Nutrition Lecture 3

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Questions and Answers

What is the normal range for Blood Urea Nitrogen (BUN) levels in the blood?

7–20 mg/dL (correct)

0.1–1.2 mg/dL

44–147 U/L

0.6–1.2 mg/dL

Which anthropometric measure is specifically used to detect malnutrition in children?

Mid Upper Arm Circumference (MUAC) (correct)

Body Fat Percentage

Waist-to-Hip Ratio (WHR)

Body Mass Index (BMI)

What does an elevated level of ALT (Alanine Aminotransferase) indicate?

Kidney damage

Liver inflammation (correct)

Cardiovascular risk

Bile duct obstruction

Which lipid panel component is considered 'bad' cholesterol?

LDL Signup and view all the answers

The critical value for Glomerular Filtration Rate (GFR) indicating chronic kidney disease is?

Below 60 mL/min/1.73 m² Signup and view all the answers

What measurement is used to assess the amount of fat relative to total body weight?

Body Fat Percentage Signup and view all the answers

Which device is considered the gold standard for body composition analysis?

Dual-Energy X-ray Absorptiometry (DEXA) Signup and view all the answers

What is indicated by a Continuous Glucose Monitor (CGM)?

Real-time blood glucose levels Signup and view all the answers

The desirable HDL cholesterol level is considered to be:

40 mg/dL or higher Signup and view all the answers

Which nutritional assessment tool uses resistance measurement to estimate body composition?

Bioimpedance Scales (BIA) Signup and view all the answers

What is the formula for calculating Body Mass Index (BMI)?

Weight (kg) / Height² (m²) Signup and view all the answers

What does the Alkaline Phosphatase (ALP) level indicate when elevated?

Bile duct obstruction or liver disease Signup and view all the answers

What is the primary purpose of the Nutrient Facts Panel on a food label?

To help consumers compare foods and choose healthier options Signup and view all the answers

Which of the following elements is NOT a component of the ABCD approach for direct nutritional assessment?

Cellular Signup and view all the answers

Which type of food label provides detailed nutritional information and is standardized by health authorities?

Nutrient Facts Panel Signup and view all the answers

What does the % Daily Values (% DV) on a food label indicate?

The amount of a nutrient in a serving of food relative to a daily diet Signup and view all the answers

Which assessment method evaluates broader nutritional environments rather than individual intake?

Indirect Methods Signup and view all the answers

Which tool would most likely be used to evaluate an individual's eating patterns over a specified time frame?

Food Frequency Questionnaire (FFQ) Signup and view all the answers

What is a common feature of Front of Package Warning Labels (FOPWL)?

They highlight essential information like calories and fats. Signup and view all the answers

Which component of a dietary history focuses on cultural and personal dietary restrictions?

Food Preferences and Restrictions Signup and view all the answers

During a Nutrient/Additive Scavenger Hunt, which additive is commonly identified in processed foods?

Calcium Carbonate Signup and view all the answers

What is one of the key components measured during anthropometry?

Body Mass Index (BMI) Signup and view all the answers

What is the primary purpose of the Recommended Dietary Allowance (RDA)?

To prevent nutrient deficiencies in healthy individuals Signup and view all the answers

Which statement accurately describes the Adequate Intake (AI)?

It is based on observed intakes of healthy individuals. Signup and view all the answers

What does the Tolerable Upper Intake Level (UL) signify?

The maximum daily intake unlikely to cause adverse health effects Signup and view all the answers

Which component of the Dietary Reference Intakes is specifically used for population-level nutrient adequacy assessment?

Estimated Average Requirement (EAR) Signup and view all the answers

If a food product states it contains 20% Daily Value (DV) of iron, what does this imply?

The product provides 20% of the recommended daily intake of iron based on 18 mg. Signup and view all the answers

What is the normal range for Hemoglobin A1c (HbA1c) levels?

Below 5.7% Signup and view all the answers

Which of the following is an example of the Acceptable Macronutrient Distribution Range (AMDR)?

Carbohydrates should constitute 45-65% of total daily calories. Signup and view all the answers

Which of the following accurately describes the Estimated Average Requirement (EAR)?

It meets the nutritional needs of 50% of individuals in a specific group. Signup and view all the answers

Study Notes

Dietary Reference Intakes (DRIs)

DRIs are scientifically-based reference values for nutrient intake
They help create nutrition labels and dietary guidelines
Key components include RDAs, AIs, ULs, EARs, AMDRs, and DVs

Recommended Dietary Allowance (RDA)

RDA is the average daily intake needed for 97-98% of healthy individuals in a specific age/gender group
Purpose: prevent nutrient deficiencies
Example: RDA for calcium (adults 19-50): 1000 mg/day

Adequate Intake (AI)

AI is used when an RDA cannot be determined due to insufficient scientific evidence
It's based on observed intakes in healthy individuals
Example: AI for fiber in women: 25 g/day

Tolerable Upper Intake Level (UL)

UL is the highest daily intake unlikely to cause adverse effects
Purpose: prevent nutrient toxicity
Example: UL for vitamin D in adults: 4000 IU/day

Estimated Average Requirement (EAR)

EAR is the average daily intake needed for 50% of individuals in a specific group
It's used to assess population-level nutrient adequacy
Example: EAR for iron (women 19-50): 8.1 mg/day

Acceptable Macronutrient Distribution Range (AMDR)

AMDR is the range of macronutrient intake associated with reduced chronic disease risk
It provides essential nutrients and energy
Example: Carbohydrates should be 45-65% of daily calories

Daily Value (DV)

DV is a reference value on food labels, usually based on a 2000-calorie diet
Example: 20% DV for iron means the product provides 20% of the recommended 18 mg/day iron

