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Nutrition Final
Mercy College of Ohio
| Question | Answer |
|---|---|
| recognize why we eat? | |
| what stimulates you to eat? | |
| The food industry influences our food choices | we are all influenced by our environment and the food industry plays a major role in making certain foods readily available |
| The food industry's priority is to make money. It's priority is not your health | The food industry attempts to manipulate you to spend money and buy their products. |
| the majority of new annual food products are made from cheap unhealthy materials accompanied with irresistible marketing. | |
| generally the foods that are readily available are high Calories, high fats, unhealthy foods that taste good | |
| our culture is also designed for convenience-so physical activity is naturally at a minimum | cars computers on-line shopping drive through remote controls |
| how do we combat the evil forces against us??? | |
| how can you avoid eating unhealthy readily available foods? | |
| how can you combat the convenience of our society by introducing physical activity into your day? | |
| overview of nutrients | |
| all food nutrients can be broken down into tow categories | a. organic molecules b. inorganic molecules |
| organic molecules | composed of carbon and hydrogen generally do not dissolve in water if they do dissolve, do not release ions (non-electrolytes) |
| Examples of organic molecules which serve as nutrients | a. carbohydrates b. lipids (fats) c. proteins d. vitamins e. phytochemicals f. fiber |
| inorganic molecules | dissolve in water to release ions (electrolytes) |
| two examples of inorganic molecules | minerals and water |
| energy (ATP) yielding molecules | this means that the chemical energy storied in the molecular bonds of the molecule can be converted into the body's energy molecule: ATP 1. Carbohydrates 2. lipids (fats) 3. proteins |
| Energy Yielding reactions | these three groups of molecules are broken down by the following processes to yield byproducts that will enter the kreb cycle. a. Proteins--> deamination b. Fats--> beta oxidation c. carbohydrates --> glycolysis |
| In order for these reactions to proceed, the body's cells require enzymes | |
| Why should you consume vitamins and minerals? | Enzymes require coenzymes (vitamins) and cofactors (minerals) to work. If you do not have these nutrients in your diet you are not able to release the energy in the carbs, protein and fat. |
| nutrient dense | most important foods to include in your diet are nutrient dense foods. b. whole foods (not processed foods) c. provides adequate energy and nutrients while preventing overeating d. Nutrient density: foods that deliver the highest nutrient values (vitamins, minerals, phytochemicals, fiber ) per cal |
| Good foods | calories and phytochemicals and vitamins and minerals and fiber b. the more these foods have of the extra ingredients, the more nutrient dense they are. BAD FOODS a. only calories b. added fat, sugar, salt |
| vegetables are the most nutrient dense foods available | |
| Essential Nutrients | substances that cannot be synthesized at all or cannot be synthesized in great enough quantities to maintain homeostasis of the body, and must come from the diet. |
| Essential Nutrients Continued... | omission of essential nutrients leads to decline in health. b. the body regains normal function when essential nutrients are restored to the diet. c. essential nutrients have specific biological functions |
| What is a calorie? | a. measurement of energy b. the amount of heat it takes to raise the temperature of 1 gram of water by 1 degree Celsius c. 1,000 calories = 1 kcal= 1 food calorie |
| Calorie = Energy | a. carbohydrate: 4 cal/g b. fat: 9 cal/g c. protein: 4 cal/g |
| contribution to total cal | a. one day's intake (1980 Cal) b. 290 g of carbohydrate (x 4 cal/gm) c. 60 g of fat (x9 cal/gm) d. 70 g of protein (x 4 cal/gm) e. % of CAl as carbohydrate = (290 x 4) /1980 = 0.59 or 59% f. % of Cal as fat = (60 x 9) /1980 = 0.27 or 27% g. % of Cal as protein = (70 x 4) /1980 = 0.14 or 14% |
| alcohol | a. 7 cal/g ethanol b. can be converted to body fat c. usually accompanied by a high carbohydrate content |
