Cancer - Nutritional & Lifestyle Guidance
Stomatitis
Answer
Stomatitis
- Choose foods that are easy to chew/swallow (e.g., custard, scrambled eggs, milkshakes).
- Cut food in small pieces and take small bites.
- Drink with a straw (bypasses painful sores in mouth).
- Eat room temperature or cold foods.
- Avoid citrus, spicy, salty foods/drinks and alcohol.
- Avoid raw vegetables and sharp/crunchy foods (e.g., chips).
- Rinse mouth every 1 - 2 hours (e.g., mixture of baking soda, salt, warm water).
- Avoid alcohol-based mouthwash & lemon glycerin swabs.
- Use numbing lozenges or sprays as prescribed.
Card 2
Cancer - Nutritional & Lifestyle Guidance
Xerostomia
Taste Alterations
Answer
Cancer
Xerostomia:
- Sip water throughout day.
- Eat sweet/tart foods, chew gum, or suck on candy (to ↑ saliva).
- Moisten foods with sauce/gravy to make them easier to swallow.
- Rinse mouth every 1 - 2 hours.
- Avoid alcohol-based mouthwash.
Taste Alterations:
- Marinate foods.
- Try tart foods/drinks (e.g., lemon custard).
- Add extra flavor to foods (e.g., herbs, sauces, sweeteners).
- For metallic taste, eat with plastic silverware.
- Keep mouth clean with brushing and flossing.
Card 3
Cancer - Nutritional & Lifestyle Guidance
Decreased Appetite & Weight Loss
Answer
Cancer
- Eat on a schedule, even if you do not feel hungry.
- Eat foods high in protein and calories (e.g., peanut butter, nuts, olive oil, avocado, jam, honey) to help rebuild tissue damaged by cancer treatment. Do not fill up on low calorie foods/drinks.
- Eat 5 - 6 smaller meals throughout the day (vs. 3 large meals).
- Eat meals earlier in the day when appetite is better.
- Drink liquid meal replacements for extra nutrition.
- Sip small amounts of liquids during meals. Drink plenty of liquids between meals.
- Use protein-fortified milk in recipes.
Patients with AIDS are at risk for malnutrition and will benefit from the same nutritional guidance.
Card 4
Cancer Treatment
Potential Complications Affecting Nutrition
Answer
Cancer Treatment
Complications Affecting Nutrition
Additional
Information
↓ Appetite and weight loss
Card 76
Taste or smell alterations
Card 77
Constipation or diarrhea
Card 59
Nausea/vomiting
Card 58
Xerostomia (dry mouth) and taste alterations
Card 77
Stomatitis (inflammation and sores/ulcerations in the mouth)
Card 78
↑ Risk of infection, including foodborne-infections
Cards 60-61
Card 5
Cancer Prevention
Nutrition & Lifestyle Recommendations
Answer
Cancer Prevention
- Eat more plant-based foods (e.g., fruits, vegetables, legumes, nuts, seeds).
- Limit foods high in added fat, sugar, and salt.
- Limit consumption of red meat, processed/smoked/nitrite-cured meats, and salt-preserved foods (e.g., ham, hot dogs, deli meats).
- Limit alcohol consumption.
- Maintain a healthy body size (obesity ↑ cancer risk).
- Engage in physical activity every day.
- No smoking or other nicotine use!
Renal Disorders
Nephrotic Syndrome: Kidney disorder that causes massive loss of protein in the urine.
- Restrict fluids. Low sodium, moderate protein diet (~ 1 g/kg/day).
Glomerulonephritis: Inflammation of the glomeruli, often following a streptococcal infection (strep throat).
- Restrict fluids, sodium, protein.
Urolithiasis: Presence of stones (calculi) in the urinary tract.
- ↑ Fluid intake, ↓ sodium intake, ↓ consumption of animal protein.
- Calcium oxalate stones: Limit foods high in oxalate (e.g., peanuts, rhubarb, beets, spinach, sweet potatoes, chocolate).
- Uric acid stones: Limit high-purine foods (e.g., red meat, organ meat, shellfish), fructose drinks and alcohol.
Renal Disorders
AKI: Sudden loss of kidney function; usually reversible.
- Nutritional Guidance: ↓ Potassium, sodium, phosphorus intake.
- Fluids: During oliguric phase, fluids are restricted. During diuretic phase, fluid replacement may be required.
- Protein: For non-dialysis patients 0.6 - 0.8 g/kg/day. For dialysis patients 1 - 1.4 g/kg/day.
CKD: Gradual, irreversible loss of kidney function.
- Nutritional Guidance: Restrict fluids, sodium, potassium, phosphorus. Provide vitamin supplementation.
- Protein: Restricted based on GFR. 0.6 - 1 g/kg/day for non-dialysis patients, or ~ 1.3 g/kg/day for dialysis patients.
↑ Protein needed with dialysis, as protein is lost with each exchange.
Endocrine Disorders
Cushing's Syndrome: Overproduction of cortisol by the adrenal cortex.
- Restrict fluid and sodium. ↑ Intake of protein and calcium/vitamin D (to ↓ muscle and bone loss).
Hypothyroidism: Inadequate production of thyroid hormones by the thyroid gland.
- ↑ Fiber and fluids to prevent constipation. Calorie-controlled diet to prevent weight gain.
Hyperthyroidism: Excess thyroid hormones released from the thyroid gland, resulting in a hypermetabolic state.
- ↑ Calories and protein intake prior to thyroidectomy.
Endocrine Disorders
Diabetes Insipidus: Insufficient ADH released from the posterior pituitary gland (or inadequate kidney response to ADH), resulting in fluid volume deficiency.
- ↑ Fluid intake, low sodium diet for nephrogenic DI.
SIADH: Excess release of ADH from the posterior pituitary gland, causing fluid volume excess.
- Restrict fluids and replace sodium as ordered.
Addison's Disease: Inadequate secretion of hormones by the adrenal cortex, causing dehydration, electrolyte imbalances, and hypoglycemia.
- ↑ Salt intake, IV fluids and dextrose for Addisonian crisis.
Hypoglycemia
Blood glucose
S/S: Hunger, irritability, confusion, diaphoresis, headache, shakiness, blurred vision, pale/cold/clammy skin, seizure/coma.
If their skin is cold and clammy, then your patient may need some candy!
Nutritional Guidance (for conscious patient):
- Have patient consume ~ 15 g of a quickly absorbed carbohydrate (e.g., 4 oz juice/soda, 8 oz milk).
- Recheck blood glucose in 15 min. If still
- Once blood glucose is > 70 mg/dL, have patient consume a snack containing a protein and carbohydrate (e.g., cheese and crackers).
