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NUTR 202: FINAL EXAM
Nutrition |
The science that studies the interactions between the body's function and health |
Nutrient |
A substance that the body requires for energy, regulation of body processes, and structure |
Essential Nutrients |
Body needs to acquire through diet |
Non-Essential Nutrient |
Body makes adequate amounts of (Ex: Vitamin D) |
Calorie |
unit to measure energy |
Macronutrients |
nutrients that provide energy |
Micronutrient |
nutrients that don't provide energy, but help regulated body processes and structure |
Metabolism |
Biochemical activity that occurs in cells and releases energy from nutrients or uses energy to form a new substance (proteins) |
Electrolyte |
A mineral that assumes a charge when dissolved in water (sodium, potassium, and chloride) |
Phytochemical |
Chemical compounds in plants that have various effects on body functions
*NOT A MINERAL*
*SUPERFOOD* |
Nutrigenomics |
Understanding genetics and molecular connection of how dietary compounds alter individual genetic makeup thus affecting their health and risk of disease |
3 broad functions of nutrients |
1. Provide energy
2. Regulate body processes
3. Structure |
Which nutrients yield energy? |
Macronutrients
Carbohydrates (4kcal)
Fats/Lipids (9 kcal
Proteins (4kcal) |
General Functions of Carbohydrates |
Provide energy |
General functions of Lipids |
Provides and stores energy |
General Functions of Proteins |
Promotes growth, repair, and maintenance |
General Function of Vitamins |
Regulates biochemical reactions, antioxidants |
General Function of Minerals |
Regulates biochemical reactions; provides structure |
General Function of Water |
Regulates temperature, provides lubrication |
Fat Soluble vs. Water Soluble Vitamins |
Fat Soluble - stored for a long, can NOT dissolve in water, and doesn't need to be consumed everyday
Water Soluble - Dissolves in water, not stored in body, excreted through urine |
List the factors that influence food choices |
Taste
Environment
Culture
Family
Finances
Connivence
The Media
Age
Health Issue |
Overnutrition |
Too much of a specific nutrient |
Undernutrition |
not adequate amount of a specific nutrient |
Regions of the world where undernutrition is most prominent |
sub-Saharan Africa and Africa |
3 components of a healthy eating plan |
Variety
Balance
Moderation |
Examples of nutrient dense foods |
Fruits, vegetables, whole grains |
Example of foods with empty calories |
Candy, cookies, and sweets |
Describe the purpose of DRIs and the set of values that compromise the DRIs |
Dietary Reference Intakes are designed for healthy people, categorized based on age group and life stage. It is used to asses and improve the nutritional status of Americans |
Current vs. New Nutrition Facts Labels |
The new labels will not have "calories from fat" but will include an "added sugar portion" |
3 basic types of label claims allowed on food products |
Authorized Health Claims
Qualified Health Claims
Authoritative Health Claims |
Primary Monosaccarides and disaccharides in foods |
Monosaccaride:
"one chemical ring"
*Glucose* (most common) - circulates in blood to give us energy
Fructose - fruit, honey, agave
Galactose - (lactose in milk)
Disaccharide:
"2 monosaccharides"
Sucrose (fructose + glucose)
Maltose (glucose + glucose)
Lactose (glucose + galactose) |
Nutritive vs. Non-nutritive sweeteners |
Non-nutritive sweeteners: Do NOT provide calories and may be natural or synthetic (ex: Splenda)
Nutritive Sweeteners: Can be digested and yields calories (ex: honey, sucrose, fructose) |
Complex Carbohydrates |
Polysaccharides (glucose molecules)
Starch (stored form in plants)
Glycogen (stored in liver and muscles)
Dietary Fiber (Glucose & Monosaccharide, can not be digested) |
Primary components of whole grains |
Endosperm (*86%) - starch
Bran (14%) - Dietary Fiber and structure
Germ (3%) - oils and vitamins
*BRAN & GERM ARE REMOVED DURING PROCESSING |
Gluconeogenesis |
The synthesis of new glucose from a non-carbohydrate source |
Ketosis |
Body has extremely high fat-burning because the body does not have enough glucose for energy |
Discuss the roles of insulin and glucagon in regulating blood glucose |
Glucagon triggers gluconeogensis and raises blood glucose
Insulin meets the immediate energy needs and lowers glucose levels |
Describe the 3 categories of diabetes mellitus and associated complications |
Type 1: Pancreas unable to produce insulin (children) (thought to be autoimmune)
Type 2: 90% of adults - may produce too much insulin - cells are insulin resistant
Gestational - diabetes that occurs during pregnancy
|
Soluble vs. Insoluble Fiber |
Soluble Fiber: can dissolve in water, jelly like material that acts like cement in plants (ex: Fruits, Legumes, Oat bran, Potatoes
Insoluble Fiber: mainly composed of plant cell walls (cellulose...); cannot dissolve in water and resists human digestive enzymes. (cereal, whole grains, legumes, wheat bran, brown rice) |
Resistant Starch |
starch that escapes digestion within the small intestine but is not classified as dietary fiber.
