Nutrition

• Nutrition for pregnant people

  • Increase vitamin d --> calcium
  • Increase folic acid
  • Increase iron
• Healthy pregnancy weight

  Healthy BMI should gain 25-35 lbs, overweight less
• Newborn feeding

  1. One year of milk

  2. Pureed food at 6 months

  3. Pinch reflex solids

  4. Introduce one food at a time

  5. Eat 2-3 hours expect 8-10 diapers

  6. Vitamin D supports calcium
• Macrocytic anemia

  Associated with vit B12 + folate deficiency, bone marrow produces too large blood cells, causes pallor, dyspnea (shortness of breath), weakness, fatigue, and palpitations
• Microcytic anemia

  Associated with iron + vit B6 deficiency, bone marrow produces too small blood cells
• Health concerns for older adults

  • Osteoporosis esp women
  • Isolation + inaccessibility leads to malnutrition
  • HTN
• Hypoglycemia symptoms

  Dizziness, fatigue, shakiness, fainting (stroke symptoms)
• Hyperglycemia symptoms

  Thirst, frequent pee, fatigue, blurred vision, weight loss, recurrent infections
• Treatments for type II diabetes

  1. Oral medications that increase glycogen and increase insulin activity

  2. Lifestyle changes
• Treatments for type I diabetes

  1. Insulin injections

  2. Carb counting
• Diet for cardiovascular disease

  • Low sodium
  • Watch fluid intake
  • Low caffeine
• DASH diet

  Low fat and low sodium diet to reduce hypertension
• having had one before is a risk factor for myocardial infarctions
• Healthy cholesterol levels

  • HLD >40
  • LDL <100
  • Cholesterol <200
  • Triglycerides <150
• Metabolic syndrome criteria

  • Central obesity
  • High triglycerides
  • Low HDLs
  • Elevated blood pressure
  • Elevated fasting blood glucose
• Vitamin B3

  Deficiency associated with pellagra - dermatitis, diarrhea, dementia, death. Used to lower cholesterol
• Vitamin B6

  Deficiency associated with weakened immunity, depression, cheilosis, glossitis, microcytic anemia
• Vitamin B12

  Deficiency associated with GI disorders, glossitis, macrocytic anemia, nervous system changes. Supports metabolism and cell production
• Vitamin B1

  Deficiency causes beriberi, nervous system deficits, confusion, calf pain
• Diet for kidney disease

  • Low protein
  • Low water
  • Low potassium
• Diet for total kidney failure

  Increase protein when on dialysis
• Signs of kidney diseases

  • Low GFR
  • Proteinuria
  • High BUN + creatinine
  • Edema
  • HTN
• Ulcerative colitis

  Autoimmune disorder in the colon, if it expands beyond the colon then it's Chohn's. Treated with immunosuppressants (remicade)
• Diet for crohn's

  • Probiotics
  • Low dairy
  • Easily digestible food
• Feeding for low absorption

  Parenteral (feeding through central line)
• Bariatric surgeries

  • Gastric Sleeve: removing a portion of the stomach to make it smaller
  • Gastric bypass: creating a small gastric pouch and creating a new tube connecting to the small intestine
  • Gastrectomy: Removal of the stomach
  • Gastric band: adding an adjustable band around the upper portion of a patient's stomach to control portion consumption without permanently dividing it
• Transition off feeding tube

  Clear → full liquid → puree → soft → solid
• Low-FODMAP diet

  Diet with low fermental oligo, di, monosaccharides and polyols used for people with IBS and other gastrointestinal disorders to reduce irritation. Restricts honey and fruits, wheat, onions, garlic, milk, legumes, and "sugar free" substitutes - sugar alcohols
• Vegan dietary concerns

  • Iron deficiency
  • B12 deficiency
  • Eat more peas
• Dysphasia (inability to swallow) diet should be full liquid, NPO, small bites, or pureed
• Peptic ulcer disease causes

  • H. pylori
  • NSAIDS
  • Stress
• IgA

  Immunoglobulin that spikes in response to allergens
• IgA transglutaminase

  Immunoglobulin that reacts to gluten
• Food borne pathogens

  • Salmonella
  • Listeria
  • E. Coli
  • Trichinosis
• Dumping syndrome

  Excessive excretion caused by sudden heavy feeding, not tolerating enteral feeds, commonly seen after GI procedures
• BMI percentile ranges

  • Underweight: <5th
  • Healthy: 5th – 84th
  • Overweight: 85th – 95th
  • Obese: 95th
• BMI ranges

  • Healthy: 18.5-24.9
  • Overweight: 25-29.9
  • Obesity I: 30-34.9
  • Obesity II: 35-39.9
  • Obesity III (severe): 40+
• Medication interactions

  • Grapefruit: anticonvulsants, cholesterol, psych meds
  • Spinach: warfarin
  • Milk/dairy: prevents absorption of antibiotics