has all essential amino acids

found in animal derived foods, meat, poultry, fish, eggs, and most dairy products

soybeans are the only plant that is a complete protein

eggs and human milk are the best sources because they are easily digested

does not have all the essential amino acids; lack one or more

many plant foods contain considerable amounts of incomplete proteins

grains and legumes contain better sources of incomplete proteins

20-35% of total cals 

most fat from polyunsaturated and monounsaturated

less than 10% from sat. fats

less than 300mg/day of cholesterol

low trans fats

RDA: 130 g/day- adults and children

AMDR: 45-65% of total cals/day

20-38 g/day 

25 g/day (women)

38 g/day (men)

most common sterol

found only in animals

richest sources: liver and egg yolks

total  <200mg/dL

LDL <130mg/dL

triglycerides <150mg/dL)

total  200-239

LDL  130-159

triglycerides  150-199

total  > or = 240

LDL  > or = 160

triglycerides200-499

major risk factor for heart diseas

<40mg/dL for men

<50mg/dL for women

omega-3

omega-6 fatty acids

linolenic acid and linoleic acid

bad fats

act like saturated fats in body, but not fully saturated

raise LDL cholesterol

lower HDL cholesterol

underweight <18.5

normal 18.5-24.9

overweight  >25

obesity  >30

pancreas produces no insulin

tends to occur early in life

cause: viral or autoimmune destruction of parts of pancreas; genetic factors 

trmt: insulin injections to control blood glucose levesl balanced with food intake and lifestyle behaviors to dreduce complications

health risks: heart disease, kidney disorders, and retinal damage

pancrease produces defective inslulin unable to serve needs of body

cause: genetic, environmental, and lifestyle factors

trmt: exercise and consume moderate kcal, high-fiber, low-fat diet; may require oral meds and/or insulin injections

health risks: samt as for type 1

blood glucose levels- remain abnormally high during pregnancy

may result in: pregnancy-induced hypertension, premature birth, large fetus size, congenital abnormalities, future obesity, and diabetes in infants

mother tends to develop type 2 DM later in life

management: dietary modifications and physical, psychosocial, and educational requirements

pure vegetarians

smallest group of vegetarians

no animal products of any kind

lower body weight

lower in fat and cholesterol

reduces risk of ceratin diseases

spiritual

economical

compounds that guard other compounds from damaging oxidation.

Vit. A, C, E, and Selinium (ACES) are antioxidants

a condition in which a person experiences increased fluid retention and edema

associated with a compromised regulatory mechanism, excess fluid intake, or excess sodium intake

a person experiences vascular, cellular or intracellular dehydration

severe fluid volume deficit occurs when body fluid levels fall by 10% of body weight

male- 40-97g/day

female- 40-97g/day

male- 130g/day

female- 130g/day

male- 56g/day

female- 46g/day

vision problems

vision, immune system

live, whole milk, fish, organe/green leafy veg.

ricketts

maintains Ca/Ph, bone mineralization

sunlight, liver, fatty fish, egg yolks, fortified milk

cystic fibrosis (secondary deficiency)

protects cell membranes, antioxidants

veg. oil, nuts, dark green veg.

decreses effect of coumadin

synthesis of protein clotting factor

green leafy veg., eggs, bacterial intestinal synthesis

thiamin

beri beri, wernicki

coensyme in energery metabolism, nervous system function

whole grain, legumes, nuts, liver, pork

chelosis, glossotis

coenzyme in energy metabolism

milk, eggs, fish, dark leafy veg. whole grains

niacin

pellagra (3 Ds)

coenzyme in energy metabolism

meats, milk, whole grain

peroxidine

dermatitis, anemia

coenzyme in amino acid and fatty acid metabolism

meats, fish, fuits, green leafy veg. legumes

spina bifida (neural tude defects)

coenzyme in synthesis of new cells

animal sources

pernicious anemia

coenzyme in synthesis, antioxidant, wound healing

citrus fruits, broccoli, tomatoes

scurvy

collagen synthesis, antioxidant, wound healing

citrus fruits, broccoli, tomatoes

RBC anemia, PICA

formation of hemoglobin

meats, grains, legumes, beans, dried fruit

goiters

thyroid regulator

cabbage, turnips, salt

insulin resistant

ricketts, osteoporosis

bone and teeth structure

milk, cheese, yogurt, broccoli, kale, almonds

hypo/hyperkalemia

major intracellular cation

whole grains, oranges, bananas, legumes

twitching of muscles, growth failure

nerve/muscle function

broccoli, legumes, whole grains, nuts, poultry

hypo/hypernatremia

major extracellular cation, fluid/electrolyte balance

spinach, beets, salt, milk, fish, poultry, celery, eggs

refeeding syndrome

energy transfer, acid/base balance

eggs, meat, fish

clear, non-nutritive; used for short term only, post op

broth, popsicles, gelatin, apple juice

used for transition diet; can be adequately nutritive with snacks

soups, milk, custard, veg juice

used for oral or facial surgery, chewing/swallowing difficulties

all items on liquid diet, scrambled eggs, mashed potatoes, and pureed meats, fuits/vegs