- R1 *least digestable* (seeds,unprocessed whole grains, legumes)
- R2: granular type of starch (uncooked potatoes, green banana flours) |
Celiac Disease |
*intolerance to gluten* autoimmune disorder that causes GI problems including intestinal cramps and diarrhea, and in more severe cases damage to the intestine leads to a reduced ability to absorb nutrients.
Food Sources: GLUTEN FREE, fruits, and veggies
|
Pros and Cons of low carb diets |
- Helps weight loss (forces fats to be metabolized
- high in fats (especially saturated fats), bad breath, constipation, dehydration, and increase in risk of heart disease |
Lactose Intolerance |
Inability to digest lactose (due to loss of function of enzyme)
Can be supplemented for:
Smaller portions at one time
• Lactose-hydrolyzed milk
• Yogurt
• Lactase drops or pills |
Classes of Lipids |
Fatty Acids
Triglycerides
Phosopholipids
Sterol/Cholesterol |
Common dietary sources of saturated, unsaturated,trans-fatty acid, and cholesterol in the American Diet? |
Saturated Fats: dairy, meats, tropical (coconut/palm) oils
Unsaturated: sunflower, vegetable oils, olive oil, nuts, seeds, fish
Transfat: milk, meat, and margarine
Cholesterol: animal products (meats, eggs, etc)
|
Describe the role of Omega 6 and Omega 3 fatty acid products in health maintenance |
Omega-6
- Precursors to powerful biological compounds that can play a role in reproduction and blood flow
Omega-3
- Help prevent tissue inflammation
- Reduce Heart Disease & formation of blood clots |
Two essential fatty acids |
Omega 6 (linoleic acid) eggs, soybean oil, corn
Omega 3 (linolenic) - fish, flax seeds
|
What functions do lipids perform in our body? |
- energy storage |
3 Fat replacers |
FAT MIMETICS
Carbohydrate based: ex. cellulose, gums, starches, fibers
add creaminess, bulkiness, and moistness
Protein based: Denature under high heat
Used in frozen and refrigerated products
FAT SUBSTITUTE
Fat based: ex. olestra, salatrim, caprenin
non-digestible/partially digested
|
What is a fat blocker? |
marketed as weight loss drugs.
*contains fiber chitosan*
Side effects are anal leakage, malabsorption of oral contraceptives, and reduced fat soluble vitamin A, D, E, K absorption
|
Identify the type of lipid carried by each of the four lipoproteins |
Low-Density Lipoproteins (LDL)
Contain Cholesterol
High-Density Lipoproteins (HDL)
Contain Cholesterol
Very- Low Density Lipoproteins (VLDL)
Contain Tryglycerides and cholesterol
Chylomicron - Fats (dietary lipids)
|
Functions of HDL and LDL ad their impact on heart disease |
LDLs (BAD)
- Deliver cholesterol to other tissues, including blood vessels
HDLs (GOOD)
- Decrease heart disease risk by removing excess cholesterol from cells and blood vessels and returning it to the liver for breakdown and elimination |
Lifestyle recommendations to reduce risk of heart disease |
- Mediterranean diet (eat more fruits and veggies)
- Physical activity
- Maintain or attain a healthy weight
- Alcohol in moderation
*higher levels of fat intake leads to higher risk of chronic disease*
|
Mediterranean Diet vs. Western Diet |
- Daily physical activity
- Emphasis on food from plant sources
- Emphasis on minimally processed, more homegrown food
- Olive Oil
- No trans fat
- Consume cheese in moderation
- Weekly consumption of meat
- Very small amounts of red meat |
What elemental units make up amino acids? |
amine group
R group
Hydrogen Group
Carboxyl Group
|
Building Blocks of Proteins |
Amino acids
*only macronutrients to contain Nitrogen* |
Deamination |
process by which amino acids are broken down if there is an excess of protein intake. The amino group is removed and converted to ammonia. |
Denaturation |
A process in which a protein’s structure and function are changed by heat, acid, enzymes, agitation, or alcohol
Becomes inactive and does NOT function
|
Transamination |
Transfer amine group from an essential amino acid to make another amino acid |
Essential Amino Acid |
Must be acquired by diet because is not synthesized by the body |
Non-essential amino acid |
Amino acids that the body can synthesize |
Conditionally essential amino acid |
These are nonessential amino acids that may become essential due to the body's inability to produce the required amount necessary for proper function. |
Examples of essential amino acids: |
- Histidine
- Isoleucine
- Leucine
- Lysine
- Methionine
- Phenylalanine
- Threonine
- Tryptophan
- Valine
(HILLS MAKE PEOPLE VOMIT)
|
Examples of conditionally essential amino acids |
Arginine, cysteine, glutamine, glycine, proline..... (front of alphabet?) |
How does the shape of a protein affect its function? |
Certain shapes carry out specific functions |
How do limiting amino acids affect protein takeover (process of synthesis and breakdown)?
