Nutri Sci 350 Quiz 1 Study Guide (Lectures 1-4)Lecture 1 and 21. What are the 4 types of malnutrition? What causes each type?a. Overnutritioni. Too many calories and not enough exercise, contributing to obesity,diabetes, hypertension, and cardiovascular diseaseb. Secondary Malnutritioni. Not directly caused by the dietii. Results from a condition that inhibits a person’s ingestion, digestion orabsorption, and metabolismiii. Another causative condition is diversion of nutrients to parasitic agentsc. Micronutrient Malnutritioni. Caused by dietary deficiencies of micronutrients1. Vitamin A2. Iodine3. Irond. Protein Calorie/Energy Malnutritioni. Occurs when a person has an extremely deficient intake of protein andcaloriesii. More feed is need and people rarely have protein efficiency withoutcaloric deficiency2. What is “environmental enteropathy” and what is its proposed mechanism?- Small intestinal disorder triggered by constant ingestion of feces via contaminatedfood and water- Results in “leak” of bacteria through intestinal walls into blood stream- Results in low-grade infections that require large amounts of energy to fight- Leaves fewer nutrients for growth3. What is the relationship between toilets and stunting?- Parasites can enter the body via fecal-oral route- Secondary malnutrition with subsequent stunting occurs as the parasite divertnutrients from the host/child to themselves4. Describe the changes in the use of carbohydrate, fat and protein during starvation.- Negative nitrogen balance- Glucose is produced from protein breakdown to provide energy- Then fat breakdown and metabolism provides ketones for all tissues except CNS,RBC, and WBC- Serum fatty acid levels increase5. What is a problem in both industrialized and developing countries and why?6. How does the body adapt metabolically to malnutrition?7. What nutrient is required for energy production; where does it come from when not in thediet?8. How is nutritional status assessed? What is the result of good nutrition?9. What might happen to the capacity to work with undernutrition?10. How did the subjects in the Keys study adapt to semistarvation?11. What were the physical and psychological symptoms exhibited during semistarvation inKeys’ study?12. How long did full recovery take in Keys’ study subjects?Lecture 3: Protein Energy Malnutrition & Microbiome1. How does the body adapt physiologically to PEM?2. What is the result of the changes in the immune system during protein energymalnutrition?3. What happens to the functional capacity of the heart during protein calorie malnutrition?The lungs?4. What is the effect of electrolyte changes on muscle tissue?5. Why is there diarrhea with severe PEM?6. What is the major effect of early life PEM?7. What are the 2 types of PEM? How do they differ? What has been linked to themicrobiome?8. What is the proposed way to change the microbiome?Lecture 4: Micronutrient Malnutrition1. What are the major micronutrient deficiencies in the world?a. What are the symptoms of these deficiencies?b. Who is most likely to be deficient in each of these nutrients?c. What are the dietary sources of these nutrients and what are the issues associatedwith availability, intake and absorption?d. What impact do these deficiencies have on life?2. What nutrient deficiencies are associated with decreased cognitive ability? How?3. What nutrient has been successfully supplemented in the diet via salt? Sugar?4. What nutrient deficiency has a decrease in immune function before the presentation ofmore obvious clinical signs?5. Why is obtaining iron and vitamin A different from animal versus plant sources?Four Types of Malnutrition1. Overnutritiona. Too many calories and not enough exercise, contributing to obesity, diabetes,hypertension, and cardiovascular disease2. Secondary Malnutritiona. Not directly caused by the dietb. Results from a condition that inhibits a person’s ingestion, digestion orabsorption, and metabolismc. Another causative condition is diversion of nutrients to parasitic agentsd. Causes:i. Loss of appetiteii. Increase in BMR (basal metabolic rate)iii. Prevention of nutrient absorption1. Diarrheaiv. Parasitic agents3. Micronutrient Malnutritiona. Caused by dietary deficiencies of micronutrientsi. Vitamin Aii. Iodineiii. Iron4. Protein Calorie/Energy Malnutritiona. Occurs when a person has an extremely deficient intake of protein and caloriesb. More food is need and people rarely have protein efficiency without caloricdeficiencyEnvironmental enteropathy: small intestinal disorder due to constant ingestion of feces viacontaminated food and waterHow do we determine nutritional status?- Anthropometric Assessment- Low height for age measure: stunting- Chronic- Low weight for height measure: wasting (i.e. BMI)- Acute- Low weight for age measure: underweight- Both acute and chronic- Biomedical assessment- Clinical- DietaryKeys Case Study- Background/motivation:- Real world concern: Deal with people in war-torn Europe who had undergoneextreme starvation after the end of the war.- Study motivation: How people would be affected physiologically andpsychologically by a limited diet and what would be the most effective way toprovide postwar rehabilitation?- Human experiment: To subject volunteers (36 conscientious objectors; get datafrom 32 out of 36) to semi-starvation and then re-feed them.- Experiment process- Standardized period (3 months)- Received normal diet (3200 kcal)- Semi starvation period (6 months)- Received a semi-starvation diet (1800 kcal), 2 meals a day (reflectedfoods in the war-torn areas of Europe, i.e., potatoes, turnips, dark bread,etc.)- Required daily exercise and allowed class participation- Received regular tests of physical and mental abilities, and carefulmedical care- Rehabilitation period (3 months)- Received normal diet- Participants were not back to “normal” at the end of this period. It took 2months to 2 years to fully recover- Impacts of Semi-Starvation- Physical- Loss of active tissue- Loss of weight- Other: anemia, fatigue, dizziness, and edema- Mental- Personality changes: irritability, apathy, impatience, etc.- Attitude changes- Loss of sex drive- Insights of the study- This study finds that starvation dramatically alters personality and thatnutrition directly and predictably affects mind as well as body.- Diet alone could have a large effect on basic body functions, e.g., blood pressure,cholesterol level, heart rate, areas previously