Alimentación - ERA - 2024

Alimentación - ERA - 2024

• Talla: If a person cannot be measured using a standard method, it can be estimated using the formula AR = height from the heel to the ankle in centimeters along with the subject's age.
  • Male: 64.19 - (0.04) + (2.02 x AR)
  • Female: 84.88 - (0.24) + (1.83 x AR)
• Weight: Weight loss is a simple indicator of calorie malnutrition, but weight loss is also a common symptom of aging, so weight declines may not always indicate malnourishment. Weight loss greater than 2% per week, 5% per month or more than 10% in 6 months are usually indicative of malnutrition, while in patients that are dependent, weight can be estimated with a crane-type scale.
• BMI: Body Mass Index is calculated as weight in kilograms divided by height in meters squared, used to categorize nutritional status. Minimum mortality rates for people over 65 are within a BMI range of 24-31 kg/m2. A healthy range between 22 kg/m2 and 27 kg/m2 is considered normal for older people because of height loss.
• Skin folds: Skin folds are indicators of body fat. Common measurements include the triceps skinfold (non-dominant arm) and the subscapular skinfold.
• Circumference measurements: Arm circumference (non-dominant arm) and calf circumference reflect muscle protein levels.
• Waist circumference: Measuring waist circumference helps assess cardiovascular risk. A waist circumference of more than 95cm in men and 82cm in women is considered a high-risk. A measurement greater than 102 cm in men and 90 cm in women is considered a very high risk.
• Waist-to-hip ratio: The ratio of waist circumference to hip circumference is used to assess cardiovascular risk. A healthy ratio is less than 1 in men and 0.85 in women.
• Biochemical parameters: Biochemical parameters such as albumin, prealbumin and cholesterol levels can reflect nutritional status and usually change early, often before anthropometric changes are seen.
• Nutritional Assessment Scales: The Mini Nutritional Assessment (MNA) is a frequently-used assessment tool for older adults. The MNA is 18 questions with a maximum score of 30, a score above 23.5 is considered normal. The MNA is used to evaluate malnutrition risk in various contexts such as among frail, hospitalized, and institutionalized older adults.

Scales of nutritional assessment

• MNA is a nutritional assessment tool commonly used among the frail, sick elderly. People who have a score below 12 in the MNA are at risk of malnutrition.

Intervention nutritional

• Nutritional intervention is indicated when a person ingests less than 75% of their nutritional requirements, when consuming less than 1,000 kcal daily or less than 30 grams of protein daily for 7-10 days if not malnourished or 3-5 days if they are malnourished.
• Nutritional advice will include a varied and balanced diet for all nutrients.

Diabetes Mellitus

• The pancreas is a gland located behind the stomach. It has an exocrine (releases digestive enzymes) and endocrine (releases hormones) function. The important hormones are insulin and glucagon which have opposite effects. A third hormone is somatostatin, regulating insulin and glucagon.

Insulin

• Insulin is produced in the beta cells of the pancreas and allows glucose to enter cells and be used as energy.
• When blood sugar levels rise, the pancreas releases insulin to bring the levels down.

Glucagon

• Glucagon has the opposite effect of insulin. It releases stored glucose when needed to keep blood sugar levels stable.

Diabetes Mellitus Types

• Type 1 diabetes is an autoimmune disease where the body's immune cells destroy the insulin-producing cells in the pancreas, resulting in the absence of insulin.
• Type 2 diabetes is associated with insulin resistance, where the body's cells don't respond effectively to insulin, meaning there's insufficient insulin production or resistance to insulin.
• Gestational diabetes is a type detected during pregnancy and usually goes away after delivery.

Diabetic complications

• Complications associated with diabetes (DM) include macrovascular (large blood vessel) and microvascular (small blood vessel) damage.
• Some complications are:
• Eye diseases (retinopathy)
• Kidney diseases (nephropathy)
• Nerve damage (neuropathy), leading to conditions like diabetic foot.
• Problems with blood flow in the extremities (macroangiopathy). This involves thick plaques that build up, causing problems in the arteries and thus, blood flow.

Treatment for Diabetes

• A balanced diet, exercise, medications (insulin or oral medications), and diabetic education are crucial to controlling and managing diabetes.

Digestive System

• The digestive system is designed to break down food into smaller molecules and absorb nutrients. Key parts are: mouth, esophagus, stomach, small intestine, large intestine, liver, and pancreas.

Digestive Processes

• Food intake (ingestion), mechanical digestion(chewing and churning), chemical digestion (enzymes breaking down nutrients), absorption (nutrient uptake into bloodstream), and elimination (defecation) are involved in breaking down food, and absorbing it into the body, after which waste is eliminated.