15/15 rule (15 g of carbohydrates, wait 15 min).
Card 11
Diabetes
Signs/Symptoms
Nutritional Guidance
Answer
Diabetes
Chronic hyperglycemia (i.e., ↑ blood glucose) due to insufficient insulin production by the pancreas and/or insulin resistance of cells in the body.
S/S: 3 Ps (polydipsia, polyphagia, polyuria), weight loss, warm/dry skin, dehydration (weak pulses, decreased skin turgor), fruity breath odor, Kussmaul respirations (↑ rate and depth of respirations), nausea, vomiting, lethargy.
If their skin is warm and dry, their blood sugar might be high!
Nutritional Guidance:
- Follow a carbohydrate-controlled diet as prescribed.
- Administer insulin, oral hypoglycemic agents (type II DM only) as ordered. Goal with therapy: HgbA1C
- To prevent Somogyi phenomenon (morning hyperglycemia due to overnight hypoglycemia), consume snack with nightly insulin dose.
Card 12
Eating Disorders
Anorexia Nervosa & Bulimia Nervosa:
- Nursing Care
Answer
Eating Disorders
- Maintain strict I&Os. Weigh patient first thing in the morning (upon arising) using the same scale.
- Stay with patient during meals and for ≥ 1 hour after meals.
- Offer privileges for treatment compliance and weight gain.
- For inadequate oral intake, tube feedings may be ordered.
- Restrict strenuous activity.
- Monitor for refeeding syndrome, which can occur when nutrition is introduced too rapidly after prolonged starvation (S/S: severe electrolyte and fluid imbalances, arrhythmias, seizures, coma).
Card 13
Bariatric Surgery
Nursing Care
Patient Teaching
Answer
Bariatric Surgery
Reduction of gastric capacity or absorption in morbidly obese patients (BMI > 40, or BMI > 35 with other risk factors).
Post-op Nursing Care: Monitor for dumping syndrome (S/S: abdominal cramping, tachycardia, nausea, diarrhea, diaphoresis).
PT:
- Chew food slowly and completely.
- Eat 6 small meals a day (vs. 3 big meals).
- Do NOT consume liquids with meals.
- DO recline (↓ HOB) after meals to slow gastric emptying.
- Avoid foods high in sugar, fat, carbohydrates.
- Take vitamin/mineral supplements as directed.
Gastrointestinal Disorders
Cholelithiasis: Gallstones.
- Eat a high-fiber, low-sugar diet. Eat healthy fats, fewer refined carbs, lose weight if obese, get regular physical activity.
Cholecystitis: Inflammation of the gallbladder.
- Low-fat diet, weight loss (if applicable).
Cirrhosis: Degeneration and fibrosis (scarring) of the liver.
- Low-sodium diet, small frequent meals, vitamin supplementation (e.g., zinc), no alcohol.
Pancreatitis: Inflammation of the pancreas.
- Bowel rest (NPO) and IV fluids during acute attacks. No alcohol, low-fat diet, pancreatic enzymes, avoid nicotine.
Card 15
Gastrointestinal Disorders - Nutritional Guidance
Short Bowel Syndrome
Diverticulitis
Ostomies
Answer
Gastrointestinal Disorders
Short Bowel Syndrome: Decrease in small bowel length and surface area, causing malabsorption.
- Parenteral nutrition, enteral nutrition, oral rehydration solution.
Diverticulitis: Inflammation of diverticula (small pouches in the intestine).
- NPO or clear liquid diet during exacerbations, then progress to a low-fiber diet. As maintenance for the chronic condition diverticulosis, eat a high-fiber diet.
Ostomies: Surgical procedure that reroutes part of the intestine through the abdominal wall, forming a stoma (e.g., colostomy, ileostomy).
- Chew food thoroughly. Consume a low-fiber diet for first 6 - 8 weeks. Eat meals on a schedule to promote a regular bowel pattern.
- Avoid foods that cause gas/odor (e.g., alcohol, cabbage, broccoli, dairy products, beans, eggs).
Gastrointestinal Disorders
IBS: Intestinal disorder that causes abdominal pain and changes in bowel movements (in the absence of other diseases).
- Keep a food/symptom journal to identify triggers (e.g., milk, alcohol, caffeine). ↑ Fiber intake, avoid gluten, low FODMAP diet. ↑ Physical activity, reduce stress.
IBD: Chronic inflammatory disease of the colon and/or small intestine causing severe diarrhea (e.g., Crohn's disease, Ulcerative Colitis).
- Consume a high-calorie, high-protein, low-fiber diet. Avoid caffeine, alcohol, lactose. Eat smaller, more frequent meals. Enteral or parenteral nutrition may be necessary with IBD complications.
Card 17
Celiac Disease
Signs/Symptoms
Patient Teaching
Answer
Celiac Disease
Autoimmune disorder that causes gluten intolerance, leading to malabsorption and damage to the small intestine.
S/S: Bloating, nausea, vomiting, chronic diarrhea and/or constipation, gas, steatorrhea, abdominal pain, weight loss.
PT: Maintain a strict gluten-free diet. Substitute grains with corn, rice, or millet.
Think BROWN to remember which foods to avoid:
Barley, Rye, Oats, Wheat - Nope!
Oats do not contain gluten, but they are commonly processed in facilities that process gluten-containing grains.
Card 18
Foodborne Illness
Prevention
Answer
Foodborne Illness
- Wash hands after using the bathroom and prior to food preparation.
- Wash fruits and vegetables thoroughly prior to preparing or eating.
- Use separate equipment to prepare raw meats and cooked foods.
- Use a meat thermometer to ensure meat is thoroughly cooked.
- Refrigerate perishables within 2 hours of purchasing or cooking (or within 1 hour if outside temp > 90°F).
- Ensure refrigerator is ≤ 40°F and freezer is ≤ 0°F.
Card 19
Foodborne Illness
Common Pathogens
Risk Factors
Signs/Symptoms
Treatment
Answer
Foodborne Illness
Contamination of food or beverages with bacteria, viruses, or parasites that cause illness.
Common Pathogens: Norovirus, Salmonella, Campylobacter, E. coli, Listeria, Toxoplasmosis.
RF: Raw or undercooked meat/poultry/eggs, unpasteurized milk or juice, fruits/vegetables contaminated with animal feces, raw sprouts.
S/S: Nausea, vomiting, diarrhea, fever, dehydration.
Tx: ORS, IV fluids/electrolytes, antibiotics.
Gastrointestinal Disorders
Constipation:
- ↑ Fluid and fiber intake (e.g., whole grains, raw fruits, veggies).
- ↑ Physical activity.
