Assignment Code: MFN-005/AST2/TMA-2/2023-24

Course Code: MFN-005

Assignment Name: Clinical and Therapeutic Nutrition

Year: 2023-2024

Verification Status: Verified by Professor

Q1a) What is Nutrition Care process? Enlist the steps involved?

Ans) Nutrition Care Process: The Nutrition Care Process (NCP) is a systematic approach used by registered dietitians and nutritionists to provide high-quality nutritional care to individuals.

It involves the following steps

a) Assessment: This is the initial step where the patient's nutritional status and needs are evaluated. It includes gathering information about medical history, dietary habits, physical activity, and any existing conditions.

b) Diagnosis: Based on the assessment, a specific nutritional diagnosis is made. This helps in identifying the nutritional issues or problems that need to be addressed.

c) Intervention: A personalized nutrition intervention plan is developed. This may include dietary modifications, meal planning, and recommendations for supplements or other interventions.

d) Monitoring and Evaluation: The patient's progress is monitored, and the effectiveness of the intervention is evaluated. Adjustments are made as needed to achieve the desired outcomes.

Q1b) What do you understand by the term diet counselling? Mention a few tips for counselling children.

Ans) Diet Counselling: Diet counselling is a process of providing individuals with guidance and information related to their dietary choices and habits. When counselling children, it's important to consider their unique needs and preferences.

Here are a few tips for counselling children:

a) Make it fun: Incorporate games, colourful foods, and enjoyable activities to make learning about nutrition engaging for children.

b) Involve parents: Collaborate with parents to ensure a consistent and healthy eating environment at home.

c) Use simple language: Explain concepts in a way that is easy for children to understand.

d) Be patient: Children may be hesitant to try new foods, so it's essential to be patient and offer them multiple opportunities to explore different foods.

e) Positive reinforcement: Encourage and reward healthy eating habits to reinforce positive behaviour.

Q1c) Discuss the factors affecting diet prescription. Also, calculate the basal energy expenditure of a female patient admitted to a hospital whose weight is 65 kg, height is 155 cm and age is 55 years.

Ans) actors Affecting Diet Prescription: The diet prescription for an individual is influenced by various factors, including:

a) Medical Condition: The specific medical condition or diagnosis of the patient plays a significant role in determining the dietary requirements.

b) Age: Different age groups have varying nutritional needs. Children, adults, and the elderly may require distinct dietary recommendations.

c) Activity Level: The patient's physical activity level and energy expenditure influence the calorie and nutrient requirements.

d) Food Preferences: Dietary recommendations should align with the patient's food preferences and cultural considerations.

e) Allergies and Sensitivities: Any food allergies or sensitivities must be taken into account when prescribing a diet.

To calculate the Basal Energy Expenditure (BEE) of the female patient, you can use the Mifflin-St Jeor equation:

BEE (kcal/day) = 10 weight (kg) + 6.25 height (cm) - 5 * age (years) – 161

Substituting the provided values:

BEE = 10 65 kg + 6.25 155 cm - 5 * 55 years - 161

BEE = 650 + 968.75 - 275 - 161

BEE = 1182.75 kcal/day

The patient's Basal Energy Expenditure is approximately 1182.75 calories per day. This represents the energy required at rest and serves as a baseline for determining total daily calorie needs.

Q2a) What are the various modes of feeding patients. Which one of these is the most preferred?

Ans) Modes of Feeding Patients: There are several modes of feeding patients, and the choice depends on the patient's condition and nutritional needs. The most preferred mode is one that aligns with the patient's ability to eat and their specific medical requirements.

The modes of feeding include:

a) Oral Feeding: This is the most preferred mode, as it involves the patient eating regular food or modified textures (if needed) by mouth. It maintains the patient's sense of taste and normalcy.

b) Enteral Nutrition: This involves providing nutrients via a feeding tube directly into the gastrointestinal tract. It is commonly used when a patient cannot consume food orally but has a functional gut. The most preferred type is a nasogastric or gastrostomy tube feeding, which involves passing a tube through the nose or directly into the stomach.

c) Parenteral Nutrition: This method delivers nutrients intravenously and is used when the digestive system cannot be used for nutrient absorption. It is typically reserved for patients with severe malabsorption or bowel obstruction.