| nutrition guidelines | dietary reference intake: major revision fo the RDA |
| RDA | estimated needs of healthy persons based on scientific evidence, to protect against nutrient deficiencies. DRI has broadened this goal to include prevention of chronic diseases, etc. |
| adequate intake | values set by scientific hypotheses (whenever scientific evidence is insufficient to generate an RDA). |
| Estimated average requirements | a. values which establish population-wide average requirements for nutrition policymakers. b. the amount of nutrient that will maintain a specific biochemical function in half the people of a given age and sex group. |
| tolerable upper intake levels | a. upper limits of intake or nutrients posing a hazard when consumed in excess. b. valuable information when considering taking supplements. c. used for public health officials who set allowances for nutrients that are added to foods and water. |
| Nutrition Guidelines (Dietary Guidelines) | a. emphasize prevention of over-nutrition b. over-nutrition and relation to chronic diseases c. emphasize the importance of physical activity. |
| fitness guidelines | a. published by the American college of sports medicine b. different guidelines for fitness vs Health benefits c. physical activity promotes health and prevents disease |
| guideline for physical fitness | a. cardiovascular: 20-60 mins - 3-5 days/wk - aerobic activity using large muscle groups -55-90% of maximum heart rate b. strength - resistance activity 2-3 days/week c. flexibility -2-3 days/wk |
| Be physically active each day | |
| Diet-planning principles (ABC) | 1. adequacy: enough energy, fiber and nutrients to meet daily needs. 2. Balance 3. calorie control |
| A. Diet-Planning Principles | 4. nutrient density: foods that deliver the highest nutrient values (vitamins, minerals, phytochemicals, fiber) per cal b. provides adequate energy (cal) and nutrients while preventing overeating c. nutrients refer to the amount of vitamins, minerals, phytochemicals and fiber contained within the food. The more of these nutrients per cal the more nutrient dense the food-the better it is for you. |
| Diet-Planning Principles continued... | 5. moderation- prevent overeating 6 Variety- no food is guaranteed entirely free of constituents that in excess could harm you, by varying foods you ensure that your total diet will have diluted concentrations of any contaminants that may be present in the foods available to you |
| D. Food group plans | 1. food groups: group foods into cluster that make the same key nutrient contributions. 2. Miscellaneous foods: foods not included in the groups because they make no nutrient contribution. 3. Daily food guide: Figure 1-4 4. New food pyramid My Pyramid.go |
| E. Nutritional surveys: used to assess population health - malnutrition obesity - health care costs | |
| A nutritional labeling | A. Information 1. common name of product 2. name and address of manufacturer 3. amount 4. **the ingredients, in descending order of predominance by weight |
| B Nutrition Label: Nutrition facts | B. Nutrition facts 5. standard serving size 6. number of servings per container 7. food energy per serving (cal/serving) 8. Fat grams w/breakdown of saturated fat and cholesterol 9. sodium 10. total carbohydrate, protein, fiber 11. vit A, C, Ca, Fe % of Daily values for a person requiring 2000 cal/day |
| C. Health claims: FDA sets strict guidelines for claims | 1. fats and sodium in foods that make health claims are controlled by law. 2. can contain no more than 20% of the daily value 3. Table 1-8 4. Health claims are an asset to the consumer who does not want to worry about grams, percentages, etc. |
| Evaluating claims | www.eatright.org www.acsh.org www.quackwatch.com www.ncahf.org www.dietary-supplements.info.nih.go www.fda.gov www.navigator.tufts.edu |
| studies | laboratory animal experiments; human studies; case-control study; double-blind study; peer review; follow-up studies |
| carbohydrates | primary energy source for the body - carbohydrates have been getting a bad rap in the media. AT this end of this week, be able to explain why this is the case |
| human brain depends exclusively on glucose as it's energy source | |
| recommended carbohydrate intake | 45-65% of total energy intake Ex: 2000 cal/day = 900-1300 cal/day = 225-325g/day |
