Term
| What is the current nutritional problem in US? |
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Definition
| dietaryexcesses and imbalances that create new problems and rank among the leading causes of illness and death |
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Term
| Dietary factors are risk factors for which leading causes of death in US? |
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Definition
•Coronary heart disease
•Cancer
•Stroke
•Diabetes Mellitus
•Unintentional Injuries (related to excess alcohol) |
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Term
| What are the types of studies for nutritional imbalances? |
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Definition
1. Laboratory animal studies, human metabolic studies and population studies: Relationships between dietary factors and disease are investigated indirectly.
2.Human studies: include clinical and laboratory measurements of physiologic indicators of nutritional status or risk factors, as well as dietary intake data for individuals or populations
3.Epidemiological studies: compare the dietary intake and disease rates in different countries or populations within the same country.
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Term
| What do evidence of most nutritional diet show relating to chronic disease in US? |
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Definition
dietary pattern containing an excessive intake of foods high in calories, e.g. fat (esp. saturated fat), cholesterol, and sodium but low in complex carbohydrates and fiber is one that contributes significantly to the high rates of chronic disease in the U.S
reversing such dietary patterns should lead to a reduced incidence of these chronic diseases
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Term
| What is the energy unit for fat? |
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Definition
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Term
| What is fat important for? |
|
Definition
1.Essential fatty acid, linoleic acid, is used in phospholipids to form arachidonic acid, then prostaglandins or leukotrienes
2.Vitamins A, D, E, K
3.Structural components of cell membranes
4.Precursor for hormones
5.Source of energy |
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Term
| What is increased fat consumption increased risk for? |
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Definition
obesity, insulin resistance, DM-2, some types of cancer (breast, colon; and possibly, rectum, ovary, endometrial, and prostate), hypertension, coronary heart disease, dyslipidemia, stroke, obstructive sleep apnea, obesity hypoventilation syndrome, osteoarthritis, gall bladder disease, and impaired psychosocial function |
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Term
| What effect does saturated fats have on serum cholesterol? |
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Definition
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Term
What effect does polyunsaturated fats have on serum cholesterol?
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Definition
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Term
What effect does monounsaturated fats have on serum cholesterol?
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Definition
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Term
| What is the dietary recommendation for fat? |
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Definition
| 20-35% of the total calories to come from fat with 10% from saturated fat |
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Term
| What are ways to control serum triglycerides? |
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Definition
1.Optimize weight
2.Restrict fat intake to less than 30% of total calories (NCEP Step 1 diet)
3.Limit intake of concentrated sweets
4.Restrict alcohol intake
5.Increase consumption of soluble fiber
6.Increase consumption of fish |
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Term
| What is cholesterol important for? |
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Definition
Sex and adrenal hormones, Bile acids, Vitamin D, Cell membranes |
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Term
| Where is dietary cholesterol usually found? |
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Definition
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Term
| What is the recommended dietary cholesterol intake |
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Definition
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Term
| What is the relationship of risk of CHD and serum CHL? |
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Definition
| Risk for CHD is directly related to the elevation of the total and LDL cholesterol and inversely related to HDL cholesterol |
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Term
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Definition
Dietary Cholesterol, Saturated Fatty Acids |
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Term
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Definition
Fiber, Monounsaturated Fatty Acids, Medications |
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Term
|
Definition
Cigarette Smoking, Obesity |
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Term
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Definition
Female gender, Exercise, Alcohol (moderate), Estrogen / Medications |
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Term
| What is protein important for? |
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Definition
1. Structural components of cells and tissues
2. Enzymes in metabolic/biochemical reactions
3. Peptide and hormone messengers
4. Components of the immune system
5. Source of energy, 4 kcal/gm |
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Term
| How much of body protein in used intracellular? |
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Definition
2/3
enzymes, transport proteins, contractile and structural elements |
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Term
How much of body protein in used extracellular?
