C787 Nutrition Study Guide 2021

C787 Nutrition Study Guide 2021 C787 NUTRITION STUDY GUIDE » DRI: Dietary refence intakes/ Family name of other recommendations • Food Labeling must 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 » M • 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 • BMI30 = 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