Nutritional Problems Care - Essay Example

Assignment 4 Lessons 14-17 Define and discuss osteoporosis. Include in your discussion information how osteoporosis develops; how age, sex hormones, and genetics affect it; how activity affects it; and what dietary interventions can help prevent or treat osteoporosis. Osteoporosis is a metabolic disease of bones that occurs due to loss of normal density of bones. The bones become abnormally porous and fragile. There is increased risk of fractures in these bones. These fractures occur even due to minimal injury. The patient may be completely asymptomatic until decades before osteoporosis is detected following an X-ray due to fracture or low back pain. Osteoporosis can be diagnosed in early stages using dual energy X-ray absorptiometry scan. Bone density T score of –2.5 SD or below is called osteoporosis while T score between –1 and –2.5 SD is called osteopenia (Whiting 2005; Medicinet.com). Bone mass (bone density) is the amount of bone present in the skeletal structure. The higher the density is, the stronger are the bones. Bone density is strongly influenced by genetic factors, hormones (especially in women), environmental factors and medications. Men have a higher bone density than women; hence osteoporosis is more common in women. African Americans have a higher bone density than Caucasian or Asian Americans. Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density is then maintained for about ten years. After age 35, both men and women will normally lose 0.3 to 0.5% of their bone density per year as part of the aging process. Women may lose more density because of physiological demands like pregnancy and lactation. Estrogen is important in maintaining bone density in women. When estrogen levels drop after menopause, bone loss accelerates. Accelerated bone loss after menopause is a major cause of osteoporosis in women (Edwards 1995; 931-932). Factors that will increase the risk of developing osteoporosis are female gender, Caucasian or Asian race, thin and small body frames, family history of osteoporosis, smoking, alcohol consumption, lack of exercise, poor calcium intake, poor nutrition and general health, malabsorption conditions, low estrogen levels (menopause, surgical removal of ovaries, chemotherapy, amenorrhoea, chronic inflammatory diseases), immobility, hyperthyroidism, hyperparathyroidism, Vitamin D deficiency and certain medications like heparin, phenytoin, phenobarbitone and long-term corticosteroids. Nutrients important for osteoporosis are calcium, vitamin D, protein, sodium, caffeine, and isoflavones. Intake of vegetables, fruits, and low-fat diary products and avoiding consumption of processed foods fulfills the need for optimal intake of many bone beneficial nutrients. The DASH diet (Dietary Approaches to Stop Hypertension) which is recommended to prevent hypertension is also good for bone health. The Osteoporosis Society of Canada Guidelines has recommended this diet (Whiting 2005; Medicinet.com). Adequate calcium intake, moderate exercise, maintenance of desirable body weight, and avoidance of laxative and antacid abuse with patients throughout the life cycle prevents osteoporosis. Some may require supplementation of the diet with calcium and vitamin D in amounts equal to the RDAs if patients are unable to consume adequate calcium and vitamin D and if exposure to sunlight is minimal. 2. Explain the difference between heme and non-heme iron. How can the efficiency of absorption be increased for both types of iron? Heme is the iron-containing part of hemoglobin present in the blood of animals and humans. Heme-iron is found in animal foods such as meat, liver, poultry and fish. Non-heme iron is that form of iron we get from plant products such as cereals, fruits, vegetables and pulses (beans). Heme -iron is more easily absorbed and used by the body than non-heme iron. Its absorption is little influenced by the person’s iron status, whereas, the absorption of non-heme iron is greatly influenced by a persons iron status and is more absorbed when people have low iron stores. The absorption of iron in food depends not only on its iron content and the form its in, but more importantly on the presence of other foods that enhance or reduce its absorption. Vitamin C or ascorbic acid