EUC-NUTRI cheat sheet

Atwater factors: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g, dietary fiber 2 kcal/g (EU labeling value).

Energy density (kcal/g) drives satiety per calorie: water and fiber lower it; fat raises it (9 kcal/g).

Essential amino acids (9): histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine.

Conditionally essential nutrients become limiting under stress or disease: glutamine, arginine, cysteine, taurine, choline.

Bioavailability is the fraction of an ingested nutrient absorbed and metabolized; heme iron (~15-35%) exceeds non-heme iron (~2-20%).

Nutrient–nutrient interactions: vitamin C enhances non-heme iron absorption; phytates, tannins, and calcium inhibit it.

Dose–response curve concepts: EAR (median requirement), RDA/RI (covers ~97.5%), UL (tolerable upper intake), AI used when EAR is unavailable.

Thermic effect of food: ~10% of energy intake for mixed diets; protein (~20-30%) > carbohydrate (~5-10%) > fat (~0-3%).

Indirect calorimetry: Weir equation REE = (3.941 × VO2) + (1.106 × VCO2) − (2.17 × urinary N); RQ = VCO2/VO2.

RQ values: fat 0.70, protein ~0.82, carbohydrate 1.00, mixed diet ~0.85; RQ >1.0 indicates lipogenesis/overfeeding.

Mifflin–St Jeor: men REE = (10 × kg) + (6.25 × cm) − (5 × age) + 5; women = same − 161.

Glycemic index compares 50 g available carbohydrate test food to glucose (or white bread); glycemic load = GI × available carbohydrate (g) / 100.

Protein requirement for healthy adults is 0.8 g/kg/day; resistance-trained athletes 1.2-2.0 g/kg/day; critical illness up to 1.2-2.0 g/kg/day.

Fatty acid classes: SFA (no double bonds), MUFA (one), PUFA (≥2); n-3 and n-6 are essential; trans fats raise LDL and lower HDL.

Fiber: soluble/viscous fibers (beta-glucan, pectin, psyllium) lower LDL cholesterol; insoluble fibers (cellulose, wheat bran) promote laxation.

Ketogenesis occurs when hepatic acetyl-CoA exceeds TCA capacity; ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone) fuel brain and muscle.

Vitamin D status: serum 25(OH)D ≥50 nmol/L (20 ng/mL) sufficient; 30-50 nmol/L insufficient; <30 nmol/L deficient (IOM/EFSA thresholds).

Iron status panel: ferritin <15-30 µg/L suggests depletion; soluble transferrin receptor and transferrin saturation (<20%) help distinguish iron deficiency from inflammation.

Vitamin B12 deficiency markers: elevated methylmalonic acid and homocysteine precede low serum B12; macrocytic anemia may appear late.

Folate: 400 µg/day dietary folate equivalents for adults; pregnancy 600 µg/day; UL 1,000 µg/day of synthetic folic acid.

Calcium absorption declines with age and low vitamin D; recommended adult intake 1,000 mg/day (1,200 mg/day for women >50 and men >70).

Iodine: 150 µg/day adults, 250 µg/day pregnancy/lactation; urinary iodine concentration is the population biomarker.

Sodium–potassium balance: WHO recommends <2 g sodium/day (5 g salt) and ≥3.5 g potassium/day from foods.

Hydration: adequate total water intake ~2.5 L/day men, 2.0 L/day women (including food water); urine color and osmolality are practical indices.

BMI = weight (kg) / height (m)²; WHO categories: underweight <18.5, normal 18.5-24.9, overweight 25-29.9, obese ≥30 kg/m².

Waist circumference thresholds (WHO): increased risk at >94 cm men and >80 cm women; substantially increased at >102 cm and >88 cm.

Mid-upper arm circumference (MUAC) <11.5 cm in children 6-59 months indicates severe acute malnutrition.

Weight loss percentage = (usual weight − current weight) / usual weight × 100; ≥5% in 1 month or ≥10% in 6 months signals malnutrition risk.

MUST screening: BMI, unintentional weight loss, and acute disease effect; score ≥2 = high risk, requires dietitian referral.

Bioelectrical impedance estimates body composition from resistance/reactance; accuracy depends on hydration status and is limited in edema or obesity.

24-hour recall and food frequency questionnaires have different error structures; weighed food records reduce recall bias but increase respondent burden.

WHO healthy diet targets: ≥400 g/day fruits and vegetables, <10% energy from free sugars, <30% energy from fats, <5 g salt/day.

