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MFN-005: Clinical and Therapeutic Nutrition

MFN-005: Clinical and Therapeutic Nutrition

IGNOU Solved Assignment Solution for 2022-23

If you are looking for MFN-005 IGNOU Solved Assignment solution for the subject Clinical and Therapeutic Nutrition, you have come to the right place. MFN-005 solution on this page applies to 2022-23 session students studying in MSCDFSM, PGDDPN courses of IGNOU.

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Assignment Solution

Assignment Code: MFN-005/AST-2/TMA-2/2022-23

Course Code: MFN-005

Assignment Name: Clinical and Therapeutic Nutrition

Year: 2022-2023

Verification Status: Verified by Professor


Maximum Marks: 100

This assignment is based on Units 1 -18 of the MFN-005 Course.


Section A - Descriptive Questions


There are eight questions in this part. Answer all questions. (80 marks)


1. a) What are the nutritional assessment methods and tools you could use for the elderly? (3)

Ans) The nutritional assessment methods we could use for the elderly are:


  1. Bodyweight is still the most useful and cost-effective way to measure something. Rapid weight loss, like 2 percent in one week or up to 10 percent in six months, is considered to be significant. The BMI calculation is a good way to compare weight changes because skin fold measurements don't work well because of changes in skin turgor.

  2. Physical Exam: A diagnosis can be made based on the results of a physical exam, such as the presence of oedema and signs of vitamin deficiency.

  3. Biochemistry: Hypoalbuminemia is not thought to be a sign of poor nutrition, but it is important to find the older people who are at high risk and need nutritional help. When levels are less than 3 g/dl, you need to be careful and take action.

  4. In haematology, a lower total lymphocyte count can also help figure out how bad the undernutrition is. If levels are less than 4500, it is linked to poor nutrition and a weaker immune system.


The nutritional assessment tools we could use for the elderly are:


  1. Nutrition Screening Initiative (NSI) tries to find basic risk factors, such as eating the wrong foods, being poor, being alone, having a disability, having a short-term or long-term illness, taking long-term medications, and the age of the subject. It is a useful epidemiological tool and makes patients and caregivers more aware of undernutrition.

  2. Mini Assessment Tool for Nutrition: It is a complete and easy-to-use tool that can put people into three different groups, such as well-nourished, at risk, and undernourished. Most of the time, this tool takes the place of more invasive tests like drawing blood.


b) Give salient features for nutritional management of Hepatic Encephalopathy. (5)

Ans) The salient features for nutritional management of Hepatic Encephalopathy are:

  1. Hepatic encephalopathy is not helped by eating less protein, but the type of protein should be thought about.

  2. Oral supplementation with branched chain amino acids has a role in cirrhosis not only because it improves nutrition, but also because it lowers the risk of hepatic encephalopathy coming back.

  3. Changes in gut microbiota happen at the same time that cirrhosis gets worse and changing gut microbiota may be a good way to treat and prevent hepatic encephalopathy.

  4. Prebiotics and probiotics might help with this goal, but we need to learn more about them or test them out first.

  5. Micronutrient deficiency, which is common in advanced liver disease, is bad for the brain and may cause encephalopathy either directly or by interacting with the processes that lead to encephalopathy.


c) Discuss the complications of burns. (2)

Ans) The complications of burns are:

  1. Bacterial infection, which may lead to a bloodstream infection (sepsis).

  2. Fluid loss, including low blood volume (hypovolemia).

  3. Dangerously low body temperature (hypothermia).

  4. Breathing problems from the intake of hot air or smoke.

  5. Scars or ridged areas caused by an overgrowth of scar tissue (keloids). Bone and joint problems, such as when scar tissue causes the shortening and tightening of skin, muscles or tendons (contractures).