| all carbohydrates are made up of sugar | |
| good carbs | sugar, phytochemicals, fiber, vitamins, minerals |
| bad carbs | sugar, added salt, added fat |
| simple carbohydrates (monosaccharides) | 1. glucose: chief energy source 2. fructose: sweetest, found in fruits 3. Galactose: found as part of milk sugar (lactose) |
| Disaccharide | 1. sucrose: table sugar, honey glucose and fructose 2. lactose: principle carbohydrate of milk glucose and galactose lactose intolerance- loss of lactase 3. maltose: plant sugar (sprouts) glucose and glucose |
| polysaccharides (a string of glucose moleucles) | |
| complex carbohydrates Polysaccharides 3 types (a string of glucose molecules) | 1. starch: made by plants and is digestible by humans and is a source of energy. 2. glycogen: storage form of carbohydrates in the human body. Stored in the liver and skeletal muscles. Provides short-term available energy. Glycogen is not a significant food source. 3. cellulose: made by plants and is not digestible by humans and therefore not a energy source. |
| fibers | a. a types of polysaccharide-cellulose b. make up plant cell walls c. non-digestible by humans d. serve many important functions |
| fibers functions | 1. relieve constipation and hemorrhoids, solidify stools 2. stimulate muscle contraction of intestine keeping it toned and preventing diverticulosis. 3. reduce risk of colon cancer. 4. bind cholesterol and carry it out of the body with the feces (heart disease) 5. delays emptying of stomach--> slows glucose absorption (diabetes) 6. weight control |
| glycemic index | a. ranking of foods based on how quickly they are broken down to glucose and absorbed. b. healthy foods have low glycemic indexes. c. good carbohydrates vegetables, whole grains and fruits have low glycemic indexes. |
| glycemic load | a. takes into account a food's glycemic index and how much carbohydrate the food delivers in a single serving b. GL = (GI x carbohydrate/serving)/100 c. Low GL =<10 d. Intermediate GL =11-19 e. High GL = >20 |
| phytochemicals | the good carbohydrates which comprise vegetables, whole grains, and fruit also contain |
| examples of phytochemicals | isoflavones, lignans lycopenes, indoles, isothiocynates, saponins, tannins, phytic acid, ellagic acid |
| phytochemicals | a. know the best way to ingest phytochemicals. b. know why phytochemicals are important. c. know which foods contain these groups of phytochemicals and know their functions. - flavonoids -carotenoids -lycopene |
| It is best to eat whole foods | - it is better to get your nutrients from whole foods rather than from supplements. - a whole is greater than the sum of its parts - there are emergent properties that occur from eating the whole food that you do not get when you just eat parts of the food. - we are just learning about phytochemicals- if you take a vitamin and eat junk food you are missing out on these important nutrients, as well as, the fiber and other nutrients that we have not yet learned about. |
| It is best to eat whole foods continued.. | the concentrations of these nutrients in whole foods are also in the correct amounts. they are not a guess, as they are in supplement form |
| Carbohydrate and health | sugar: consumption of concentrated sugar should be reduced to 10% of total intake. Fruits, vegetables and grains should predominate. |
| how much of the grains, vegetables and fruit are enough? | a. check your pyramid plan and record the servings you should be eating. b. gains-whole grains c. substitute good foods for bad. Don't just add calories to try and rectify a bad diet. |
| Eat more vegetables | |
| carbohydrates- pros | a. provide energy for brain b. provide most efficient energy source for the body c. provide vitamins, minerals and phytochemicals and fiber |
| carbohydrates- cons | a. comprise junk foods b. consumption of too much will be converted to fat c. consumption of too much may be related to insulin sensivity |
| Carbohydrate digestion | a. mouth--> salivary amylase b. small intestine--> enzymes on the surface of the small intestine cells break disaccharides into monosaccharides for absorption c. pancreas produces pancreatic amylase into small intestine d. fiber--> mostly passes intact through the GI tract to colon |
