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FSHN 360- Final
| Question | Answer |
|---|---|
| Willpower | limited resource, but everyone has it |
| Microbiota controls | appetite, energy, glucose/lipid metabolism, inflammation |
| SCFAs microbiota | butyrate; anti-inflammatory anorexigenic |
| Leading cause of death for men/women & most ethnicities | heart disease |
| ___ Americans have at least one of | 50%; high BP, high LDL, smoking |
| CAD risk factors (2) | type two diabetes, post menopausal (others) |
| Inactive adults, what percentage have CHD risk factors? | 53% |
| What affects cardiovascular health factors most? | diet |
| LDL | cholesterol transport |
| HDL | reverse transport |
| Average %kcal from added sugars adolescents | 16% |
| __ of all instances of CHD occur in individuals ___ overt dyslipidemia | half, without |
| 3 plasma biomarkers CHD | C-reactive protein, homocysteine, lipoprotein A |
| C-reactive protein aka | hs-CRP |
| C-reactive protein is a marker of | inflammation (so atherosclerosis and thrombosis) |
| Homocysteine is a biomarker of (3) | platelet aggregation, inflammation, oxidation of LDL |
| Lipoprotein a is a biomarker of | myocardial infarction/angina |
| Fortified sources of plant sterols | spreads, orange juice, butter |
| Precision | reproducibility |
| Accuracy | validity |
| Children usually have high___ BP if high BP | diastolic |
| HTN adults | normal, pre, stage 1, stage 2 |
| HTN children | CDC percentiles for sex, age, height |
| Nutrients associated with lowering sat/trans fat, cholesterol (5) | protein, fiber, potassium, magnesium, calcium |
| High sodium considered an ___ cause of ____ | indirect, obesity |
| High sodium intake associated with (3) in adolescents | adiposity, leptin, tumor necrosis factor a |
| Adults with diabetes are ___x more likely to have ____ | 2-4x, heart disease/stroke |
| Integrative medicine diabetes | address the whole person |
| Diabetes microvascular disease (3) | retinopathy, nephropathy, neuropathy |
| 4 classes of diabetes | gestational, 1, 2; due to causes like genetics, pancreas, diseases |
| 3 symptoms of DM | polyuria, polydipsia (thirst), polyphagia (hunger) |
| HbA1c | 2-3 months; glycated hemoglobin |
| Cutoff for diabetes | >126 mg/dL |
| 3 targets for diabetes treatment | improve insulin action, lower GI glucose absorption, improve insulin secretion |
| Bone strength | density and quality |
| Bone strength density | 70% of variation, amount of bone loss |
| Bone strength quality | 30% variation, accumulation of damage to bone |
| Two types of bone | cortical/compact and trabecular/cancellous |
| Turnover rate is faster in ___ bone | trabecular |
| Osteoporosis classifications | primary= age; secondary= lifestyle |
| Medications that cause osteoporosis (2) | glucocorticoids, anticonvulsants |
| Vitamin A osteoporosis | too much retinol bad, but has role in borrowing/depositing calcium in bone |
| Vitamin K osteoporosis | calcium regulation, low levels associated w/ low bone density |
| Caffeine promotes ____ excretion in urine | calcium |
| Two measures of bone density | DEXA, QUS |
| QUS | quantitative ultrasound (high frequency sound through bone), heel bone (does not measure mineral content, just bone mass) |
| Biochemical tests | objective and quantitative assessment of nutritional status (detect deficits before clinical signs and symptoms) |
| Static test | direct (biochemical) |
| Functional test | indirect (biochemical) |
| Functional tests measure | intended, nutrient dependent biological function |
| Functional test example | dark adaptation for vitamin A |
| Limitation functional test | nonspecific; not all nutrients have one |
| Sensitivity | probability that the test is positive given that the patient is sick |
| Specificity | probability that the test is negative given that the patient is not sick |
| No single test is___ | sufficient for monitoring nutritional status by itself |
| Somatic protein | skeletal muscle, 75% of body cell mass |
| Visceral protein | organs/blood cells/serum protein, 25% of body cell mass |
| Body cell mass | 30-50% |
| Malnutrition | the pathophysiology over or undernutrition and inflammatory activity on body composition and biological function |
| Causes of protein insufficiency | primary= insufficient intake, secondary= other diseases |
| Kwashiorkor | protein deficiency w/ adequate kcal |
| Marasmus | energy deficiency |
| CHI/creatinine | affected by many factors, expressed as a % of the expected value |
| Protein is __% nitrogen | 16% |