Q2b) What are the different routine hospital diets? How is a mechanical soft diet different from a normal diet?

Ans) Routine Hospital Diets: There are various routine hospital diets designed to meet the nutritional needs of different patients.

Some common types include:

a) Regular Diet: This is a standard diet provided to patients without specific dietary restrictions. It includes a variety of foods and textures.

b) Mechanical Soft Diet: This diet is modified to include foods that are easier to chew and swallow, making it suitable for patients with dental issues or swallowing difficulties.

c) Liquid Diet: A liquid diet includes foods in liquid form, such as clear fluids or full liquids. It is often used for patients who cannot tolerate solid foods or need to prepare for medical procedures.

d) Low-Sodium Diet: This diet restricts sodium intake and is commonly prescribed for patients with hypertension or heart conditions.

e) Low-Fat Diet: A low-fat diet limits the intake of dietary fat and is often recommended for patients with digestive issues or cardiovascular conditions.

Mechanical Soft Diet vs. Normal Diet

a) A mechanical soft diet includes foods that are softer in texture and easier to chew and swallow.

b) It is suitable for individuals with dental problems or swallowing difficulties.

c) In a normal diet, there are no texture modifications, and it includes a wide range of foods in their regular forms.

Q2c) List the salient features of the diet given to a typhoid patient?

Ans) Diet for a Typhoid Patient: Typhoid is a bacterial infection that affects the digestive system. The diet for a typhoid patient should be easy to digest and aim to prevent dehydration.

Salient features of the diet include:

a) Clear Fluids: At the onset of the illness, clear fluids like oral rehydration solutions, clear broths, and water are recommended to prevent dehydration.

b) Bland Foods: As the patient's condition improves, bland foods like rice, boiled potatoes, plain yogurt, and well-cooked cereals can be introduced.

c) Avoid Spicy and Oily Foods: Spicy, greasy, and heavily seasoned foods should be avoided, as they can irritate the stomach.

d) Hydration: It's essential to maintain hydration through frequent sips of fluids, even if the appetite is reduced.

e) Small, Frequent Meals: Offer small, frequent meals to ease digestion and provide nutrients gradually.

f) Avoid Raw Foods: Raw vegetables, fruits, and uncooked salads should be avoided to prevent contamination.

g) Recovery Phase: As the patient recovers, a normal diet can gradually be reintroduced based on their tolerance.

Q3a) Classify burns on the basis of their depth? Mr. Ravi is a 40 year old male who has suffered from 45% total body surface area burn. Calculate his energy requirement by using the Currie formula.

Ans) Classification of Burns by Depth:

Burns can be classified into three main categories based on their depth:

a) First-Degree Burns (Superficial Burns): These burns affect the outer layer of the skin (epidermis) and are characterized by redness, pain, and mild swelling. They usually heal without scarring.

b) Second-Degree Burns (Partial-Thickness Burns): These burns affect both the epidermis and the layer beneath it (dermis). They can cause blisters, severe pain, and may result in scarring. Second-degree burns are further divided into two categories: superficial partial-thickness and deep partial-thickness, depending on the depth of tissue damage.

c) Third-Degree Burns (Full-Thickness Burns): These burns extend through the epidermis and dermis, damaging underlying tissues. They often appear charred or white, may not be painful due to nerve damage, and typically require surgical treatment like skin grafts.

It's important to note that burns can be even more severe, affecting deeper tissues or multiple layers.

Calculating Energy Requirement using the Currie Formula:

The Currie formula is used to estimate the daily energy requirement of burn patients:

For the first 24 hours after a burn, the formula is:

Energy Requirement (kcal) = 25 kcal/kg x Body Weight x % Total Body Surface Area Burned

For subsequent days, the formula is:

Energy Requirement (kcal) = 30 kcal/kg x Body Weight x % Total Body Surface Area Burned

In this case, for Mr. Ravi:

Body Weight = 70 kg (assumed)

% Total Body Surface Area Burned = 45%

For the first 24 hours:

Energy Requirement = 25 kcal/kg x 70 kg x 45% = 7875 kcal

For subsequent days:

Energy Requirement = 30 kcal/kg x 70 kg x 45% = 9450 kcal

Q3b) What are three steps involved in IgE medicated allergic response?

