final exam review

1. FINAL REVIEW Intro to Nutrition

2. Essential • A necessary nutrient that can be obtained only from the diet • The body cannot make for itself • or cannot make enough

3. Organic - contains carbon protein mineral fat carbohydrate vitamin

4. Energy Yielding Nutrients protein fat carbohydrate

5. Malnutrition • A deficiency of nutrients • An imbalance of nutrients • An excess of nutrients • An individual can be overweight and malnourished

6. Nutritious Diet • Adequacy: getting enough nutrients • Balance: proportionality • Variety: different types of foods • Moderation: not too much of any one food • Calorie Control: getting enough energy, but not too much energy

7. DRI • FAT: 20-35% total calories • SATURATED FAT: < 10% of total calories AHA < 7% • TRANS FAT: as low as possible (<1%) • CHOLESTEROL: < 300mg • CARBOHYDRATE: 45-65% of total calories • ADDED SUGAR: < 10% of total calories • PROTEIN: 10-15% upper limit 35% • or 0.8g/kg

8. Research Designs Epidemiological: studies of populations Case study: study of an individual Interventional Study: experimental manipulation Placebo controlled: One group being studied is given a sham treatment Blinded: either the group being studied or the investigator does not know who is taking the sham treatment * Gold Standard: Placebo controlled double blinded

9. Leading Causes of Death Related to Nutrition: • Heart Disease • Cancer • Stroke • Diabetes

10. Nutrient Structure • all are organic • all have carbon, hydrogen and oxygen • all provide energy • only protein has nitrogen

11. RDA

12. RDA vs AI • Nutrient recommendations for individuals • RDA: indisputable scientific evidence • AI: educated guess based on research

13. EER: Energy Requirement Energy Requirement

14. Phytochemicals • Non-nutrient plant chemicals which have a beneficial effect on the body • Can act as antioxidants • NOT proven to prevent disease • NOT guaranteed to make us live longer

15. Fruit vs Vegetable • Fruit is a plant which includes the seeds of that plant (edible portion surrounding the seeds) • A vegetable is the remaining edible portions of that plant (roots, stems, leaves, etc) • USDA divides foodsinto subgroupsbased on nutrients

16. Illusions • Dr. Wansink tested Nutrition Experts by giving them big bowls and big scoops or small bowls and small scoops. • These experts scooped 53% more ice cream with big bowls and big scoops!

17. Daily Values • Great for comparing products • Not a good tool for recommendations for individuals • Same on every label

18. Digestion and Absorption • Mouth • Stomach • Intestines • Liver • Gallbladder • Colon

19. Stomach & Acid • How does the stomach avoid getting burned by stomach acid?

20. Stomach & Acid • How does the stomach avoid getting burned by stomach acid? • Secrete mucus which protects them from the acidic contents of the stomach

21. Digestion & Absorption • Digestion: Breakdown of nutrients • Absorption: passage of nutrients from the digestive tract to the bloodstream

22. Heartburn Recommendations • Smaller, more frequent meals • Drink before and after meals, not during • minimize fiber • Don’t lie down immediately after meals • Wear loose clothing

23. Storage Systems Carbohydrates are stored? Fat is stored? Protein is stored?

24. Storage Systems • Carbohydrates are stored? • Liver (glycogen) and Adipocytes (fat) • Fat is stored? • Adipocytes (fat) • Protein is stored? • Not stored in the body, but excess is converted to fat and stored in adipocytes

25. Simple Carbohydrates disaccharides monosaccharides

26. Carbohydrates Simple Carbohydrates Complex Carbohydrates fiber glycogen

27. Fiber (Table 4-2) Soluble (upper GI) • Lower blood cholesterol by binding bile • Slow glucose absorption ( DM,CAD) • Slow transit through upper GI tract • Hold moisture Insoluble (lower GI) • Increase fecal weight • Increase speed through colon ( constipation) • Provide bulk and feeling of fullness (help with weight loss)

28. Blood Sugar Blood sugar : results in insulin secretion by the pancreas Blood sugar : results in glucagon secretion by the pancreas