increases the amount of non-heme iron that can be absorbed from plant foods. Hence, the inclusion of vegetables or fruits rich in vitamin C at a vegetarian meal may double or even triple iron absorption. The presence of heme iron from animal foods also enhances non-heme iron absorption. The presence of certain compounds such as tannin (in tea) reduces the "bioavailability" of iron. Some foods contain iron inhibitors or ligands that bind with iron and prevent it from passing through the intestinal wall into the bloodstream. Besides tannin in tea, other iron-inhibitors include phytates (found in unprocessed cereals and bran) and certain spices (such as oregano). Calcium also blocks iron absorption. Hence, it is advisable to drink milk and take calcium supplements in between meals. In addition, certain foods can bind the non-heme iron in another food eaten at the same time. For instance, wheat and rice contain ligands that bind most of the non-heme iron in kidney beans (“Sources of Iron”). 3. What factors influence the bodys use of glucose during physical activity? and how? During physical activity the muscles work harder and hence need more energy. The main source of energy is glucose. The glucose necessary for providing energy is drawn from the blood as well as from the muscles where it is stored in the form of glycogen. Insulin works on the walls of the cells of the muscles to allow glucose to enter. Also, during physical activity, the muscle cells become more sensitive to the action of insulin and hence the body doesnt need as much insulin to achieve the same job. Because of this the body starts to gradually reduce its production of insulin. After about 30 minutes of moderate physical activity, the supply of glucose from the blood and from the stored glucose in muscles (glycogen) starts to run out and blood glucose levels start to slightly drop. This causes increase of glucagon and adrenaline and further decrease of insulin. The change in these hormone levels then causes the body to switch to using stored glucose from the liver and to stimulate the liver to start making new glucose from stores of protein and fat. Thus the body maintains a constant glucose level (“Glucose utilization”; Diabetes.org). 4. Discuss the use of protein, fat and carbohydrate as fuels during low, moderate and intense exercise. Carbohydrate, fat and protein are the three main energy fuels for exercise. The amount of usage of each of this fuel during exercise depends on various factors like dietary intake, fitness level, type of exercise and length of work-out. Anaerobic activities only use glucose, whereas aerobic activities use all three fuels - but protein is used to a lesser extent than glucose and fat. During low-intensity exercise, which uses less than 300 kcal each hour, greater proportion of fat, a smaller proportion of glucose and fewer calories are used. As the intensity of exercise increases, the body will gradually use less fat, more glucose and more calories. Therefore, most of the fuel during moderate and high intensity exercise (using more than 500 kcal each hour) will come from glucose. If one continues to exercise aerobically for a longer period, the body will gradually use more fat and less glucose in an attempt to conserve the limited glucose stores. The fitter the person is, the more efficiently will the muscles use fat and the longer he can work out (“Energy fuel”; Sugar-bureau.co.uk). Assignment 5: Lessons 18-21 1. Compare and contrast major differences in nutrient content of breast milk and cows milk. G= grams LA= lactalbumin LF= lactoferrin LG= lactoglobulin Adopted from: Nutrition and Child development by K E Elizebath, Paras Medical Publisher, India. 2. Describe the normal events of fetal development. How does malnutrition impair fetal development? Week of gestation Event      0-1                        Implantation 1-2                         Embryo formation 3-4                         Heart beats, brain forms 2 lobes 4-5                         Formation of head, trunk, arm buds 6-7                    Stomach, liver and kidneys start functioning 7-8                          CVS established 9-10                        Total body movements 12                         Swallows amniotic fluid, finger mails, eyelids, bony ribs and vertebrae form.                               