Avoid regular use of laxatives.
Diarrhea:
- Replace lost fluids and electrolytes to prevent dehydration.
- Adults should drink liquids that contain electrolytes (e.g., sports drinks, broths). BRAT diet (bananas, rice, applesauce, toast) may improve symptoms.
- Children should be given an oral hydration solution (ORS) and resume a regular diet as soon as possible. A BRAT diet should be avoided.
- Monitor for S/S of dehydration (card 22). Infants, children, and older adults are at ↑ risk for dehydration and electrolyte imbalances!
Gastrointestinal Disorders
Nausea:
- Eat 5 - 6 smaller meals throughout the day (vs. 3 large meals).
- Sip only small amounts of liquids during meals.
- Eat/drink foods at room temperature or chilled.
- Eat readily digested, low-fat carbohydrates (e.g., dry toast, crackers). Avoid high-fat foods.
- Avoid strong food and/or drink smells.
Vomiting:
- Do not eat or drink until vomiting stops. Afterwards, drink clear liquids, then progress to full liquids.
- Monitor for S/S of dehydration (card 22).
Gastrointestinal Disorders
Hiatal Hernia: Protrusion of part of the stomach through the diaphragm into the chest.
- Same nutritional/lifestyle guidance as GERD (card 56).
PUD: Erosion in the mucosa of the stomach, esophagus, or duodenum.
- Avoid NSAIDs, alcohol, caffeine, nicotine.
Gastritis: Inflammation of the gastric mucosa (stomach lining).
- Change diet (↓ intake of fatty, spicy, acidic foods), avoid alcohol and nicotine, reduce stress.
Gastroesophageal Reflux Disease (GERD)
Gastric contents (including enzymes) backflow into the esophagus, causing pain and mucosal damage.
S/S: Dyspepsia (indigestion), regurgitation, dysphagia, throat irritation, burning pain in esophagus (worse when lying down, improves when sitting upright), chronic cough.
Nutritional & Lifestyle Guidance:
- Eat smaller meals. Avoid fatty, fried, citrus, spicy foods.
- Remain upright after meals, avoid eating right before bedtime.
- Avoid tight-fitting clothing.
- Lose weight (if applicable), avoid nicotine, ↓ alcohol intake.
- Elevate HOB with blocks.
Card 24
Dysphagia
Risk Factors
Signs/Symptoms
Nursing Care
Answer
Dysphagia
Difficulty swallowing, causing ↑ risk of aspiration and aspiration pneumonia.
RF: Neurological disorders (e.g., stroke/CVA, cerebral palsy, Parkinson's disease, dementia, ALS, GBS, Myasthenia Gravis, Huntington's disease), head/neck/esophageal injury, GERD, infection.
S/S: Coughing, throat clearing, difficulty eating and/or drinking.
NC:
- Coordinate referral to speech language pathologist for swallow evaluation and implement recommended interventions, which may include:
- Provide thickened liquids and dysphagia diet as ordered.
- ↑ HOB (e.g., High Fowler's). Have patient remain in an upright position for 45 - 60 minutes after eating.
- Have suction equipment available.
- Instruct patient to tuck chin when swallowing.
Musculoskeletal Disorders
Osteoporosis: Metabolic bone disorder that causes a lack of bone mass, leading to fragile bones and ↑ risk for fractures.
- ↑ Calcium and vitamin D intake, sun exposure with sunscreen, weight-bearing exercise.
Osteomalacia: "Bone softening" due to a vitamin D deficiency.
- ↑ Doses of vitamin D.
Gout: Metabolic disease that causes hyperuricemia (↑ uric acid) and uric acid crystals to be deposited in the joints (especially the big toe), causing pain, inflammation, and acute arthritis.
- Avoid purine-rich foods (red and organ meat, shellfish, fructose drinks), alcohol, "starvation" dieting. ↑ Fluid intake. ↓ Stress.
Nervous System Disorders
Neurologic Dysphagia: Difficulty swallowing due to a neurological injury or disorder.
- Implement interventions for dysphagia (card 55).
Migraine Headaches: Neurovascular disorder causing unilateral throbbing head pain.
- Avoid foods containing MSG, tyramine, nitrites.
Meniere's Disease: Inner ear disorder that affects balance and hearing.
- ↓ Salt intake and distribute fluid intake evenly throughout the day. Avoid alcohol and caffeine.
Card 27
Heart Health
Heart-Healthy Diet
Heart-Healthy Lifestyle
Answer
Heart Health
Heart-Healthy Diet (DASH or Mediterranean Diet):
- Include fruits, veggies, whole grains, healthy proteins (e.g., low-fat or fat-free dairy, fish, poultry, nuts, beans).
- Limit saturated fat and trans fat.
- Limit sweets and sugar-sweetened beverages.
- DASH diet also emphasizes foods rich in potassium, calcium, magnesium, fiber, and protein.
Heart-Healthy Lifestyle:
- Get regular physical exercise.
- Maintain a healthy weight.
- Limit alcohol intake.
- Avoid nicotine use and smoking.
- Manage stress and get enough good quality sleep.
Cardiovascular Disorders
CAD: Impaired blood flow and oxygen delivery to the heart due to atherosclerosis (build-up of plaque on the arterial walls).
- Adopt heart healthy diet/lifestyle.
Hypertension: High blood pressure.
- Limit sodium to 1,500 mg per day, adopt heart healthy diet/lifestyle.
MI: Sudden blockage of blood flow to the heart.
- Encourage small frequent meals, adopt heart healthy diet/lifestyle.
Heart Failure: Inability of the heart muscle to pump enough blood to meet the body's needs.
- Restrict fluids to
Metabolic Syndrome
Combination of disorders characterized by ↑ abdominal obesity and insulin resistance, resulting in ↑ risk for heart disease, diabetes, and stroke.
RF: Obesity, lack of physical activity, genetics.
S/S: Hypertension, ↑ LDL and triglycerides, ↓ HDL, ↑ waist circumference.
Dx/Labs: Three of the following criteria are present:
- Waist circumference > 40" in men, > 35" in women.
- Triglycerides > 150 mg/dL.
- HDL
- Fasting glucose ≥ 100 mg/dL.
- SBP > 130 mmHg and/or DBP > 85 mmHg.
Nutritional/Lifestyle Guidance: Weight loss, heart healthy diet, ↑ exercise, manage stress, quit smoking, get enough sleep.
Card 31
Protein Energy Malnutrition (PEM)
Marasmus
Kwashiorkor
Answer
Protein Energy Malnutrition (PEM)
Lack of protein, calories, or both. Deficiencies can lead to organ damage and death. PEM is common in poverty-stricken regions of the world.