|
the body will break down existing protein to obtain the missing amino acid or protein synthesis will not occur. The amino acid that is not available in adequate amounts for protein synthesis is referred to as the limiting amino acid. |
Positive Nitrogen Balance |
Periods of growth, recovery from illness, and pregnancy
* Infants, children, and pregnant women |
Negative Nitrogen Balance |
AIDS, Cancer, starvation, extremely low calorie diets |
What are the potential health benefits and nutritional deficiencies associated with vegetarian diets? |
health benefits: lower risk of heart disease, lower BMI, lower risk of cancer
nutritional deficiencies: lack or iron, vitamin B12, zinc, calcium, protein, Vitamin B16 |
Complete Proteins |
HIGH QUALITY. Contain ALL essential amino acids, easy to absorb/ digest
*veggie protein in soy
*animal proteins
|
Incomplete Proteins |
Does NOT contain adequate amounts of amino acids
*legumes, grains, and vegetables |
Complementary Proteins |
LOW QUALITY. Combined to provide adequate levels of essential amino acids (rice and beans) |
DRIs for protein in an adult |
weight in kg(divide body weight by 2.2) then multiply by .8g |
Protein-energy malnutrition(PEM) |
-protein deficiency conditions when a person does not consume enough protein, calories, or both
which include marasmus and kwashiorkor |
Marasmus |
form of PEM characterized by emaciation, or skeletal appearance due to inadequate intake of both protein and calories |
Kwashiorkor |
form of PEM, characterized by swollen appearance esp. in abdomen (frequently in children being breast fed, may be getting enough calories, but not enough protein) |
Digestion |
The breaking down process of food to allow absorption. |
Absorption |
movement of smaller products of digestion across the lining of the intestinal tract into our bodies and ultimately into our cells |
Mechanical Digestion vs. Chemical Digestion |
Mechanical digestion is the movement and breaking down of foods by physical means (chewing or peristalsis).
Chemical digestion is the breaking down of foods into small enough forms to allow absorption of nutrients. (secretion of enzymes)
|
Location of he 3 sphincters involved in digestion |
Upper esophageal sphincter - separates pharynx and esophagus
Lower Esophageal Sphincter (cardiac sphincter) - separates esophagus and stomach
pyloric sphincter - separates stomach and Small Intestine
|
Describe the functions of the 5 gastric secretions. |
mucus: protects lining of stomach from HCI/pepsin.
HCI: denatures proteins and neutralizes bacteria
Intrinsic Factor: essential for absorption of B12 Vitmain
Pepsinogen: proenzyme (inactive) that is converted to the active form "pepsin" by stomach acid
Hormones/Gastrin: controls the movement of stomach and secretion of HCl...communicates with the rest of the body |
Components of Small Intestine |
Duodenum (Top) *starts at pyloric sphincter
Jejunum (Middle) *WHERE MOST ABSORPTION & DIGESTION OCCURS*
Illeum (Bottom)
|
What structures in the small intestine facilitate absorption of nutrients? |
Villi and microvilli |
Where does the most energy metabolism occur? |
Mitochondria |
Energy Metabolism: CARBS |
Once the glucose is in the cell, glycolysis breaks it down to become a pyruvate |
energy metabolism of fats |
lipase is released-> bile emulsifies fats into small particles-> absorbed through villli then form triglycerides-> short chain fatty acids enter blood-> longer chains made into chylomicrons |
Energy Metabolism of Amino acids |
the first step in breaking down AA is removing the nitrogen group through deamination, then the carbon skeleton is what remains of the amino acids, the nitrogen is converted to urea and excreted in urine |
Glycolysis |
metabolic process that breaks down glucose to a usable form of energy (ATP and Pyruvate) |
Pyruvate |
Product of glycolysis (when glucose is broken down) |
Lactate |
created from pyruvate if not enough oxygen is available for the Krebs cycle |
acetyl CoA |
STEP AFTER PYRUVATE
when enough oxygen is available and when the glucose has become pyruvate, it enters the mitochondria for aerobic metabolism and becomes acetyl coA (pyruvate cannot go back to pyruvate once it has been changed to acetyl coA) |
Tricarboxylic acid cycle |
AKA KREBS CYCLE
which is a complex series of reactions that converts acetyl CoA derived from carbs, fats, and proteins into ATP |
Electron Transport Chain |
primary site where ATP is made, used only for aerobic metabolism bc oxygen is the final acceptor of hydrogen in this chain |
Oxaloacetate |
four carbon compound; begins and ends with Citric Acid Cycle and reacts with acetyl CoA |
Describe the fate of additional glucose in the body when energy needs are met and these nutrients are not needed for energy. |
excess glucose is converted into glycogen which is stored in the liver and muscles, it is used to maintain blood glucose between meals. |
Describe the fate of additional fats in the body when energy needs are met and these nutrients are not needed for energy. |
excess fat is mostly stored in the adipose tissue but a small amountt is stored in the muscles |
Describe the fate of additional amino acids in the body when energy needs are met and these nutrients are not needed for energy. |
small amount of AA are stored in the amino acid pool in the blood and cells |
