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Transcript
Nutritional and Dietary
Issues: A Survey
Galit Sacajiu MD MPH
Director, Medical Education
HME Project
Dietary recommendations
 Maintain calorie balance over time to achieve and
sustain a healthy weight.
 focus on consuming nutrient-dense foods and
beverages.
recommended Macronutrient Proportions
carbohydrate Protein
Young children (1–3 yrs) 45–65%
5–20%
fat
30–40%
Older children (4–18 yrs) 45–65%
10–30%
25–35%
Adults (19 and older)
10–35%
20–35%
45–65%
Foods and food components to
reduce
 Reduce daily sodium intake to less than 2,300




milligrams (mg) and further reduce intake to 1,500 mg
among persons who are 51 and older and special
chronic disease Consume less than 10 percent of
calories from saturated fatty acids by replacing them
with monounsaturated and polyunsaturated fatty acids.
Consume less than 300 mg per day of dietary
cholesterol.
Keep trans fatty acid consumption as low as possible
Reduce the intake of calories from solid fats and added
sugars.
Limit the consumption of foods that contain refined
grains,
foods and nutrients to increase
 Increase vegetable and fruit intake.
 Eat a variety of vegetables, especially dark-green





and red and orange vegetables and beans and peas.
Consume at least half of all grains as whole grains.
Increase intake of fat-free or low-fat milk and milk
products.6
Choose a variety of protein foods, which include
seafood, lean meat and poultry, eggs, beans, soy
products, and unsalted nuts and seeds.
Use oils to replace solid fats where possible.
Choose foods that provide more potassium, dietary
fiber, calcium, and vitamin D, which are nutrients of
concern in American diets.
Vitamins
Nutrients
Nutritional assessment of an adult
patient – History
ClinicalDetailed food consumption history
Recent Weight loss or gain
GI Symptoms (BM; N/V; Abd Pain)
Derm/neuro/Psych
Social Access to food (quantity and quality)
 Shelter
 Dependents
 Cooking utensils
Nutritional assessment of an adult
patient – Physical Exam
 Body Mass Index
 Inspection of skin, hair, nails, gums
 Neurological exam
 Abdominal exam
 Signs of edema
 Basal Energy Expenditure (BEE) (kcal/day)
Men = 66 + (13.7 x wt in kg) + (5 x ht in cm) - (6.8 x age).
Women:= 655 + (9.6 x wt in kg) + (1.7 x ht in cm) - (4.7 x age).
Nutritional assessment of an adult
patient – laboratory tests
 Proteins- Albumin, Prealbumin, Transferrin
 Immune function- Total Lymphocytes
 Measurements of specific vitamin and
minerals
 Assessment of Anemia
 Stool examinations
Mal-nutrition in Rich countries
CAN OBESITY CO-EXIST WITH HUNGER AND FOOD
INSECURITY?
YES!
The trade-off between food quantity and
quality.
 Overeating when food is available.
 Physiological changes may occur to help
the body conserve energy.

Mal-Nutrition in Resource poor
countries
not enough food, and of poor quality
Merci
THANK YOU