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Definition
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Term
| What are the 8 essential aa? |
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Definition
| isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine and they must come from the diet |
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Term
| What is the dietary protein requirement? |
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Definition
0.8 gm/kg or 10-35% of total calories |
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Term
| What is nitrogen balance? |
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Definition
Nitrogen Balance = Nitrogen Intake – Nitrogen Output
Nitrogen Balance = Protein Intake / 6.25 - [ (1.25 x UUN) + 2 ] |
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Term
| What is positive nitrogen balance? |
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Definition
Positive Nitrogen Balance = Anabolism ( I > O ); protein synthesis and fat storage |
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Term
| What is negative nitrogen balance? |
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Definition
| Negative Nitrogen Balance = Catabolism ( O > I ); provides energy |
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Term
| What is the energy of carbohydrate? |
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Definition
|
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Term
| What is carbohydrate used for? |
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Definition
| Constituent of cellular substances – nucleic acids, glycoproteins, enzyme cofactors and structural components of cell membranes |
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Term
| What can carbohydrate help reduce the risk? |
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Definition
Diverticulosis , cancer (colon cancer), Constipation, CHD and DM(difficult to interpret research) |
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Term
| What are monosaccharides? |
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Definition
| glucose, fructose, galactose |
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Term
|
Definition
| sucrose, maltose, lactose |
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Term
| What are polysaccharides? |
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Definition
| Starch, glycogen, and most types of fiber that are large and have high molecular weight |
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Term
| What is daily requirement of carbohydrate? |
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Definition
| 45-65% of total caloric requirements |
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Term
What is daily requirement of fiber?
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Definition
| 20-35 gm/day (14 gm/1,000 kcal) |
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Term
| What are the 2 types of fiber? |
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Definition
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Term
| What is insoluble fiber for? |
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Definition
absorbs water and increases stool weigh
(cellulose, lignin, some pectin and hemicellulose) t |
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Term
|
Definition
reduces blood cholesterol, enhances glucose tolerance and increases insulin sensitivity
(gums, mucilage, some pectin and hemicellulose) |
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Term
| What diseases is sucrose associated? |
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Definition
–Obesity
–Diabetes mellitus – 2
–Reactive hypoglycemia
–Heart disease
–Dental caries |
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Term
| What are 3 things needed to form dental caries? |
|
Definition
a.A fermentable carbohydrate
b.Acid producing bacteria
c.A susceptible tooth
Thus demineralizing teeth |
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Term
| What is the recommended sodium requirements daily? |
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Definition
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|
Term
| What is the average intake of sodium? |
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Definition
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Term
| What effect does inadequate amount of calcium have on body? |
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Definition
| Inadequate dietary calcium consumption in the first three to four decades of life may be associated with increased risk for osteoporosis in later life |
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Term
| What effect does higher intake of calcium have on body? |
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Definition
| Higher intakes of dietary calcium could increase peak bone mass and delay the onset of bone fractures until later in life |
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Term
| What is daily dietary calcium recommendation for men and women age 19-50 yrs? |
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Definition
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Term
What is daily dietary calcium recommendation for pregnant and lactating women?
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Definition
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Term
What is daily dietary calcium recommendation for women age >50 yrs on HRT/ERT?
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Definition
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Term
What is daily dietary calcium recommendation for women > 50 yrs without HRT/ERT?
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Definition
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|
Term
What is daily dietary calcium recommendation for men age > 50 yrs?
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Definition
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Term
| What can iron deficiency anemia cause? |
|
Definition
a.Reduced work capacity
b.Depressed immune function
c.Changes in behavior
d.Impaired intellectual performance |
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Term
| What vitamin cause iron absorption? |
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Definition
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Term
| Which food is high in iron? |
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Definition
| lean meats, fish, certain kinds of beans, iron enriched cereals and whole grain products |
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Term
| How much energy does alcohol have? |
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Definition
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Term
| What affect does alcohol have on HDLs? |
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Definition
| Increases the HDL-3 sub-fraction but does not change the anti-atherogenic HDL-2 sub-fraction |
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Term
| What are the risks of alcohol? |
|
Definition
1.Addiction
2.Birth defects in pregnant mothers who drink
3.Impaired judgment and ability to drive
4.Adverse reaction with certain medications
5.Disruptive family functioning, suicide and homicide
6.Liver disease – principal cause of cirrhosis
7.Some types of cancer – CA of mouth, larynx, esophagus
8.High blood pressure – direct association between high blood pressure and alcohol consumption > 2 drinks
9.Stroke
10.Cardiomyopathy |
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Term
| What is the recommendation for alcohol? |
|
Definition
| No more than 1 drink/day for women, 2 drinks/day for men |
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Term
| 1 drink has how much alcohol? |
|
Definition
|
|
Term
| How much is 1 drink equivalent to? |
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Definition
•12 ounces of beer
•5 ounce glass of wine (12% alcohol)
•1 ½ ounces (one jigger) of 80-proof distilled spirits |
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Term
| How much would the risk of CHD reduce when CHL is reduces 1%? |
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Definition
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Term
| How do you manage high CHL? |
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Definition
1.Optimize weight (diet + restrict sigar and alcohol)
2.Restrict fat intake
3.Limit intake of concentrated sweets
4.Restrict alcohol intake
5.Increase soluble fiber intake
6. Increase fish consumption |
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Term
| What are the 3 non-drug methods to reduce high BP? |
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Definition
Weight control, Sodium restriction, Alcohol restriction |
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Term
| How much BP reduce with loss of 10 kg of weight? |
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Definition
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|
Term
True or False?
