C787 Nutrition Study Guide 2021
C787 NUTRITION STUDY GUIDE
» DRI: Dietary refence intakes/ Family name of other recommendations
• Food Labeling must
... [Show More] include about them
• The differ depending on age group
» Nutrition labeling
• Serving size will always be found (In US)
» Recommended Daily Allowance (RDA) Most important RDI
• People who are sick don’t count as a healthy population for RDA.
• Use when planning meals
» Acceptable Macronutrient Dietary Range (AMDR)
• a range of percentage of calories that you should get each day. Not just one food.
• Carb AMDR for a typical adult: is between 45-65 %. Which means 45-65% of the calories throughout the day should come from carbs.
• 20-30% should come from fat
• CARBS-45-65%
• FATS -20-35%
• PROTEINS- 10-35%
» Macronutrient: Big nutrients that supply calories.
• Carb, Fat, protein
» Tolerable upper intake level
• The highest level of daily consumption that current data has shown to cause no side effects in humans
• Ensures people do not take harmful amounts
• Used for people taking supplement
» Estimated Average Requirements (EAR):
• Used to guide recommendations and meal planning for communities (NOT FAMILY) in combination with upper intake
» Myplate.gov
• Half the plate should be veggies (over the course of the day)
» What is the nutritional benefit of fruits and veggies?
• They provide nutrients and reduce the risk of some types of cancers.
» Fruit and veggie Facts
• People should get 9 servings daily
• Increasing the amount of colorful veggies
• Reduces the risk of stroke
• Fruits and veggies don’t have B12
» Skim milk has roughly the same amount of calcium and protein as whole milk
» The current dietary guidelines suggest/emphasize reduced fat dairy products
» Half of all grain products consumed should be wholegrain products
» There is no DRI for trans-fat & added sugar
» Recommended daily amount of protein intake
• 60g/ day or 0.9g/kg
» Examples of good sources of protein: garbanzo beans, eggs, chicken, yogurt, cheese, ground beef, peanut butter, and tofu.
» Vegetarian
• Mature legume products & grain product
• Whole grains are better than refined
» MSG= amino acid derivative
» A carb with a high glycemic index causes a quicker return to hunger
» Omega 3 fatty acids = good for the heart
» Healthy Sources of fat: fish , nuts, olive oil
» Common sources of high levels of sodium
• Manufactured breads
• Processed foods
• Canned soups and broths
» Legumes= best source of iron
» Reducing risk of heart disease/ stroke
• LDLs below 120mg/dl
• Limit cholesterol intake to less than 30mg/day
• Saturated fat: less than 7% of total calories
• At least 30 minutes of activity in DAILY routine
• Sodium levels below 1600mg per day (VARIES)
• Increase intake of fiber, especially insoluble fiber (most intake will be soluble)
• Limit alcohol intake to 1-2 drinks per day
» Dietary intervention for a patient with a low albumin: High protein diet
» Appropriate foods for a patient with a kidney disease
• Raspberries, wheat bread
• Kidney Disease- Have trouble with protein
» D.A.S.H Diet = Dietary approach to stop hypertension
» Factors controlling hypertension:
• Sodium below 1600mg daily
• Daily exercise – half hour walk
• BMI <25
» Fiber helps protect body against spikes of sugar
» Obesity is now considered a disease
• Affects many organ systems
• Hormones
» Important BMIs
• BMI>30 = Obese
• BMI >25 = overweight
• BMI <17 = low BMI.
» Low BMI = Risk of infertility, osteoporosis, and premature death
» BMI calculation:
• Take height in inches -> square it
• Divide weight in pounds by that number
• Multiply whole thing by 703
» Risk factors for heart disease that are modifiable
• Sedentary lifestyle
• Diet high in trans fat
• BMI >30
» Obese kids and teens are at an increased risk for coronary heart disease
» Obesity is a significant risk factor for osteoarthritis
» As BMI increases, these also increase:
• Heart disease
• Type 2 diabetes
• Premature death
• Osteoarthritis
• Sleep apnea
» Genetic influence on body weight
• Body weights of parents are often predictive of that of their children
» Maintain body weight loss long term patients should:
• Eat just enough calories for activity level “Balance energy expenditure w/ intake”
» Weight loss diet advice: The Draft
• Reduce processed foods
• Increase activity
• Ask yourself “am I hungry?”
• Eat 5 small meals to maintain energy
• Limit sugary drinks
» A person that sticks to their diet long term are more likely to keep it off
» Managing body weight how much to lose to make health changes
• Move decimal place over
» Social reason to lose weight -> not sustainable
• Need positivity goals
» Societal factors in obesity epidemic:
• More desk based low activity jobs
• Increased size of food portions at restaurants and home
• Increased consumption of processed foods
» Don’t serve different/ separate meals to different family members
» Along with diet to support weight loss: patients should strive for 90 min of moderate physical activity for at least 3x a week
» Ergogenic aids: Anything that purports athletic ability
• Protein powder: Legal supplement body builder use to increase muscle mass and increase retention
» Anthropometrics
• Weight management assessment tools including weight, height, and waist size
» How do you calculate Physical Activity Level (PAL)?
• Total energy expenditure (cal you burn working out) / Basal metabolic rate (cal you burn being alive)
» Infants and nutrition
• Human milk contains immune factors that infant formula does not
» Juice isn’t recommended for infants because:
• It contributes to dental decay
• Lacks fibers and may contribute to diarrhea
• Highly caloric source of fluid
» Infants need more water per body weight than adults
» Sharing utensils may lead to risk cavities in infancy
» Pacifier use PAST infancy can cause dental problems
» What behavior do parents have that may put a child at risk of having a poor relationship with food?
