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FSHN 360- Midterm

three general categories of nutritional status desirable, under-nutrition, over-nutrition
nutritional assessment evaluation of nutritional status through measurements of food and nutrient in take and evaluation of nutrition-related health indicators
5 purposes of nutrition assessment determine prevalence of chronic disease/malnutrition, high risk individuals, needs assessment, measurement, evaluation
ABCDE methods used in nutritional assessment anthropometrics, biochemical, clinical, diet assessment, environment
screening vs monitoring screening= tests, monitoring= surveys
HP 2020 vision a society in which all people live long, healthy lives
HP goals (3) high quality lives, health equity, create healthy social/physical environments
implementing HP 2020 (MAP-IT) mobilize, access, plan, implement, track
DRI umbrella term to include current standards for nutrient recommendations
EAR intake level to meet nutrient requirements of 50% of healthy individuals, prevent classic deficiency diseases and maintain metabolic pathways (not an intake goal)
RDA level adequate to meet needs of 97-98% of all healthy individuals (set only if EAR established)
AI used if insufficient data available to calculate EAR (frequently used for infants)
EER (estimate energy requirement) average intake to maintain energy balance
uses of DRIs (3) assessing nutrient intakes of individuals and groups, planning nutrient intakes, address health promotion/disease prevention
3 common approaches to assessing diet comparing intake of certain nutrients to a standard, comparing food groups to a standard, evaluating both at once
diet quality index evaluates overall diet quality of groups and risk of chronic disease related to dietary pattern (10 indicators)
healthy eating index summary measure of diet quality and adherence to dietary guidelines (12 components); focused on nutrient density, 0-100
healthy eating index uses (4) monitor changes in consumption patterns, evaluate menus/diet plans, ID target areas, program evaluation
proposed changes to nutrition facts label (nutrition science)- 4 added sugars, update daily values, required vs voluntary nutrients, remove calories from fat
other 2 proposed changes to nutrition facts label update serving size requirements and labeling for certain sizes, refreshed design (ie calories/servings per container more prevalent)
what are the 4 new vitamin/minerals to be on labels? vitamin D, calcium, iron, potassium
correlational studies compare level of some factor w/ another factor
cross-sectional studies provide snapshot of health at a point in time
case-control studies compare levels of past exposure to some factor of interest
longitudinal/cohort studies nurses study
4 challenges of estimating intake weaknesses of data-gathering techniques, human behavior, variability in intake and requirements, limitations of databases
5 factors affecting choice of dietary analysis method literacy, memory, interest, communication, culture
5 factors to consider in dietary analysis method time frame, sample size, number of measures per person, cost, data analysis
strengths of 24-hour recall (3) low burden, non-diet altering, single for groups/multiple for individual
limitations of 24-hour recall (5) single recall, memory, under/over reporting, omissions/phantom foods, data entry
5 step pass quick list, meal specifics, forgotten foods, detail, review
strengths of food records (4) not based on memory, more representative than 1-day, fewer phantom foods, greater detail
limitations of food records (5) analysis, burden, writing down may alter report, bites don't get recorded, literacy/knowledge
#1 source of error in recalls/diaries portion size
amorphous foods take on the shape of the container
three types of FFQ simple, semi-quantitative, quantitative (also self vs interviewer administered)
two types of variation systematic (weekend) vs random (birthday party)
which vitamin takes the most days to estimate intake? vitamin A
validity ability of an instrument to measure what is intended
reproducibility ability to produce the same estimate on two more occasions
DILQ validation researchers used observation of school lunch to validate Day in the Life questionnaire
use adipose to measure linoleic acid
use plasma to measure TG, carotenoids, lycopene, vitamin C, vitamin E
use nitrogen to measure protein intake **assuming nitrogen balance
strengths of biomarkers (2) easily accessible, provides a validity check of dietary intake