29. Wheat Kernel A: Husk - removed B: Bran - most of fiber C: Endosperm - starch D: Germ - nutrients/ protein

30. Diabetes • Type I Diabetes • Autoimmune disease • Cells of the pancreas do not secrete insulin • Typical onset is childhood • Type II Diabetes • Insulin resistance • Pancreas secretes enough or too much insulin • Typically adult-onset, now seen in children

31. Lipids • Three classes of lipids • Triglycerides (TG) • ≈95% of all lipids in foods and the human body. TG = FAT • Phospholipids • For example, lecithin • emulsifiers • Sterols • For example, cholesterol * Know functions of lipids

32. Lipids • Triglycerides • Main form of fat storage in the body • Main for of fat we consume • Three fatty acids and a glycerol (carbon backbone)

33. Fatty Acids • Essential Fatty Acids • Omega - 6 • Omega - 3

34. Lipoproteins • LDL • Transport cholesterol and other lipids to body tissues • HDL • Carry cholesterol from body cells to the liver for disposal (scavenges cholesterol)

35. Trans Fatty Acids Trans fats are a byproduct of hydrogenation

36. Cholesterol •  LDL increases heart disease risk • HDL increases heart disease risk • Dietary cholesterol has little impact on blood cholesterol • Decrease saturated and trans fat • More impact than decreasing cholesterol intake

37. Proteins • Genes determine the sequence • String of amino acids • Peptide bond • Not a straight chain • Shape determines function.

38. Proteins • Multiple functions - we don’t want to use proteins for energy • Antibodies • Enzymes • Connective Tissue (muscle, ligament, etc) • Hormones • Acid Base Balance • Buffers

39. Using Proteins for Energy • Nitrogen is wasted when protein is used for energy

40. Digestibility • Dry heat  digestibility: BBQ • Moist heat  digestibility • Crock pot / stew • Meat - better digestibility • Grain - lower digestibility

41. Denaturing Protein • Uncoiling and unfolding protein • acid (stomach acid) • heavy metals (ie: mercury) • base • heat (cooking) • alcohol

42. PEM • KWASHIOKOR • Older infants ( 1-3 yr) Rapid onset • Inadequate protein intake • Some weight loss and muscle wasting (not severe) • Edema (belly) • Belly often bulges with a fatty liver • MARASMUS • 6 - 18 months of age • Protein and energy deprivation • Develops slowly • Severe wasting • No edema • Looks like a Little Old Man/matchstick arms • Can go to point of no return

43. Vegetarian/Vegan Diet • A healthy vegetarian diet is associated with a lower risk of chronic disease • Both a vegetarian diet and a meat eater’s diet should include a wide variety of fruits and vegetables and whole grains • A vegan diet needs to be supplemented with Vitamin B12 • Mutual supplementation is the combining of plant foods to form complete proteins

44. Vitamin A • Vision • Growth and maintenance • Needed by the body linings and skin • For growth of bones and teeth • Immune defenses Can be toxic from food (Vit A potentially the most toxic)

45. Beta - carotene • Precursor to Vitamin A • Not toxic from foods • Supplements are not recommended • Can turn the skin orange • Plant source

46. Other Fat Soluble Vitamins Vitamin D Vitamin E Vitamin K

47. Other Fat Soluble Vitamins Vitamin D Regulate blood calcium Vitamin E Antioxidant / works with Selenium Vitamin K Forms blood clotting and bone proteins * Given to infants a birth because they do not have vitamin K producing bacteria

48. Other Fat Soluble Vitamins Vitamin D - deficiency Vitamin E - deficiency Vitamin K - deficiency

49. Other Fat Soluble Vitamins Vitamin D - deficiency Rickets Vitamin E - deficiency Erythrocyte hemolysis in premature infants Vitamin K - deficiency Fractures and bleeding

50. Other Fat Soluble Vitamins Vitamin D - SEVERE deficiency Rickets Low levels of Vitamin D associated with • Osteoporosis • Autoimmune diseases (RA, type 1 DM) • Some cancers (colorectal, breast, prostate) • Hypertension (high blood pressure)