitamin b12
The intestinal absorption of calcium is controlled by:
vitamin d, parathyroid hormone, calcitonin and estrogen
why are premature infants at risk for hemolytic anemia
vitamin e is normally stored with body fat in the last two months of gestation, without the last two months, vit e cannot provide the antioxidant protect from the rbcs breaking down
what are micronutrients
vitamins and minerals
main cause of chloride deficiency
vomiting up hydrochloric acid, excessive diarrhea or sweating
sodiums main three roles
water balance muscle action nutrient absorption
potassium functions
water balance, metabolic reactions, muscle relaxant, insulin release, blood pressure
water output
water loss through kidneys, skin, lungs, feces metabolic byproducts
electrolytes role in water balance
water(fluid) and electrolyte balances are intimately related; change in one = change in the other
thyroxine affects
weight heartbeat temp muscle contraction
treatment of calcium deficiency
weight bearing exercises medications calcium intake in diet (Mediterranean diet)
two scenarios of vitamin e deficiency
weight-loss medications (orlistat), cystic fibrosis
when do physiological buffer systems establish
when chemical buffers cannot reestablish pH equilibrium the lungs and kidneys help
recommendations for lowering risk of obesity
wide variety of nutrient dense foods fruits and veg lower in fridge limit juice and non-nutrient dense snacks have family meals limit screen time make PA a daily family thing
Can you use the WHO charts to track formula fed infant growth?
yes; although the chart was based on breastfed infants
Vitamin E deficiency is rare unless
you cant absorb or metabolize fat
which mineral plays a role in reproductions, optimal growth hormone activity and successful synptic neurotransmission
zinc