What compounds can be stored as fat? |
anything that can form acetyl CoA--including fats, carbs, alcohol, and amino acids |
Describe conditions in which amino acids are used for energy in greater quantity |
During starvation or when carb intake is low |
What is the most common cause of peptic ulcers? |
Helicobacter pylori (H. plyori) - resistant to stomach acids |
Constipation |
makes having a bowel movement difficult---caused by low fiber, not enough exercise, medication, dehydration, ignoring the urge to defecate, and disease |
GERD |
heartburn/gastroesophageal reflux disease...produces pain in the chest when stomach acid refluxes back into the esophagus--caused by being overweight, pregnancy, hiatal hernia (part of the stomach pushing on the esophagus) and diet |
Diarrhea |
produces loose, watery stools occurring more than three times per day---caused by bacterial or viral infections from contaminated food or water, food intolerances, medication, disease |
Probiotic |
food products/supplements that contain live bacteria (microbiota) that may improve the health and microbial balance of the intestine (mainly large intestine)
--yogurt, buttermilk, kefir |
Prebiotic |
indigestible carb sources that reach the colon and support the growth and activity of desirable bacteria (found in whole foods and supplements)--oatmeal, flax, whole grains |
Synbiotic |
combination of pro and pre biotic |
Energy intake vs. Body weight |
calories intake>calories expended = weight gain |
Components of Total Energy Expenditure (TEE) |
1. Basal metabolic rate (resting)
2. Physical Activity
3. Thermal effect of food |
BMI |
underweight: <18.5
overweight: >= 25
obese: >= 30
normal: 18.5-25
|
BMI Limitations |
fails to distinguish between fat and muscle mass |
Factors that influence energy burned during excercise |
body weight and muscle mass utilized
duration of activity
intensity of activity
type of activity
Fitness level
|
Excess body fat |
android: apple shape, most body fat is carried in the abdomen--more common in men, higher risk of hypertension, type 2 diabetes, and heart disease than gynoid
visceral fat: fat stored under abdominal muscle around internal organs--higher health risks
VS.
subcutaneous fat: fat stored under the skin
gynoid pattern: pear shape, most body fat is carried on hips and thighs |
Causes of Obesity |
energetics, environment, and genetics |
Hormones that influence hunger/appetite |
ghrelin: hunger stimulating hormone prod.by cells lining the stomach (think-- im like a gremlin when im hungry)
leptin: hormone produced by fat cells that do body weight regulation, suppresses appetite, produced toward end of a meal to stop eating
|
Neurotransmitter that influences hunger |
neuropepetide Y |
Hunger vs. Appetite |
-Hunger: the painful sensation caused by a lack of food that initiates food-seeking behavior (physical) (NEED)
-Appetite: the integrated response to the sight, smell, thought, or taste of food that initiates or delays eating (psychological) (WANT) |
Why are fad diets unsuccessful in the long term? |
they do not involve permanent lifestyle changes, consuming fewer calories causes your metabolism to lower making it more difficult to burn calories, rapid weight loss means you are losing water and muscle mass which is temporary |
Recommendations for a long healthy weight loss |
Increase physical activity and decrease processed foods. Intake 500 less calories |
3 weight loss surgeries |
vertical sleeve gastrectomy -cut a sleeve off of stomach to make it smaller
adjustable gastric band procedure -band to make entrance to stomach smaller
roux en Y Gastric - intestine attached at upper part of stomach where it has been stapled off, to decrease absorption
|
Recommendations to treating Childhood Obesity |
Weight vs Height maintainance |
What are the 2 compartments in which water is found? |
Intracellular (60%) and extracellular |
Sources of water intake |
Ingested food and water |
Sources of water excretion |
urine, feces, sweating, through the lungs each time you exhale, breast feeding |
How water intake and retention is regulated |
hypothalamus (monitors body fluid sodium concentaration)
antidiuretic hormone (released by the pituitary gland in the brain to signal the kidneys to retain water)
aldosterone (induces the kidneys to retain more sodium and water)
brain
|
Hyponatremia |
sodium levels in the blood are too low--older adults are at higher risk |
Functions of water and electrolytes |
electrolytes: heavily involved in the proper maintenance of water balance
water: temperature regulation (sweating)
|
3 foods high in sodium and potassium |
SODIUM: cured meats, canned soup, and cheese
POTASSIUM: Tomatoes, bananas, legumes, fruits and veggies |
AI for water in healthy adults |
1.9-2.2 L |
Organ responsible for water and waste elimination |
Kidneys |
Describe how proposed changes to the nutrition facts label on foods may alter sodium and potassium intake in the U.S. Population |
Including potassium on the new food labels will help people understand how it relates to daily diets. |
Systolic Blood Pressure |
Highest pressure generated during cardiac contraction |
Diastolic Blood Pressure |
Lowest pressure during cardiac relaxation |
What is the systolic and diastolic blood pressure reading reading that correspond to hypertension?