There is a direct association between blood pressure and alcohol consumption beyond 2 standard sized drinks daily |
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Definition
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|
Term
| What other nutritional factors can reduce hypertension? |
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Definition
| potassium, calcium, magnesium and fiber omega-6 and omega-3 polyunsaturated fatty acids |
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Term
| Which types of cancers have relationship with dietary fat? |
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Definition
| incidence of breast and colon cancer and possibly rectum, ovary, endometrial and prostate |
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Term
| What type of food reduce risk of colon cancer? |
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Definition
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Term
| What are the guidelines to reduce risk of cancer? |
|
Definition
1.Reduce fat intake to 30% or less of calories
2.Increase fiber intake to 20–30 gm/day, with an upper limit of 35 gm
3.Include a variety of vegetables and fruits in the daily diet
4.Avoid obesity
5.Consume alcoholic beverages in moderation, if at all
6. Minimize consumption of salt-cured, salt-pickled and smoked foods |
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Term
| What is the action of antioxidants? |
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Definition
| vitamin A, C and E trap organic free radicals and deactivate excited oxygen molecules that are a metabolic by-product |
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Term
| What is the actions of phenols? |
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Definition
| Food additives butylatedhydroxyanisole (BHA) and butylatedhydroxytoluene (BHT) inhibit mutagenesis and the promotional phase of carcinogenesis and raise the levels of glutathione-S-transferase, which detoxifies carcinogens |
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Term
| What is the action of flavone? |
|
Definition
Found in fruits and vegetables
Increase the activity of aryl hydrocarbon hydroxylase that appears to inhibit the formation of lung cancers |
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Term
| What is the action of indoles? |
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Definition
found in cruciferous vegetables (cauliflower, cabbage, brussel sprouts)
increases microsomalmonooxygenaseoxidase activity that inhibits the development of pulmonary and breast cancers |
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Term
| What is the action of aromatic isothiocyanates? |
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Definition
in found in cruciferous vegetables
Induce glutathione-S-transferase which inhibits cancers induced by polycyclic aromatic hydrocarbons |
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Term
| What is the difference between obesity and overweight? |
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Definition
Obesity is a state of excess adipose tissue.