| what is sugar's relationship to the following? | 1. obesity 2. diabetes -obesity is a major factor causing type II diabetes, sugar may be a causative factor when it contributes to obesity. High glycemic load foods may contribute to insulin resistance. EAT food with low glycemic load. 3. heart disease - moderate sugar intake should not influence heart disease. |
| what is sugar's relationship to the following continued... | 4. behavior: lack of nutrients in children's diets, not sugar itself, can lead to undesirable behavior. 5. dental caries - bacteria that live in the plaque on teeth will consume and metabolize carbohydrates, producing acids. acid dissolves the tooth enamel. a. bacterial action is maximal in the first 20 min after the first contact b. sticky foods cause more tooth decay. c. saliva protects against tooth decay: alkaline pH, rinses and dilutes |
| complex carbohydrates: especially vegetables and grains | a. diet high in complex carbohydrates and low in sugar are low in fat, low in cal., high in fiber, vitamins and minerals, phytochemicals. b. these factors reduce the risk of obesity, cancer, C.V. disease, diabetes, tooth decay and malnutrition |
| E. alternative sugars sweeteners | 1. sugar alcohols (ex. mannitol, maltitol, sorbitol) a. yield equivalent energy 2-4 cal/g, as carbohydrates b. absorbed or metabolized slower c. side effects: gas, diarrhea, etc d. do not contribute as heavily to carie formation |
| Alternative sugars sweeteners continued... | 2. artificial sweeteners a. provide no energy b. do not promote tooth decay c. examples - saccharin aspartame sucralose d. weight control: should be used to replace sugar, not in addition to sugar e. moderation |
| Diabetes Mellitus | |
| Diabetes Mellitus | a. insulin deficiency or insulin resistance - insulin is needed by most cell types in order to utilize glucose b. Exceptions - brain -absorption via digestive tract - exercising muscle can utilize glucose without proportionate amounts of insulin. |
| Type 1: Insulin-dependent diabetes (juvenile diabetes) | a. absolute deficient of insulin b. auto-immune disorder c. requires replacement therapy d. onset acute e. accounts for 5-10% of diagnosed cases of diabetes. |
| Type 2- non-insulin dependent diabetes (adult onset diabetes) | a. decrease availability of insulin b. insulin resistance (response to insulin is less sensitive) c. diet/drug therapy d. onset insidious e. accounts of 90-95% of diagnosed diabetes cases. f. obesity is a big risk factor g. this disorder used to exhibit itself only in adult. With the rise in obesity there ahs been a prevalence of childhood cases |
| development of diabetes | a. insulin deficit results I decreased glucose transportation and use in many cells. b. hyperglycemia: blood glucose levels rise c. glucosuria: excess glucose spills into the urine as the level of glucose in the filtrate exceeds the capacity of the renal tubular transport threshold. d. polyuria: glucose in the urine exerts osmotic pressure in the filtrate, resulting in large volume of urine excreted with loss of sodium, other electrolytes and fluid. |
| development of diabetes | a. dehydration due to fluid loss--> nonketotic coma b. polydipsia--> increased thirst c. polyphagia--> lack of nutrients in the cells stimulates appetite. d. catabolism of fats and proteins to meet cellular needs. Leads to the buildup of Ketones (acetone, beta-hydroxybutyric acid, acetoacetic acid) |
| development of diabetes continued.. | a. ketoacidosis (may lead to)--> decompensated metabolic acidosis (may lead to )--> coma/death b. dawn phenomena: early morning hyperglycemia resulting from excessive secretion of counter-regulatory hormones that act to raise blood glucose after and overnight fast. |
| signs/symptoms of diabetes | a. polyuria (nocturnal) b. polydipsia c. polyphagia d. weight changes: -type1: weight loss -Type2 : initial gain and then moderate weight loss |
| Signs/symptoms of diabetes continued... | hypoglycemia: due to inappropriate management of diabetes. Ex: - too much insulin -medication -physical activity -delayed meals |
| metabolic syndrome | Syndrome X: exhibits as a combination of: -insulin resistance - obesity - HTN - elevated LDLs and reduced HDLs - cardiovascular disease - Type II diabetes |
