Lecture 01 - Nutrition

Lecture 01 - Nutrition - Understand the concept of...

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Understand the concept of malnutrition MALNUTRITION: Imbalance between intake and requirement of energy, protein, and/or other essential nutrients (U ntreated, results in loss of body mass and impairment of normal bodily function) 1. Inadequate access to resources 1) Socioeconomic 2) Withholding nutrition in hospitalized patients 2. Failure of nutrient assimilation 1) Maldigestion (pancreatic insufficiency or biliary obstruction) 2) Malabsorption (mucosal disease or short bowel syndrome) 3. Intake of excess nutrients 1) Major cause of morbidity/mortality in US 4. Failure to meet increased requirements due to illness 1) Failure to recognize requirements and/or importance of nutrition support by healthcare providers 5. Very common; significant impact on important health outcomes 6. Prevalence: 20-50% of hospitalized patients 7. Impact of malnutrition 1) Impaired wound healing in surgical patients 2) Increased risk for infectious complications 3) Increased length of hospital stay 4) Increased mortality in HIV/AIDS, chronic liver disease, chronic kidney disease, cancer, COPD, stroke, hip fracture, and many others 8. Maintaining body mass and function 1) Energy homeostasis 2) Adaptation to starvation 3) Impact of illness on homeostasis and adaptation to starvation 4) Appreciate the contribution of underlying illness to nutritional requirements 9. Modifiers of basal energy expenditure 1) Physiological Modifiers = Tissue Growth Nutrition repletion, pregnancy, childhood Newly synthesized tissue composed of fuel Synthesis of tissue from AA, FA, glucose requires energy 2) Pathological Modifiers Decreased: fasting, hypothyroidism, hypothermia Increased: Hypermetabolism and Hypercatabolism occur in illness Wounds that need to heal = metabolic goes up 10. Adaptation of fasting/starvation 1) Body cannibalizes own tissues as energy source in absence of food Hormonally driven process Loss of lean body mass 2) Maintaining glucose is vital Glycogen stores deplete after 12-24 hours Protein and glycogen from triglyceride turnover are catabolized thereafter With prolonged starvation, alternate fuels utilized 11.
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