limitations of biomarkers (2) affected by factors other than diet, many nutrients do not have good biomarkers
goals of nutritional monitoring (3) dietary/nutritional status of a population, quality of food, changes in a population's intake
KAB assessments knowledge, attitude, behavior
monitoring vs surveillance quantitative, precise vs. local and less precise measures
goals of monitoring/surveillance (2) ID high risk groups/geographic areas, assess progress toward achieving healthy people objectives
how do we use survey data? (3) nutrition-related programs, development of regulations, research
NHANES stands for national health and nutrition examination survey
NHANES comprised of detailed interviews and comprehensive examinations
achievements of NHANES (5) folate, lead, smoking, growth charts, DRI
___ Americans consume ___ on any given day, provides ___ 1 in 8, pizza, 1/4 of daily energy
USDA and pizza promotion helps pizza makers (McDonald's and Dominos) "dairy checkoff program"
teens sugar 150% average
biggest source of calories sugar/soda
reasonable limit for added sugar 10g per day
GRAS sugar scientific consensus (unsafe at levels consumed)
petitions for added sugar "added sugars" instead of "sugars", limit over-sized beverages
Congress to nutritionists telling nutritionists not to incorporate agricultural production and environmental factors into dietary guidelines
Which country implemented environmental factors into dietary guidelines? Brazil
Commodity prices plunge maybe will lower grocery costs, reduced foreign competition
Obesity and depression 43% of depressed adults are obese, more likely to obese than people w/ out depression
Growth chart under 2 WHO
Growth chart over 2 CDC
5 indices for measuring children weight for height/length/stature, weight for age, height/length/stature for age, BMI (>2), head circumference
3 height indices stature, length, knee height
height of children <2 years recumbent
height of children >2 years height board
head circumference up to 36 months, detect head abnormalities
measuring non-ambulatory persons bed scale, chair scale, calf circumference, midarm circumference, sub-scapular skinfold thickness
hamwi equation females 100 lbs for first 5 feet, 5 pounds per inch
male hamwi equation males 106 lbs for first 5 feet, 6 pounds per inch
relative weight actual/reference (Hamwi) x 100
power-type indices preferred index; maximally correlated w/ body mass and minimally correlated w/ stature
BMI units kg/m2
2 groups to take into account w/ BMI athletes will over-estimate fat, elderly will under-estimate
BMI children use growth chart
Normal BMI 18.5-24.9
Overweight BMI 25.0-29.9
Frame size measure wrist to find if small, medium, large boned
Wrist circumference insulin resistance excess fat, can ID young subjects for CVD
2 body types android and gynoid (diseases associated w/ android)
Higher waist circumference associated w/ type 2 diabetes and high blood cholesterol
Waist to hip ratio indicator of body fat (better indicator of CHD and DM than BMI)
2 compartment model fat mass and lean body mass
4 compartment model water, protein, mineral, fat
2 classifications of body fat essential (membranes, bone marrow), nonessential/storage (subcutaneous or visceral)
essential fat women 8-12%
essential fat men 3-5%
skinfold subcutaneous adipose tissue, estimate of total body fat
skinfold sites chest, tricepts, subscapular, midauxillary, superiliac, abdomen, thigh, medial calf
skinfold females triceps, superiliac, thigh
skinfold males chest, abdomen, thigh
drawbacks of skinfold well-trained, water retention, not ideal to estimate visceral, hard to measure if BMI over 35
densitometry mass (kg) / volume (L)
body density weight in air (kg)/ volume of water (or air) displaced (L)
hydrostatic weighing based on what Archimedes principle (displaced H2O)
2-compartment model hydrostatic weight fat mass density and fat-free mass density
biggest assumption of hydrostatic weighing constant density of fat-free mass
second way to measure body density air displacement plethysmography
isotope dilution technique used for TBW, tracer equilibrates w/ body water (must fast beforehand)
assumption tbw assume that fat-free tissue has a constant water content
electrical conductance difference in electrolyte content b/w fat and fat-free tissues (current b/w ankle and wrist), use regression equations
red electrode (electrical conductance) proximal
black electrode (electrical conductance) distal
DEXA dual energy (high and low energy, picks up ratio)
Gold standard body composition DEXA
Created by: melaniebeale