Ans) Steps in IgE-Mediated Allergic Response:

a) Sensitization: The first exposure to an allergen triggers the production of specific IgE antibodies. These antibodies bind to mast cells and basophils.

b) Re-Exposure: When the individual is re-exposed to the same allergen, it binds to the IgE antibodies on mast cells and basophils.

c) Degranulation: This binding triggers the release of chemical mediators, such as histamine, from mast cells and basophils. These mediators cause the allergic symptoms, including swelling, itching, and inflammation.

Q3c) Differentiate between food allergy and food intolerance.

Ans)

Q4a) Enlist the risk factors associated with the etiology of Cancer. Briefly discuss the dietary and non-dietary factors known to cause Cancer.

Ans) Risk Factors for Cancer:

a) Tobacco Use: Smoking and smokeless tobacco increase the risk of various cancers, including lung, mouth, throat, and oesophageal cancers.

b) Dietary Factors: A diet high in processed and red meats, low in fruits and vegetables, and excessive alcohol consumption are associated with an increased risk of cancer. For example, colorectal cancer is linked to high red meat consumption, and oesophageal cancer is associated with hot and/or scalding drinks and foods.

c) Obesity: Excess body weight is a risk factor for multiple types of cancer, including breast, colorectal, and endometrial cancer.

d) Physical Inactivity: A sedentary lifestyle can contribute to obesity and increase the risk of certain cancers.

e) Ultraviolet (UV) Radiation: Exposure to UV radiation from the sun or tanning beds can lead to skin cancer.

Dietary Factors:

a) High Red and Processed Meat Consumption: Consuming significant amounts of red and processed meats has been linked to an increased risk of colorectal cancer.

b) Low Fruit and Vegetable Intake: Diets low in fruits and vegetables, which are rich in antioxidants and fibre, are associated with higher cancer risk.

c) Excessive Alcohol Consumption: Heavy alcohol consumption is a known risk factor for several types of cancer, including mouth, throat, oesophagus, and liver cancer.

Non-Dietary Factors

a) Tobacco Use: Smoking is a leading cause of preventable cancer deaths worldwide.

b) UV Radiation: Overexposure to UV radiation from the sun or artificial tanning sources can lead to skin cancer.

c) Infectious Agents: Infections with cancer-causing viruses, such as HPV, hepatitis B, and hepatitis C, increase cancer risk.

d) Occupational Exposures: Exposure to carcinogens in the workplace, such as asbestos, can lead to lung cancer and mesothelioma.

e) Radiation: Exposure to ionizing radiation from medical imaging or nuclear fallout can cause cancer.

Q4b) What are the different levels of sodium restriction advised in hypertension?

Ans) Sodium restriction levels advised for hypertension management are typically categorized as follows:

a) Mild restriction: 2,400 to 3,000 milligrams of sodium per day.

b) Moderate restriction: 1,500 to 2,400 milligrams of sodium per day.

c) Severe restriction: Less than 1,500 milligrams of sodium per day.

The level of restriction recommended depends on an individual's blood pressure, overall health, and specific dietary needs.

Q4c) Discuss the factors responsible for causing atherosclerosis.

Ans) Atherosclerosis is primarily caused by the accumulation of fatty deposits, especially low-density lipoprotein (LDL) cholesterol, on the inner walls of arteries.

The factors responsible for causing atherosclerosis include

a) High blood cholesterol levels, particularly elevated LDL cholesterol.

b) Hypertension (high blood pressure), which can damage artery walls.

c) Smoking, which can lead to the formation of arterial plaque.

d) Diabetes, which can increase the risk of atherosclerosis.

e) Obesity, as excess body fat can lead to elevated LDL cholesterol levels.

f) Inflammation within the arteries, leading to the attraction of LDL cholesterol.

g) Genetic factors and family history of heart disease.

h) Sedentary lifestyle and lack of regular physical activity.

Dietary factors can also contribute to atherosclerosis, especially diets high in saturated and trans fats, as well as excess salt intake. A diet rich in fruits, vegetables, whole grains, and healthy fats (such as those found in nuts and fatty fish) can help reduce the risk of atherosclerosis.

