IPHY 2420: FINAL
89 Cards in this Set
| Front | Back |
|---|---|
|
Pine Ridge Demographics
|
Oglala Lakota (Sioux) Reservation
southwest corner of South Dakota (8th largest res in nation)
larger than delaware/rhode island combined
not good for farming (done on purpose, told to go there)
different rules, taxes, cops, courts in these nations
|
|
Pine Ridge Social Issues
|
Poorest res in the country (median income: $3,100)
Unemployment rate 83-85% (casino main source of income, not outsiders --> don't drive to it)
School dropout rate 70% (school funding by the US Bureau of Education in the bottom 10%)
Housing is poor (average 17 people per home, small tr…
|
|
Pine Ridge Nutritional Choices
|
Commodities Program
donates extra food to Indian reservations, schools, prison food
tell them how many people you have, they give you a box, take whatever you get
Sioux Nation Grocery Store
only grocery store on the res
no public transportation
|
|
Pine Ridge Health Conditions
|
-Diabetes rates 8x higher
-Infant mortality rates 3x higher (mold?)
-Cervical cancer 5x higher
-Blood quantum
-50% of adults have addiction issues (has to be dry)
-life expectancy: males = 48, females= 52
|
|
Pine Ridges Health Conditions
|
Highest rates of early childhood cavities
dental plaque buildup
leads to peridontal disease
not taught to brush their teeth
50% access to fluoride water
smokeless tobacco
|
|
Dental Plaque
|
a biofilm that forms on the surface of teeth
microorganisms consume carbs and convert them to acid
causes demineralization and inflammation of gums
|
|
CVD plaque
|
composition: cholesterol
cause: poor diet
result: CVD/ high blood pressure
|
|
Pine Ridge and Dental Plaque
|
Native Americans show higher concentrations of decay causing microorganisms at early ages
Current theory: malnutrition during first trimester of pregnancy
|
|
Native Americans and bottleneck
|
Only the ones that survived diseases became the population today
Societal factor: nutrition, education, health care
High baseline of:
pro-inflammatores (high immunity)
IL-6: interlucken 6
Could account for early onset of dental problems
Early onset dental problems could help cause s…
|
|
Pro-inflammatories: high immunity but
|
Thrifty gene hypothesis (April months)
periods of starvation in April
run out of food but cant grow food (too cold)
benefits you to be as large as possible
if you have the thrifty gene you can make it through the starvation month because you hold onto fat but causes type 2 diabetes/ h…
|
|
IL-6: interlucken 6
|
is everything okay?
frantic checking for disease
as soon as they are exposed to disease they react very quickly, if you have high IL-6 levels you are prone to Type 2 Diabetes
|
|
TAKE HOME OF THE LECTURE: CHRONIC INFLAMMATION
|
societal factors/genetics: IL-6, health care/blood quantum, Education (no good teachers/resources), Access to food, Commodities (no choice), Transportation, Housing/black mold, Addiction, Thrifty gene, Addiction, Thrifty gene, Income
Malnutrition during pregnancy: how they cook meal
De…
|
|
Premiums
|
how much you pay yearly (paycheck deduction)
|
|
Deductibles
|
how much you pay before insurance starts paying ($10,000)
|
|
Co-payments
|
how much you pay each time you see the doctor or specialist or go to the ER
|
|
Health savings accounts
|
a savings account that can only be used to pay medical expenses out of pocket
|
|
Pre-existing condition
|
a documented medical condition
sometimes will not cover you because you will be expensive
|
|
Affordable Care Act
|
before 2010, 50 mil americans did not have any kind of health insurance
NOT a gov't run healthcare system
set up by the gov't run by private insurance
ACA built off of current public and private insurance (patchwork solution)
before ACA, if you worked less than 40 hours they did not g…
|
|
3 key features of ACA
|
new customer protections
improving quality and lowering costs
increasing access to affordable care
|
|
New customer protections
|
Prohibits discrimination due to pre-existing conditions or gender
- cannot refuse or renew policies, cannot charge higher rates based on health status (smoker)
establishes customer assistance programs in the states
-states can apply for federal grants to help consumers
-actual person …
|
|
Improving quality and lowering costs