| metabolic syndrome pg. 535-537 | what causes metabolic syndrome? What is the treatment? |
| Tests | a. fasting blood glucose b. glucose tolerance c. glycosylated Hb: As blood glucose rises, glucose attaches to hemoglobin (Hb) molecule and remains there until the red blood cell carrying the Hb dies. This test reflects diabetes control over the past 2-3 months, rather than just prior to the test. |
| treatment | a. Diet (reduce simple sugars) -Parallels that for a healthy individual -carbohydrates have the greatest effect on blood glucose levels. Raise within the hour after ingestion. (45-60% of total intake) 1. eat low glycemic index - carbohydrates throughout the day |
| Diet-proteins | a. raise blood sugar very slowly and in small amounts b. 20% of total intake c. first sign of kidney disease- limit protein |
| diet- fats | a. are not converted into glucose in any significant amount (30% of total intake; <105 from saturated fat) - if LDLs are elevated or the client has CV disease, restrict fat |
| Other diet concerns | a. consistent timing and composition of meals b. sodium: 2400mg/day unless hypertensive, then sodium must be decreased. |
| diet continued | a. alcohol: consumed only with consent of physician 1. no more than 2 drinks per day with meals 2. avoid alcohols with simple sugars 3. substitutes for fat exchanges or avoid if obese. |
| diet | a. illness causes an increase in blood sugar (due to the stress effect). Diabetics should decrease carbohydrate intake moderately during illness. b. development of hypoglycemia: ingest 10-15g carbohydrates - readily available to eat - avoid foods that also contain fat because it slows down the absorption of sugar. |
| meal planning strategies | a. strictly define potion sizes and use exchange lists b. see page 522-524 c. see appendix C d. diabetes exchange lists-groups foods based on how many carbs, fat and protein grams they possess |
| Exchange lists | Carbohydrates 1. starch 2. fruit 3. vegetables 4. milk See Table C-1 in appendix C |
| exercise | Type II a. improves blood glucose control b. contributes to weight loss c. improves blood lipid levels d. lowers blood pressure Types I and II a. benefits the cardiovascular system |
| concerns of diabetics in regards to exercising | a. diabetics should check blood glucose level before and after exercise b. blood glucose should not be too low ( hypoglycemia c. blood glucose should not be too high (> than 300mg/100ml of blood)--> exercise will cause it to go even higher d. well hydrated |
| Drugs | a. all type I diabetic's need insulin b. Type II can usually control their diabetes with diet and exercise. Medications do not replace these lifestyle changes - if you have ever watched "the biggest loser" on TV- you have seen individuals improve their Type II diabetes status by exercising and loosing weight) |
| Drugs (tables 20-6 and 20-7) | a. oral hypoglycemic drugs- stimulate increased secretions by the pancreas b. enhance uptake reducing insulin resistance c. reduce the rate of carbohydrate and sucrose digestion in the intestine. d. Insulin and insulin analogs (lispro) table 20-6 on page 525 |
| Insulin injections | a. insulin is a protein-can not be taken orally b. multiply daily injections: mixture of two or more types 3 or more times a day c. external pumps--> insulin enters through a needle in the abdominal area. d. an intermediate acting insulin would be given to mimic the baseline release and a fast acting insulin to process energy needs after a meal. |
| chronic complications: increased blood sugar damages blood vessels and nerves | a. microangiopathy: destruction of small vessels--> poor circulation leads to degenerative tissue changes: such as ulcers. b. nephropathy: loss of kidney function c. retinopathy: retinal degeneration |
| Chronic complications | a. Macroangiopathy -HTN and CV disease b. neuropathy - nerve tissue degenerates. Itnitial painful prickling sensation --> to a loss of sensation. Injuries and infections go unnoticed. c. infection d. cataracts |
| Insulin therapy can not achieve the same degree of blood glucose control as a body that produces its own insulin | |