| Serum proteins reflect | short term changes in nutritional status |
| Serum albumin and CRP | high during acute stress |
| Serum albumin | elevated during PCM |
| Prealbumin/retinol binding protein | short half life |
| Calcium functions | BP, muscle, nerve, hormones, enzymes |
| Ideal sources of calcium | non-dairy with vitamin D |
| Calcium atherosclerosis | calcium incorporated into fatty plaques |
| Excessive calcium | interferes with iron absorption, constipation, prostate cancer, CVD, kidney stones |
| PTH calcium | bone resorption of calcium and phosphorus |
| Calcitonin | induce calcium accretion (addition) in bone |
| Serum calcium | tightly controlled by the body |
| Urinary calcium | more responsive to diet than serum |
| what causes decreased urinary calcium output? | sodium, protein, low phosphate |
| What causes decreased urinary calcium output? | increased phosphate, alkaline (f/v) |
| Phosphorus | increases need for calcium, usually excess not deficiency |
| What converts 25OH-D to 1,25 OH D? | kidney |
| Serum 25OH-D | long half life |
| Serum 1,25OH-D | short half life, levels don’t decrease until deficiency is severe |
| Vitamin D deficiency | 1 billion worldwide (intake/sun exposure) |
| IOM vitamin D | should probably be increased from 2000-4000 IU per day |
| VITAL | see if omega 3 and vitamin D affect cancer/heart disease/stroke |
| Vitamin D and diabetes | decreased insulin, hyperglycemia |
| Excess vitamin D | can’t get it from the sun, can damage heart/blood vessels/kidneys |
| Total lymphocyte count | high levels intake body is trying to fight viral infections |
| Delayed cutaneous hypersensitivity | degree of reactivity is a function of T-cell mediated immunity (decreased w/ PEM, B6, iron, A, zinc deficiency) |
| Single most common nutrient deficiency | iron |
| Absolute iron deficiency | total body iron stores depleted (bleeding/intake) |
| Functional iron deficiency | failure to release iron rapidly enough for erythropoiesis |
| 4 factors that affect iron status | stores, utilization, intake, loss |
| 3 most common causes of anemia (RBCs) | microcytic, macrocytic, hypochromatic (low hemoglobin) |
| children iron deficiency | increased absorption of heavy metals (many others) |
| what elevates serum ferritin? | inflammation, trauma, overload, hepatitis, cancers |
| soluble transferrin receptor | # tfr proportional to requirement for iron |
| transferrin saturation | low with iron deficiency |
| athletes iron deficiency | significant portion have it, recuperation helps but not enough |
| erythrocyte phytoporphyrin | precursor of heme, accumulates with iron deficiency |
| limitation of hemoglobin test | not low until late deficiency |
| hematocrit | % of RBCs making up entire volume of whole blood (depends on # and size) |
| body iron model | ratio of sTfR to serum ferritin |
| ferritin model | tends to over-estimate presence of deficiency |
| MCV iron model | reflects altered RBC formation |
| Folic acid | fully oxidized monoglutamate form (used in supplements) |
| Folate functions | homocysteine metabolism, nucleic acid synthesis, amino acid synthesis, RBC formation |
| 1 dietary folate equivalent= | 1ug food folate, 0.6ug folic acid with food, 0.5ug empty stomach |
| primary sign of folate deficiency | megaloblastic anemia |
| megaloblastic anemia | sign of folate deficiency; large and abnormally nucleated erythrocytes |
| 4 groups at risk of folate inadequacy | alcohol dependence, women of reproductive age, pregnancy, malabsorptive disorders |
| excess folate | generally non-toxic |
| serum folate | sensitive to dietary and non-nutritional changes (3 weeks negative balance) |
| erythrocyte folate | best clinical index of depleted tissue stores |
| intrinsic factor | binds B12 in the ileum |
| pernicious anemia | B12 malabsorption |
| excess B12 | low potential for toxicity |
| B12 deficiency | megaloblastic anemia, weakness, fatigue, neurological |
| Folic acid and B12 | large amounts of folic acid can mask B12 deficiency |
| Does folate or B12 deficiency develop faster? | folate |
| Functional indicators of B12 | MMA, total homocysteine (no gold standard) |
| Groups at risk for vitamin A deficiency | infants, pregnant, cystic fibrosis, premature infants |
| Excess vitamin A | promotes fractures (retinol only) |
| Direct measurement of liver vitamin A | gold standard of vitamin A (invasive) |
| Retinol isotope dilution | ratio of labeled and unlabeled from blood |
Created by:
melaniebeale
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