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Adequate nutrition essential for:
- 1. Growth
- 2. Nml body system function
- 3. Resistance to infection
- 4. Repair of tissues
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Mirconutrients
- 1. Vitamins
- 2. Minerals
- 3. Electrolytes
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Macronutrients
- 1. Carbohydrates
- 2. Proteins
- 3. Fats
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Energy produced from calories for
1. Carbs
2. Protein
3. Fat
- 1. 4cal/gm
- 2. 4cal/gm
- 3. 9cal/gm
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How much and where are body stores for carbs
How long does this last
- 250gm (1000 cal)
- Stored in liver and muscle as glycogen
- Lasts approx 15-20 hours
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How much and where are body stores for protein
- 6,000gm (24,000 cal)
- Stored as plasma, hgb, clotting components, hormones, antibodies, skeletal and smooth muscle
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How much and where are body stores for fat
- 15,000gm (135,000cal)
- Stored as triglycerides
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In the starvation process what order are stores used
Is metabolism increased or decreased
- During first 15-20 hours glycogen (carbs) from muscle and liver--> Fat--> Protein
- Metabolism decreases
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In the stress process what order are stores used
Is metabolism increased or decreased
- First 15-20 hours, CHO stores are used--> Protein
- Metabolism increased
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When can you see the starvation process
in chronic illness
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When can you see the stress process
in major trauma, major sx, sepsis, burns
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At what age is the brain 100% of adult size?
8
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How many fewer calories are needed after puberty
- 200-300 fewer calories.
- Obesity occurs is caloric intake does not decrease
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Indications for a nutritonal assessment
1. Overwight or underweight
2. Unintentional weight loss
- 1. <80% of IBW or >120% of IBW
- 2. >10 lbs or > or equal to 10% of usual weight
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Recommended total fat intake
25-35% total calories
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Recommended saturated fat intake
- <7% total calories
- Found in meat fat, palm oil, coconut oil
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Recommended polyunsaturated fat intake
- <10% of total calories
- Found in corn oil and safflower oil
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Recommended monounsaturated fat intake
- <20% of total calories
- Found in olive oil, avocado
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Recommended cholesterol fat intake
- <200mg/day
- Comes from an animal source
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Recommended CHO intake
- 50-60% of total calories
- Preferably from fruits, grains, veggies
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Recommended PRO intake
14-20% total calories
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Recommended fiber intake
25-30gm/day
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Ideal body weight for women
- 100 lbs for first 5 ft plus 5 lbs for each additional inch
- +/- 10% for large/small frame
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Ideal body weight for men
106lbs for first 5ft plus 6lbs for each additional inch
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BMI for underweight
<18.5
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BMI for overweight
25-29.9
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BMI for obese
> or equal to 30
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Body wieght as a % of IBW
1. Mild malnutrition
2. Moderate malnutrition
3. Severe malnutrition
- 1. 80-90% of IBW
- 2. 70-79% of IBW
- 3. <70% of IBW
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Increased risk for waist circumfrence
1. Females
2. Males
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Metabolic Syndrome
Three of the following:
- BP > or equal to 130/85
- FBG > or equal to 110
- TG > or equal to 150
- Decreased HDL (women <50) (men<40)
- Increased waist circumfrence (women >35) (men >40)
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Calculations for BMR
- Harris-Benedict equation
- Mifflin equation
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Nml Hgb levels for
1. Females
2. Males
- 1. 12-16 g/dl
- 2. 14-18 g/dl
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Nml hematocrit
1. Females
2. Males
- Hbg x 3
- Females: 36-46%
- Males: 37-49%
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Goals for cholesterol
<200mg/dl
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Goals for LDL
- <160mg/dl (0-1 CAD risk factor)
- <130mg/dl (> or equal to 2 CAD risk factors)
- <100mg/dl (CAD, DM or <70 in some cases)
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Marasmus
PRO and calorie malnutrition (e.g. CA cachexia)
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Kwashiorkor
- Diets high in CHO and calories, but low in PRO
- 3rd world countries
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Serum Albumin
- Long half life (17-20 days)
- Indicated nutritional status almost 3wks prior
- Nml 3.5-5.5 gm/dl
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Serum Transferrin (Protein that carries iron)
- Shorter half life than albumin (8-10 days)
- Earlier indicator of malnutrition than serum albumin
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Prealbumin
- Shortest half life (2-3 days)
- More reflective of current nutritional status
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