List 3 ways to decrease the risk of cardiovascular disease
- Increase omega-3 fatty acid intake e.g. oily fish
- Reduce saturated fat intake e.g. processed meat, dairy
Antioxidant supplementation e.g. cranberry juice
Name the mineral that causes hypertension
What effect does calcium supplementation have on BP?
Small decrease in BP, however a reduction in salt has a greater effect
How is BMI calculated?
List 3 groups which would BMI would be unhelpful for
When should the patient be referred to their GP with regards to their weight?
If they are underweight or obese class 2 or 3
A state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue or body form
When does malnutrition occur?
When diet is insufficient to meet the demands of the body
Define: MUST score
Malnutrition Universal Screening Tool
Indicates risk of malnutrition, completed for all hospital admissions
List the 5 steps of the MUST score
- Height and weight for BMI
- Note unplanned weight loss and score
- Establish acute disease score
Add scores from steps 1-3 for complete score
- Use management guidelines or local policies to create action plan
List 2 criteria of malnutrition according to NICE
BMI of less than 18.5 kg/m2
Unintentional weight loss greater than 10% within the last 3-6 months
List the 3 stages of starvation
Describe the glycogenolytic stage of starvation
Glycogen stores in the liver and muscle used up in 24 hours
- Fall in blood glucose
- Increase in glucagon
Describe the gluconeogenic stage of starvation
- Fall in insulin
Protein breakdown (lean tissue) releases amino acids for glucose production
Describe the ketogenic stage of starvation
Lipolysis releases free fatty acids and glycerol from adipose tissue
Glycerol converted to glucose by liver and kidneys
- Free fatty acids converted to ketones by liver
Define: Refeeding syndrome
When a person in a state of prolonged starvation is given nutrition which causes serious complications
Why can refeeding syndrome cause serious complications?
- Sudden shift in energy source and insulin secretion when person starts to eat
Glycogen, fat and protein synthesis begins which requires phosphate, magnesium and thiamine
Increased absorption of potassium and magnesium into cells
- This leads to a decrease in serum levels of K+, PO4- and Mg2+
List 4 symptoms of refeeding syndrome
- Cardiac failure
Which 4 minerals should be checked for their levels before re-feeding?
Name an alternative route for re-feeding
Why is parenteral nutrition sometimes used for re-feeding?
- Non-functional, inaccessible or perforated (leaking) GI tract
- It is a complete mixture of all nutrients
List 3 risks of providing nutrition via the parenteral route
- Liver abnormalities
- Fluid abnormalities
List 3 pieces of dietary advice for diabetics
- Manage body weight
- Treat and prevent dyslipidaemia
- Treat and prevent hypertension
Who are coelicas?
What does ingestion of gluten lead to in coeliacs?
Intestinal atrophy - malabsorption
List 3 symptoms of coeliac disease