Nutritional.pdf

Nutrition and Disease David Wagner, MD Associate Professor Department of Pathology at UNMC Email: [email protected] No financial interests to disclose Objectives Nutritional Disease List several common causes of dietary insufficiency Define...

Nutrition and Disease David Wagner, MD Associate Professor Department of Pathology at UNMC Email: [email protected] No financial interests to disclose Objectives Nutritional Disease List several common causes of dietary insufficiency Define Marasmus and Kwashiorkor Define Cachexia Discuss sources, function, and deficiency states of Vitamins A, C, and D Discuss diagnosis, pathophysiology, and adverse clinical effects of obesity Malnutrition ’ The appropriate diet provides 1. Sufficient energy for the body's daily metabolic needs (carbohydrates, fats, proteins) 2. Essential amino acids and fatty acids 3. Vitamins and minerals ’ Primary malnutrition: one or all components missing ’ Secondary (conditional) malnutrition: dietary intake is adequate but malabsorption, increased need, excess losses (eg GI diseases, chronic wasting disease, acute & critical illness) Fat soluble vitamins – A, D, E, K; body storage Water soluble vitamins – eliminated in urine Dietary Insufficiency-Causes ’ Poor diet ’ Increased dietary needs ’ Lack of knowledge of common dietary items (iron, iodine); ships (vitamin C - scurvy) ’ Poverty ’ Chronic alcoholism ’ Poor diet, increased loss, increased metabolic needs  lack of vitamins (especially thiamine) ’ Drink rather than eat. ’ Acute and chronic illness ’ Increased metabolic rate ’ Self-imposed diet restriction (anorexia nervosa, bulimia) ’ Other ’ GI diseases, malabsorption (acquired or inherited), drug therapies, total parenteral nutrition (TPN) Severe Acute Malnutrition Previously called protein energy malnutrition WHO definition: weight/height ratio