2:45-3:15 pm on thursday (28 th november). meet with quality assurance external reviewers for the...
TRANSCRIPT
2:45-3:15 PM on Thursday (28th November).
Meet with quality assurance external reviewersfor the school of professional studies.
Nutrition transfer student volunteers please email me and Marcy [email protected]
indicating whether you are year 1 or 2 andwith you willingness to do so- your help is verymuch required and appreciated. Thank you!!!
Final exam 15 questions-short answer-point form covering whole term5 Q on diabetes and atherosclerosis10 Q on blood pressure, stroke, and kidney disease-10 points each- 3 hours-no choice on questions
Outline of todays talk
I. Pathology
II. Socioeconomic factors contributing to ESRD
III. Elementary nutritional approaches to be taken to avoid and treat ESRD including foods available to those at risk
IV. First Nations and other Cape Breton individuals at risk
V. How is nutritional assessment made for kidney disease?
VI. How would one assess from a nutritional perspective the socioeconomics, pathology and success of
nutritional interventions relative to ESRD?
Kidney DiseaseI. Pathology
Types of Kidney Disease
glomerular diseasenephrotic syndromenephritic syndrome
Kidney DiseaseI. Pathology
Types of Kidney Disease
glomerular diseasenephrotic syndrome
-loss of glomerlular barrier to
proteinnephritic syndrome
-inflammation of capillary loops of glomerulus
Kidney DiseaseI. Pathology
Types of Kidney Disease
Diseases of the tubules and interstitiumacute renal failurepyelonephritisnephrolithiasis
Focus on end stage renal disease
Kidney DiseaseI. Pathology
Types of ESRD
Diseases of the tubules and interstitiumacute renal failure
sudden reduction in glomerular filtration rate-pre-, intrinsic and post- renal flow drops
pyelonephritisnephrolithiasis
Kidney DiseaseI. Pathology
Diseases of the tubules and interstitiumpyelonephritis-urinary tract infection
nephrolithiasis-kidney stones
End stage renal disease (ESRD)I. Pathology
End-stage renal disease
inability to produce waste products, maintain fluid, and electrolyte balance and produce hormones
diabetes
ESRD
I. Pathology
End-stage renal disease-associations
diabetes (types I and II)
glomerulonephritis
hypertension
End stage renal diseaseI. PathologyWhat are the risk factors?End-stage renal disease
Obesity and all its sequelae leading to metabolic syndrome
genetics and dietary risk factors for type I diabetes
End stage renal disease
I. PathologyWhat are the risk factors?
Glomerulonephritisinfection- immune
system requires adequate balanced
nutrition
End stage renal diseaseI. PathologyWhat are the risk factors?
Hypertension-damages tissues
-all causes of hypertension
Socioeconomic factorsFood and hence nutritional choices depend on:
Personal preference-protective factors(preventative)-absence is a risk factor
type I and type II diabetes-review
infection-review
hypertension-review
Socioeconomic factors
Food and hence nutritional choices depend on:
Habittype I and type II diabetes-review
infection-review
hypertension-review
Food and hence nutritional choices depend on:Ethnic heritage or tradition
type I and type II diabetes-review
infection-review
hypertension-review
Social interactionrelate social interaction to ethnic heritage or tradition
Food and hence nutritional choices depend on:
Availability of food
• type I and type II diabetes-review• infection-review• hypertension-review
Convenience of food
• type I and type II diabetes-review• infection-review• hypertension-review
Food and hence nutritional choices depend on:
Economy of food
• type I and type II diabetes-review
• infection-review
• hypertension-review
Food and hence nutritional choices depend on:
Positive and negative associations
• type I and type II diabetes-review
• infection-review
• hypertension-review
Food and hence nutritional choices depend on:
Emotional conflict
• type I and type II diabetes-review
• infection-review
• hypertension-review
Food and hence nutritional choices depend on:
Values-how does this apply to:
• type I and type II diabetes-review
• infection-review
• hypertension-review
Food and hence nutritional choices depend on:
Body image
• type I and type II diabetes-review
• infection-review
• hypertension-review
Food and hence nutritional choices depend on:
Advertising-who is responsible for encouraging or not encouraging
• type I and type II diabetes-review
• infection-review
• hypertension-review
More on socioeconomic factors
Prestige-occupational-
lower the occupation the greater the risk of ESRD-why?
low occupational fathers tend to have low or lower occupational kids
could be a number of generations before population end-stage renal disease risk is reduced
More on socioeconomic factors
Prestige-occupational-
higher the occupation the less the risk of ESRD-why?