|
making health care more affordable
tax credits are available to help lower the cost of their insurance**
Establishing the health insurance marketplace (high transparent and competitive market)
if an employer does not offer individual insurance
able to buy directly from marketplace***
|
|
Increasing access to Medicaid
|
qualifications for Medicaid expanded to 133% of the poverty level
states will receive 100% federal to support expanding covering
|
|
Extending coverage to young adults
|
under the law, young adults will be allowed to stay on their parents' health plan until age 26
used to be 19
|
|
CASE STUDY: Diabetes
|
Uninsured male, 67, Type 1 diabetes
the annual costs for diabetes is expensive
Under ACA, diabetes is categorized as "pre-existing condition"
PCIP: pre-existing condition insurance plan: provides insurance to U.S. citizens with a pre-existing condition who have been uninsured for over …
|
|
PCIP: Pre-existing condition insurance plan
|
covers major medical and prescription drug expenses, hospital care, preventative care, and annual physicals
PCIP users required to pay any premiums, deductibles, copayments
eligible for Medicare, which can cover the remainder
bandages, wound healing, extensive stays
|
|
CASE STUDY: Pneumonia
|
Female, 25, pneumonia
remain covered until age 26
if parents are uninsured: the daughter qualifies for Medicaid id she is unemployed, or she can purchase individual health care
|
|
Coverage options 26-36
|
ACA relies on this age group to buy into the Marketplace insurance plans to help pay for the increased pool of insurance Americans
Options:
public coverage: provided by gov't, based on low income, age, disability, etc
private coverage: private company, more access with ACA, limits on c…
|
|
ACA Summary
|
Before ACA, 50 mil Americans could not afford health care, so they were left uninsured
risk for the country, population risks bankruptcy if they fall ill
discourages healthy lifestyle because population ignores illness/have chronic diseases (preventative vs. reactive)
Pool of insured A…
|
|
Most nutrient dense dessert
|
pumpkin pie
|
|
Highest number of calorie appetizers
|
o Texas cheese fries with chili and ranch 2120 calories. 70
o Hot spinach and artichoke dip with chips 1610.
o Boneless Buffalo wings with blue cheese 1490.
o Loaded baked potato soup 410.
|
|
Highest number of protein appetizers
|
o Texas cheese fries with chili and ranch 97.
o Hot spinach and artichoke dip with chips 33.
o Boneless Buffalo wings with blue cheese 76.
o Loaded baked potato soup 15.
|
|
IHOP high sodium
|
ham has heavy salt content
|
|
High Saturated fat
|
grilled cheese sandwich- butter and cheese
|
|
Epigenetic Generations
|
Mother: 1st generation
Fetus: 2nd generation
Reproductive cells: 3rd generation
-if mom is smoking all 3 generations are affected
YOUR FOOD CHOICES INFLUENCE WHAT GENES ARE TURNED ON, INFLUENCES HOW YOU AGE, WHAT DISEASE YOU GET
|
|
Epigenome
|
protein and other molecules that regulate expression of genes
turning genes on and off
inherited or altered
Regulation:
Histones
methyl groups
|
|
Bioactive food components and gene expression
|
Bioactive food component (nutrient or phytochemical)
gene expression activated or silenced
protein synthesis increased or decreased
changes in cell and tissue functioning
disease prevention or progression
|
|
Epigenetics
|
future generation effects
embryonic development
health implications
bioactive constituents in whole foods
|
|
Dutch Hunger winter
|
germans cut off food supplies to the netherlands in WW2
calories reduced to 500-1000 per person
women who were pregnant during the time had babies with altered genetics (more prone to obesity and heart disease than their siblings before or after famine)
|
|
TEST QUESTION
IFG2 gene is..
|
the gene that is altered during starvation event
|
|
Hunger in America
|
Americans don't like to talk about it
"wealthiest country in the world"
1968 video Hunger in America (1st time Americans heard about it)
1:6 Americans vs 1:20 Europeans
|
|
Who are the hungry?
10 years ago and today?
|
the working poor
unemployed/ under-employed
migrant farm workers (how much they pick)
undocumented workers (can be let go)
elderly (lost their wages, on social security)
homeless
children
|
|
Who are the hungry?