2. Write short notes on:


a) Drug effects on nutritional status (3)

Ans) Many medications have specific recommendations regarding food intake in order to maximise their absorption. Such recommendations can alter the usual pattern of food intake and may reduce overall food intake when meals are omitted, as is often the case in the elderly. Anorexia is a common side effect of several medications resulting in weight loss and patients with pre-existing malnutrition should be closely monitored when initiating medicines associated with hypogeusia and/or dysgeusia. Drugs are also associated with weight changes, nausea and vomiting, decreased gastrointestinal motility, diarrhoea, xerostomia, and taste, as well as olfactory disturbances. Medications can also impair the absorption of nutrients by forming pharmacological compounds, changing gastric acidity, altering the rate of absorption, reducing bacterial flora and directly irritating or damaging the lining of the digestive tract.


b) Effect of nutrition on drugs (3)

Ans) After oral intake the drug is transported from the gut lumen to the intestinal erythrocytes. Transported in the blood the drug is usually plasma protein bound. Deactivation occurs by a two-stage metabolic process oxidation by the microsomal enzymes involving NADPH and cytochrome P450 in the liver, lungs and small intestine and conjugation with glucuronic acid, sulphate or glycine. The conjugate is then excreted in the urine or bile.


The absorption of a drug can be reduced, delayed or increased by food consumption. The presence of food in the stomach and proximal intestine may reduce drug absorption as a result of:

  1. Delayed gastric emptying.

  2. Altered gastrointestinal pH.

  3. Competition for binding sites with nutrients.

  4. Chelating of drugs by food cations, e.g., tetracycline with calcium ions in milk.

  5. Dietary fats impeding the absorption of hydrophilic drugs.


c) Salient features of the diet you would prescribe to a patient with HIV (4)

Ans) The salient features of the diet to prescribe to a patient with HIV are:

  1. Eating a diet high in vegetables, fruits, whole grains, and legumes.

  2. Choosing lean, low-fat sources of protein.

  3. Limiting sweets, soft drinks, and foods with added sugar.

  4. Including proteins, carbohydrates, and a little good fat in all meals and snacks.

  5. Have high-calorie protein drinks or shakes. Adding powdered milk can increase the nutrition in other drinks.

  6. Drink 8 to 10 glasses of filtered water each day.

  7. Keep nutritious snacks on hand, such as nuts and carrot sticks.

  8. Eat high-calorie foods if losing weight.

  9. Call your doctor if you lose 5 pounds or more when you didn’t intend to.

  10. Talk to your doctor about taking a multivitamin every day. Take your multivitamin with a meal to help prevent an upset stomach.

3. a) Give the salient features of the nutritional management of the following diseases/disorders: (5+5)


i) Type I Diabetes

Ans) The salient features of the nutritional management of Type I Diabetes are:

  1. Carbohydrates from fruits, vegetables, whole grains, beans, and low-fat milk should be part of a healthy diet. People with diabetes are told to stay away from drinks with a lot of sugar (including fruit juice). It's not clear how much carbohydrate you should eat. In addition to total carbohydrates, meals with a low glycemic index and glycemic load may help control blood sugar levels in a small way.

  2. There are many good ways to eat, such as low-fat, low-carb, Mediterranean, and vegetarian.

  3. The type of fat is more important than how much fat there is. Saturated fat and trans-fat are both linked to coronary heart disease. On the other hand, monounsaturated and polyunsaturated fats have a protective effect.

  4. People with kidney disease should try to get the recommended daily amount of protein, which is 0.8 g/kg of body weight per day. Patients should be told to eat less red meat and more lean meats, fish, eggs, beans, peas, soy products, nuts, and seeds.

  5. Blood sugar levels and glycated haemoglobin may be easier to control with a diet that has 25 to 30 grammes of fibre per day.

  6. A diet that is high in fruits, vegetables, and low-fat dairy products and low in sodium (less than 2300 mg per day) can help control blood pressure. People with diabetes and heart failure may feel better if they eat less salt.


ii) Nephrotic syndrome

Ans) The salient features of the nutritional management of Nephrotic syndrome are:

  1. You can reduce swelling by cutting down on the amount of sodium you eat. Salt is the main source of sodium in food. Drink more fluids to help reduce swelling.

  2. Hyperlipidaemia can be better controlled by eating less saturated fat and cholesterol. It's a good idea to eat less full-fat dairy, red meat, processed meat, cheese, fried foods, baked goods, and sweets.

