Study guide: Health and Nutrition Units 2 and 3
Reading:
Macronutrients are carbohydrates, lipids and proteins
Micronutrients are vitamins and minerals A, C, D, E, K, and eight B vitamins
Identify the differences between macronutrients and micronutrients
Macronutrients needed in large quantities
Micronutrients needed in smaller quintinites and help proteins do their job in the body.
-Differentiate basic S/S for the following diseases:
Obesity is a condition in which the body accumulates an abnormally large amount of adipose tissue, or fat.
Marasmus is due to a general deficiency of macronutrients, also referred to as protein-calorie malnutrition. literally
means “to waste away”. Body fat stores are used up to provide energy, and eventually muscle tissue is broken down for
body fuel. Victims appear as skin and bones, gazing with large eyes from a bald head with an aged, gaunt appearance.
Once severe muscle wasting occurs, death is imminent. children extremely susceptible to respiratory and
gastrointestinal infections.
Kwashiorkor is primarily attributed to a deficiency of dietary protein.
anorexia nervosa restricted intake
bulimia nervosa binge eating followed by purging, vomiting, or misuse of laxatives or diuretics
Pellagra is the deficiency disease of niacin (vitamin B3). It is characterized by “the Four Ds of pellagra”: dermatitis,
diarrhea, dementia, and death.
Reading: Micronutrients
Micronutrients are those vitamins and minerals that organisms require in very small amounts for good health and
development.
Identify diseases/illness related to specific vitamin deficiencies (vitamin A, vitamin C, vitamin D, iron,
iodine, etc.).
Anemia Iron deficient. characterized by small, pale red blood cells, causes weakness, fatigue, and sensitivity to cold
temperatures.
Scurvy vitamin C deficient, bleeding gums and pinpoint hemorrhages under the skin
Rickets Vitamin D deficient, bowlegged or knock-kneed appearance
Physical and developmental problems deficient iron and folic acid deficient
Ariboflavinosis (lack of riboflavin) describes a collection of symptoms such as cracks and redness of the eyes and
lips; inflamed, sensitive eyelids; and a purple-red tongue.
Osteoporosis occurs when calcium reserves are drawn upon to supply the other body parts with calcium. General loss
of stature and fractures of the hip, pelvis, and wrist are common, and a humpback appears. Caucasian and Asian
women of small stature are at greatest risk for osteoporosis.
Reading: Malnutrition
means “bad nutrition.” It can be used broadly to mean an excess or deficiency of the nutrients that are necessary for
good healt
Reading: Treating Malnutrition
Identify effects of and treatments for malnutrition.
Factors contributing to malnutrition
They can be divided into physical, lifestyle and psychological factors but many will link together.
Physical factors may include poor appetite, poorly fitting dentures affecting the ability to chew food, loss of taste
and smell, disability and disease e.g. stroke, cancer, dysphagia and Parkinson's disease.
Lifestyle factors affecting a person's ability to maintain their nutritional intake may include reduced income,
isolation and loneliness, religious or 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 may include confusion, depression, bereavement or dementia, which can affect a
person's ability or desire to prepare food.
,Medications should be reviewed as part of the screening process as they may have side effects that can affect dietary
intake. Drugs used in the treatment of Parkinson's, such as co-beneldopa, can cause a dry mouth and alter taste
sensation. Clopidogrel, usually prescribed following a stroke or myocardial infarction, can cause dyspepsia and
diarrhoea and irbesartan, an anti-hypertensive may cause nausea and vomiting.
Malnutrition Universal Screening Tool (MUST), which is widely used in both hospital and community settings. The
MUST screening tool consists of three parts:
Body mass index (BMI). This is calculated using the individual's weight and height. A BMI of 18.5/m 2 suggest a
significant risk of malnutrition
Recent unintentional weight loss of more than 10% of normal body weight in the last 3–6 months is suggestive
of a significant malnutrition risk
Acute illness resulting in no nutritional intake for more than 5 days
Individuals scoring 2 or above are regarded as being at high risk of malnutrition and would require treatment.