|
Systolic > 140
Diastolic > 90 |
What minerals influence blood pressure? |
Sodium (increases risk of hypertension)
Potassium (relaxes blood vessels and lowers BP)
Calcium
Magnesium |
DASH diet |
Dietary Approaches to Stop Hypertension.
↓ Sodium Intake
↑ Magnesium: Whole Grains
↑ Potassium: Fruits and Vegetables
↑ Calcium: Low/Fat free Milk
↑ Dietary Fiber |
Diet and lifestyle recommendations to prevent hypertension |
reduce sodium intake
eat less processed food
increase physical activity
quit smoking
limit alcohol consumption
maintain healthy body weight |
General functions of vitamin and minerals (MICRONUTRIENTS) |
DO NOT yield energy but
Involved in metabolic processes that help provide energy
Vitamins = Organic
Minerals = Inorganic (no carbon |
Water-soluble vitamins vs. fat-soluble vitamins |
Fat Soluble:
Vitamin A, D, E, K
increased risk in toxicity
Long storage in liver and fat cells
Large amounts
Water Soluble:
Vitamin C and B (1-3,5-6,7,9,12)
low risk of toxicity, BUT high risk of deficiency
Short storage, small amounts
|
What are the functions of Vitamin A? |
Retinol*(most active form stored in liver), Retinal, Retinoic Acid
1. integrity of epithelial cells (lining of skin & GI tract)
2. bone growth
3. reproduction, cell membrane stability
4. gene regulation (turns on and off genes, indirect role in metabolism regulation)
5. vision (maintenance of cornea tissue - outer layer or eye)
6. immune function (makes white blood cells)
7. Cell specialization/differentiation |
Preformed vs. Provitamin A |
Preformed
Ready to use
Animal-based, fortified foods
Provitamin A
Converted to active form as needed
(beta-carotene - antioxidant in plant)
- Found in plant based foods (green leafy, red and orange produce)
|
Vitamin A deficiency and toxicity symptoms |
liver damage and birth defects
- permanent blindness (Xerophthalmia)
|
What is the role of Vitamin D (hormone, steroid and vitamin) in calcium metabolism |
Regulation of calcium metabolism:
stimulates cells of the small intestine to produce, calbindin, a calcium binding protein to raise calcium absorption
stimulates kidneys to conserve calcium, decreases urinary calcium excretion
Stimulates calcium release from bone to increase blood levels |
What are potential reasons for increased vitamin D needs in older adults? |
- decreased ability to convert vitamin D into its active form
- decreased ability to have adequate exposure to the sun. (nursing homes) |
Dietary and non-dietary sources of Vitamin D |
Natural sources:
Cod liver oil
mushrooms exposed to UV light
sardines, salmon
shrimp, liver
Fortified foods: *provide majority of Vitamin D*
milk and margarine
cereal
juices
*Cheese and yogurt are NOT fortified* |
Making your own vitamin D |
*Human body makes Vitamin D with adequate exposure to sunlight through a series of steps*
Cholesterol in skin combines with UV rays
Converted into precursor of Vitamin D (SYNTHESIS)
Makes its way to the kidneys where it is converted to active Vitamin D3 (ACTIVATION) |
Chronic conditions associated with deficiency of Vitamin D |
-heart disease
-respiratory infections
-diabetes
-hypertension
|
Individuals at risk for low Vitamin D |
Children:
- Rickets (softening/deformity of long bones because of the inability to deposit calcium in newly formed bones)
- Malformation of skull, rib cage, and end of long bones
Adults
- Osteomalacia (softening of bone caused be decalcification)
|
Factors that influence Vitamin D synthesis |
Distance from equator (the further away from equator the less direct UV rays are)
Clothing coverage on body
Use of sunblock
Cloud cover, smog
Skin color
Age
|
What are the primary functions of Vitamin E |
1. works as an antioxidant by neutralizing free radicals that can damage cell membranes, DNA, and proteins
2. enhances immune function
3. required for nerve cell develpoment
---in the past, use of vit E was thought to protect against cancer and CVD |
What population is at greatest risk for Vitamin E deficiency and Why? |
Premature infants because of unstable conditions |
What are the functions of Vitamin K |
Blood Clotting
Activates proteins required to make Fibrin (forms blood clots)