  3. Think about how much protein you eat. For nephrotic syndrome, you should eat 1 gramme (g) of protein per kilogramme of body weight per day, which is 0.45 g per pound per day. But this amount may change based on how healthy your kidneys are right now.

  4. Limit sodium intake to 400 milligrams (mg) per meal (150 mg per snack).

  5. Salty seasonings should be used less or not at all. More salt is in these than in herbs and spices. If a recipe calls for garlic salt, fresh garlic or garlic powder can be used instead.

  6. Make food at home. There may be more salt in meals from restaurants. Look at the nutrition information on a restaurant's menu ahead of time and choose entrees with less than 400 mg of sodium. Check with the restaurant to see if they can make your food without salt.

  7. Use healthy oils like olive or coconut oil to cook.

  8. Take the salt off the table.

  9. To cut down on sodium, choose fresh vegetables or canned vegetables with no added sodium or low sodium.


4. Rita, age 30yrs, weight 50 kg and height 5’5” is admitted to a hospital for surgery. Her gastro-intestinal tract is functioning, but she is unable to swallow solid food.

a) Calculate her basal energy expenditure by Harris Benedict equation (3)

b) What are the factors to be considered in estimating the actual energy requirements for her? (2)

c) What are the various methods of feeding Rita? (3)

d) Which one of the methods of feeding is the most suited for her and why. (2)


Ans) Calculating your basal metabolic rate is easy; all you need to measure is your weight and height, although your age and sex also come into play. The calculators for both sexes are as follows:


For men: BMR = 66.5 + (13.75 * weight in kg) + (5.003 * height in cm) - (6.75 * age)

For women: BMR = 655.1 + (9.563 * weight in kg) + (1.850 * height in cm) - (4.676 * age)


Weight = 50 kg

Height = 5 ft. 5 in.

Age = 30 years

Sex = Female

BMR = 1298.4 kcal/day

PAL = Light exercise 1-2 times a week

Total energy expenditure = 1785 kcal/day


To determine your total daily calorie needs, multiply your BMR by the appropriate activity factor as follows:


Sedentary (little or no exercise) calories = BMR x 1.2

Lightly active (light exercise/sports 1-3 days/week) calories = BMR x 1.375

Moderately active (moderate exercise/sports 3-5 days/week) calories = BMR x 1.55

Very active (hard exercise/sports 6-7 days/week) calories = BMR x 1.725

If you are extra active (very hard exercise/sports and a physical job) calories = BMR x 1.9


5. a) Enumerate the modifiable risk factors of cardiovascular diseases. (2)

Ans) The modifiable risk factors of cardiovascular diseases are:


1) Behavioural

a) Smoking

b) Sedentary Lifestyle Habits

c) Dietary Errors


2) Physiological

a) Hyperlipidaemia

b) Hypertension

c) Obesity

d) Diabetes Mellitus

e) Hyperuricaemia and Gout

f) Fibrinogen

g) Platelet Aggregation

h) Lipoprotein (a)

i) Homocysteine Levels

j) Low Birth Weight


3) Psychological

a) Stress

b) Low Socio-Economic Strata

c) Type A Personality


4) Geographic

a) Soft Drinking Water

b) Cold Weather


b) Present the dietary management for hypertension. (4)

Ans) The dietary management for hypertension:

  1. Energy: The number of calories you need should be based on the idea of staying at a healthy weight. So that the weight stays the same, it's important to cut back on fats and carbs that have too many calories.

  2. Proteins: You should eat more protein than usual. 15-20% of the total energy needs should come from protein. People should avoid eating too much non-vegetarian food, especially red meat and egg yolks, because they have a lot of saturated fatty acids.

  3. Fats: The fats in the diet should be high in unsaturated fatty acids and shouldn't provide more than 20% of the total energy.

  4. Carbohydrates: About 60–65 percent of the energy you need should come from complex carbohydrates (polysaccharides) instead of simple sugars (monosaccharides and disaccharides).

  5. Calcium (Ca): Getting enough calcium is an important part of the treatment. You can make sure you get enough calcium by eating enough milk and milk products, green vegetables, cereals, and pulses.

