NUTR 302L Lab Exam 1 Review Spring 2024 PDF

NUTR 302L Lab Exam 1 Students should be able to: 1. Identify the categories of nutritional assessment (ABCD) and provide examples of each method. a. A – anthroprometrics: measurement of body i. Height and weight using BMI (kg/m2) ii. Body...

NUTR 302L Lab Exam 1 Students should be able to: 1. Identify the categories of nutritional assessment (ABCD) and provide examples of each method. a. A – anthroprometrics: measurement of body i. Height and weight using BMI (kg/m2) ii. Body composition using DEXA, bioelectric impedance analaysis, skin fold/calculations iii. Body shape/type using waist/hip ratio, regional distribution apple vs pear (android, gynoid) b. B – biochemical analysis: lab measurements i. Static measures: measures of a nutrient or its metabolite (cholesterol, glucose, iron, calcium) ii. Functional measures: reflects failure of a function or process of the body as a result of nutritional deficiency (visual adaptation to dark is compromised due to vitamin A deficiency) c. C – clinical manifestations: signs/symptoms i. Physical condition information gathered by medical history and physical examination, NFPE (mild muscle wasting, temporal loss, adipose… ) d. D – dietary intake: food/nutrients consumed i. 24 hour recall ii. Food record iii. Food frequency : questionnaire iv. Weighed food intake: foods weighed when portioned and after consumed, gold standard for assessing intake v. Diet history 2. Understand the basics of scientific research including: Different types of research (cell to epidemiological), parallel vs crossover designs, independent and dependent variables. a. Cell culture studies: high control b. Population: top for nutrition  c. Human studies: top for nutrition d. Epidemiological: Epidemiological research is a type of medical research that studies the distribution, patterns, and determinants of health and disease within a population, e. Animal studies: high level of control f. Parallel: In a parallel study, participants are randomly assigned to a single treatment group and remain in that group throughout the study. g. Crossover: Crossover trials allow the response of a subject to treatment A to be contrasted with the same subject's response to treatment B. In a crossover study, participants are randomly assigned to receive treatments in a sequence, such as AB or BA. Removing patient variation in this way makes crossover trials potentially more efficient than similar sized, parallel group trials in which each subject is exposed to only one treatment. h. Independent variable: WHAT you manipulate (exercise intensity, feeding, nutrition supplementation, etc.) variable that is changed i. Example: caffeine dosage i. Dependent: variable you’re measuring (biomarkers, cholesterol, triglycerides, amino acids, physiological outcomes) variable affected by the change i. Example: mile time 3. Calculate BMI, IBW (Hamwi formula), %IBW, %UBW, % weight change and interpret. a. BMI – kg/m2 b. IBW i. Female 5’– 100# 5 for each additional inch ii. Male 5’ - 106# 6 for each additional inch c. IBW% - current wt/ ideal wt x 100 d. UBW% - current wt/usual wt x 100 e. % wt change usual wt- actual wt/usual wt x 100 i. 6-9% mild degree of malnutrition ii. 10-15% moderate degree of malnutrition iii. > 15% severe degree of malnutrition 4. Compose a PES statement  a. [Problem] related to [Etiology] as evidenced by [Signs and symptoms] 5. Calculate sample concentrations of biochemical markers and interpret. a. Nitrogen Balance – N2 balance = protein intake/6.25 – UUN – 4 i. Positive: anabolism ii. Negative: catabolism 6. Distinguish between the types and causes of Anemia and the vitamins/minerals associated with them. a. Causes: i. Excessive blood loss (hemorrhage) ii. Excessive blood cell destruction (hemolysis) iii. Deficienct RBC production (ineffective hematopoiesis) b. Types: i. microcytic, not enough iron, low colored rbc and smaller rbcs. Hypochromic ii. macrocytic, vitamin deficiency, b12 and folate important for making blood cells and dna synthesis. not able to divide cells right way and leads to bigger cells - know MCV high, more likely microcytic iii. normocytic- ingesting enough iron but losing it due to gi bleed or chronic disease or inflammation 7. Identify factors that may increase or decrease nutrition-related biochemical markers. Ex: Aside from protein intake, why might albumin be high or low? a. Albumin: (protein) i. High due to dehydration, less solutes. ii. Low ß indicate inflammation or chronic disease (Is albumin a good marker for malnutrition or protein status? NO) b. Glucose: i. High due to diabetes or not eating properly/too much, lack of exercise ii. Low due to insulin or diabetic medications c. Hgb  i. Low ß anemia, iron deficient. Could be from pregnancy, heavy menstrual bleeding, blood loss, hemorrhage ii. High ß polycythemia, disease d. Hct: i. Lowß anemia, low iron. Too few red blood cells. Blood loss or poor nutrition ii. High ß dehydration, too