Also requires for the bone protein synthesis: Osteocalcin |
What population is at greatest risk for vitamin K deficiency? |
New borns (rare in adults)
because sterile GI tract and breast milk is a poor source of vitamin K
*shot given at birth*
|
Functions of Vitamin C |
*aka Ascorbic acid*
Acts as an antioxidant in immune system health
Synthesis of collagen
Facilitates iron absorption in GI |
What condition is caused by vitamin C deficiency? |
- scurvy
- anemia (due to poor iron absorption)
- scorbutic rosary
|
What group has an increase requirement for Vitamin C? |
Smokers |
3 sources of Vitamin C |
Orange juice, fruits and veggies (citrus fruits, strawberries, sweet potatoes, brussel sprouts) |
Deficiency of Thiamin (B1) |
In malnourished people:
Beriberi - A condition in which heart becomes enlarged, fluid accumulates beneath skin
and muscles weaken and atrophya
Wet beriberi (CVD) and Dry beriberi (nervous system)
In Alcoholics:
Wernicke-korsakoff syndrome |
Deficiency of Niacin (B3) |
Pellagra - symptoms referred to as the 4 Ds
(diarrhea, dermatitis, dementia, death)
*major problem in 1900s because their diet was void of niacin (ex: grits and molasses)
|
Deficiency of Folate (B9) |
inability to synthesize DNA during folate deficiency
Deficiency during pregnancy
Spina bifida: Failure of spinal cord to close completely
Anencephaly: Lack of/incomplete development of brain and skull
BOTH are known as Neural tube defect |
Deficiency of B12 |
Macrocytic anemia or pernicious anemia (if due to lack of intrinsic factor b/c of genetic defect, aging, portion of stomach removed) |
Primary Function of Vitamin B6 |
Participates in diverse biochemical reaction
Main Function: Synthesis of nonessential amino acids (transamination)
Other Functions:
Synthesis of glucose, production of serotonin (neurotransmitter), hemoglobin synthesis
*B6 deficiency can lead to anemia |
Primary Function of Folate (B9) |
FUNCTION: Cell Division (DNA replication requires folate for cell division)
affect red blood cell synthesis and central nervous system formation during fetal development
|
Primary Function of B12 |
ESSENTIAL in converting folate into the active form
Maintains myelin sheath (insulating lining that covers nerve fibers) |
Sources of Vitamin B12, folate, folic acid. |
B12 - foods from animal orgin
Folate - OJ, Legumes/lentils, leafy greens
Folic Acid - supplements and enriched grains
Biotin |
B12 absorption |
B12 has to be released from dietary protein before its can be absorbed...when it has released, vitamin B12 is bound to the protein secreted in the stomach (R binder protein)
*absorption occurs in lower ileum
|
Individuals at risk for vitamin B12 deficiency |
Vitamin B12 absorption decreases during aging
Because ↓ intrinsic factor, ↓ hydrochloric acid secretion, and ↓ ability to release from protein
*50+ year olds are recommended to take B12 supp.
|
Enrichment |
Restoration of micronutrients originally present in food but were lost during processing
*Mandatory in products containing milled, refined, or polished grain-based ingredients
|
Fortification |
Addition of vitamins and minerals to foods in which the vitamin/mineral is not naturally present
*mandated in milk (vitamin A and D) and enriched cereals and grain products (folic acid)
* makes significant contribution to daily vitamin intake
|
B vitamins that are added back to processed grains |
B1, B2, B3 ( thiamin, riboflavin, and niancin) |
Macrominerals |
Present in larger amounts
about 5 grams
Recommended intake of ≥ 100 mg
Example: Calcium, Phosphorous, potassium, chloride, Sodium, sulfur, magnesium (CCPPSSM)
|
Microminerals |
smaller amounts
less than 5g
less than 100mg
Example: Zinc, iron, copper, iodine, manganese, selenium
|
Describe Blood Calcium regulation when it is low |
*most abundant mineral* (99% in bones)
Blood levels of calcium regulated by:
Vitamin D and parathyroid hormone (PTH)
*Bone may be sacrificed when blood levels of calcium are low*
When blood calcium is low, PTH increases to release calcium from bone |
Functions of Calcium |
Main Function: building and maintenance of bone |
3 sources of Calcium |
Dairy products mainly but...
