Nutritional Health Status Review for Optimal Well-being

1. Review for final

2. Nutritional Health Status • Desirable Nutritional Status • Undernutrition • Subclinical deficiency • Clinical deficiency • Overnutrition • Toxicities • Excesses of energy nutrients-obesity

3. EARs and RDAs • EARs • Only set for nutrients that have functional markers • Meets needs for 50% population group • RDAs • Based on EARs • Meet 97-98% population group • Prevent deficiency and chronic disease

4. AIs and ULs • AIs • Insufficient data for an EAR • Estimate of average nutrient intake that appears to maintain a defined nutritional state (bone health) • Ideally meets more than RDA • Uls • Based on chronic intake of nutrients that are not likely to cause adverse effects in almost all individuals • Based on nutrient intake from all sources • Exceptions: niacin, magnesium, zinc and nickel are only nonfood sources

5. EERs and AMDRs • EERs • Average daily caloric need for each life stage group • AMDRs • Range of intake, as a percentage of energy (for example fat is 20-35% of kcal) • Values are for Carbohydrates, Fat, Protein and Essential fatty acids

6. Nutrient Density • Divide the amount of the nutrient per serving by the recommended amount • Divide the calories in a serving by daily caloric need • Compare the two • “Empty calorie foods”

7. Energy Density • Comparison of a food’s caloric content per gram weight of the food • High energy density foods (>4 kcal/g) • Graham crackers, potato chips, peanuts, bacon • Low energy density foods (<0.6 kcal/g) • Lettuce, strawberries, grapefruit, carrots

8. Fat Metabolism • Carbohydrates aid fat metabolism by providing enough of key substrates to keep the citric acid cycle going • Ketogenesis • Ketone bodies formed by incomplete fatty acid oxidation • Ketosis in Diabetes Mellitus • Ketosis in Semistarvation or Fasting or No carbohydrates in diet

10. Vitamin E Functions • Antioxidant (also C and carotenoids) • Reduces oxidative stress from free radical damage • Vitamin E is a “chain breaking antioxidant”

11. Vitamin A • Caroteinoids • Provitamins-can be converted to Vitamin A • Dietary sources: dark green and yellow orange vegetables and fruits • Retinoids • Active form: preformed Vitamin A • Retinal, retinol and retinoic acid • Dietary sources: liver, fish oils, fortified dairy products and eggs

12. Potassium • Foods (beans, potato, dairy, fruits, vegetables) • Needs • AI is 4700 mg • Average intake below this • Function: intercellular cation so same functions as sodium except that it decreases calcium excretion • Deficiency • Hypokalemia (low blood potassium) can lead to irregular heartbeat • Usually from urinary losses • UL • Hyperkalemia (high blood potassium) with poor kidney function

13. Match the deficiency with the anemia • Vitamin E • Folate • Vitamin B12 • Iron • Copper • Megaloblastic • Microcytic • Hemolytic *** See book for summary

14. Successful Weight Management: Lessons from The National Weight Control Registry • Registry members have lost an average of 66 pounds and kept it off for 5.5 years • 90% exercise, on average, about 1 hour per day. • 62% watch less than 10 hours of TV per week. • 78% eat breakfast every day. • 75% weigh them self at least once a week.

15. Preventing CVD (limit) • Total fat 20-35% total calories • Saturated fat < 7 % total calories • Trans fat low • Polyunsaturated < 10% total calories • Monounsaturated < 20% total calories • Cholesterol < 200 mg daily

16. Preventing CVD (emphasize) • Include 2 grams plant stanols/sterols • Soluble fiber 20-30 g • Eat fatty fish 2x/week • Keep body weight at a healthy level • Increase physical activity • Do things to increase your HDL (exercise) • Eat foods that prevent oxidation

17. Two Essential Fatty Acids • Alpha-linolenic (3) • Polyunsaturated • Major source of Omega 3 fatty acids in foods • Used to make EPA and DHA and Eichosanoids • Linoleic (6) • Polyunsaturated • Major source of Omega 6 fatty acids in foods • Used to make Arachidonic acid, and Eicosanoids

18. Two Essential Fatty Acids • Alpha-linolenic • Cold water fish (salmon, tuna, sardines), walnuts, flax, canola oil • Reduces inflammation, thins blood, and reduces plasma triglycerides • Linoleic • Beef, poultry, safflower oil, sunflower oil, corn oil, mayonaise • Regulates blood pressure, can increase blood clotting and inflammation

20. Recommended Intakes of Protein • Equilibrium • Protein intake equals protein losses • Positive Nitrogen Balance • Protein intake exceeds protein losses • Negative Nitrogen Balance • Protein losses exceed protein intake

21. Calcium supplements • Calcium carbonate (HCl-food) and calcium citrate • Who should take which? • When should you take it? • How much should you take? • Interactions • Zinc, iron, and magnesium

22. Calcium • Absorption • Slightly more efficient in upper SI (more acidic) • Things that influence absorption: • Food source • Vitamin D needed • Efficiency increases during times of need • Full stomach • Age • Fiber, oxalate, phosphorus, polyphenols (tea)