Marasmus: Malnutrition due to calorie deficiency.
- S/S: Wasted appearance (lack of subcutaneous fat), hypotension, bradycardia, hypothermia, delayed growth.
Kwashiorkor: Severe protein malnutrition.
- S/S: Abdominal distension, peripheral edema, round face, muscle atrophy, poor growth, hepatomegaly (enlarged liver).
Pronounced Kwash-your-core, i.e., "Your core" is distended with Kwashiorkor.
Card 32
Food/Nutrient - Medication Interactions
Dairy Products
Vitamin K
Protein
Potassium
Answer
Food/Nutrient - Medication Interactions
Dairy Products: ↓ Absorption of iron supplements and some antibiotics (e.g., tetracycline).
- Avoid taking iron supplements with milk, calcium, or antacids.
Vitamin K: ↑ Doses may ↓ effectiveness of warfarin.
- Maintain consistent intake of vitamin K while on warfarin.
Protein: ↓ Absorption of medications that require the same transport mechanism as amino acids (e.g, levodopa, a Parkinson's medication).
Potassium: ↑ Risk of hyperkalemia with some antihypertensives (e.g., ACE inhibitors, ARBs) and potassium-sparing diuretics (e.g., spironolactone).
Card 33
Food/Nutrient - Medication Interactions
Tyramine
Grapefruit Juice
Alcohol
Answer
Food/Nutrient - Medication Interactions
Tyramine: ↑ Risk for hypertensive crisis with MAOIs (e.g., phenelzine, selegiline).
- Avoid tyramine-rich foods: cheese, avocados, bananas, red wine, salami/pepperoni, chocolate.
Grapefruit Juice: ↑ Risk for toxicity with MANY medications (e.g., antihypertensives, statins, psychiatric meds).
Alcohol: ↑ Drowsiness with CNS depressants (e.g., antihistamines), ↑ risk of hepatotoxicity with some medications (e.g., acetaminophen).
Card 34
Parenteral Nutrition
Indications
Nursing Care
Answer
Parenteral Nutrition
Intravenous administration of nutrition outside the GI tract.
Indications: Malabsorption, hypermetabolic state, malnutrition, prolonged NPO.
NC:
- Confirm TPN ingredients on the label match the order.
- Gradually increase/decrease flow rate.
- Monitor I&Os, daily weights, electrolyte and glucose levels.
- Use IV tubing with a filter. Change tubing/bag every 24 hours.
- If the next TPN bag is unavailable, administer 10 - 20% dextrose/water until it arrives.
- Do not administer other fluids or meds through TPN line.
- Monitor central line insertion site for S/S of infection or infiltration.
Card 35
Tube Feeding
Best Practices (2 of 2)
Answer
Tube Feeding
- Flush with 30 mL water before and after feeding, medications, GRV check, and every 4 hours during continuous feeding.
- Change delivery sets (e.g., bag and tubing) every 24 hours or per facility policy.
- Clean opening and rim of formula cans before use. Refrigerate opened cans and discard after 24 hours.
- To prevent bacterial growth, limit hang time to
4 hours for open systems and 24 - 48 hours for closed systems (or per manufacturer guidelines).
Card 36
Tube Feeding
Best Practices (1 of 2)
Answer
Tube Feeding
- Before feeding, perform abdominal assessment and confirm presence of bowel sounds.
- Keep HOB 30 - 45° during feeding and for ≥ 1 hr after feeding to ↓ aspiration risk.
- Confirm tube placement:
- Confirm INITIAL placement with X-ray!
- Measure length of exposed NG tube and confirm with documented length.
- Verify pH of aspirated contents.
Do not instill air into tube to check placement!
- Aspirate all gastric contents with syringe and measure gastric residual volume (GRV). Follow facility policy re: holding feeding for large GRV (e.g., > 500 mL) and returning residuals to the stomach.
Card 37
Enteral Nutrition
Indications
Types of Enteral Feeding Tubes
Administration Options
Answer
Enteral Nutrition
Obtaining nutrients via the GI tract (by mouth or feeding tube).
Indications: Disorders that prevent oral nutrition (e.g., dysphagia, coma, upper GI obstruction, severe anorexia nervosa, malnutrition).
Types of Enteral Feeding Tubes:
- Short-term use: Nasogastric tube.
- Long-term use (> 4 weeks): Percutaneous endoscopic gastrostomy (PEG), or surgically placed gastrostomy tube.
Administration Options:
- Continuous feeding: Delivered via gravity or pump.
- Intermittent feeding: Delivered via gravity, pump, or bolus feeding with syringe.
SLOWLY increase feeding rate until ordered rate is achieved (per facility policy).
Oral Diets
NPO: Nothing by mouth. May require diet advancement in stages after being NPO.
Clear Liquid: Items clear at room temperature (e.g., water, ice chips, clear sodas, jello, tea, coffee, and clear broth).
Full Liquid: Any liquids (e.g., clear liquids, milk, orange juice, soups).
Puréed: Food with a smooth consistency. Food processor/blender used until there are no solid pieces/lumps (e.g., mashed potatoes, puréed meat, pudding, jelly).
Soft/Mechanical: Soft consistency, low fiber (e.g., low-fat dairy, eggs, pudding, cooked veggies, tofu, lean skinless meat).
Dysphagia: Thickened liquids; moist/soft or puréed foods.
Regular: No dietary restrictions.
Card 39
Nursing Nutritional Assessment
Components of Assessment
Answer
Nursing Nutritional Assessment
- Obtain patient's height/weight and BMI (card 24).
- Assess for recent weight loss/gain.
- Assess for difficulty chewing or swallowing. If swallow evaluation is needed, refer to speech language pathologist.
- Identify food allergies, diet restrictions.
- Discuss religious or cultural dietary preferences.
- Assess labs:
- Prealbumin: Expected range: 15 - 36 mg/dL. ↓ Levels may indicate protein-calorie malnutrition.
- Albumin: Expected range: 3.5 - 5 g/dL. ↓ Levels may indicate malnutrition, liver or kidney disease.
- Assess for S/S of malnutrition (e.g., dry/brittle hair, dry/scaly skin, poor wound healing, muscle wasting, weakness, lethargy).
Card 40
Older Adults
Nutrition & Lifestyle Guidance
Answer
Older Adults
- ↑ Protein intake to improve muscle function.
- ↑ Fluid intake to prevent dehydration, constipation, and urinary tract infections.
- ↑ Fiber intake to prevent constipation, ↓ cholesterol levels, and regulate blood sugar levels.
- Prevent osteoporosis: engage in weight-bearing exercise (e.g., walking) and strength-training, ↑ calcium and vitamin D intake, avoid smoking and heavy alcohol intake.
