An adult who eats an adequate, balanced diet is diagnosed with a vitamin B12 deficiency. How might this deficiency have developed, and how will it likely be treated?
Vitamin B12 deficiency most often reflects poor absorption due to (1) too little stomach acid to liberate vitamin B12 from food or (2) a lack of intrinsic factor (IF), a compound made by the stomach and needed for B12 absorption. There are a few reasons for B12 deficiency that are not associated with inadequate dietary intake. With age, many people lose their ability to produce enough stomach acid and intrinsic factor to allow efficient absorption of vitamin B12 . Additionally, intestinal diseases, surgeries, or stomach infection with an ulcer-causing bacterium can also impair B12 absorption. Taking a common diabetes drug can also make vitamin B12 deficiency likely. In cases of B12 malabsorption, the vitamin must be supplied by injection or via nasal spray to bypass the defective absorptive system.
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Social-cognitive theory was developed to explain how people acquire and maintain certain behaviors
a. True b. False Indicate whether the statement is true or false
Binge-eating disorder is more common in:
1.underweight people. 2.overweight and obese people. 3.normal-weight people. 4.underweight men.
Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase,
and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat, and was also prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat. Anthropometric: Ht: 5'2 . Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium. Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin. Current Chief Complaints: A.R.'s current problems include constipation and dry skin. Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine—I am getting bored with water. I like to bake and miss baked goods, and I also miss cheese—I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day. A.R.'s doctor recommends that she take a multivitamin-mineral supplement because: a. pancreatic enzyme replacements can decrease the absorption of iron. b. steatorrhea can promote the loss of vitamins and minerals. c. pancreatic enzyme replacements can decrease the absorption of folate. d. all of the above
What could countries do to deal with more frequent droughts to ensure a more stable and steady food supply for its people?