Marconutrients - ✔️ Carbs, lipids & proteins. Provides energy needed for growth, thermoregulation, physical activity, pregnancy/lactation. Neede... [Show More] d in larger amounts than
micronutrients.
Micronutrients - ✔️ Vitamins/minerals in small amts for good health/development. Play various
roles in cell metabolism. Deficiencies cause widespread health problems.
Obesity - ✔️ Excess consumption. Increased risk for CAD, some cancers & type 2 diabetes. Puts
stress on knee/ankle joints. Is an energy imbalance, where energy intake exceeds energy
expenditure. Influenced by genetic/environmental factors.
Marasmus - ✔️ General deficiency of macronutrients. Also called protein-calorie malnutrition.
Kwashiorkor - ✔️ Primarily attributed to deficiency of dietary protein. s/sx include fatigue, irritability,
lethargy, poor growth, apathy, edema, decreased muscle mass, large belly, diarrhea, dermatitis,
change in hair, infections. Can lead to coma/death.
Anorexianervosa - ✔️ Restricted intake. Body weight @ or < 85% of normal. Intense fear of wt gain,
distorted perception of body wt. 3rd most common condition of adolescents. Common co-
morbid conditions: OCD, depression, anxiety, social phobia. Can lead to decreased
micronutrient intake, which leads to death.
Bulimia nervosa - ✔️ Binge eating f/b purging (vomiting or misuse of laxatives/diuretics). Can lead
to obesity.
Pellagra - ✔️ Deficiency of Niacin (Vit B3). Characterized by "4 D's of Pellagra:" dermatitis, diarrhea, dementia & death.
Vit C Deficiency (Scurvy) - ✔️ Early signs are bleeding gums/pinpoint hemorrhages under skin, rough scaly skin, hardening of arteries or massive bleeding can happen & lead to death.
Vit D Deficiency (Rickets) - ✔️ Bone formation impaired. Bow legged appearance.
Vit A Deficiency - ✔️ Leads to blindness. Even mild deficiency causes diarrhea & URIs
Iron Deficiency ( Anemia) - ✔️
Iodine Deficiency - ✔️ Leads to physical/mental developmental delays. Arboflavinosis lack of riboflavin.
Kwashiorkor vs Marasmus - Kwashiorkor - ✔️ Adequate calories, not enough protein. Often occurs in areas of famine, low food supply, low education levels. Often tropical regions w/ diet high in starch/low in protein. Early RX has+ results. Without RX, is fatal.
Kwashiorkor vs Marasmus - Marasmus - ✔️ Means to "waste away." Is acute form of malnutrition. Deficiency of BOTH calories
AND protein. Most severe form of childhood malnutrition. Body fat stores used for energy &
then muscle is broken down for body fuel. Person appears as skin/bones w/ lg eyes, bald head,
aged/gaunt appearance. Once severe muscle wasting occurs, death is imminent. Have below
norm body temp
Treatments for malnutrition - ✔️ Physical factors- poor appetite, poorly fitting dentures, affecting the ability to chew foods, loss
of tase and smell, disability and disease e.g. stroke, cancer dysphagia and Parkinson's
Lifestyle factors- ability to maintain their nutritional intake may include reduced income,
isolation and loneliness, religious and cultural beliefs, lack of food choices, e/g/ people
resident in care homes may have reduced variety menus, or the effects of reduced mobility in
relation to shopping or preparing food
Psychological factors - confusion, depression, bereavement or dementia, which can affect a
persons ability to desire to prepare food
Meds should be reviewed. Parkinson's drugs, co-beneldopa, may cause dry mouth and alter
taste. Clopidogrel (for stroke or MI) can cause dyspepsia and diarrhea and irbestatrit and anti-
htn may cause n/v/
Malnutrition Universal Screening Tool *MUST*
BMI - 18.5 RISK for malnuturtion
loss of 10% or more of normal body weight in 3-6mths is malnutrition risk
Acute illness resulting in no nuturaionl intak for more than 5 days
2 or > high risk of malnutrition
A "food first" approach is usually the first step towards tx or reventing malnutrition. - high
nutritional value, add snacks, reducing portion size to encourage completion of meals, may prescribe (ONS) oral nutritional supplments - ONS may be stopped when the following
conditions apply
-DI is meeting requirements
-Wt has increase to target
BMI is within healthy range
condition has changed- eg. Swallowing condition recovers
0 no longer tolerat them due to taste fatigue
Key points: 1 in 4 addults affect by malnutrition on admission to hospital
screening should be completed upon initial contact and rescreening
Malnutritional mgt should look at with a "food first" approach
ONS should be prescribed to monitor its effectives and stop/ as required. Reg monitoring. [Show Less]
