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Thread: The Nutrition Support Pharmacist's Manual

  1. #11

    Default 2.USDA Food Patterns

    Analysis using the USDA Food Patterns, which appear on ChooseMyPlate.gov as "Daily Food Plans," will quantify food consumed from each of the major food groups. These data give the clinician an overview of adequacy, variety, moderation, and balance.
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  2. #12
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    Default 3.Exchange Lists for Diabetes/Carbohydrate Counting

    This method of analysis uses the dietary exchanges established jointly by the American Diabetes Association and the Academy of Nutrition and Dietetics.

    Use of the exchanges provides a quick, rough estimate of kcal, protein, carbohydrate, and fat in the diet. Carbohydrate counting concentrates on estimation of carbohydrate counting concentrates on estimation of carbohydrate only and is used primarily by individuals with diabetes who are balancing their insulin dosages with dietary intake of carbohydrate.

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    1.Information about carbohydrate counting from USDA
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    Last edited by admin; Wed 3rd February '16 at 5:09pm.
    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease. Chengdu, Sichuan, China.

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  3. #13
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    Default Serving Size Unit

    The Serving Size Unit

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    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease. Chengdu, Sichuan, China.

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  4. #14
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    Default 4.Individual Nutrient Analysis

    The USDA first published food composition values in 1896. The Nutrient Data Laboratory of the USDA maintains and updates the National Nutrient Databank System (NDBS).

    Historically, this information has been published in series of Agriculture Handbooks, but now this information is available only online (http://ndb.nal.usda.gov). Other sources of data include other online databases, nutrition labels, food manufacturers, and restaurants and fast-food establishments. Data on food labels may not be 100% reliable, especially for products from small companies or imported foods.
    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease. Chengdu, Sichuan, China.

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  5. #15
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    Cool 5.Dietary Reference Intakes and Daily Values

    One method of evaluating dietary macro- and micronutrient amounts is use of the Dietary Reference Intakes (DRIs) and Daily Values (DVs). DRIs are standards established by the National Academy of Sciences. These standard reference values allow evaluation of energy, protein, vitamin, and mineral intakes for healthy people.

    There are four different sets of standards within the DRI: Adequate Intakes (AIs), Recommended Dietary Allowances (RDAs), Tolerable upper Intake Levels (ULs), and Estimated Average Requirements (EAR).

    The value of the RDAs meet the needs of most healthy people, but falls below the RDA or AI for a specific nutrient do not necessarily mean the client is deficient in this nutrient.

    However, DRIs serve as important benchmarks for evaluating the patient's dietary intake, not only from food, but also from dietary supplements.

    The UL values can assist in assessing a patient's use of supplements and whether their current dosage poses any health risk.

    Populations with diseases

    In the clinical setting, many patients have specific diseases or medical conditions that may have unique nutrient requirements. In addition, medications and treatments may alter absorption, utilization, excretion, or storage of specific nutrients. In these situations, patients may need higher or lower levels of these nutrients.

    The DRI are established for the healthy population and hence may not be appropriate in clinical situations. Nonetheless, they can always be used as a starting point in dietary evaluation, and as the medical condition and subsequent nutrition therapy are established, adjustments can be made for specific nutrient requirements.

    DVs

    The DV were established by the Food and Drug Administration to assist consumers in interpreting nutrition labeling information. These standards set target goals for fat, saturated fat, cholesterol, total carbohydrate, fiber, sodium, potassium, and protein for a 2000- and 2500-kcal reference diet (note that these are different from the DRI goals). In general, the DV are much more useful to the consumer purchasing groceries than the dietitian performing a nutrition assessment. The dietitian will use much more specific, individualized reference data.
    Last edited by admin; Wed 3rd February '16 at 9:54pm.
    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease. Chengdu, Sichuan, China.