Swimming is good for cardiovascular health, but is not weight-bearing exercise!
Card 41
Older Adults
Key Changes Affecting Nutritional Status
Answer
Older Adults
- ↓ BMR = ↓ caloric requirements.
- ↓ Bone density = ↑ risk of osteoporosis and fractures with falls. Bone loss begins at 30 - 40 years old.
- ↓ Salivation and mastication function. ↑ Risk of dysphagia and aspiration (card 55).
- ↓ Appetite and taste sensation = ↑ risk of malnutrition.
- ↓ Thirst mechanism = ↑ risk of dehydration.
- ↓ Gastric emptying rate and bowel motility = ↑ risk of constipation.
Card 42
School-Age Children & Adolescents
Nutritional Guidance
Answer
School-Age Children & Adolescents
School-Age Children:
- Average weight gain = ~ 4 - 6 lbs per year.
- Encourage 5-2-1-0 framework: ≥ 5 servings of fruits/vegetables per day, ≤ 2 hours of screen time per day, ≥ 1 hour of physical activity per day, 0 (or limited) sugar-sweetened beverages.
Adolescents:
- ↑ Nutrient requirements needed for growth associated with puberty.
- Calcium and iron supplementation may be needed, especially for menstruating teens.
- Unhealthy eating habits can lead to excess calories, fat, sodium, and sugar intake.
- Monitor for S/S of eating disorders (e.g., anorexia nervosa and bulimia nervosa).
Card 43
Toddlers
Weight Gain
Nutritional Guidance
Answer
Toddlers
Weight Gain:
- Gain ~ 4 - 6 lbs per year.
- Weight is 4 times the birth weight at age 2 ½ years.
Nutritional Guidance:
- Whole milk should be introduced after the age of 12 months. Change to 2% at 2 years of age. Limit milk intake to 2 - 3 servings/day to prevent iron-deficiency anemia.
- Limit juice to 4 oz. daily. Offer water several times a day.
- Supervise child during meal time, avoid choking hazards (card 34).
- Encourage grazing on small amounts of healthy foods throughout the day.
Card 44
Infants
Breastmilk Dos and Don'ts
Formula Dos and Don'ts
Answer
Infants
Breastmilk Dos and Don'ts:
- Store at room temp up to 4 hrs, or in refrigerator up to 4 days.
- Freeze up to 6 months, or in deep freezer up to 12 months.
- Do not refreeze thawed milk.
- Do not microwave breast milk.
- Discard unused portions of breastmilk.
Formula Dos and Don'ts:
- Use the exact water amount listed on the powdered formula label. Use water from a safe source.
- Use prepared formula within 2 hrs of preparation.
- Refrigerate prepared formula up to 24 hrs.
- Do not freeze or microwave formula.
- Discard unused formula remaining in bottle.
Card 45
Infants
Weight Gain
Nutritional Guidance
Answer
Infants
Weight Gain:
- Infant initially loses weight, but should be back to birth weight by 1 week of age.
- Weight doubles by 4 - 6 months and triples by 12 months.
Nutritional Guidance:
- Breastmilk or formula for the first 12 months. Do not prop bottles up!
- Introduce solids at ~ 4 - 6 mos., when baby has good head control and can sit unsupported. Start with iron-fortified infant rice cereal.
- No supplemental water or other fluids without an order until 6 mos.
- No honey or cow's milk until 12 months.
- Avoid choking hazards (anything round or requiring lots of mastication): Hot dogs, nuts, seeds, chunks of meat/cheese/peanut butter/raw vegetables, whole grapes, hard/sticky candy, popcorn, chewing gum.
Card 46
Nutrition for Pregnancy Disorders
Phenylketonuria (PKU)
Gestational Diabetes
Hyperemesis
Answer
Nutrition for Pregnancy Disorders
PKU: Defect in protein metabolism that can result in congenital defects and intellectual disability in the developing fetus.
- Follow strict low-phenylalanine diet (LOW in protein), monitor phenylalanine levels throughout pregnancy.
With PKU, Protein can Kill Ur baby!
Gestational Diabetes: Impaired glucose tolerance during pregnancy.
- Monitor blood glucose levels, follow carbohydrate-controlled diet, take insulin as prescribed, monitor for S/S of hyperglycemia and hypoglycemia (cards 68 - 69).
Hyperemesis: Severe nausea and vomiting that extends beyond the first trimester of pregnancy.
- Implement measures to prevent nausea/vomiting (card 58), monitor for dehydration and electrolyte imbalances.
Card 47
Pregnancy
Weight Gain
Caloric Intake
Answer
Pregnancy
Total Weight Gain: For underweight women: 28 - 40 pounds. For women of average weight: 25 - 35 pounds. For overweight women: 15 - 25 pounds.
- 1st Trimester: Gain of 1.1 - 4.4 pounds.
- 2nd Trimester: Gain of 1 pound per week.
- 3rd Trimester: Gain of 1 pound per week.
Caloric Intake:
- 1st Trimester: Do not increase calorie intake.
- 2nd Trimester: ↑ Calorie intake by 340 per day.
- 3rd Trimester: ↑ Calorie intake by 450 per day.
- Breastfeeding: ↑ Calorie intake by 450 - 500 per day.
Card 48
Pregnancy
Folic Acid
Protein
Iron
Calcium
Vitamin D
Fluids
Answer
Pregnancy
Folic Acid: ↑ Intake to 600 mcg/day (prevents neural tube defects).
Folic acid prevents Fetal problems.
Protein: ↑ Intake to 60 g/day (supports tissue growth).
Iron: ↑ Intake to 27 mg/day (for production of RBCs to supply oxygen to the fetus). Take iron supplement (ferrous sulfate) with vitamin C to ↑ absorption.
Calcium: 1,000 mg/day (helps formation of fetal bones/teeth).
Vitamin D: 600 IU/day (allows for absorption of calcium).
Fluids: 2 - 3 L/day.
Avoid alcohol. Limit caffeine to
Card 49
Cultural Dietary Considerations
African Americans
Mexican Americans
Asian Americans
Answer
Cultural Dietary Considerations
African Americans: Traditional "soul food" diet is high in fat, cholesterol, and sodium.
- ↑ Risk of obesity, heart disease, stroke, hypertension, diabetes.
Mexican Americans: Traditional diet is low-fat and high-fiber, with an emphasis on corn, beans, and rice. Acculturation (adopting the dietary practices of the host country) has led to ↓ fiber/fruit/vegetable intake, ↑ fat/sodium intake.
- ↑ Risk of obesity, diabetes.