  6. Sodium: Limiting sodium and losing weight are both good ways to control mild to moderate high blood pressure (1-2 x per day), along with taking diuretics.


c) Give the classification of blood pressure and stages of hypertension in adults. (2)

Ans) The classification of blood pressure and stages of hypertension in adults are:

d) Present the dietary guidelines for prevention of heart disease. (2)

Ans) The dietary guidelines for prevention of heart disease are:

  1. Change how much energy you take in and how much you use up to get and stay at a healthy weight.

  2. Eat a lot of different kinds of fruits and vegetables.

  3. Instead of refined grains, choose foods that are mostly made with whole grains.

  4. Choose protein sources that are good for you.

  5. Protein mostly comes from plants (legumes and nuts)

  6. Seafood and fish

  7. Instead of full-fat dairy products, buy low-fat or fat-free dairy products.

  8. If you want to eat meat or poultry, choose lean cuts and stay away from processed forms.

  9. Instead of tropical oils (like coconut, palm, and palm kernel), animal fats (like butter and lard), or partially hydrogenated fats, use liquid plant oils.

  10. Instead of ultra-processed foods, choose foods that haven't been changed much.

  11. Reduce how much you drink and eat that has added sugar.

  12. Pick and cook foods that have little or no salt.

  13. If you don't drink now, don't start. If you do drink, don't drink too much.

  14. Follow these rules no matter where food is being made or eaten.


6. a) Define the following inborn errors of metabolism and also give dietary management of these diseases: (3+3+3)


i) Tyrosinemia

Ans) Tyrosinemia is a genetic disorder characterized by disruptions in the multistep process that breaks down the amino acid tyrosine, a building block of most proteins. If untreated, tyrosine and its by-products build up in tissues and organs, which can lead to serious health problems.


Dietary Management: High-protein foods are high in both tyrosine and phenylalanine. So, kids with tyrosinemia should eat foods with less protein. Each child can "tolerate" a different amount of tyrosine/phenylalanine, so each will have a slightly different food pattern. But a child with tyrosinemia needs his or her formula more than any other food. Formula gives the body energy (in the form of calories), protein, and vitamins and minerals (including those that are found in high protein foods). Foods high in protein, like meat, chicken, fish, milk, cheese, beans and legumes, peanut butter, and eggs, should be avoided by all children with tyrosinemia.


ii) Homocystinuria

Ans) Homocystinuria is an inherited disorder in which the body is unable to process certain building blocks of proteins (amino acids) properly. There are multiple forms of homocystinuria, which are distinguished by their signs and symptoms and genetic cause.


Dietary Management: When planning a diet for someone with homocystinuria, you need to think about their needs for energy, protein, methionine, cysteine, folate, vitamins B6 and B12, and fluid. All people with hypermethioninemia and homocysteine are usually given a therapeutic dose of pyridoxine (1 g per day). Patients who don't respond to pyridoxine are put on a low-methionine diet with L-cysteine added to it. Folate should be given as a supplement if the amount of folate in the blood is below normal.


iii) Maple Syrup Urine Disease

Ans) Maple syrup urine disease (MSUD) is a rare but serious inherited condition. It means the body cannot process certain amino acids (the "building blocks" of protein), causing a harmful build-up of substances in the blood and urine. Normally, our bodies break down protein foods such as meat and fish into amino acids.


Dietary Management: The diet of a MSUD patient should therefore involve:

  1. The amount of natural protein or leucine in foods that has been measured.

  2. A protein, vitamin, and mineral supplement that does not have BCAA.

  3. The natural protein and vitamin/mineral supplement should be taken at the same time every day, if possible, so that the amino acids can be used most effectively for protein anabolism and the supplement can be tolerated.

  4. Free foods that are low in BCAA, such as sugars, fats, and oils, as well as foods made for a low-protein diet (breads, biscuits, pastas, etc.) and supplements should be given.

  5. Valine and/or isoleucine supplements can help.


b) Name the enzyme whose deficiency causes PKU. (1)

Ans) Phenylalanine hydroxylase (PAH) is the enzyme whose deficiency causes PKU.