Overweight is excess weight compared to an arbitrary standard |
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Term
| How is obesity and weight related? |
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Definition
| Obesity is being 20% or more than an ideal body weight |
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Term
| Does a lean but very muscular individuals who may be overweight be obese? |
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Definition
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Term
| What are the different ways to determine body fat? |
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Definition
1.Skin fold calipers
2.Body conductivity
3.Life insurance tables
4.Body mass index (kg/m²)
5.Underwater weighing
6.MRI/CT |
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Term
| How do you calculate BMI? |
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Definition
| weight (kg) / height (m)2 |
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Term
|
Definition
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|
Term
| What is the BMI for obese people? |
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Definition
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|
Term
| Where do men and post-menopausal women store fat? |
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Definition
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|
Term
| Where do pre-menopausal women store fat? |
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Definition
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|
Term
| What waist to hip ratio has increased risk for HBP, CHD, DM-2? |
|
Definition
>1.0 in males
> 0.9 in females |
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Term
| At what waist size in indicative of health risk? |
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Definition
> 40 inches in males
> 35 inches in females |
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Term
| What are the causes of obesity? |
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Definition
1.Genetic – ob gene and leptin in adipose cells, PraderWilli Syndrome, Laurence Moon Biedl Syndrome
2.Environmental / Cultural
3.Primary overeating
4.Altered adipose cell metabolism
5.Decreased or defective thermogenesis in brown adipose tissue
6.Endocrine associations – Cushings Syndrome, hypothyroidism, insulinoma, craniopharyngioma
7.Medications – propranolol, clonidine, prednisone, antidepressants, birth control pills |
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Term
| What is obesity risk factor for? |
|
Definition
1.Coronary heart disease
2.Hypertension
3.Stroke
4.Hyperlipidemia
5.Diabetes mellitus-2
6.Insulin resistance/fasting hyperglycemia
7.Some forms of cancer – breast and colon
8.Osteoarthritis
9.Sleep apnea
10.Cholelithiasis |
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Term
| What type of diest would cause loss of fluids over the 1st week? |
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Definition
| Total starvation or diets restricted to less than 600 kcal |
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|
Term
| What can chronic caloric restriction result in? |
|
Definition
| Diminish metabolic rate and slow weight loss |
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Term
| How much energy is lost with 1kg or 2.2 lbs |
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Definition
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|
Term
| What is the Harris-Benedict formula defined as? |
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Definition
| Determine the number of calories in the diet based on the patient’s ideal weight |
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|
Term
| What is the Harris-Benedict formula? |
|
Definition
adult 25-30 kcal/kg IBW
injury 40-45kcal/kg IBW
Basal IBW in pounds x 1
Sedentary IBW in pounds x 3
Moderate IBW in pounds x 5
Strenuous IBW in pounds x 10
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|
Term
| What is the recommendation for adults regarding exercise? |
|
Definition
| 30 minutes every day for all adults |
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|
Term
What is the recommendation for children regarding exercise?
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|
Definition
|
|
Term
| When should you prescibe weight loss drugs? |
|
Definition
| patients with BMIs 30 and over or for patients with BMIs 27 – 29.9 who also have concomitant risk factors, such as DM-2, CHD |
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Term
| What guidelines help determine to approve surgery to lower obesity? |
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Definition
1.A BMI ≥ 35 with an associated comorbidity or
a BMI ≥ 40;
2.Repeated failures of other therapeutic approaches;
3.At eligible weight for 3 to 5 years;
4.Capability of tolerating surgery;
5.Absence of alcoholism, other addictions, or major psychopathology
6. Prior clearance by a psychiatrist |
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Term
| What is the BMI to advise surgery for obese patients? |
|
Definition
| BMI of 40 or higher or a BMI of 35 - 39.9 with comorbid conditions |
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|
Term
| What are the surgical procedures to reduce obesity? |
|
Definition
1. Vertical banded gastroplasty
2. Laproscopic gastric band
3. Roux-en-Y gastric bypass |
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|
Term
| What are the goals of Healthy People 2010 regarding obesity and overweight? |
|
Definition
•Reduce the proportion of children and adolescents who are overweight or obese to 5%.
•Reduce the proportion of adults who are obese to 15%. |
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Term
| A 30 year old male with a positive PPD and a normal chest x-ray is started on six months of isoniazid (INH) 300 mg daily. The vitamin deficiency associated with the usage of INH |
|
Definition
Pyridoxine - Vitamin B6
That is what you give to pateints taking INH in order to prevent neuropathy and sideroblastic anemia (disease in which the bone marrow produces ringed sideroblasts rather than healthy red blood cells )
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Term
A 45 year old obese female has a TC: 240, TG: 400, HDL: 40 and LDL: 120. Which of the following would be a dietary recommendation to lower her serum triglycerides? |
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Definition
| Increase fish consumption and soluble fiber |
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Term
Using the Harris Benedict formula, it is calculated that your patient requires 1800 Kcal / day for weight maintenance. How many grams of total fat should be in the diet to achieve the NCEP guidelines for total fat? |
|
Definition
- First calculate how much calorie is attributed to fat (30% of 1800 Kcal = 540 kcal)
- Convert calories to grams of fat (1 g of fal = 9 cal; 540/9)
- Answer: 60 g of total fat
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