Asian Americans: Emphasis on rice and vegetables. Limited consumption of dairy products, ↑ sodium intake.
- ↓ Risk of obesity, ↑ life expectancy.
Food preparation practices and dietary preferences vary within cultural groups and across individuals. Ask about dietary intake/preferences; do not make assumptions!
Card 50
Religious Dietary Considerations
Buddhism
Catholicism
Hinduism
Islam
Jehovah's Witnesses
Judaism
Mormonism
Answer
Religious Dietary Considerations
Buddhism: Vegetarianism and fasting common. Alcohol avoided.
Catholicism: Meat restricted on Fridays of Lent, Ash Wednesday, Good Friday. Fasting is often practiced.
Hinduism: Vegetarianism and fasting common. Alcohol avoided.
Islam: Pork and alcohol are prohibited. Fasting during the month of Ramadan.
Jehovah's Witnesses: Avoid food that contains blood.
Judaism: May be Kosher-observant (no pork products, shellfish, or meat with dairy).
- Example: Hamburger is ok, cheeseburger is not.
Mormonism: Alcohol, coffee, and tea are discouraged.
Vegetarian Diets
Diet focused on plant-based food, associated with ↓ risk of diabetes, hypertension, cardiac disease, cancer.
Vegan: Excludes ALL animal products (i.e., meat, poultry, fish, dairy, eggs).
Lacto Vegetarian: Excludes meat, poultry, fish, eggs. Allows dairy products.
Lacto-Ovo Vegetarian: Excludes meat, poultry, fish. Allows dairy products and eggs.
Pescatarian: Addition of fish/seafood to a vegetarian diet.
Ensure vegetarians get sufficient protein, vitamin B12, iron, calcium, vitamin D, and omega-3 fatty acids in their diet.
Card 52
Weight Loss
Calorie Consumption
Best Practices for Healthy Weight Loss
Answer
Weight Loss
Calorie Consumption:
- 3,500 calories = 1 pound.
- To lose 1 pound/week, ↓ daily calories by 500
(500 calories x 7 days = 3,500 calories).
Best Practices for Healthy Weight Loss:
- Set realistic goals.
- Keep a food diary.
- Get support (e.g., weight loss support group, friends/family).
- Plan meals ahead of time.
- Address unhealthy eating habits (e.g., eating too fast, eating without being hungry).
- Monitor weight regularly and get daily physical activity.
Physical Activity Guidelines
Aerobic Activity: Improves cardiovascular and respiratory function.
- Engage in 150 minutes/week of moderate aerobic activity (e.g., brisk walking), OR 75 minutes/week of vigorous aerobic activity (e.g., jogging).
Children and adolescents should get ≥ 60 minutes/day of moderate-vigorous activity.
Muscle Strengthening: ↑ Bone strength and muscle mass, ↓ risk of osteoporosis.
- Engage in muscle strengthening activities (e.g., lifting weights) ≥ 2 times/week.
Card 54
Nutritional Guidelines
Key Recommendations for Adults
Answer
Nutritional Guidelines for Adults
- Include a variety of vegetables, fruits (especially whole fruits), grains (≥ ½ should be whole grains), low-fat or fat-free dairy, proteins (e.g., lean meat/poultry, legumes, eggs).
- Avoid trans fats and limit saturated fat to
- Limit sodium intake (
- Limit alcohol consumption to ≤ 1 drink/day for women and ≤ 2 drinks/day for men.
MyPlate is a nutritional guide published by USDA to help people eat the right amount of each food group (50% fruits/veggies, 25% protein, 25% grains, and a serving of dairy).
Card 55
Body Mass Index (BMI)
Calculation
BMI Ranges
Answer
Body Mass Index (BMI)
Measure of body fat based on height and weight. Calculate by: weight (kg)/height (m)².
BMI
Weight Status
≤18.4
Underweight
18.5 - 24.9
Healthy
25 - 29.9
Overweight
≥ 30
Obese
Daily Caloric Requirements
Daily Caloric Requirements = Basal Metabolic Rate (BMR) + Physical Activity + Thermic Effect of Feeding (TEF).
BMR: The energy required by involuntary activities of the body in a resting condition (e.g., regulation of body temperature, breathing, heart function). Represents ~ 70% of energy needs.
- ↑ BMR: ↑ Muscle mass and height, males, children, pregnancy, hyperthyroidism, fever, very hot or cold environments, caffeine, smoking.
- ↓ BMR: ↓ Muscle mass and height, females, older adults, hypothyroidism, fasting/malnutrition.
Physical Activity: Energy required by skeletal muscles for body movement. Represents ~ 20% of energy needs.
TEF: Energy required to digest and metabolize food. Represents ~ 10% of energy needs.
Card 57
Water
Functions
Recommended Daily Intake
Types of Water Loss
Signs/Symptoms of Dehydration
Answer
Water
Functions: Involved in ALL body processes, including temperature and BP regulation, cushioning/lubrication of joints, waste removal.
Recommended Intake: 30 mL/kg of body weight (~ 2 - 3 L/day).
Fluid intake ≈ output. ↑ Water intake required for hot temperatures, exercise, fever, diarrhea, vomiting.
Types of Water Loss:
- Sensible: Measurable excretion (e.g., urination).
- Insensible: Other routes of fluid loss (e.g., sweat, respiration).
S/S of Dehydration: ↓ Weight, tachycardia, hypotension, tachypnea, ↓ urine output, ↓ skin turgor, dry mucous membranes, weak/thready pulses.
Trace Minerals
Fluoride:
- Functions: ↓ Tooth decay, bone growth.
- Sources: Tea, coffee, enriched water, shrimp, raisins.
Your teeth will fall out and hit the floor without fluoride!
Iodine:
- Functions: Thyroid hormone function.
- Sources: Iodized salt, seafood, eggs, fortified bread.
Zinc:
- Functions: Immune system function, cell division and growth, wound healing.
- Sources: Nuts, oysters, red meat, poultry, seafood, beans, whole grains, fortified cereals, dairy.
Card 59
Iron (Fe)
Functions
Sources
S/S of Deficiency
Treatment
Patient Teaching
Answer
Iron (Fe)
Functions: Hemoglobin formation, oxygen transport.
Sources: Meat, poultry, fish, iron-fortified cereal, legumes, vegetables (e.g., spinach), nuts, dried fruits (e.g., raisins).
S/S of Deficiency: Anemia (S/S: pallor, fatigue, cold hands/feet, shortness of breath, tachycardia).
Tx: Iron supplementation (oral or IM using Z-track method).
PT:
- Vit C ↑ absorption of iron, dairy ↓ absorption of iron. Take with orange juice, not milk/antacids!