Free sugars: added sugars plus honey, syrups, and fruit juice concentrates; intrinsic sugars in whole fruit and milk are excluded.

Saturated fat should be <10% of energy; replace with PUFA/MUFA to reduce LDL cholesterol.

Fiber target: ≥25 g/day women and ≥38 g/day men (US) or 30 g/day (EFSA); most adults fall short.

Food-based dietary guidelines translate nutrient targets into food patterns (e.g., Mediterranean-style, Nordic, DASH).

DASH pattern lowers blood pressure: rich in fruits, vegetables, low-fat dairy, whole grains; limits sodium and saturated fat.

Front-of-pack labels (Nutri-Score, traffic-light, warning labels) summarize nutrient density; they are interpretive, not nutrient declarations.

Infants: exclusive breastfeeding for ~6 months, complementary foods from ~6 months with iron-rich foods; vitamin D 400 IU/day supplementation.

Energy needs: ~100-120 kcal/kg/day in infancy declining to ~30-40 kcal/kg/day in adulthood; growth velocity drives requirement.

Pregnancy: +340 kcal/day in 2nd trimester, +450 kcal/day in 3rd; folic acid, iron, iodine, and DHA are key nutrients.

Lactation: energy cost ~500 kcal/day; protein +25 g/day; ensure adequate iodine and choline for infant neurodevelopment.

Adolescence: peak calcium and iron needs (girls 15 mg/day iron; both 1,300 mg/day calcium) for bone accrual and growth.

Older adults: sarcopenia risk; protein 1.0-1.2 g/kg/day and vitamin D, calcium, and B12 attention; hydration risk due to blunted thirst.

Failure to thrive in children: weight-for-age and length-for-age <−2 SD; investigate organic and psychosocial causes.

Type 2 diabetes: medical nutrition therapy targets 5-7% weight loss, carbohydrate awareness, and glycemic control (HbA1c reduction 0.3-1.0%).

Hypertension: DASH plus sodium <2,300 mg/day lowers systolic BP 5-11 mmHg; potassium-rich foods add benefit.

CKD: protein restriction 0.6-0.8 g/kg/day in non-dialysis stages with adequate energy; limit sodium, potassium, and phosphate as indicated.

Dyslipidemia: reduce saturated fat to <7% energy, add 2 g/day plant stanols/sterols, and 5-10 g/day soluble fiber to lower LDL.

Obesity management: a 500-750 kcal/day deficit yields ~0.5-0.75 kg/week loss; ≥5% loss improves metabolic markers.

Cancer cachexia: high-protein, energy-dense diet; treat inflammation and symptoms; avoid unproven restrictive diets.

IBD: individualized diet during flares; low-FODMAP may help IBS-type symptoms; screen for micronutrient deficiencies (iron, B12, vitamin D).

HACCP has 7 principles: hazard analysis, CCP identification, critical limits, monitoring, corrective actions, verification, and record-keeping.

Danger zone: 5-60 °C (41-140 °F); refrigerate ≤4 °C, freeze ≤−18 °C, reheat to ≥74 °C.

EU allergen labeling covers 14 major allergens (e.g., cereals with gluten, milk, eggs, fish, crustaceans, tree nuts, peanuts, soy, celery, mustard, sesame, lupin, molluscs, sulphites).

Nutrition declaration in the EU: energy, fat, saturates, carbohydrate, sugars, protein, and salt per 100 g/mL and per portion.

Health claims require EFSA scientific substantiation and Commission authorization; general function claims use a permitted wording list.

Codex Alimentarius sets international food safety and labeling standards; national regulators (EFSA, FDA, FSA) implement them.

Foodborne pathogens: Salmonella, Listeria monocytogenes (growth at refrigeration), E. coli O157:H7, Campylobacter, and Staphylococcus aureus toxins.

Scope of practice: dietitians provide individualized medical nutrition therapy; nutritionists/coaches should refer clinical cases.

Informed consent requires capacity, disclosure of risks/benefits, and voluntary agreement before intervention.

Evidence hierarchy: systematic reviews and RCTs outrank observational studies and expert opinion; GRADE rates certainty.

Motivational interviewing uses OARS (open questions, affirmations, reflections, summaries) and avoids confrontation.

Conflict of interest: disclose industry funding and avoid supplement promotion without evidence; follow professional codes of ethics.

Health literacy: plain language, teach-back, and culturally adapted materials improve adherence and comprehension.

Documentation should include assessment, diagnosis (PES statement), intervention, monitoring, and evaluation (ADIME/NCP model).