7. a) Briefly discuss the classification and the dietary modification for obesity. (5)

Ans) The classification of obesity:


The dietary modification for obesity:

  1. The main thing that will affect how well a diet works for people who are overweight or obese is how many calories they take in. The ideal body weight can be used to figure out how much energy is needed.

  2. Moderate deficit diets with 1200–1400 Kcals and low-calorie diets with at least 1000 calories per day are both safe to use. They can be planned to give you the best nutrition and help you lose weight in a healthy way.

  3. The VLCDs with 400–800 Kcal/day, on the other hand, help people lose weight quickly, but they should only be done under the close supervision of a doctor and dietitian, and only for 12–16 weeks, to reduce the risk of protein loss and heart problems. They can only be thought of for obese people with a BMI of at least 32.

  4. Carbohydrates are important for regular bowel movements. Constipation is a common problem among obese people. About 50–55 percent of the calories in the body may come from complex carbs and 10 percent from simple carbs. Include a lot of fresh vegetables and fruits that are high in fibre, preferably raw and with their peels.

  5. A diet high in sodium may cause the body to hold on to water. If a person is also overweight and has high blood pressure, limiting how much table salt they eat may help them lose weight.


b) What is Bulimia Nervosa? Briefly discuss the nutritional management of Bulimia Nervosa. (5)

Ans) Bulimia Nervosa is a disorder characterized by repeated episodes of binge eating followed by inappropriate compensatory methods such as purging, including self-induced vomiting or misuse of laxatives, diuretics or non-purging including fasting or engaging in excessive exercise.


The nutritional management of Bulimia Nervosa is as follows:


Most of the time, 1200–1500 Kcals are given at first, along with the same amount of nutrients as for anorexia nervosa. The first thing that is given is a standard multivitamin and mineral supplement. In general, a balanced diet is one that gets 50–55 percent of its calories from carbs, 15–20 percent from proteins, and 25–30 percent from fat. At each meal, you might be encouraged to eat a small amount of fat. People may be able to handle fat better when they can't see it, like in whole milk and cheese.


Also, adding more sources of essential fatty acids to the diet would be helpful. It's important to remember that people with bulimia nervosa are more likely to stay on a low-calorie diet for a longer time than people with anorexia.


Each meal or snack should have a lot of carbs and a moderate amount of protein, vegetables, and fruit. They should be encouraged to eat foods that aren't on a diet and foods that have fat. It's also a good idea to have them make a list of foods they usually don't eat or only eat when they binge, and to encourage them to eat those foods when they feel they can.


The amount of food you need to get enough nutrients is less than the amount you need to get enough energy. So, we should encourage people to eat some foods that are high in calories but not as good for you.


8. a) Enumerate the nutritional problems associated with cancer. Briefly discuss the macro and micronutrient requirement of a patient with cancer. (5)

Ans) The nutritional problems associated with cancer are:

  1. Taste, smell, appetite, and the ability to eat enough food or absorb the nutrients from food can be affected by cancer and cancer treatments. This can lead to malnutrition, which is when you don't get enough of certain nutrients. Malnutrition can be made worse by drinking too much and being overweight.

  2. Malnutrition can make a person weak and tired, so they can't fight off infections or finish their cancer treatment. Because of this, malnutrition can lower the patient's quality of life and even threaten his or her life. If the cancer grows or spreads, it could make malnutrition worse.

  3. Patients with cancer often lose their appetite. Anorexia can happen early on in the disease, or it can happen later if the cancer gets worse or spreads.

  4. Patients with tumours that make it hard to eat and digest food often get cachexia. It can happen to people with cancer who eat well but don't gain fat or muscle because their tumours are growing.


The macro and micronutrient requirement of a patient with cancer are:

  1. Energy: Because cancer cachexia can make it hard to eat, it may not be possible to encourage people to eat more than 2000 Kcal per day. Malnourished patients can be helped to eat around 30-35 Kcal/kg of body weight per day (3000-4000 Kcal/day) with the help of appetite stimulants and/or nutrition support systems (enteral tube feeding). Chemotherapy and cancer cachexia can have bad side effects, but a high-energy diet can help stop them.