- For iron suspensions use straw and brush teeth after administration to prevent stained teeth.
- Green or "tarry black" stools are expected.
- Increase fluid/fiber intake due to ↑ risk for constipation.
Card 60
Sodium (Na)
Sources
Hypernatremia
Hyponatremia
Answer
Sodium (Na)
Electrolyte important for nerve/muscle function and fluid volume maintenance. Normal Range = 136 - 145 mEq/L.
If you shake a salt shaker, you will get ~ 136 - 145 grains of salt (Na) out of it.
Sources: Shellfish, meat, table salt, frozen/processed food.
Hypernatremia: Na > 145 mEq/L.
- S/S: Thirst, lethargy, confusion, GI upset, muscle twitching, seizures, irritability/agitation.
Hyponatremia: Na
S/S: Confusion (common in elderly!), fatigue, nausea, vomiting, headache, seizure.
Card 61
Potassium (K)
Sources
Hyperkalemia
Hypokalemia
Answer
Potassium (K)
Electrolyte important for maintenance of ICF and regulation of muscle/heart contractions. Normal Range = 3.5 - 5 mEq/L.
Bananas (high in K) come in bunches of 3 - 5!
Sources: Fruits (e.g., bananas, apricots, raisins, orange juice, cantaloupe, tomatoes), vegetables (e.g., potatoes, spinach, broccoli), legumes (e.g., lentils), milk, salt substitutes.
Hyperkalemia: K > 5 mEq/L.
- S/S: Dysrhythmias, muscle twitching/weakness, paresthesia (i.e., burning/prickling sensation), diarrhea.
Hypokalemia: K
S/S: Dysrhythmias, muscle weakness, constipation/ileus, hypotension, weak pulses.
Phosphorous (P)
Electrolyte needed for bone and teeth mineralization, cell structure, and energy (ATP) production. Normal Range = 3 - 4.5 mg/dL.
Phos4us is normally around 4 mg/dL!
Sources: Dairy products (e.g., yogurt, milk, cheese), fish, poultry, eggs, legumes.
Hyperphosphatemia: P > 4.5 mg/dL.
- S/S: Same as hypocalcemia (i.e., positive Chvostek's and Trousseau's signs, muscle spasms).
Hypophosphatemia: P
S/S: Same as hypercalcemia (i.e., bone pain, muscle weakness, confusion).
There is an inverse relationship between calcium and phosphorus. When calcium is ↑, phosphorus is ↓, and vice versa.
Magnesium (Mg)
Electrolyte critical for muscle/nerve function and biochemical reactions in the body. Normal Range = 1.3 - 2.1 mEq/L.
MGs are VERY small British cars - you can only fit 1- 2 people in them.
Sources: Nuts, seeds, legumes, whole grains, green leafy vegetables, milk, yogurt, fortified cereal.
Hypermagnesemia: Mg > 2.1 mEq/L.
- S/S: Hypotension, lethargy, muscle weakness, ↓ DTRs, respiratory depression, dysrhythmias, cardiac arrest.
Hypomagnesemia: Mg
S/S: Tremors, ↑ DTRs, paresthesia (i.e., burning/prickling sensation), dysrhythmias (Torsades de pointes), tachycardia, hypertension, seizures.
Card 64
Calcium (Ca)
Sources
Hypercalcemia
Hypocalcemia
Answer
Calcium (Ca)
Electrolyte critical for bone/teeth formation, muscle/nerve function, and clotting. Normal Range = 9 - 10.5 mg/dL.
California (CA) is due for a big earthquake, 9 - 10.5 on the Richter scale.
Sources: Dairy products (e.g., milk, yogurt, cheese), kale, broccoli, fish (e.g., sardines, salmon), fortified foods (e.g., cereal).
Hypercalcemia: Ca > 10.5 mg/dL.
- S/S: Kidney stones, GI upset, constipation, bone pain, muscle weakness, confusion.
Hypocalcemia: Ca
S/S: Positive Chvostek's and Trousseau's signs, muscle spasms, paresthesia (i.e., burning/prickling sensation).
Card 65
Vitamin K
Functions
Sources
Deficiency
Toxicity
Answer
Vitamin K
Functions: Blood clotting, bone maintenance.
Sources: Green leafy vegetables (e.g., collards, spinach, kale, broccoli), soybeans, vegetable oil.
Deficiency: Bleeding due to ↑ prothrombin time, osteoporosis.
Toxicity: Low potential for toxicity, but ↑ intake of vitamin K can ↓ the effectiveness of warfarin (anticoagulant).
Patients taking warfarin must maintain a consistent intake of vitamin K as it is the antidote to warfarin! Be careful to not confuse vitamin K with potassium (K)!
Card 66
Vitamin E
Functions
Sources
Deficiency
Toxicity
Answer
Vitamin E
Functions: Antioxidant, immune function, metabolism.
Sources: Seeds, nuts, vegetable oil, green leafy vegetables.
Deficiency: Peripheral neuropathy, ataxia, ↓ immune response.
Toxicity: Impaired blood coagulation and ↑ risk of bleeding.
Too much E = blEEding.
Card 67
Vitamin D
Functions
Sources
Deficiency
Toxicity
Answer
Vitamin D
Functions: ↑ Calcium absorption, bone growth and remodeling, ↓ inflammation.
Sources: Sunlight, fatty fish (e.g., salmon, tuna), fish oil, fortified foods (e.g., milk, cereal).
Deficiency: Rickets (S/S: ↓ bone density, developmental delay, seizures, skeletal deformity), osteomalacia (S/S: bone deformity, pain, seizures).
Low vitamin D can cause Decreased bone Density, bone Deformity.
Toxicity: Hypercalcemia, nausea, vomiting, muscle weakness, dehydration.
Card 68
Vitamin A
Functions
Sources
Deficiency
Toxicity
Answer
Vitamin A
Functions: Vision, immune function, and cell growth.
Sources: Orange/yellow vegetables and fruits (e.g., carrots, sweet potatoes, cantaloupe, mango), liver, fish, dairy, eggs.
Deficiency: Xerophthalmia (night blindness, drying of the cornea and conjunctiva).
Toxicity: ↑ Intracranial pressure, nausea, headache, joint pain, coma, liver damage, birth defects in developing fetus.
Card 69
Vitamin C
Functions
Sources
Deficiency
Answer
Vitamin C
Functions: Antioxidant. Collagen growth, bone formation, wound healing, iron absorption, immune function.
Sources: Citrus fruits (e.g., oranges, grapefruit), tomatoes, potatoes, red/green peppers, broccoli, kiwis, strawberries.
Deficiency: Scurvy.
- RF: Smoking, poor nutrition, alcoholism.