Biochemical Assessments

Hemoglobin A1c (HbA1c)

HbA1c measures average blood glucose over 2-3 months
Reflects long-term glucose control
Normal range: below 5.7%
Prediabetes range: 5.7% to 6.4%
Diabetes diagnosis: 6.5% or higher

Renal Function Tests (RFTs)

RFTs evaluate kidney function using biochemical markers like:
- Creatinine: muscle metabolism waste product; elevated levels = impaired kidney function; normal range: 0.6–1.2 mg/dL
- Blood Urea Nitrogen (BUN): measures urea in blood; high levels = kidney issues; normal range: 7–20 mg/dL
- Glomerular Filtration Rate (GFR): assesses kidney blood filtration; critical value: below 60 mL/min/1.73 m² = chronic kidney disease

Liver Function Tests (LFTs)

LFTs measure enzymes and proteins to assess liver health
- ALT (Alanine Aminotransferase): liver inflammation; normal range: 7–56 U/L
- AST (Aspartate Aminotransferase): liver damage; normal range: 10–40 U/L
- ALP (Alkaline Phosphatase): bile duct obstruction or liver disease; normal range: 44–147 U/L
- Bilirubin: jaundice or liver dysfunction; normal range: 0.1–1.2 mg/dL

Lipid Panel

Lipid panel assesses cardiovascular risk by measuring lipids in the blood
- Total Cholesterol: desirable level < 200 mg/dL
- LDL ("Bad" Cholesterol): desirable level < 100 mg/dL
- HDL ("Good" Cholesterol): desirable level ≥ 40 mg/dL
- Triglycerides: desirable level < 150 mg/dL

Nutrition Assessment Technology & Software

Body Composition Analysis Tools

Bioimpedance Scales (BIA): estimate body composition (fat, lean mass, water) using electrical current
Applications: clinical, fitness; weight loss, muscle gain, hydration tracking
Fat Calipers: measure subcutaneous fat using skinfold pinching; cost-effective but accuracy depends on technique
Dual-Energy X-ray Absorptiometry (DEXA): gold standard for precise body composition, bone density, fat, and muscle; expensive and less portable

Glucose Monitoring Tools

Blood Glucose Monitors: portable devices using finger-prick blood samples for immediate glucose level readings
Continuous Glucose Monitors (CGM): track glucose continuously via a sensor under the skin; provide real-time data via smartphones/apps

Other Monitoring Tools

Blood Pressure Meters: measure blood pressure
- Manual (Aneroid): uses stethoscope and gauge
- Digital: automatic inflation and display
- Wrist Monitors: portable but less accurate than upper-arm
- Key Measurements: Systolic (during heartbeat) and Diastolic (between heartbeats)
Wearable Fitness Trackers: monitor physical activity, heart rate, and energy expenditure (steps, calories, activity)
Examples: Fitbit, Apple Watch, Garmin
Smart Kitchen Scales: digital scales that connect to apps to track food portions and nutritional content

Food Tracking Apps

Mobile apps for logging food intake and tracking nutrients
Features: barcode scanning, calorie/macronutrient/micronutrient tracking, recipe/meal planning

Anthropometrics (Physical Measurements)

Anthropometry is the science of measuring human body dimensions, forms, and functional capacities to assess nutritional status and health risks

Key Anthropometric Measures

Weight: total body mass; doesn't differentiate fat/muscle. Applications: overall size change tracking with other measurements.
Body Fat Percentage: proportion of body weight from fat; Healthy ranges differ for males and females
Body Mass Index (BMI): measure of weight relative to height. Formula: Weight (kg) / Height² (m²). Categories: Underweight, Normal Weight, Overweight, Obese. Limitations: doesn't distinguish fat/muscle.
Mid Upper Arm Circumference (MUAC): upper arm circumference (shoulder to elbow midpoint). Applications: malnutrition detection, especially in children, pregnant women, and the elderly. Cut-off values vary by age/population
Waist-to-Hip Ratio (WHR): waist circumference / hip circumference. Applications: cardiovascular and metabolic risk predictor. High WHR = increased risk of heart disease and type 2 diabetes.

Food Labels

Food labels provide nutritional information for informed dietary choices

Key Elements of a Food Label

Nutrient Facts Panel: on back/side, detailed nutrients, calories, %DV
Front of Package Warning Labels (FOPWL): highlights calories, fats, sugar, health claims

Nutritional Assessments

Nutritional assessment: comprehensive evaluation of food intake, nutrient consumption, and overall health
Types of Assessments:

Direct Methods (ABCD Approach)

A: Anthropometry: measures body dimensions (height, weight, BMI, MUAC)
B: Biochemical/Biophysical: analyzes blood/urine/tissue samples for nutrient concentrations
C: Clinical: complete physical examination for deficiency/excess signs
D: Dietary: examines food intake, eating patterns, and diet history

Indirect Methods

Assesses broader nutritional environment via mortality rates, health service statistics, infection rates, and economic factors

Conducting a Dietary History

Detailed food intake, eating habits, and dietary preferences to identify nutritional imbalances
Key Components: 24-hour recall, food frequency questionnaires, meal patterns, preferences/restrictions, cooking/shopping habits

Assessment Tools and Techniques

Nutrient/Additive Scavenger Hunt: identify nutrients/additives in food products using labels

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Description

This quiz explores the concept of Dietary Reference Intakes (DRIs), focusing on key components such as Recommended Dietary Allowance (RDA), Adequate Intake (AI), Tolerable Upper Intake Level (UL), and Estimated Average Requirement (EAR). Understand how these values guide nutrition labels and dietary guidelines for maintaining health and preventing deficiencies.