  2. Protein: A healthy adult needs between 80 and 100 grammes of protein per day to meet maintenance needs and keep anabolism going. But a malnourished person needs to eat 100–150 g of protein every day to restore a positive nitrogen balance and refill their reserves.

  3. Fat: About 15–20 percent of the adjusted energy needs should come from fat because it makes meals more calorie-dense and better tasting.

  4. Carbohydrates: There should be enough (60 percent of the total energy) carbohydrates.

  5. Fluids: Getting enough fluids is important to make up for fluids lost because of GI problems, infection, or fever, and to help the kidneys get rid of waste products from the metabolism of dead cancer cells and toxic drugs used in treatment. Some drugs, like cyclophosphamide, need you to drink 2–3 litres of fluids to keep cystitis from happening.


b) What are the health consequences of low birth weight. Discuss briefly the nutritional management and feeding of the premature infant. (5)

Ans) Low birth weight is bad for your health in these ways: Due to LBW, preterm birth, or IUGR, there is a higher risk of death and a slower rate of growth and brain development in new-borns. Low birth weight is also thought to be linked to coronary artery disease (CVD), high blood pressure, diabetes, high cholesterol, and obstructive lung disease. IUGR, or premature birth, can be prevented in mothers who have stopped smoking, are eating a balanced protein-energy diet, and have their urinary tract and vaginal infections under control.


The nutritional management of the premature infant:

  1. Energy: 120-130 kcal/kg/day to grow 15-20 g/day as they catch up to term.

  2. Protein: 2-3 g/kg/day – on the lower end closer to term, on the higher end when around 34 weeks.

  3. Calcium: 70-140 mg/kg/day – on the lower end closer to term, on the higher end when around 34 weeks.

  4. Iron: 2-4 mg of elemental iron/kg/day – on the lower end for routine care of late preterm infants.

  5. Lipids: Docosahexaenoic acid (DHA) and arachidonic acid (ARA) requirements are higher in preterm (including late preterm) infants.


The feeding of the premature infant:

  1. Volume of Feedings: Usually between 150 and 200 ml/kg/day for babies eating 20 kcal/kg/day. This amount may be lessened for babies eating breast milk or formula with a higher caloric density or for babies with certain medical conditions that require a reduction in volume.

  2. When it is possible for the mother and child, breast milk is still the best way for a term baby to get food. The average amount of energy in 1 ounce of breast milk is 20 kcal.

  3. Specialized formulas are made for premature babies to meet their changing needs and to keep up with the growing knowledge of what they need. Preterm formulas made for care after leaving the hospital include 22 kcal/30 ml formulas, which should be thought of especially for babies with birth weights of less than 1500 g for 9 to 12 months.

  4. Keeping an eye on the lab: In addition to looking at the baby's measurements to make sure he or she is growing normally, it may be helpful to keep an eye on blood urea nitrogen, a complete blood count with ferritin or reticulocyte haemoglobin, protein markers like retinol-binding protein and/or prealbumin, alkaline phosphatase, and/or Vitamin D 25-OH to figure out how well a high-risk baby is eating.



Section B - OTQ (Objective Type Questions) (20 marks)


1. Calculate/define/explain the following in 2-3 sentences each: (10)


i) Calculate the BMI for a 40yrs female of small frame with Height of 5’3” and weight of 60kg

Ans) BMI = 23.4 kg/m2


ii) Calculate the % Ideal body weight (IBW) using the data given in section B 1 Based on %IBW assess the degree of nutritional status

Ans) % Ideal Body Weight = 52 kg

The degree of nutritional status is Normal.


iii) Celiac disease

Ans) Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye. If you have celiac disease, eating gluten triggers an immune response in your small intestine.


iv) A disease condition where MCT is beneficial

Ans) MCT could help manage epilepsy, Alzheimer's disease, and autism. Studies have shown that MCT oil and a ketogenic diet may help manage conditions such as epilepsy, Alzheimer's disease, and autism.