- S/S:Swollen/bleeding gums, tooth loss, poor wound healing.
The letter C is Curvy (to remind you of sCurvy).
B-Complex Vitamin Deficiencies
Vitamin
Deficiency
B1
Beriberi (affects cardio and neurovascular systems, leading to ↑ HR, peripheral neuropathy), Wernicke-Korsakoff syndrome (degenerative brain disorder).
B2
Cheilosis (dry swollen lips, fissures at the corners of the mouth) Your 2 lips will Be swollen and cracked from a lack of B2.
B3
Pellagra. 3Ds: Diarrhea, Dermatitis, Dementia.
B6
Peripheral neuropathy, anemia.
B9
Fetal neural tube defects (fetal spine or brain defects).
Folic acid prevents Fetal problems.
B12
Pernicious anemia (lack of intrinsic factor in the gastric mucosa impairs absorption of B12).
Card 71
B-Complex Vitamins
Functions
Sources
Risk Factors for Deficiency
Answer
B-Complex Vitamins
Functions: Biochemical reactions, body growth and development, healthy skin, metabolism, heart and nerve function, red blood cell formation.
Sources: Meat, fish, poultry, eggs, dairy products, leafy green vegetables, beans, peas, fortified cereals/bread.
RF for Deficiency: Alcohol use disorder, malnourishment, malabsorption syndromes (e.g., short bowel syndrome), bariatric surgery.
Card 72
Protein Metabolism
Anabolism vs. Catabolism
Nitrogen Balance
Answer
Protein Metabolism
Anabolism: Protein synthesis (assembling individual amino acids into chains, creating proteins).
Anabolism Adds Amino Acids together.
Catabolism: Breakdown of protein for energy.
Catabolism is the catastrophic breakdown of proteins.
Nitrogen balance: Balance between anabolism and catabolism.
- Healthy adults should have a neutral nitrogen balance.
- Positive Nitrogen Balance: Protein synthesis > protein breakdown. Periods of growth, pregnancy.
- Negative Nitrogen Balance: Protein breakdown > protein synthesis. Starvation (i.e., insufficient calorie intake), severe injuries (e.g., burns).
Card 73
Proteins
Functions
Sources
Composition
Types
Answer
Proteins
Functions: Tissue building and repair (e.g., wound healing), immune system support, energy, maintenance of oncotic pressure.
Sources: Seafood, meat, poultry, eggs, beans, soy products, nuts, seeds, dairy products (e.g., yogurt, milk, cheese).
Composition: Individual or chains of amino acids.
- 9 Essential Amino Acids: Cannot be made by the body, must come from food.
It's essential to eat essential amino acids.
- 11 Nonessential Amino Acids: Produced by the body under normal physiologic conditions.
Types:
- Complete Proteins: Contains all essential amino acids (e.g., animal sources, soy).
- Incomplete Proteins: Lack one or more essential amino acids (e.g., vegetables).
- Complementary Proteins: Two or more incomplete proteins eaten together that form a complete protein (e.g., rice and beans).
Card 74
Cholesterol
Functions
Types
Recommended Intake
Answer
Cholesterol
Waxy, fat-like substance produced by the liver and found in dietary sources. Cholesterol is carried through the blood as lipoproteins (part lipid, part protein).
Functions: Cell membrane component, hormone and vitamin D synthesis, digestion.
Types:
- Low Density Lipoprotein (LDL): "Bad cholesterol". Excess levels lead to sticky plaque buildup and ↑ risk for atherosclerosis, heart disease, stroke.
L for Lethal/Lousy (i.e., bad).
- High Density Lipoprotein (HDL): "Good cholesterol." Returns cholesterol to the liver, so that it can be removed from the body.
H for Happy (i.e., good).
Recommended Intake:
Card 75
Lipids
Functions
Sources
Types
Answer
Lipids
Functions: Main source of stored energy, provide cell structure/function, temperature regulation, protection for organs.
Sources: Fats, oils, dairy, meat.
Types:
- Saturated Fat: Mostly found in animal products (e.g., meat, dairy). ↑ LDL levels and risk for heart disease.
- Trans Fat: Mostly found in processed foods (ingredient listed as "partially hydrogenated" oil or shortening).
↑ LDL and ↓ HDL levels.
- Unsaturated Fat: "Heart Healthy" fat, found in avocados, nuts, seeds, olive oil, and vegetable oil.
Card 76
Fiber
Health Benefits
Types and Sources
Recommended Intake
Answer
Fiber
Non-digestible complex carbohydrates.
Health Benefits: ↑ Healthy bacterial growth in the colon, softens and bulks stool to promote more effective defecation, stabilizes blood glucose levels. ↓ Risk of hemorrhoids, diverticulitis, colorectal cancer, coronary artery disease.
Types:
- Soluble: Dissolves in fluid, derived from the inner flesh of plants. Sources: oats, barley, beans, fruit.
- Insoluble: Does not dissolve in fluid, derived from the outer skin of plants. Sources: whole grains, nuts, seeds, vegetables, potatoes.
Recommended Intake: 38 g/day for men, 25 g/day for women.
Card 77
Carbohydrates
Functions
Sources
Types
Answer
Carbohydrates
Functions: Primary source of energy, control blood glucose and insulin metabolism.
Sources: Vegetables, fruits, whole grains, dairy.
Types:
- Simple: Easy to digest, provides quick energy, causes fast ↑ in blood glucose levels (e.g., fruit juice, honey, candy).
- Complex: Takes longer to digest, slower ↑ in blood glucose levels (e.g., apples, brown rice, lentils).
- Glycogen: Stored carbohydrate energy in the liver and muscles. Broken down and released in the bloodstream as needed through glycogenolysis.
Card 78
Overview of Nutrients
Macronutrients
Micronutrients
Answer
Overview of Nutrients
Macronutrients:
- Carbohydrates: 45- 65% of calories/day, 4 kcal of energy/gram.
- Lipids: 20 - 35% of calories/day, 9 kcal of energy/gram.
- Protein: 10 - 35% of calories/day, 4 kcal of energy/gram.
Micronutrients:
- Vitamins:
- Water-soluble: B-complex vitamins, vitamin C.
- Fat-soluble: Vitamin A, D, E, K. Think of A fat DEcK of cards.
Water soluble vitamins require regular replacement in the body. Fat soluble vitamins are stored in the liver and fatty tissue for a long time, causing an ↑ risk for toxicity when consumed in excess.
- Minerals:
- Major minerals (electrolytes): Calcium, chloride, magnesium, phosphorus, potassium, sodium.
- Trace minerals: Copper, fluoride, iodine, iron, selenium, zinc.