A 'food first' approach is usually the first step towards treating or preventing malnutrition. choosing foods with high
nutritional values and adding snacks in between meals. It may also involve reducing the portion sizes to encourage
completion of the meal.
may prescribe oral nutritional supplements (ONS)
ONS may be stopped when the following conditions apply:
Dietary intake is meeting nutritional requirements
Weight has increased to target
BMI is within healthy range
The individual's medical condition has changed, e.g. an individual with a swallowing difficulty recovers some or
all of their functionality
The individual can no longer tolerate them due to taste fatigue
Key Points
1 in 4 adults are affected by malnutrition on admission to hospital. ([ 3])
Screening should be completed upon initial contact and rescreening should take place as appropriate
Malnutrition management should be looked at with a 'food first' approach as this is the most familiar to the
person affected
ONS should be prescribed by a health professional who will then continue to monitor its effectiveness and stop
or amend as required
Regular monitoring is needed to ensure the management is appropriate and can be amended as needed
Reading: Chapter 1: Applying Nutrition Science to Public Health (PLEASE ACCESS THE CHAPTER THROUGH THE
UNIT 2 COURSE MATERIAL IF THE LINK DOES NOT WORK FOR YOU)
What changes were made when DRIs were established in the late 1990s? Pg 22
DRI’s (Dietary Refrence Intake) replaced the RDA’s (Recommended Daily allowance). DRI's are specificified
on age, gender, and life stage, and cover more than 40 nutrient substances.
They rely on best scientific evidence. Design for healthy individuals overtime and can vary depending on life
cycle stage or gender. the reference values for height and weight of adult in children used in the DRI’s are
from NHANES III. The DRI’s differ from the original RDA's in that they incorporate in the concepts of disease
prevention, upper levels of intake and potential toxicity, in non traditional nutrients. Scientists learn more
about the relationship of phytochemical's, herbals, botanicals, and health these 2 can incorporate into the
recommendations.
DRI's are a set of at least for nutrient based reference values these are estimated average requirements
(EAR), upper intake level (UL), adequate intake (AI), and Recommended Daily allowance RDA
What do the acronyms DRI, UL, EAR, RDA signify? Describe how these numbers are developed and how
they are used to guide nutritional recommendations for people and populations. Pg 22
DRI's are a set of at least for nutrient based reference values these are estimated average requirements
(EAR), upper intake level (UL), adequate intake (AI), and RDA
EAR: is the median intake value to meet requirements. Not all nutrients have an ERA. The ERA is used to
calculate the RDA
, UL: is the highest level of continued daily nutrient intake that is unlikely to pose an adverse health effect
AI: Can be used as a guidance for intake but not be used for all the applications a EAR is used for
RDA: RDA= ERA + 2 Standard deviation of the requirement. If there is not ERA there can be no RDA, if this is
the case an AI is provided.
It is important to meet the RDA or AI without exceeding the UL
Identify the types of dietary fats (including trans-fats) and recommendations regarding their
consumption.
What is the DASH diet and what level of sodium has been shown to reduce high blood pressure?
Dietary Approach to Stop Hypertension (DASH)
Reduce sodium intake bellow the current recommendation of 100 mmol/day and the DASH diet lowered BP
Reading: MyPlate Method
Understand the MyPlate tips including recommended proportions of grains, fruits and vegetables and
other food groups.
● Make half your plate fruits and vegetables. ● Move to low-fat and fat-free milk or yogurt.
○ Focus on whole fruits. ● Vary your protein routine.
○ Vary your veggies. ● Drink and eat less sodium, saturated fat, and
● Make half your grains whole grains. added sugars.
Reading: Healthy.gov Dietary Guidelines 2015: Recommended Shifts Chapter 2
What recommendations would you make to a pregnant patient regarding folate and why? Pg 28/51
To prevent neural tube defects
Provide examples of whole grains versus refined grains and how could a patient better meet the
recommendation for consumption of whole grains?
Whole-Grain Flour
Contains all three parts of the grain kernel: bran, endosperm, and germ.
Has a slightly denser texture.
Has a higher nutrient content, including fiber and B vitamins.
Has a shorter shelf life.
Refined Flour
Contains only the endosperm. The refining process removes the germ and bran.