Q5) Give the salient features of dietary and lifestyle management of the following conditions:

Q5a) Obesity

Ans) Dietary and Lifestyle Management for Obesity:

a) Dietary Management:

1) Caloric Restriction: The cornerstone of weight management is consuming fewer calories than you expend. This involves reducing daily caloric intake.

2) Balanced Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid or limit high-calorie, low-nutrient foods.

3) Portion Control: Be mindful of portion sizes. Use smaller plates and avoid super-sized or oversized portions.

4) Regular Meal Patterns: Eating at regular intervals helps control hunger and prevents overeating. Aim for three main meals and healthy snacks.

5) Hydration: Drink plenty of water throughout the day to stay hydrated and curb false hunger signals.

6) Limit Sugary and High-Fat Foods: Reduce the consumption of sugary beverages, sweets, and high-fat, processed foods.

b) Lifestyle Management:

1) Physical Activity: Incorporate regular physical activity into your daily routine. Aim for a combination of aerobic exercise and strength training.

2) Behaviour Modification: Identify and address emotional or habitual triggers for overeating. Consider counselling or support groups.

3) Sleep: Ensure you get adequate and quality sleep as poor sleep can affect hormones regulating appetite.

4) Stress Management: Chronic stress can lead to overeating. Practice stress-reduction techniques such as meditation or yoga.

5) Social Support: Engage with a support network of friends, family, or professionals to help you stay motivated and accountable.

6) Monitoring: Keep a food diary or use a smartphone app to track your food intake and exercise.

Q5b) Peptic Ulcer

Ans) Dietary and Lifestyle Management for Peptic Ulcer:

a) Dietary Management:

1) Avoid Trigger Foods: Identify and avoid foods that trigger or worsen ulcer symptoms. Common triggers include spicy foods, caffeine, alcohol, and acidic foods.

2) Small, Frequent Meals: Instead of three large meals, opt for smaller, more frequent meals to reduce stomach acid production and pressure on the ulcer.

3) High-Fiber Diet: Include fibre-rich foods like whole grains, fruits, and vegetables to promote healing and maintain regular bowel movements.

4) Probiotics: Probiotic-rich foods like yogurt can help balance gut bacteria and support ulcer healing.

5) Milk and Dairy: Some individuals find relief by consuming milk or dairy products, as they can have a soothing effect on the stomach.

b) Lifestyle Management:

1) Stress Reduction: Chronic stress can exacerbate ulcer symptoms. Practice relaxation techniques like deep breathing, meditation, or yoga.

2) Smoking Cessation: Smoking can delay ulcer healing and increase the risk of complications. Quitting smoking is essential.

3) Alcohol Moderation: Limit alcohol consumption or avoid it altogether, as excessive alcohol can irritate the stomach lining.

4) Medication Adherence: Take prescribed medications, such as proton pump inhibitors or antibiotics (if H. pylori infection is present), as directed by your healthcare provider.

5) Regular Follow-up: Keep scheduled appointments with your healthcare provider to monitor the healing progress and adjust treatment if needed.

6) Avoid NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen can worsen ulcers. Use pain relievers as recommended by your healthcare provider.

Q6a) Discuss the role of dietary fibre and glycaemic index in the dietary management of diabetes mellitus.

Ans) Role of Dietary Fiber and Glycaemic Index:

Dietary fibre is an essential component of a diabetes-friendly diet. It offers the following benefits:

a) Blood Sugar Control: Soluble fibre helps slow the absorption of glucose, preventing rapid spikes in blood sugar levels after meals. This can improve glycaemic control in individuals with diabetes.

b) Appetite Control: High-fibre foods promote a feeling of fullness and satiety, reducing the tendency to overeat or snack between meals.

c) Weight Management: A high-fibre diet can assist in weight control, which is crucial for people with diabetes, especially those with type 2 diabetes.

d) Glycaemic Index (GI): The GI is a measure of how quickly a carbohydrate-containing food raises blood sugar levels.