regular diet w/chopped, ground, minced; used for poorly fitting dentures, dysphagia

mashed, soft, ripened fruit, cooked soft veg., cottage cheese, pancakes

used as transition diet or w/mild GI problems

past, canned fruist/veg., moist, tender meats

no restrictions

all foods

controls protein, sodium, potassium, phosphorus and fluids; used for kidney problems (chronic renal failure)

fresh meats, eggs, rice, noodles, w/small amounts fruits, vegs, and milk

daily kcal distributed equally among bfast, lunch, dinner and snacks; give calculated amounts of carbs

no simple sugars, jams, honey, syrup, or frosting; may be limited in fat, sodium, or cholesterol

used for hypertension, heart disease, fluid retention, and renal patients; DASH diet

restrictions from milkd, moderate, and severe on sodium; fresh fruits/vegs, cheese, meats, alternative seasonings

high fiber-used for constipation, IBS, obesity, hyperkalemia, diabetes

bran, oartmeal, steamed vegs, uncooked fruits

low fiber- used before surgery; limited to <10mg/day

canned fruits, cooked vegs, processed breads, cream/broth soups

refusal to maintain normal body weight through self-imposed starvation

heart arrhythmias and death can occur

binge and purge syndrome

vomiting may cause dental problems

may use laxatives and enemas to purge food

often comes with obesity

also called compulsive eating

do not purge

assessment

diagnosis

intervention

monitoring and evaluation

tube feeing through catheter or stoma

still uses the GI system

intermittent tube feeding

bolus feeding- short period of time

continuous drip method

cyclic feedings

does not use GI system

goes into vein

uses the subclavian vein to the superior vena cava

also referred to as total parenteral nutrition (TPN)

used for longer term use- more than 2 wks

smaller peripheral vein is used

usually in the forearm

shorter period of time

age

sex- men have higher BMR than women

body size-larger bodies have higher BMR

if the body has more lean muscle, higher BMR

body temp- fever= higher BMR

fasting/starving- lowers BMR

stress

menstruation

thyroid function- hypo lowers, hyper raises

estimated average requirement

amount of a nutrient needed to meet needs of 50% of a specific group that represents the need of a population

adequate intake

approximate level of an average nutrient intake by observation of or experiementation with a particular population that appears to maintain good health

AI is used when not enough data for RDA

tolerable upper limit

safety boundary

acceptable macronutrient distribution

% of intake values

estimated energy requirement

energy needed to maintain body weight

historical information

meical history- family and pt

personal and social history

cultural and religious consideration

food and nutrition history

biochemical analyses- visceral protein, serum albumin, prealbumin, total lymphocytes

physical exam- anthropomorphic data, etc.

assessment

diagnosis

planning

implementation

evaluation

no synthetics, pesticides, antibiotics, hormones

provide energy

regulate body processes

aid growth and tissue repair

organic nutrients have CHO

linoleic

arachodonic

linolinic

healthy skin

aids in blood clotting and inflammation

ex. fish, shellfish, flax seeds

total of 13

A, D, E, K, B1-thiamine, B2-riboflavin, B3-niacin, B6-folate, B12, biotin, pantothenic acid, C

do not give energy, assist enzymes that release the energy from carbs, protein and fats

MAJOR

calcium, phosphorus, magnesium, sulfure, sodium, potassium, chloride

TRACE

iron, zinc, iodine, selenium, copper, fluoride, chromium, manganese, molybdenum

cannot be digested by human enzymes

goes through the large intestines

bacteria digests some of it and the rest is eliminated as waste

binds to fats an cholesterol which helps the heart

diminished total body water

water can help with constipation

dehydration can increase the risk of blood clots, fatal cardiac disease and stroke

need vit D= need doubles over 50 and triples over 70

need calcium= for bone loss

vit. B12= poor absorption

energy decreases but calorie needs increase, decreased protein due to ability to chew

need folic acid (400-600 at least one month prior) and 600 mcg while pregnant

need 50% more iron and no ETOH, keep caffeine to less than 300mg/day (none is best)

add 25g above usual protein

1st trimester= 2200-2900

2nd trimester= add 300-400

3rd trimester= add 452

breastfeeding= add 500

apple shape

greater risk for development of diseases related to weight gain

waist= >40" men and >30" women

pear shape

lessened health risk for weight carried in backside and thighs

gets enough calories but not enough protein intake

(think plenty of Kcals goes with K in Kwashiorkor)