Reading:
Macronutrients are carbohydrates, lipids and proteins
Micronutrients are vitamins and minerals A, C, D, E, K, and eight B vitamins
Identify the differences between macronutrients and micronutrients
Macronutrients needed in large quantities
Micronutrients needed in smaller quintinites and help proteins do their job in the body.
-Differentiate basic S/S for the following diseases:
Obesity is a condition in which the body accumulates an abnormally large amount of adipose tissue, or fat.
Marasmus is due to a general deficiency of macronutrients, also referred to as protein-calorie malnutrition. literally
means “to waste away”. Body fat stores are used up to provide energy, and eventually muscle tissue is broken down for
body fuel. Victims appear as skin and bones, gazing with large eyes from a bald head with an aged, gaunt appearance.
Once severe muscle wasting occurs, death is imminent. children extremely susceptible to respiratory and
gastrointestinal infections.
Kwashiorkor is primarily attributed to a deficiency of dietary protein.
anorexia nervosa restricted intake
bulimia nervosa binge eating followed by purging, vomiting, or misuse of laxatives or diuretics
Pellagra is the deficiency disease of niacin (vitamin B3). It is characterized by “the Four Ds of pellagra”: dermatitis,
diarrhea, dementia, and death.
Reading: Micronutrients
Micronutrients are those vitamins and minerals that organisms require in very small amounts for good health and
development.
Identify diseases/illness related to specific vitamin deficiencies (vitamin A, vitamin C, vitamin D, iron,
iodine, etc.).
Anemia Iron deficient. characterized by small, pale red blood cells, causes weakness, fatigue, and sensitivity to cold
temperatures.
Scurvy vitamin C deficient, bleeding gums and pinpoint hemorrhages under the skin
Rickets Vitamin D deficient, bowlegged or knock-kneed appearance
Physical and developmental problems deficient iron and folic acid deficient
Ariboflavinosis (lack of riboflavin) describes a collection of symptoms such as cracks and redness of the eyes and
lips; inflamed, sensitive eyelids; and a purple-red tongue.
Osteoporosis occurs when calcium reserves are drawn upon to supply the other body parts with calcium. General loss
of stature and fractures of the hip, pelvis, and wrist are common, and a humpback appears. Caucasian and Asian
women of small stature are at greatest risk for osteoporosis.
Reading: Malnutrition
means “bad nutrition.” It can be used broadly to mean an excess or deficiency of the nutrients that are necessary for
good healt
Reading: Treating Malnutrition
Identify effects of and treatments for malnutrition.
Factors contributing to malnutrition
They can be divided into physical, lifestyle and psychological factors but many will link together.
Physical factors may include poor appetite, poorly fitting dentures affecting the ability to chew food, loss of taste
and smell, disability and disease e.g. stroke, cancer, dysphagia and Parkinson's disease.
Lifestyle factors affecting a person's ability to maintain their nutritional intake may include reduced income,
isolation and loneliness, religious or 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 may include confusion, depression, bereavement or dementia, which can affect a
person's ability or desire to prepare food.
,Medications should be reviewed as part of the screening process as they may have side effects that can affect dietary
intake. Drugs used in the treatment of Parkinson's, such as co-beneldopa, can cause a dry mouth and alter taste
sensation. Clopidogrel, usually prescribed following a stroke or myocardial infarction, can cause dyspepsia and
diarrhoea and irbesartan, an anti-hypertensive may cause nausea and vomiting.
Malnutrition Universal Screening Tool (MUST), which is widely used in both hospital and community settings. The
MUST screening tool consists of three parts:
Body mass index (BMI). This is calculated using the individual's weight and height. A BMI of 18.5/m 2 suggest a
significant risk of malnutrition
Recent unintentional weight loss of more than 10% of normal body weight in the last 3–6 months is suggestive
of a significant malnutrition risk
Acute illness resulting in no nutritional intake for more than 5 days
Individuals scoring 2 or above are regarded as being at high risk of malnutrition and would require treatment.