many red blood cells e. BUN: (protein) i. High ß consuming a lot of protein, dehydration ii. Low ß not consuming enough protein, malnutrition, overhydration 8. Understand the strengths/limitations of protein/muscle status indicators and which is the best to use in a given situation. a. Biochemical markers: i. Serum proteins: albumin 1. Not a good indicator of nutrition status ii. Nitrogen balance: positive, anabolism. Negative, catabolism. Amount of nitrogen consumed = amount excreted b. Anthropometrical/Clinical: i. NFPE 1. Asseses muscle mass, fat stores, fluid status, micronutrient deficiencies ii. Grip strength 1. Could be related to muscle mass nutrition focused exam, grip strength ß predictive for sarcopenia. Low? Protein energy malnutrition, sarcopenia, etc. 9. Explain the differences between Type I, Type II, and Gestational Diabetes and understand the methods of diagnosis and intervention. Know the measurements of diagnosis of diabetics for memorize (A1C, fasting blood sugar, random blood sugar test) may or may not ask questions for glucose tolerance test a. Type 1 – autoimmune response, something happening to beta cells so cant produce insulin.. Beta cells destruction of pancreas i. Methods of diagnosis: Elevated blood sugar/high blood glucose.  ii. Intervention: have to take insulin injections b. Type 2 – Insulin resistance, body producing insulin, but muscle cells and intake glucose is no longer working. So we cannot shuttle in glucose and results in high blood glucose and high blood insulin. i. Methods of diagnosis: High blood glucose AND high insulin ii. Intervention: weight control, food selection, exercise helps w blood glucose management c. If patient exercises, adding insulin and check blood sugar. Causes hypoglycemia d. Gestational diabetes: transient, will last throughout pregnancy. Too high blood sugar damages vasculature, arteries and veins, and also FETUS i. Methods of diagnosis: oral glucose tolerance test ii. Intervention: Managed through metformin iii. May lead to delivery complications – macrosomia large baby, and neonatal hypoglycemia e. OGTT test i. Provide glucose load of at least 75g ii. Monitor glucose over 2 hrs f. Lab markers: i. A1C test 1. Diabetes: 6.5% or above 2. Prediabetes: 5.7-6.4% 3. Normal: 5.7% or below ii. Fasting blood sugar test 1. Diabetes: 126mg/dL or above 2. Prediabetes:100-125mg/dL 3. Normal: 99mg/dL or below iii. Glucose Tolerance Test 1. Diabetes: 200mg/dL or above  2. Prediabetes: 140-199mg/dL 3. Normal: 140mg/dL or below iv. Random Blood Sugar Test 1. Diabetes: 200mg/dL or above 2. Prediabetes: N/A 3. Normal: N/A 10. Identify populations at risk for iron deficiency. a. Heavy Menstruation – blood loss, increased needs b. Vegetarians –vegetarians get iron from plant sources, non-heme so less bioavailable, increased RDA requirements for iron 1.8x of those consuming normal omnivore diet i. How to increase bioavailability of iron? Vitamin C (enhances iron absorption) c. Pregnant females d. Some endurance athletes e. Infants/children with low iron intake and/or during growth spurts 11. Know the normal biochemical marker ranges for the following: glucose, iron status, protein status as well as the diabetes diagnostic ranges for A1c, fasting glucose, random glucose, and OGTT. a. Protein status: i. EAR for adult à 0.66g/kg/d ii. RDA for adult à 0.8g/kg/d b. A1C gives us estimate on average blood sugar over 3 month period of time, 3 months bc RBCs die off and get repleted every 120 days c. Indicators of iron status: Hct, hgb, MCV, serum ferritin, total irob binding capacity, %transferrin saturation, serum srfr i. MCV:80-100fL m+f avg. volume of rbcs 1. If MCV increases, folate or b12 deficiencies 2. Decreases, chronic iron deficiency ii. Hct: % of rbc making up entire volume of blood. Affected by hydration level d. Serum ferritin: primary storage form of iron in body  i. Iron stores depleted à tissue ferritin levels decrease ii. Positive acute phase reactant e. Transferrin, tibc, %tsat i. TIBC(total iron binding capacity): amount of fe capable of being bound to serum transferrin; used to indirectly measure transferrin, iron status ii. Transferrin saturation: represents percentage of transferrin saturated with iron 1. Low in stage 2 iron deficiency 2. Low when Fe intake is low 12. Depending on stages of iron deficiency, what do you expect to see? How would you identify iron depletion, what is the biochemical marker? - Stage 1 Ferratin (storage form of iron) amount in our blood stream is directly proportional to the amt stored in our liver, spleen, o Serum ferritin concentration is below 12ug/L and total iron binding capacity TIBC is more than 400 ug/dL - Stage 2: rbc production starts to slow down, decrease of rbc production o Transferrin saturation 70 ug/dL, serum transferrin receptor - Stage 3: iron deficiency anemia, microcytic(small rbc) and hypochromic (below normal color) see consequences in measurements such as transferratin, hgb, hct small rbc o Hgb