Nutrition

Question 1

What is 1kcal?

Answer 1

Amount of energy required to heat 1kg of water by 1 degree celsius at sea level

4.2kJ

• 1g of fat = 9kcal
• 1g of protein = 4kcal
• 1g of carbohydrate = 4kcal

Question 2

What is the basal metabolic rate?

Answer 2

25kcal/kg/day

Male: 1750kcal
Female: 1400kcal

+ dietary-induced thermogenesis, non-exercise activity thermogenesis, exercise activity thermogenesis

= Male: 2200kcal
= Female: 1800kcal

Question 3

What are the properties of the macronutrients?

Answer 3

PROTEIN (~17%-20% of diet)

• source of nitrogen required for muscle, DNA, albumin, etc.
• expensive in terms of price and energy

CARBOHYDRATE (~50% of diet)

• stored as glycogen in liver and muscle
• used by all organs

FAT (~30% of diet)

• high density energy storage
• broken down into fatty acids and glycerol
• converted into ketones and glucose in starvation stage

Question 4

What are the properties of the micronutrients?

Answer 4

VITAMINS:

• A = liver, vegetables (retina/skin health)
• B1 = red meat, grains, beans (neurone health)
• B9 (folic acid) = leafy vegetables (bone marrow)
• B12 = red meat (neurones and bone marrow)
• C = fruit (collagen synthesis)

ELECTROLYTES:

• 1mM of sodium/kg/day
• 1mM of potassium/kg/day

TRACE ELEMENTS: selenium, zinc, phosphate

Question 5

What is the feeding hierarchy?

Answer 5

Normal oral feeding
Oral nutrition supplements
NG feed: short/medium term, nutritional bridge to recovery/gastrostomy
PEG: medium/long term, support for chronic disease, radiotherapy, chemotherapy, palliative care
RIG: if upper GI tract inaccessible
Parenteral nutrition: intestinal failure, inaccessible/obstructed GI tract, can use alongside enteral nutrition

Question 6

What is the calorie content of PEG feeds?

Answer 6

1kcal/ml (Nutrison)

OR 1.5-2.0kcal/ml (Nutrison Energy)

at 100ml/hr

Question 7

What is the dosage for parenteral feeding?

Answer 7

IV fluids 25ml/kg/day + losses

Question 8

How much sodium is in a litre of saline?

Answer 8

154mmol