Today
|
married
clothed
housed
a bit overweight
working people (wages have declined)
1/3 of families who are hungry have at least 1 working adult- typically a full time job
|
|
Food Insecurity
|
any household where during the previous year, people did not have enough to eat
occurs whenever the availability of nutritionally adequate and safe food, or the ability to acquire acceptable foods in SOCIALLY ACCEPTABLE WAYS (dumpster diving, stealing), is limited or uncertain
|
|
Pattern of malnutrition
|
worry about how to get enough food
stretch resources, more money to other expenses and less to food
quality and variety of the diet decreases
adults eat less and less
children eat less and less
|
|
Food insecurity questionair
|
light food insecurity: didnt have enough money to get more food when food went bad
moderate food insecurity: people did not eat
severe food insecurity: children did not eat for a whole day (severe because parents feed their children first)
|
|
US programs to address food insecurity
|
SNAP, WIC
National school lunch program, school breakfast program, special milk program
food distribution on indian reservation
elderly nutrition program
summer food service program
disaster feeding program
|
|
Private sources of food/food distribution
|
soup kitchens
religious organizations (give you a meal and a bus ticket to get to the next church)
food pantries (donated food)
home delivery of meals (meals on wheels)
|
|
Three step burden
|
Poverty, hunger, malnutrition
limits access to medical care
discouraged education and personal advancement (person is working day to day to find food)
change in time scale
|
|
Poverty-obesity paradox
|
overconsumption of calories/malnutrition
food quality is low
crop subsidies (food is cheaper)
overeating when food is available
physiological changes (thrifty gene)
|
|
Food deserts
|
Urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food
instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants
|
|
Effects of hunger
|
malnutrition- iron/zinc/protein/antioxidants
veggies only available when SNAP $ available/ 1st of the month
stress from unexpected bills
ADHD or Hunger? inability to focus in school
hoarding or stealing
eating quickly when food is available
|
|
Solutions
|
Aquaponics: grow plants and underneath is fish, feces used as fertilizer
food co-ops
sponsorship boxes
big store grocery delivery
mobile produce trucks in food deserts
|
|
Epidemiology: risk assessment for obesity
|
higher rates for women than men
all racial and ethnic groups vulnerable
rapid rise exceeds genetics
childhood obesity rates concerning
|
|
Modifiable risk factors: DIETARY
|
increased caloric intake from beverages
shift to more saturated and processed fats
decreased intake of fiber
portion sizes
simple sugars
|
|
Modifiable risk factors: LIFESTYLE
|
exposure to chemicals that act as endocrine disruptors
indoor living: less sun/decreased physical activity/ altered circadian rhythm
amount of processed foods eaten
|
|
Modifiable risk factors: physiological
|
stress
forfeiting lactation: lose protection against obesity for mother and infant
stressors in the fetal environmental that increase obesity risk-gestational diabetes/epigenetics
|
|
Obesity exacerbating conditions: makes obesity worse
|
amount of time sitting per day
asthma (steroids, interferes with exercise)
depression/emotional eating, eating disorders (holds onto fat)
sleep disturbance (sleep apnea, restless leg)
type 2 diabetes eating to regulate insulin, cravings, edema, muscle atrophy
|
|
Other obesity issues
|
sex hormone imbalance (obesigenic fertility medications: ironically harder to become pregnant, pregnancy, menstruation, obesity can exacerbate hormone imbalances)
subclinical hypothyroidism (1/10 americans are low, causes slow metabolism
time of year born (winter= hold onto fat)
|
|
Gut microbiota
|
a family of gut bacteria that help people say thing
H. pylori: ulcers, regulates ghrelin, hormone that increases appetite
transfer gut biota
2/3 of people antibiotics
industrial farming: we injest antibiotics that are injected into cows.... kils h. pylori
|
|
How to lose weight
|
more fiber and water
lean proteins
less saturated fat
reducing calories
increasing activity
|
|
Bariatric surgery
|
gastric banding: put a band to trick the stomach stretch receptors to think you are fuller faster
cheapest, easiest, least successful
gastric bypass: redirect passage straight to small intestine, stomach floats around
most extreme, highest success
sleeve gastrectomy: cutting the stoma…
|
|
Providing protein for an expanding human population
|
increasing demand for protein
|
|
Aquaculture
|
the world now produces more farmed fish than beef
population and income growth
seafood has a heart healthy reputation
|
|
commercial farmed fish
|
global catch of wild fish stagnant
we need more protein but not from wild fish
concerns about feedlot industry: can pollute locally, waste from fish is small area can cause significant nitrogen toxicity
|
|
Blue revolution
|
90% of farmed fish and seafood are from Asia
tropical mangroves destroyed for shrimp farms
agricultural pollution- nitrogen/ phosphorus/ dead fish
densitites- antibiotics and pesticides
banned for use in u.s., u.s. imports 90% of its seafood, 2% inspected, found numerous banned susbst…
|
|
Blue revolution cont.