Broccoli
Turnip greens
canned sardines
salmon with bones
green leafy vegetables (except spinach) |
Primary functions of Magnesium |
*smallest macro mineral
- bone serves as a store of magnesium
Function:
Maintenance of DNA and RNA integrity (works with phosphorus)
ATP stabilization
Facilitates muscle contraction
calcium - contraction
magnesium - relaxatio |
Primary Function of Phosphorous |
*deficiency in healthy people is rare
(2nd most abundant- 85% in bones)
Roles:
Part of bone and teeth
Facilitates enzyme function
ATP component ("usable form of energy"
Phospholipid component
Acid-Base balance (acts as a buffer) |
Primary Function of Sulfur |
- bright yellow
- used in remedies
Functions:
Primary storage site for sulfur is in amino acids methionine and cysteine
Key element in glutathione (strong antioxidant)
added to foods as sulfite for preservation or flavoring |
What minerals are involved with bone health? |
Calcium, phosphorous, magnesium |
3 modifiable and non-modifiable risk for osteoporosis |
Non-modifiable: female gender, old age, small frame, Caucasian or Asian, family history, estrogen deficiency)
Modifiable: sedentary life style, diet, smoking, excess alcohol consumption, low body weight, medication |
Risk factors of pre-eclampsia |
Those at risk:
overweight women, pregnant teenagers, women with low calcium levels
Can lead to eclampsia
*Women with pre-eclampsia who increased calcium intake lowered their BP
|
Dietary and Non-dietary factors that affect absorption of minerals |
Plant based foods decrease absorption of minerals. .
Factors that can increase calcium absorption:
Frequency and quantity of calcium consumed
presence of milk sugar (lactose) in gut
Increased need for calcium (periods of growth, pregnancy, lactation)
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Identify the role of Iron in the body |
Assist in delivery of O2 to tissues and cells
• found in hemoglobin of red blood cells, which carries O2 to cells and tissues and picks up CO2 |
Heme vs. non-heme iron food sources |
Heme Iron (form found in hemoglobin): Only found in meats, fish and poultry *More readily absorbed in body
Non-heme Iron (elemental form of iron, not in hemoglobin): found in plant-based and enriched foods
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Iron absorption |
*Iron absorption ↑ when body stores are low
Factors that ↑ non-heme iron absorption:
Vitamin C and presence of meats, fish and poultry
Factors that ↓ absorption:
Tannins (coffee, tea)
Phytates (whole grains, seeds, nuts, and legumes) |
Individuals with increased iron requirements |
Women (19-50) because of iron loss during menstruation
Pregnant women because of developing fetus |
Functions of Zinc |
Development of sexual organs and bone growth
Alcohol metabolism
Antioxidant enzyme function
Blood pressure regulation
Insulin release and function
DNA replication
Protein synthesis, growth and development
Immune function
Hemoglobin synthesis |
What factors hinder and enhance zinc absorption |
Like iron, zinc absorption ↑ when: Meat, fish, and poultry present in diet
Absorption depends on body’s needs
When sufficient body stores exist, the small intestine makes protein to bind zinc and prevent absorption
Also found in legumes and whole-grain cereals • absorption ↓ due to presence of phytates |
Two symptoms of zinc toxicity and deficiency |
• Dwarfism in young teens, particularly males
• Poor sexual development (underdeveloped testes in males)
• Deformed bones
• Abnormal hair and nails; loss of hair
• Poor wound healing
• Hypogeusia - Reduced ability to taste food
• Gastrointestinal disturbances
• Impaired folate and vitamin A absorption
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Primary Function of Copper |
Needed for absorption, storage, and metabolism of iron
Primary functions of copper:
Iron use and incorporation into hemoglobin and RBCs
Antioxidant defense against free radicals
Strengthening collagen and, therefore, connective tissue
Immune defense
Synthesis of neurotransmitters
Energy production via ATP synthesis |
What factors hinder copper absorption |
too much zinc |
What is the primary role of iodine |
Facilitates production of a hormone (thyroxine) in thyroid gland
controls basal metabolic rate
*****IN NECK
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Iodine Deficiency |
an enlarged thyroid (goiter)
Deficiency in pregnant women may cause offspring to have stunted height and developmental delays (cretinism)
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2 sources of Iodine |
sea food and iodized salt |
Primary function of selenium |
Supports body’s antioxidant defense system
Part of the antioxidant enzyme, glutathione peroxidase
ESSENTIAL for good health and disease prevention |
rimary function of fluoride |
Fluoride strengthens crystals in teeth and bone (made up of calcium and phosphorus)
Results in hardening of tooth enamel
Increases resistance of teeth to tooth decay |