• Not involving children in meal planning
• Avoiding of food choices
» How does the CDC define overweight in childhood?
• BMI for age is over the 85th percentile
» Educating 5-6-year old students: Teach them rhyme with concepts
» Advice for a 9-year-old obese child & their parents:
• High family stress can contribute to poor eating
• Limit portion sizes and avoid restaurants
• Encourage child to help choose & prepare meals
• Encourage physical activity play
• Provide and model choices of healthy plant-based snacks and colorful fruit and veggies at meals
» Strategies to AVOID when teach high school students
• Do not Focus on how good nutrition will make them pretty
• Do not Explain ways to skip or replace meals
» Adolescent girls= 130% calcium for daily values
» Malnutrition
• Can cause stunted growth
• Slow development
• Cognitive development
» Young adults need more thiamine than adults
» Advice for a newly pregnant mom
• Alcohol should be avoided during all trimesters
• Possible effect of alcohol consumption during pregnancy: permanent development disability
• Folate/ Folic Acid Deficit -> neural tube defects
» Dietary sources of folate
• Lentils, spinach, oats
• How can a pregnant mother minimize the risk of preterm delivery?
• Abstain from tobacco and drugs prior to conception and through pregnancy
• Stop all alcohol use
• Maintain healthy weight
» Healthy diet => prevent gestational diabetes
» Breastfeeding
• Burns calories
• Requires extra fluid consumption
• Promotes oxytocin release
• Reduce risk of childhood obesity
» Older Adulthood
• Adults over 70 are more vulnerable to inadequacy of one or more dietary nutrients because of different GI physiology interferes with absorption
• They also decrease appetite and drive
» Potential benefits of pre and pro biotics for an older adult
• Decreased total cholesterol
• Control of IBS
• Support of immune system function
• Rebuild bond density
» Adapting to older adulthood: remain active and overall caloric needs may decrease
» Patient should talk to Healthcare provider before starting any supplements
» The phrase “not intended to diagnose, treat, cure, or prevent any disease” is required to appear on supplement labels
» Types of “Aids”
• Ergogenic Aid -> athletic performance
• Inotropic -> cognition
• Probiotic -> digestive
» Galactagogue breastmilk production
» Deficiencies
• Thiamine – Beriberi
• Iodine – Brain damage, intellectual impairment, goiter
• Vit A- Blindness in young children
• Vit D- Rickets
• Vitamin K should be avoided while on warfarin
» Vegetarians need to take B12 supplements
» These nutrients are available in food but may require special considerations
• Iron
• Vit D
• Protein – hardest macronutrient to find
• Calcium
» Food insecurity: a limited availability to acquire nutritionally adequate food in socially acceptable ways
» Contributing factors to global hunger: Food waste and overpopulation
» Famine:
• Natural causes of famine: Pests, Draught, food
• Decreased agricultural output on a large scale
» If you see “infection” on test they mean human infection
» Economic research service
• Assists in providing research and analysis on food security issues in developing countries
» Food deserts
• characterized by their lack of: availability and accessibility of healthy food
• Food deserts are filled with people who are “food insecure
• Fast food is more affordable in that area
• Markets in that area don’t have fresh produce or are limited
» Where some public strategies to reduce food deserts?
• Implement urban farmers market
• Supporting public policy to reduce costs of fresh foods
» Main focus of the food security survey model: Financial limitations to adequate nutrition
» Undernutrition
• A person who consumes many calories but without adequate nutrition
• Also included chronically hungry
» Child food security module
• Use anywhere from 4 years to adolescence
• Determines if a child is experiencing hunger at home
• Be able to use this over on the phone
» Household food security status
• An outcome measure to examine the public’s ability to secure adequate food
• Outcome measures: what result did you get out of the security survey
» Food Security: Means all people have access, at all times, to sufficient food for an active and healthy life
» Food Security Survey Module:
• It measures sufficiency of food and very low food security requires intervention
• If the outcome you get at the end of the Survey is very low that’s a diagnosis which requires an intervention
» Low Food Security is characterized by: Reduced quality, variety, or desirability of diet
» What was one effect of the national nutrition monitoring and related research act of 1990?
• Development of standardized questionnaires for measuring household food security status
» Hunger: the uneasy or painful sensation caused by lack of food
» A factor for a patients frequent ED visits for CHF: the patient often goes without medication because they cannot afford them until they are paid
» What problems or factors can be associated with food insecurity?
• Poor nutrition
• Trouble obtaining food
• Obesity
• Lower cognitive and academic performance
• Poorer health status
» What does the supplemental nutrition assistance program (SNAP) do?
• help low-income families who have trouble affording acquired food
» Question: which is the most appropriate referral to have home meals delivered by meals on wheels?
• Male, 82, limited income, BMI 17, mobility issues and cannot drive
» Question: which most appropriate referral to the woman is., infants, and children program
• Female, age 22, speaks limited English, 6 months pregnant, low income, difficulty obtaining pre-natal care.
» Question: what is not a primary consideration when addressing nutritional needs for a homeless patient?
• Is the food fair traded certified?
» Considerations when addressing nutritional needs for a homeless patient
• Is the food ready to eat or does it need to be prepared?
• Non-perishable or will it need refrigeration
• Nutritionally adequate
» What is a major barrier to nutritional education, and a strategy for overcoming that barrier?
• Illiteracy; screening for problems with written materials and providing picture-based instruction
» When working with a patient who speaks limited English, what strategies should the nurse use?
• Using pictures to teach
• Using foods from the other persons culture
» Elderly Nutrition Program: Program that teaches older adults how to shop, plan, and prepare nutritious meals, as well as conduction hypertension assessments.
» What is one way that programs seek to provide socialization to older adults: providing meals in group settings [Show Less]