high occupational fathers tend to have high or higher occupational kids
could be a number of generations before population ESRD risk is increased among descendants of initial high
occupational fathers
More on socioeconomic factors
Prestige
-societal perceptions-dictate ability of people to change their social rankings
-education-eg university professors and astronauts have a lot of sophisticated
education and they are rated highly-however this is no guarantee that there is no risk of ESRD
More on socioeconomic factors
Power-based on societal perceptions to some extent
Income-also based on societal perceptions of the importance of the job to society
More on socioeconomic factors
Wealth-based on education-lower classes tend to be less well educated and therefore less able to take advantage of the societal perceptions that improve one’s socioeconomic status including wealth
Education- lower classes tend to be less well educated and therefore less able to take advantage of the societal perceptions that improve one’s socioeconomic status including the benefits arising from that education
More on socioeconomic factors
Social stratification
-ancestry-diabetes, infection, blood pressure
-gender-diabetes, infection, blood pressure
-race- diabetes, infection, blood pressure
-ethnicity- diabetes, infection, blood pressure
More on socioeconomic factors
Social stratification-mobility-diabetes, infection, blood pressure
-mental and physical activity-mental patients-may be marginalised by society-what impact does this have onthe risk of ESRD?
physical activity
More on socioeconomic factors
Social stratification
physical activity-ESRD risk lowered by chronic aerobic activity-caution with elevated blood pressure- blood pressure increases during aerobic exercise
- benefit with exercise comes after blood pressure is lowered in rest and during exercise- this is a training effect
More on socioeconomic factors
Social stratification
physical activity-impact on type I and II diabetes
-impact on infection
More on socioeconomic factors
Class-uppers-lower uppers-upper middles-average middles-working class-lower class
How might each of these classes have an impact risk or presence of ESRD?
More on socioeconomic factors
Global economy-globalisation- impact on:• type I and type II diabetes-review• infection-review• hypertension-review
Government-nutrition policies affect risk of ESRD-how?
• type I and type II diabetes-review• infection-review• hypertension-review
More on socioeconomic factors
Business-promotion of globalisation-why would business promote globalisation?
Psychology-susceptibility to business tactics such as?- impact on the risk of ESRD?
History-one’s habits and childhood socioeconomic status
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mindAdequacy
BalanceEnergy controlNutrient densityModerationVariety
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Prevention-eat foods in accordance with:
• type I and type II diabetes-review• infection-review• hypertension-review
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Post-onset-eat foods in accordance with
• type I and type II diabetes-review• infection-review• hypertension-review
IV. First nations and other Cape Breton individuals at risk.
Aboriginals
Retired
Unemployed
Genetics
Others?
How is nutritional assessment made for ESRD-prevention and cure?Nutrient intake analysis
• type I and type II diabetes-review• infection-review• hypertension-review
How is nutritional assessment made for ESRD-prevention and cure?
Nutrient intake analysis
FLUID-WHY?SODIUM-WHY?POTASSIUM-WHY?CHLORIDE-WHY?GLUCOSE-WHY?CALCIUM-WHY?PHOSPHOROUS-WHY?
How is nutritional assessment made for ESRD- prevention and cure?
Daily food record/Diary
what are potential problems with this approach regarding ESRD?
How is nutritional assessment made for ESRD-prevention and cure?
Retrospective data
-24 hour recall
-food frequency questionnaire
both 24 hour recall and are used to cross check one another-how would this apply to ESRD
How is nutritional assessment made for ESRD-prevention and cure?
Anthropometry-
• type I and type II diabetes-review• infection-review• hypertension-review
How is nutritional assessment made for ESRD--prevention and cure?
Nutrition focussed physical exam:
• type I and type II diabetes-review• infection-review• hypertension-review
How is nutritional assessment made for ESRD-prevention and cure?
Skin testing-applicable
• type I -review• infection-applicable?• hypertension-applicable?
How is nutritional assessment made for ESRD-prevention and cure?
Biochemical analysis
• type I and type II diabetes-review• infection-review• hypertension-review
How is nutritional assessment made for ESRD--prevention and cure?
Biochemical analysis
FLUID-WHY?SODIUM-WHY?POTASSIUM-WHY?CHLORIDE-WHY?GLUCOSE-WHY?CALCIUM-WHY?PHOSPHOROUS-WHY?
How is nutritional assessment made for ESRD-prevention and cure?
CLASSIFYING MALNUTRITION
obesity is the main issue here
thin individuals are much less at risk than obese persons