Here's how it relates to diabetes management:

i) Low-GI Foods: These foods have a gradual impact on blood sugar and can help stabilize glucose levels. They are recommended for individuals with diabetes. Examples include whole grains, legumes, non-starchy vegetables, and low-GI fruits.

ii) High-GI Foods: These foods cause rapid spikes in blood sugar and should be consumed in moderation by people with diabetes. High-GI foods include sugary snacks, white bread, and certain cereals.

Dietary Management Recommendations

a) Consume a diet rich in whole grains, vegetables, fruits, legumes, and nuts, which are excellent sources of dietary fibre and low-GI carbohydrates.

b) Limit refined carbohydrates and sugary foods with high GI values.

c) Monitor portion sizes to avoid overconsumption of carbohydrates.

d) Choose foods that provide a gradual release of glucose to maintain steady blood sugar levels throughout the day.

Q6b) What are the three characteristic features of Gout? Discuss its dietary management giving a list of food items permitted and excluded.

Ans) Characteristic Features of Gout:

Gout is a type of arthritis characterized by:

a) Hyperuricemia: Elevated uric acid levels in the blood.

b) Acute Painful Attacks: Sudden and severe joint pain, often in the big toe.

c) Tophi Formation: The deposition of urate crystals in joints and soft tissues, leading to nodules called tophi.

Dietary Management of Gout

Diet plays a crucial role in managing gout and reducing the frequency of painful attacks. Here are some dietary recommendations:

Foods to Include:

a) Low-Purine Foods: Consume foods low in purines, which are metabolized into uric acid. These include most fruits, vegetables, whole grains, low-fat dairy, and plant-based proteins.

b) Cherries: Cherries and cherry juice have been associated with reduced gout attacks.

c) Water: Stay well-hydrated to help flush excess uric acid from the body.

Foods to Limit or Avoid:

a) High-Purine Foods: Limit the intake of high-purine foods like organ meats, red meat, shellfish, and certain fish (e.g., anchovies, sardines).

b) Alcohol: Alcohol, especially beer and spirits, can increase uric acid levels. Limit alcohol consumption.

c) Sugary Drinks: High-fructose corn syrup found in sugary beverages can contribute to gout attacks.

d) Moderation is Key: While some high-purine foods may be problematic, it's not necessary to completely eliminate them from the diet. Instead, consume them in moderation.

Q7a) Define the following malabsorption syndromes and also give the dietary management of these diseases:

(i) Celiac Disease

Ans) Celiac Disease:

Definition: Celiac disease is an autoimmune disorder triggered by the consumption of gluten, a protein found in wheat, barley, and rye. It leads to damage to the small intestine's lining, reducing nutrient absorption.

Dietary Management

a) Gluten-Free Diet: The primary treatment is the complete avoidance of gluten-containing foods. This includes wheat, barley, and rye products. Instead, individuals with celiac disease should focus on naturally gluten-free foods like rice, quinoa, fruits, vegetables, and gluten-free grains (e.g., corn and oats, if certified gluten-free).

b) Careful Label Reading: Patients must scrutinize food labels for hidden sources of gluten, which may be present in processed foods.

c) Dietitian Guidance: Consultation with a registered dietitian with expertise in celiac disease is crucial to ensure a balanced and nutritious gluten-free diet.

d) Vitamin and Mineral Supplements: Some individuals with celiac disease may require supplements to address deficiencies caused by malabsorption.

(ii) Lactose Intolerance

Ans) Lactose Intolerance:

Definition: Lactose intolerance is the inability to digest lactose, a sugar found in milk and dairy products, due to a deficiency of the enzyme lactase.

Dietary Management

a) Lactose-Free Diet: The mainstay of management is the avoidance of lactose-containing foods. This includes milk, cheese, yogurt, and other dairy products. Individuals can opt for lactose-free or dairy alternatives.

b) Lactase Supplements: Some individuals may tolerate small amounts of lactose with the help of lactase supplements taken before consuming dairy products.

c) Diet Modification: A dietitian can help individuals plan lactose-free diets and ensure they meet their nutrient requirements.

Q7b) Discuss the pathogenesis and complications of alcoholic liver disease.