v) Dysphagia

Ans) Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids, while others can't swallow at all. Other signs of dysphagia include coughing or choking when eating or drinking. bringing food back up, sometimes through the nose.


vi) Diet during dialysis

Ans) Once dialysis is started, the diet in ESRD can be liberalized, taking care that accumulation of metabolic wastes and water is prevented between treatments and biochemical balance is maintained. At least 70% of the protein given should be of high biological value from eggs, fish, chicken and milk, though milk may need to be limited being a rich source of potassium. daily supplement of water-soluble vitamins and minerals are usually given, as these are lost in the dialysate. Fat-soluble vitamins may be retained. Thus, their supplements are avoided except vitamin D. Supplements of minerals like calcium, iron and zinc are recommended.


vii) Hydrogenated fat

Ans) Hydrogenated fats (also called trans-fatty acids) are manufactured fats created during a process called hydrogenation whereby hydrogen units are added to polyunsaturated fatty acids to prevent them from becoming rancid and to keep them solid at room temperature.


viii) Sodium content in 1gm of common salt

Ans) The Sodium content in 1gm of common salt is 387.6 mg.


ix) “Rule of nine”

Ans) The size of a burn can be quickly estimated by using the "rule of nines." This method divides the body's surface area into percentages. The front and back of the head and neck equal 9% of the body's surface area. The front and back of each arm and hand equal 9% of the body's surface area.


x) Glycemic Index

Ans) The glycaemic index (GI) is a rating system for foods containing carbohydrates. It shows how quickly each food affects your blood sugar (glucose) level when that food is eaten on its own.


2. Give examples for each of the following: (10)


i) Low fibre foods

Ans) Example: Tender meat, fish and poultry, ham, bacon, shellfish, and lunch meat, Eggs, tofu and creamy peanut butter, Dairy products if tolerated, White rice and pasta, Baked goods made with refined wheat or rye flour, such as bread, biscuits, pancakes, waffles, bagels, saltines and graham crackers.


ii) Rich sources of omega 3 PUFA

Ans) Example: Foods high in Omega-3 include fish, vegetable oils, nuts (especially walnuts), flax seeds, flaxseed oil, and leafy vegetables. What makes omega-3 fats special? They are an integral part of cell membranes throughout the body and affect the function of the cell receptors in these membranes.


iii) Lactose rich foods

Ans) Example: salad cream, salad dressing and mayonnaise, biscuits, chocolate, boiled sweets, cakes, some types of bread and other baked goods, some breakfast cereals, packets of mixes to make pancakes and biscuits.


iv) Gluten free food sources

Ans) Example: Fruits and vegetables, Beans, seeds, legumes and nuts in their natural, unprocessed forms, Eggs, Lean, non-processed meats, fish and poultry, Most low-fat dairy products.


v) Neurological disorder of nutritional origin

Ans) Example: Deficits are most commonly seen with thiamine, vitamin B12, folate, vitamin D, vitamin E, and copper deficiencies. The neurological findings observed with these nutritional deficiencies are variable and include encephalopathy, optic neuropathy, myelopathy, polyradiculoneuropathy, and polyneuropathy.


vi) Foods to be avoided in Peptic ulcer

Ans) Example: Coffee, chocolate, spicy food, alcohol, acidic foods, such as citrus and tomatoes, caffeine.


vii) Foods avoided in CKD

Ans) Example: Dark-coloured soda, Avocados, Canned foods, Whole wheat bread, Brown rice, Bananas, Dairy.


viii) Foods to be avoided in Gout

Ans) Example: Red meat, Seafood, High-purine vegetables, Alcohol, Sugary foods and beverages, Vitamin C, Coffee.


ix) Non-nutritive sweeteners

Ans) Example: The eight non-nutritive sweeteners that have been approved by the U.S. Food and Drug Administration (FDA) are aspartame, acesulfame potassium, luo han guo (monk) fruit extract, neotame, saccharin, stevia, sucralose and advantame.


x) Food sources of soluble fibre

Ans) Example: Soluble fibre is found in oats, peas, beans, apples, citrus fruits, carrots, barley and psyllium. Insoluble fibre.

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