Note

1
Note Exam 180 minutes 120 multiple choice
questions-120 points -4 short answer
question-60 points multiple choice-lecture 7a
onwards short answer-whole Nutrition 263
course
2
Short answer Atherosclerosis- obesity decreases
HDLc and increases LDLc leading to plaque
development Hypertension-plaque development in
atherosclerosis narrows the blood vessels and
reduces the ability of the blood vessels to
vasodilate thus increasing pressure Type 2
diabetes-obesity leads to increased plasma free
fatty acids concentration which reduces insulin
sensitivity thus triggering type 2 diabetes
3
Short answer nitrosamines- attack pancreatic
beta cells thus eliminating insulin production
and secretion and thus resulting in type 1
diabetes Cows milk under the age of 1 year-
casein precipitates attack on pancreatic beta
cells thus eliminating insulin production and
secretion and thus resulting in type 1 diabetes
4
Lecture 9a 14 March 2011   Disorders of the
Upper GI tract
5
Mouth Chewing Impaired due to -sedation
and pain   Solution -mechanical soft
diet food selection or pureed foods what
is the difference?
6
Mouth Chewing Solution -pureed foods
-can be boring -bore factor may be overcome by
commercially available thickeners-
candidates?
7
Mouth Chewing Solution -pureed foods
-make more appealing by variety colour serve
foods at right temperature seasonings and
spices supplement with nutritious liquids
like milk, instant breakfasts, or liquid
formulas
8
Mouth ulcers -caused by?
Solutions   -moist soft textured foods and
eliminate spicy, salty and acid foods
-example of each of these food types?
9
Inflammation of throat and lips -nutritional
approaches-see mouth ulcers Reduced flow of
saliva -moisten foods with sauces and
gravies -problem with this?   -avoid salty
foods and snacks (examples) that dry
mouth   -give sugarless candy
10
Dysphagia   -difficulty swallowing -aging,
neurological disorders, developmental
disabilities and strokes   -muscles cannot not
push food back to back of throat or push foods
down the esophagus into stomach
11
Achalasia -cardiac sphincter does not open
up-it fails to relax -food backs up until
sphincter opens or there is regurgitation
12
Indications of dysphagia
-pain on swallowing, weight loss, feeling
food is sticking in mouth   -tendency to
hold food in mouth rather than swallowing,
-choking or coughing during meals,
-frequent throat clearing, drooling or change in
voice quality
13
Dysphagia Dietary interventions
-mono-texture meals  
-mildly spiced and moderately sweet
foods served at room temperature
-avoid sticky foods and foods that
break into small pieces when eaten
-avoid true liquids thickened
liquids are better (eg milkshakes and
puddings)  
14
Dysphagia Dietary interventions -posture- sit
up, feet flat on floor, head tilted slightly
forward to avoid choking   -tube
feedings intestinal tubes may be better than
stomach tubes to avoid aspiration  
15
Esophageal reflux -eat small meals and drink
liquids one hour before or after a meal
-limit foods that weaken cardiac
sphincter (fat,alcohol,caffeine)
-lose weight -avoid cigarettes
-during reflux avoid acidic foods like
citric acid juices, tomatoes, spices,very
hot or very cold foods
16

Nausea and vomiting Nausea -avoid foods and
aromas that make one nauseous -do not
overeat -drink cold or carbonated liquids upon
first sensation of nausea -eat carbohydrate-rich,
low fat foods before getting out of bed in
morning -if cyclical avoid food at critical
times -ginger or peppermint teas provide relief
for some people -relax after eating
17
Vomiting -if resolves clear fluids to replace
water and electrolytes -otherwise iv
feedings  
18
Gastritis Except as tolerated avoid
-alcohol and caffeine -decaffeinated
coffee -pepper and spicy foods
-fatty and greasy
foods -any other offending agent -B12
(injection or prescription nasal spray) as
indicated  
19
Ulcers Post-onset - eat slowly, chew
well -avoid overeating and any foods than
irritate the ulcer e.g. -alcohol and
caffeine -chocolate -pepper
and spicy foods
20
(No Transcript)
21
Class activity Design a diet for the
pathology/problem of your choice than meets the
dietary principles of adequacy, variety,
moderation, nutrient density, energy control, and
balance