|
tilapia, carp, cat fish: fast growing, most frequently farmed
density and intensification
feeding fish to grow quickly: cheapest=cornmeal=omega 6=pro-inflammatory
only get omega 3 (heart healthy) when fed stream insects
feeding fish to fish
|
|
Atlantic salmon industry
|
densely packed pens in oceans
norway, scotland, chile, patagonia growing atlantic salmon
feces are naturally taken away by currents
food naturually brought it
|
|
Open water vs. tanks
|
Open water:
parasites, pollution, disease
cant control situation
dont have to worry about oxygen, temp, nitrogen, feeding, cleaning
Tank:
have to be near huge sources of water, $$$$
can control situation
|
|
Land farming
|
dig a ditch and fill it with fish
always have to worry about nitrogen
|
|
Why fish?
|
fish need fewer calories to create a pound of food than other species****
cold blooded (dont spend energy/ burning fat to keep warm)
buoyant environment (not working against gravity)
|
|
Aquaponics
|
use nitrogen as link between aquatic and terrestrial system
symbiotic interaction (fish produces waste -> microbes and worms convert waste to fertilization for plants -> plants filter water that return to the fish)
scale is the problem
|
|
Insects as food source
|
1900 edible insects on earth
2 billion people eat them daily either raw or cooked
only west still has the "ick" factor
insects convert protein more efficiently than any other anima;
|
|
Entomophagy
|
consumption of insects as food
new united nations reports urges countries to eat insects
|
|
Case for insects
|
rising cost of animal protein
environmental pressures (cows belch methane that directly break down green house gases)
population growth
efficient conversion of energy
increased demand for protein among the middle class****
|
|
Case studies in insect nutrition
|
-mealworms: protein, mineral and vitamin content similar to fish
-grasshoppers: as much protein as beef but less fat
-beetles: more protein than other insects, NA ate them like popcorn over coals
-butterflies/moths: pupal stages, full of protein and iron so eaten by children and pregna…
|
|
pro insects
|
less water/ water pollution
no methane
no land use
|
|
con insects
|
cleanliness (cooking)
spoilage (if pupae die they spoil quickly)
pesticides and insecticides
toxicity
low levels of toxicity
eating a lot could be toxic
|
|
other protein sources
|
soybeans
tofu/tempeh
quinoa
beans/lentils
not complete proteins by themselves but can be added to other things
seitan: wheat meat
|
|
Cow milk
|
pros: good source of protein, vitamin A, calcium; most variety in natural vitamins and minerals
cons: fat content (your choice)
nutrients from cow milk may be more bioavailable than non-dairy alternatives
|
|
Soy milk
|
what it is: soaked soybeans and water
pros: low in cholesterol, good source of vitamins (A,D,B12, folate, riboflavin) and minerals (Mg, P, K, Ca)
cons: common allergen; possible hormonal effects due to phytoestrogens, often contains GMOs
|
|
Almond Milk
|
what it is: ground almonds, water
pros: low in calories, fat, and cholesterol; good source of fiber, vitamins (A, D, E) and minerals (Ca, Mg, Mn)
cons: high in sodium, low in protein, common allergen
|
|
Rice milk
|
what it is: boiled brown rice, rice starch, water
pros: low in sat fat and cholesterol
when fortified good source of vitamins (folate, vitamin D, vitamin B12) and minerals (Ca, P)
cons: very low in protein and fat (essentially all carbohydrates)
|
|
Coconut milk
|
what it is: coconut meat grated into water
pros: low in cholesterol and sodium, good source of manganese and iron, vitamin B12
cons: very high in sat fat (MAYBE NOT A BAD THING?), little calcium and vitamin D
|
|
Hemp Milk
|
what it is: hemp seeds soaked and ground into water
pros: low in cholesterol, sodium, sat fat; good source of vitamins (A, E, D, B12, riboflavin) and minerals (Ca, Mg, P)
cons: lower quality protein
|
|
TEST QUESTION:
WHICH TWO MILKS CONTAIN THE MOST COMMON ALLERGEN
|
almond and soy
|
|
meal replacements
|
soylent
ambronite
meal squares
|
|
Soylent
|
...
|
|
Ambronite
|
the same as soylent but better
organic, whole foods products, healthier, more expensive
|
|
Mealsquare
|
...
|
IPHY 2420: FINAL