(8/18/10) - The Malnourished Patient

'''

1. List 5 physiologic changes common among older individuals that affect nutritional status. How do they affect nutritional status?'''

1. Decline of senses: decreased appetite & intake

2. Change in dentition: decreased intake due to painful chewing; swallowing also beomces drier, resulting in incomplete absorption of starches, which leads to abdominal discomfort

3. Impaired digestion: reduced esophageal motility, less gastric acid secretion, lactose maldigestion

4. Declining metabolic/renal status: dehydration

5. Decreased muscle mass: due to lack of exercise, aging; decreased metabolic rate results '''

2. Identify 5 variables that are screened for on the Mini Nutritional Assessment tool that indicate poor nutritional status in older individuals: food intake decline, weight loss during last 3 months, mobility, psychological stress or acute disease in past 3 months, BMI

3. List 3 of the most common vitamin deficiencies in the elderly.''' B12 (due to limited protease action), vitaminD, calcium

'''4. List 4 health benefits of a vegetarian diet. '''higher fiber content, increased vitamins C/E, more unsaturated fats, many phytochemicals

'''5. List 5 of the top nutrients that vegans are at risk for deficiency of. '''omega-3 unsaturated fats, vitamin D, iron, B12, zinc

'''6. Describe a clinical signs and symptoms of 2 of the nutrient deficiencies referred to in question 2. iron: anemia, angular stomatitis, cheilosis; B12: fatigue, macrocytic anemia, glossitis, ataxia, paresthesis, cheilosis

7. Write a paragraph describing the role of complementary proteins in the diets of vegans. Is it necessary to combine complementary proteins at most meals?

8. Describe body composition changes associated with aging and the nutritional impact of these changes.''' '''9. Discuss the calorie and protein needs of the elderly. Discuss various protein sources and an elderly person’s ability to consume and tolerate each.''' need at least 1.6g protein per kg for elderly (0.6-0.8g/kg for non-elderly)

'''10. What food/beverage or supplement would a vegan need to get the nutrients they are least likely to get adequate amounts of from their diet alone? '''B12 usually from meat products

'''11. Know how to calculate ideal body weight using the Devine equation. http://www.halls.md/ideal-weight/devine.htm'''

Men: 50kg + 2.3kg/inch above 5'0"; women: 45.5kg + 2.3kg/inch