    Blog: http://www.tomhsiung.com
    Facebook: http://www.facebook.com/TomHsiung
    Twitter: @TomHsiung
    Sina Microblog (Weibo): http://weibo.com/xiongliang0



  6. #16

    Default U.S. Cooking Measurement and Conversion Charts

    Measurements Conversion Chart

    US Dry Volume Measurements
    MEASURE EQUIVALENT
    1/16 teaspoon dash
    1/8 teaspoon a pinch
    3 teaspoons 1 Tablespoon
    1/8 cup 2 tablespoons (= 1 standard coffee scoop)
    1/4 cup 4 Tablespoons
    1/3 cup 5 Tablespoons plus 1 teaspoon
    1/2 cup 8 Tablespoons
    3/4 cup 12 Tablespoons
    1 cup 16 Tablespoons
    1 Pound 16 ounces
    US liquid volume measurements
    8 Fluid ounces 1 Cup
    1 Pint 2 Cups (= 16 fluid ounces)
    1 Quart 2 Pints (= 4 cups)
    1 Gallon 4 Quarts (= 16 cups)
    US to Metric Conversions
    1/5 teaspoon 1 ml (ml stands for milliliter, one thousandth of a liter)
    1 teaspoon 5 ml
    1 tablespoon 15 ml
    1 fluid oz. 30 ml
    1/5 cup 50 ml
    1 cup 240 ml
    2 cups (1 pint) 470 ml
    4 cups (1 quart) .95 liter
    4 quarts (1 gal.) 3.8 liters
    1 oz. 28 grams
    1 pound 454 grams
    Metric to US Conversions
    1 milliliter 1/5 teaspoon
    5 ml 1 teaspoon
    15 ml 1 tablespoon
    30 ml 1 fluid oz.
    100 ml 3.4 fluid oz.
    240 ml 1 cup
    1 liter 34 fluid oz.
    1 liter 4.2 cups
    1 liter 2.1 pints
    1 liter 1.06 quarts
    1 liter .26 gallon
    1 gram .035 ounce
    100 grams 3.5 ounces
    500 grams 1.10 pounds
    1 kilogram 2.205 pounds
    1 kilogram 35 oz.
    Pan Size Equivalents
    9-by-13-inches baking dish 22-by-33-centimeter baking dish
    8-by-8-inches baking dish 20-by-20-centimeter baking dish
    9-by-5-inches loaf pan 23-by-12-centimeter loaf pan (=8 cups or 2 liters in capacity)
    10-inch tart or cake pan 25-centimeter tart or cake pan
    9-inch cake pan 22-centimeter cake pan

    Oven Temperature Conversions


    Farenheit Celsius Gas Mark
    275º F 140º C gas mark 1-cool
    300º F 150º C gas mark 2
    325º F 165º C gas mark 3-very moderate
    350º F 180º C gas mark 4-moderate
    375º F 190º C gas mark 5
    400º F 200º C gas mark 6-moderately hot
    425º F 220º C gas mark 7- hot
    450º F 230º C gas mark 9
    475º F 240º C gas mark 10- very hot

    Ratios for selected foods


    Measure Equivalents
    Butter
    1 T.
    1 stick
    14 grams
    4 ounces=113 grams
    1 Tablespoon
    8 tablespoons
    ½ cup
    4 sticks 16 ounces=452 grams 32 tablespoons 2 cups
    Lemon
    1 lemon 1 to 3 tablespoons juice, 1 to 1½ teaspoons grated zest
    4 large lemons 1 cup juice ¼ cup grated zest
    Chocolate
    1 ounce ¼ cup grated 40 grams
    6 ounces chips 1 cup chips 160 grams
    cocoa powder 1 cup 115 grams
    Creams
    Half and half ½ milk ½ cream 10.5 to 18 % butterfat
    Light cream 18 % butterfat
    Light whipping cream 26-30 % butterfat
    Heavy cream whipping cream 36 % or more butterfat
    Double cream extra-thick double cream,
    Clotted or Devonshire
    42 % butterfat
    Measures for Pans and Dishes

    Inches Centimeters
    9-by-13-inches baking dish 22-by-33-centimeter baking dish
    8-by-8-inches baking dish 20-by-20-centimeter baking dish
    9-by-5-inches loaf pan (8 cups in capacity) 23-by-12-centimeter loaf pan (2 liters in capacity)
    10-inch tart or cake pan 25-centimeter tart or cake pan
    9-inch cake pan 22-centimeter cake pan


    ONLINE METRIC CONVERSION CALCULATORS

    BEST FOR COOKING:
    Cooking Conversion Online -I use this one all the time. It is an excellent food specific metric converter (as long as you can look past the advertisements!)

    Good Basic Calculator:
    Worldwide Metric – General conversion chart (not food specific)

    Everything Converter:
    Ask Numbers – This is a fun one as it includes things like speed, power and shoe size! The cooking calculator is not food specific.