Ans) Alcoholic Liver Disease:

a) Pathogenesis: Alcoholic liver disease is a result of excessive alcohol consumption, which can lead to liver damage. The pathogenesis involves the following stages:

1) Fatty Liver: Alcohol consumption leads to the accumulation of fat in the liver cells (steatosis).

2) Alcoholic Hepatitis: Inflammation of the liver, which can cause liver cell damage.

3) Cirrhosis: Prolonged and heavy drinking can result in cirrhosis, characterized by the scarring of liver tissue and impaired liver function.

b) Complications: The complications of alcoholic liver disease include:

1) Cirrhosis: The most severe form of alcoholic liver disease, it can lead to liver failure.

2) Portal Hypertension: Increased pressure in the portal vein, which can result in complications like variceal bleeding.

3) Ascites: Accumulation of fluid in the abdominal cavity.

4) Hepatic Encephalopathy: Brain dysfunction due to the liver's inability to remove toxins.

5) Liver Cancer: Individuals with cirrhosis are at higher risk of developing liver cancer.

c) Dietary Management: Dietary management for alcoholic liver disease focuses on:

1) Abstinence from Alcohol: The primary step is to cease alcohol consumption.

2) Nutrition Support: Adequate calorie and protein intake to support liver regeneration and healing.

3) Management of Complications: Special diets may be required based on the presence of complications like ascites or hepatic encephalopathy.

4) Vitamin and Mineral Supplementation: Supplementation may be necessary to address nutritional deficiencies.

Q8a) What are the stages of Acute Renal Failure? Enlist the major points for dietary management of a patient suffering from ARF.

Ans) Stages of ARF:

Acute Renal Failure typically progresses through three stages:

a) Initiation Phase: This phase involves the initial insult or injury to the kidneys. The focus is on identifying and managing the underlying cause, such as severe dehydration, kidney damage, or toxic exposure.

b) Maintenance Phase: In this stage, the goal is to stabilize the patient's condition and prevent further kidney damage. Fluid and electrolyte balance is closely monitored. Dietary management includes:

i) Restriction of Protein: Protein intake may be restricted to reduce the load on the kidneys.

ii) Control of Electrolytes: Managing potassium, sodium, and phosphate levels in the diet.

iii) Caloric Support: Providing sufficient calories to prevent muscle wasting and malnutrition.

c) Recovery Phase: Once the patient's kidney function starts to recover, the dietary plan is adjusted accordingly. Protein and calories are gradually increased, and electrolyte imbalances are corrected.

Dietary Management

a) Protein Restriction: In the maintenance phase, protein intake may be limited to avoid the buildup of waste products in the body. High-quality proteins may be preferred.

b) Fluid Control: Maintaining fluid balance is crucial. Both excessive fluid intake and dehydration should be prevented.

c) Electrolyte Management: Controlling potassium, sodium, and phosphate levels in the diet is essential. High potassium foods should be avoided, and phosphate intake may be limited.

d) Caloric Support: Providing enough calories to meet energy needs and prevent malnutrition is crucial. Caloric intake should match the patient's metabolic requirements.

e) Supplements: Depending on the specific nutritional deficiencies or imbalances, vitamin and mineral supplements may be necessary.

Q8b) What is Mini Nutritional Assessment (MNA) tool for assessing nutritional status of the elderly?

Ans) The Mini Nutritional Assessment (MNA) is a tool used to assess the nutritional status of elderly individuals. It helps healthcare providers identify nutritional deficiencies and assess the risk of malnutrition in older adults. The MNA consists of a questionnaire and a physical assessment.

Key Components of the MNA:

a) Anthropometric Measurements: This includes measurements of height, weight, calf circumference, and mid-arm circumference.

b) Dietary Assessment: Information about food intake, appetite, and dietary changes.

c) General Health Assessment: An evaluation of an individual's mobility, psychological stress, and neuropsychological problems.

d) Self-Perception of Health and Nutrition: The person's self-assessment of their health and nutritional status.

e) Clinical Examination: This involves assessing the individual for signs of malnutrition or dehydration.