What population is recommended to take a chromium supplement? |
Diabetics to help regulate blood glucose |
Leading nutrient deficiency |
iron |
Potential causes of anemia |
Causes of iron-def anemia:
low iron
low copper
blood loss
other causes: deficiency of vitamin B6, B9, B12, or chronic disease
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Which nutrients does RDA increase and remain the same during pregnancy |
INCREASE:
Protein
Carb
Essential Fatty Acids
Polysaturated fats (in nuts oils, and whole grains)
Vitamins and minerals
STAY SAME: Total Fat intake |
What are the components of maternal weight gain during pregnancy? |
baby
amniotic fluis
placenta
uterus
breast
body fluids
30% increase in blood volume
Maternal stores of fats, protein, and other nutrients |
Negative impact of caffeine, alcohol, and smoking during pregnancy |
Caffeine: travels through the placenta and can affect fetal heart rate and breathing
Alcohol: Fetal Alcohol Syndrome (FAS) (Retardation, fetal abnormalities, and central nervous system dysfunction (CNS)
Smoking: Increase risk for preterm delivery, miscarriages, smaller birth rate, and impair blood flow to fetus, decrease nutrient and O2 delivery |
Identify food borne illnesses of greatest concern during pregnancy |
Listeria (found in uncooked meats and vegetables, unpasterized milk, and ready to eat foods)
Toxoplasma (parasite found in undercooked meats and cat liter) |
Benefits of breast feeding |
Benefits for the Mother:
loses weight faster
stronger bond with baby
decrease risk of breast and ovarian cancer
saves money
Benefits for New Borns:
- Less likely to experience...
Allergies/intolerances
ear infection
vommitting and diarheaa
respiratory disease
meningitis
reduce obesity |
how does the composition of breast milk differ from the composition of infant formula?
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Breast milk contains more protein and antibodies |
What is colostrum? |
Milk produced by the mammary glands of mammals in late pregnancy, right after giving brith |
Describe the recommendation for feeding an infant during the 1st year of life |
Exclusively breast feed for 1st 6 months
Continued supplemental breast feeding for up to a year
No additional benefit after 1 year old |
Describe the expected rate of growth for infants |
2x birth weight by 4 -6 months
3x birth weight by 1 year |
Identify nutrients of concern for infants |
Iron, zinc, Vitamin A and B. |
Identify foods with choking hazards for infants |
hot dog
whole grapes
nuts
popcorn
carrots
small candy
dried fruit
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Describe the rate of growth in children |
Rapid then slows until puberty |
How do calorie requirements during childhood change in terms of calorie per kg per day |
Calorie and Protein per kg needs increase in initial years of childhood and decrease as child ages. BUT TOTAL CALORIE AND PROTEINS NEEDS INCREASE |
Recommendations for getting a child to try new foods |
Color, flavor, texture, temperature, serving size
Attitude of server |
Which group of children is at greatest risk for iron-deficiency anemia |
Children in low income families.
Food sources: lean meat, peanut butter, fortified breakfast cereals, apricots |
Describe lead toxicity and why it is a concern for children |
Lead toxicity is another cause of anemia (inhibits iron absorption) |
Causes of Obesity in children |
physical inactivity
more "screen time"
larger portion sizes
food advertising directed to children
using food as a reward |
Describe how overweight and obesity is classified for kids |
BMI-for-age growth chart (age 2 to 20) |
Changes in growth that occur during adolescence |
Hormone change
Puberty (sex hormones produced)
boys gain more lean tissue than fat
boys get heavier skeletons |
What is the impact of calcium and iron on growth and development |
Calcium is need to support bone mass. Iron: particularly in girls b/c of blood loss during menstrual, girls consume less meat, and also diet for weight loss |
Identify poor eating habits commonly seen in teens |
skipping meals
inadequate consumption of calcium-rich foods
nutrient poor food selection away from home
Diet
Alcohol use ( B vitamin deficiency) |
List social, psychological, physical, and physiological aspects of aging and the impact it has on nutrition |
living alone
lack of motivation to cook meals
Depression
over or under eating
Anxiety
reduction in digestive secretions
Economic constraints
less likely to buy lean meats, fish, and fresh produce |
Identify the most likely causes of anemia in the elderly |
Hospitalized adults are malnourished
Little or no appeitite
Problems chewing or swallowing
eating fewer than 2 meals a day |
Describe how medications can lead to nutritional deficiency in the elderly |
Reduce appetite
Decrease absorption and utilization of some nutrients
increased nutrient excretion
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