    (Not Recommended: Many food sites have a widget on their sites called the Culiverter. This calculator is not food specific which is why I do not recommend using it.


    Other Posts on Measuring:




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    Clinical Pharmacy Specialist - Infectious Diseases

  7. #17
    PharmD Year 1 TomHsiung's Avatar
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    Default Re: [Medical Nutrition] Diet Information Collection

    Activity Factors

    Moderate-intensity activity ranges between 3 and 5.9 MET minutes, whereas vigorous-intensity activity is classified as 6 MET minutes or more.



    Note that one MET means an consumption of oxygen by 3.5 mL/min/kg. Make sure your patient's oxygenation capacity matches the activity as oxygenation delivery ability decreases as age grows.

    The Nutrition Support Pharmacist's Manual-screen-shot-2016-03-12-at-7-04-37-pm-png
    Last edited by admin; Sat 12th March '16 at 6:31pm.
    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease.

  8. #18

    Default [Medical Nutrition] Difference Responses During Starvation and Metabolic Stress

    One of the most important distinctions between starvation and metabolic stress is the difference in energy and fuel substrate requirements.

    During starvation, the body responds to a reduction in food intake by reducing its overall energy needs; the basal metabolic rate is reduced so that fewer calories are needed. In contrast, energy requirements are increased during metabolic stress and injury.

    The next major difference between starvation and metabolic stress is the source of fuel that is used to meet energy requirements. Under normal circumstances, the body uses a mixture of fuels (primarily carbohydrate and lipid) for energy. But since humans have a limited ability to store carbohydrate, the primary source of fuel shifts from glucose to lipids during periods of starvation as glucose availability decreases. Lipolysis becomes preferential and the accumulated lipid stores serve as the primary energy source. This adaptation for the use of lipid as the primary fuel and the subsequent metabolism of ketones allow for preservation of muscle mass and prevent the complications of protein deficiency (suppressed immune response, infection, and decreased protein synthesis).

    The adaptation for use of lipid as primary fuel does not occur in metabolic stress. Instead, the continued requirement for glucose as the primary fuel necessitates continued breakdown of lean body mass to support gluconeogenesis.
    Clinical Pharmacy Specialist - Hematology

  9. #19
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    Default [Medical Nutrition] Food Code Numbers and the Food Coding Scheme

    Food Code Numbers and the Food Coding Scheme

    In the Food and Nutrient Database for Dietary Studies (FNDDS), the primary (usually generic) description of a given food is assigned a unique 8-digit food code. The food code is assigned according to a scheme that associates the first three or four digits of the code number with specific food groups and subgroups. The first digit in the food code identifies one of nine major food groups:

    (1) milk and milk products
    (2) meat, poultry, fish, and mixtures (3) eggs
    (4) legumes, nuts, and seeds
    (5) grain products
    (6) fruits
    (7) vegetables
    (8) fats, oils, and salad dressings (9) sugars, sweets, and beverages

    The second, third, and (sometimes) fourth digits of a food code identify increasingly more specific subgroups within the nine major food groups. The remaining digits are used to identify particular foods within a numerical sequence. Shown below is an example of a food item and how the first three digits signify which groups the food item belongs to:

    55103000 Pancakes, with fruit
    -- The first digit (5) means this food item is in the Grain Products section.
    -- The first two digits (55) mean this item is in the Pancakes, Waffles, French Toast, Other
    Grain Products section.
    -- The first three digits (551) mean this food item is in the Pancake section.

    More information can be found in this document, see attachment.
    Attached Images Attached Images
    B.S. Pharm, West China School of Pharmacy, Class of 2007, Health System Pharmacist, RPh. Hematology, Infectious Disease. Chengdu, Sichuan, China.

    Blog: http://www.tomhsiung.com
    Facebook: http://www.facebook.com/TomHsiung
    Twitter: @TomHsiung
    Sina Microblog (Weibo): http://weibo.com/xiongliang0



  10. #20

    Default Re: [Medical Nutrition] Diet Information Collection

    Energy consumed = MET * 0.0175 kcal per kilogram body weight per minute * body weight (kilogram) * length of the exercise (minute).

    For example, a 70-kg person is going to swim for 1 hour. The energy consumed will be 7.0 * 0.0175 kcal/kg/min * 70 kg * 60 minutes = 514.5 kcal
    Clinical Pharmacy Specialist - Hematology

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