Section B - OTQ (Objective Type Questions)

Q1) Define the following in 2-3 sentences each:

i) SOAP

Ans) SOAP stands for Subjective, Objective, Assessment, and Plan. It is a widely used method for organizing clinical notes in healthcare settings. Subjective includes patient-reported information, Objective contains measurable data, Assessment involves the healthcare provider's diagnosis or evaluation, and Plan outlines the treatment or next steps.

ii) Kaposi’s Sarcoma

Ans) Kaposi's sarcoma is a rare type of cancer that affects the skin and mucous membranes. It is characterized by the formation of purplish or brownish-red lesions on the skin, often caused by human herpesvirus 8 (HHV-8) infection. It can occur in people with weakened immune systems, such as those with HIV/AIDS.

iii) MODS

Ans) MODS stands for Multiple Organ Dysfunction Syndrome. It is a severe and life-threatening condition in which multiple organ systems in the body fail to function properly. It is often seen in critically ill patients and can result from various causes, including severe infections and sepsis.

iv) Elimination Diet

Ans) An elimination diet is a dietary approach in which specific foods or food groups are temporarily removed from one's diet to identify and eliminate potential allergens or triggers of adverse reactions. After a period of elimination, foods are gradually reintroduced to pinpoint the source of adverse reactions.

v) Quetelet Index

Ans) The Quetelet Index, also known as the Body Mass Index (BMI), is a numerical value derived from a person's weight and height. It is used to assess whether an individual is underweight, normal weight, overweight, or obese. The formula for calculating BMI is weight (kg) divided by height (m) squared.

vi) Anorexia Nervosa

Ans) Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight, leading to severe restrictions in food intake and often excessive exercise. It can result in extreme thinness and a distorted body image.

vii) Glycosylated Haemoglobin

Ans) Glycosylated haemoglobin, often referred to as HbA1c, is a blood test used to measure the average blood sugar (glucose) levels over the preceding 2-3 months. It is a valuable tool for monitoring long-term glucose control in individuals with diabetes.

viii) Galactosemia

Ans) Galactosemia is a rare genetic disorder in which the body is unable to process galactose, a sugar found in milk and dairy products. It can lead to the accumulation of galactose in the body, causing various health issues.

ix) Wilson’s Disease

Ans) Wilson's disease is a genetic disorder that results in the accumulation of copper in the body, primarily in the liver and brain. It can lead to various symptoms and complications, including liver disease and neurological issues.

x) Cholecystitis

Ans) Cholecystitis is the inflammation of the gallbladder, often caused by the presence of gallstones in the gallbladder. It can lead to symptoms such as abdominal pain, fever, and nausea.

Q2) Give examples for each of the following:

i) Branched chain amino acids

Ans) Examples of branched-chain amino acids include leucine, isoleucine, and valine. These amino acids are essential and play a significant role in protein synthesis and energy production.

ii) Probiotics

Ans) Probiotics are live microorganisms that provide health benefits when consumed. Examples include Lactobacillus acidophilus and Bifidobacterium bifidum, commonly found in yogurt and dietary supplements.

iii) MAO Inhibitors

Ans) Monoamine oxidase (MAO) inhibitors are a type of medication used to treat depression. Examples include phenelzine and selegiline.

iv) Antioxidants in Cancer prevention

Ans) Antioxidants, such as vitamin C, vitamin E, and beta-carotene, can help protect cells from damage caused by free radicals, potentially reducing the risk of cancer.

v) N-3 fatty acid

Ans) Omega-3 fatty acids, found in fatty fish like salmon and flaxseeds, are a type of polyunsaturated fat known for their heart-healthy benefits.

vi) Low GI food item

Ans) Examples of low glycaemic index (GI) foods include lentils, sweet potatoes, and whole-grain pasta. These foods have a slower impact on blood sugar levels.

vii) Dietary source of Oxalate

Ans) Spinach, rhubarb, and beets are dietary sources of oxalate, which can contribute to kidney stone formation in susceptible individuals.

viii) Foods forming Cohesive bolus

Ans) Foods like bread and rice tend to form cohesive boluses in the mouth, making them easier to swallow.

ix) Low Residue food

Ans) Low-residue foods are easily digestible and leave minimal undigested material in the colon. Examples include white rice and clear fruit juices.

x) Potassium rich food

Ans) Bananas, oranges, and potatoes are examples of potassium-rich foods that contribute to maintaining proper electrolyte balance in the body.