A 'food first' approach is usually the first step towards treating or preventing malnutrition. choosing foods with high
nutritional values and adding snacks in between meals. It may also involve reducing the portion sizes to encourage
completion of the meal.
may prescribe oral nutritional supplements (ONS)
ONS may be stopped when the following conditions apply:
Dietary intake is meeting nutritional requirements
Weight has increased to target
BMI is within healthy range
The individual's medical condition has changed, e.g. an individual with a swallowing difficulty recovers some or
all of their functionality
The individual can no longer tolerate them due to taste fatigue
Key Points
1 in 4 adults are affected by malnutrition on admission to hospital. ([ 3])
Screening should be completed upon initial contact and rescreening should take place as appropriate
Malnutrition management should be looked at with a 'food first' approach as this is the most familiar to the
person affected
ONS should be prescribed by a health professional who will then continue to monitor its effectiveness and stop
or amend as required
Regular monitoring is needed to ensure the management is appropriate and can be amended as needed
Reading: Chapter 1: Applying Nutrition Science to Public Health (PLEASE ACCESS THE CHAPTER THROUGH THE
UNIT 2 COURSE MATERIAL IF THE LINK DOES NOT WORK FOR YOU)
What changes were made when DRIs were established in the late 1990s? Pg 22
DRI’s (Dietary Refrence Intake) replaced the RDA’s (Recommended Daily allowance). DRI's are specificified
on age, gender, and life stage, and cover more than 40 nutrient substances.
They rely on best scientific evidence. Design for healthy individuals overtime and can vary depending on life
cycle stage or gender. the reference values for height and weight of adult in children used in the DRI’s are
from NHANES III. The DRI’s differ from the original RDA's in that they incorporate in the concepts of disease
prevention, upper levels of intake and potential toxicity, in non traditional nutrients. Scientists learn more
about the relationship of phytochemical's, herbals, botanicals, and health these 2 can incorporate into the
recommendations.
DRI's are a set of at least for nutrient based reference values these are estimated average requirements
(EAR), upper intake level (UL), adequate intake (AI), and Recommended Daily allowance RDA
What do the acronyms DRI, UL, EAR, RDA signify? Describe how these numbers are developed and how
they are used to guide nutritional recommendations for people and populations. Pg 22
DRI's are a set of at least for nutrient based reference values these are estimated average requirements
(EAR), upper intake level (UL), adequate intake (AI), and RDA
EAR: is the median intake value to meet requirements. Not all nutrients have an ERA. The ERA is used to
calculate the RDA
, UL: is the highest level of continued daily nutrient intake that is unlikely to pose an adverse health effect
AI: Can be used as a guidance for intake but not be used for all the applications a EAR is used for
RDA: RDA= ERA + 2 Standard deviation of the requirement. If there is not ERA there can be no RDA, if this is
the case an AI is provided.
It is important to meet the RDA or AI without exceeding the UL
Identify the types of dietary fats (including trans-fats) and recommendations regarding their
consumption.
What is the DASH diet and what level of sodium has been shown to reduce high blood pressure?
Dietary Approach to Stop Hypertension (DASH)
Reduce sodium intake bellow the current recommendation of 100 mmol/day and the DASH diet lowered BP
Reading: MyPlate Method
Understand the MyPlate tips including recommended proportions of grains, fruits and vegetables and
other food groups.
● Make half your plate fruits and vegetables. ● Move to low-fat and fat-free milk or yogurt.
○ Focus on whole fruits. ● Vary your protein routine.
○ Vary your veggies. ● Drink and eat less sodium, saturated fat, and
● Make half your grains whole grains. added sugars.
Reading: Healthy.gov Dietary Guidelines 2015: Recommended Shifts Chapter 2
What recommendations would you make to a pregnant patient regarding folate and why? Pg 28/51
To prevent neural tube defects
Provide examples of whole grains versus refined grains and how could a patient better meet the
recommendation for consumption of whole grains?
Whole-Grain Flour
Contains all three parts of the grain kernel: bran, endosperm, and germ.
Has a slightly denser texture.
Has a higher nutrient content, including fiber and B vitamins.
Has a shorter shelf life.
Refined Flour
Contains only the endosperm. The refining process removes the germ and bran.