| Other complications | CHILDHOOD: unpredictable eating and exercise patterns/ growth ELDERLY: risk because of reduced appetite, altered thirst, altered organ function, depression, mental deterioration, multiple medication use |
| Gestational Diabetes | a. most common medical complication of pregnancy b. women who experience this are likely to develop Type II diabetes later in life, especially if they become overweight. c. Their offspring also have a higher change of developing Type II diabetes. |
| Pregnancy: | a. normally there is increased insulin which promotes food storage for support of the fetus. b. cells gradually become resistant. As the mother's cells become resistant she develops gestational diabetes. c. there si an increase in counter-regulatory hormones in the mother: cortisol, progesterone, prolactin, lactogen. These signal her body to stop storing food and allows the fetus to take up energy for growth |
| uncontrolled diabetes in early pregnancy | a. increased risk of spontaneous abortion. b. infants exposed to high blood glucose and ketones cause birth defect c. high blood glucose--> overfeeds the growing fetus--> large infant and difficult delivery. d. Baby responds to increase in blood glucose by increasing it's own insulin --> hypoglycemia after birth |
| one of life's mysteries is how a two pound box of candy can make someone gain five pounds | |
| you probably know the answer! | a. how many calories of fat would you need to eat to gain a pound? b. this of course is different from the actual weight of the chocolate |
| recommendations for Fat intake | 20-35% of total energy intake. Not to exceed 35% |
| Body functions of lipids | 1. primary component of the cell membrane 2. forms some of the hormones in the body 3. secondary source of energy for the body 4. insulation 5. cushions vital organs 6. slows digestion 7. needed for absorption of vitamins: A,D,E, K (fat soluble vitamins) |
| Chemistry | triglycerides "fats" Structure: Glycerol molecule and 3 fatty acids |
| fatty acids: | a chain of carbon atoms with hydrogen attached and an acid group at one end |
| fatty acid chain length and saturation | monounsaturated F.A. Polyunsaturated F.A. (PUFA) |
| Hard v. soft fats | soft: short chain f.a., unsaturated Hard: longer chain, saturated |
| Essential fatty acids (good fats) | this type of fat should make up the majority of your fat intake |
| polyunsaturated fatty acids divides into omega-3 (alpha-linolenic acid) and omega-6 (linoleum acid. The omega 3 divide into docosahexaenooic acid and Eicosapentaenolic acid. Omega-6 is further broken down into arachidonic acid | |
| linoleic | omega 6 fatty acid |
| linolenic | omega 3 fatty acids EPA (eicosapentaenoic acid) DHA (docosahexaenoic acid) structural lipid in the brain |
| functions of omega 3 and 6 fatty acids | a. both needed for brain development b. active in rods and cones c. needed for normal growth and development d. prevention of heart disease, hypertension, arthritis, cancer |
| omega-3 supplements | it's best to eat the whole foods that contain omega-3 fatty acids. |
| Example of Omega 3 fatty acids | fish, walnuts, flax seed, eggs from free range chickens |
| hydrogenation of fat acids trans-fatty acids | trans- artificial: bad fats cis-natural: good fats |
| in 2006 nutrition labels were changed to list the amount of trans-fatty acids contained in the food. Restaurants are not required to label their foods. - worst offender: Kentucky fried chicken | |
| hydrogenation of fats | a. negates any benefit of the original unsaturated fat b. results in a trans-fat c. has many negative health consequences |
| energy production from fatty acids | a. breakdown reactions of fat in the body, occurs through a process called: BETA OXIDATION, during this process fatty acid chains are broken down into segments of 2 carbons each |
| Beat oxidation | 2 carbon compounds derived from eh fatty acid--> acetyl CoA--> Karen cycle --> electron transport chain --> ATP a. usually too many 2-C segments to be utilized in making ATP b. Excess 2 carbon segments --> ketone bodies (ketone bodies are a toxic waste product with will change the pH of the cell and decrease metabolism.) c. beat oxidation occurs int he mitochondria of the cell. |