Musculoskeletal system established 24               Respiratory apparatus established, permanent teeth buds, vernix and lunago formed, eyes open 30    Nervous system established. ( Adopted from: Connor, Linda and Gourley, Rebecca. Obstetric and Gynecologic Care in Physical Therapy . Second Edition. Pages: 213:214. Tables: 8-5 and 8-6. SLACK Incorporated.2000 ) Malnutrition during pregnancy can cause prematurity, fetal growth retardation, still birth and low birth weight in babies. Deficiencies associated with malnutrition can lead to fetal anemia and neural tube defects (folic acid deficiency). It can deprive fetal brain of needed glucose and may impair its development (Sossong; “Fetal development”). 3. List six (6) nutritional problems associated with drug abuse and tobacco use in adolescents. 1. Nutrient deprivation: Many drugs like opiates and alcohol cause decreased intake of food either due to loss of appetite or due to withdrawal symptoms which leads to an imbalanced diet and decreased nutrients, the adolescents can develop anemia and multi-vitamin deficiencies. The most common vitamin deficiencies are pyridoxine, thiamine and folic acid. 2. Korsakoffs syndrome or Wet brain -this is caused due to severe nutrient deficiencies related absorption problems caused by heavy use of alcohol. 3. Electrolyte imbalance: Withdrawal symptoms (diarrhea and vomiting) due to drugs like opiates causes electrolyte imbalance. This is further added upon by poor food intake. 4. Malnutrition: Stimulant use, including use of crack, cocaine, and methamphetamine, results in a significant decrease in appetite, weight loss, and eventual malnutrition. Severe alcoholism can also lead to malnutrition. Infact, these addicts can stay up to days without eating anything. 5. Obesity: Those who are cannabis dependent can have increased appetite which may lead to over-weight and obesity. 6. Other consequences of disturbed balanced nutrition: Alcoholics may develop impairment of vital organs of metabolism and nutrition- pancreas and liver. They may have mood fluctuations due to nutrient deficiency (“Addiction Medicine”; Pennhealth.com) 4. List the factors that increase the risk for vitamin B12 and iron deficiency in older adults. 1. Blood loss due to gastrointestinal bleeding or during surgery. 2. Elderly people without teeth may depend on canned foods for diet which are deficient in folic acid and other vitamin deficiencies (“Anemia”). 3. Chronic alcoholism can cause anemia both from internal bleeding and Vitamin B deficiencies. 4. Consumption of diets poor in iron- eating more of processed foods, strict vegetarian food, etc. 5. Chronic illness: Any chronic disease that causes decreased appetite or internal bleeding or inflammation causes anemia. Also, some drugs like anti-tuberculosis drugs can also cause anemia (Whitney 1999; 290-327). References Anemia, University of Maryland Medical Center, 22nd July 2007. http://www.umm.edu/patiented/articles/who_becomes_anemic_000057_2.htm Addiction medicine, nutrition, University of Pennsylvania Health System. 22nd July 2007. http://pennhealth.com/ency/article/002149.htm Connor, Linda and Gourley, Rebecca. Obstetric and Gynecologic Care in Physical Therapy . Second Edition. Pages: 213:214. Tables: 8-5 and 8-6. SLACK Incorporated.2000. Principles and Practice of Medicine : Osteoporosis. Eds. Edwards, Christopher, Bouchier Ian, Haslett Christopher and Chilvers Edwin. 17th edn. Great Britain : ELBS, 1995. Elizebath, KE. Nutrition and Child development. India: Paras Medical Publisher, 2002. Energy fuel. 22nd July 2007. http://www.sugar-bureau.co.uk/energy_zone/energy_fuel.html Glucose utilization during physical activity. 22nd July 2007. http://www.diabetes.org.nz/managing/activity-t1.html Sossong, Norman, Fetal Development, 22nd July 2007. http://hometown.aol.com/sossong/sosweb/fetaldev.htm Sources of iron. 22nd July 2007. http://findarticles.com/p/articles/mi_m0857/is_n1_v14/ai_18027035/pg_2 Whiting, Susan and Vatanparast , Hassanali. Nutritional Interventions in Osteoporosis. Posted 12th Jan. 2005. Medicinet. 22nd July 2007. http://www.medicinenet.com/osteoporosis/article.htm Whitney, Eleanor Noss, and Sharon Rady Rolfes. Understanding nutrition. 8th ed. Belmont, CA, West/Wadsworth, c1999. Read More