| phospholipids | 1 structure: Glycerol + 2 fatty acids + choline 2. Roles: a. major component of the cell membrane b. emulsifiers: keeps fats in solutions |
| sterols | structure: large, complex interconnected rings of carbon Examples: cholesterol, vitamin D, sex hormone (testosterone) Cholesterol synthesis happens in the liver |
| sterols | 4. cholesterol's 2 routes in the body a. bile b. bloodstream--> body cells 5. cholesterol recycled: as reabsorbed bile 6. cholesterol excreted: in the GI tract can be carried out by soluble fibers 7. Blood transport: lipoproteins |
| Transport of fat from the small intestine | a. lymphatic lacteals int he villi of the small intestine carry away absorbed fats --> lymphatic system b. no pump, lymph moves by being squeezed as skeletal muscle around it contract this is one of the main reasons to exercise c. lymph -->heart-->circulatory system-->cells of the body-->liver d. (all other nutrients (protein and sugar) go to the liver first) |
| transport of lipids: fats are carried in the body by proteins (lipoproteins) | 1. chylomicrons: diet-derived lipids from the intestine 2. VLDL : mostly lipids |
| lipoproteins | 3. LDL : contains lots of cholesterol 4. HDL: more protein **body tissues --> liver |
| Ratio of LDL:HDL | 0-4.5 LDL: 62-185mg/100ml HDL: 30-80mg/100ml |
| don't believe everything you read in the magazines | |
| fats and health | excessive intakes of dietary fats contribute to many diseases including obesity, diabetes, cancer, CVD |
| Fats and fatty acids | a. total fat and saturated fat raise blood cholesterol. They are the amin dietary determinants of blood cholesterol b. elevated blood cholesterol is a major risk factor for CVD. |
| fats and fatty acids | 2. Omega-3 lower blood cholesterol (eat fish a couple of times a week or other sources of omega 3 ) b. omega-3 may also delay cancer development, slow tumor growth, etc. |
| Fats and fatty acids continued | 3. monounsaturated fatty acids also lower blood cholesterol (olive oil) 4. Recommendations: total fat intake should ideally be 20-35% of day's total energy intake |
| fat substitutes | carbohydrate based: a. stellar -starch based product from corn b. oat rim -extract of oats, retains qualities of the fibers |
| Fat substitutes | protein based a. simples: FDA-safe in 1990 - made from protein (egg white or milk) Fat based b. Olestra - sucrose and fatty acids-indigestible, no Cal contribution |
| Fat substitutes | a. do fat substitutes work? b. Xenical: (medication) blocks fat absorption by inhibiting lipase. The enzyme needed for the breakdown of fat. |
| wine | a. increases HDLs b. Contains protective compounds that prevent LDLs and cholesterol from oxidizing c. prevents platelets form sticking to artery walls |
| Fats- pros | a. satiety and flavor in foods b. primary component of the cell membrane c. compose the myelin sheath d. insulation |
| fats-cons | High fat diets have been linked to: a. obesity b. degenerative diseases c. malnutrition d. convenient fast-foods e. trigger for a heart attack |
| fat an be stored in the body in unlimited amounts | |
| vegetarian diets | why??? |
| types of vegetarian diets | a. lacto-vegetarian b. lacto-ovo vegetarian c. semi-vegetarians d. vegans |
| great protein sources for vegetarians and non-vegetarians alike | a. soybeans are a source of complete protein b. Quinoa - Hailed as the superman of the future contains more protein than any other grain. It's considered a complete protein |
| concerns of being a vegetarian | a. vegetarians need to follow the ABC's of diet planning. b. diets must include mutual supplementation of proteins. c. diets must include complementary proteins |
| concerns | 1. Vitamin B12: only found in animal derived food. - deficiencies result in severe damage to the nervous system - if not eating animal based products-a supplement must be taken. 2. vitamin D: no practical sources of this vitamin in plant foods |
| concerns Minerals | a. iron (mainly found in meat-thee sources need to be sought out!) b. zinc (mainly found in meat-other sources need to be sough out!) c. calcium (milk, Ca-fortified soy milk or orange juice, some nuts (almonds, sesame seeds) |
| trace minerals | each performs some vital role, which no substitute will do. A deficiency can be fatal and an excess can be toxic or deadly. Thus homeostasis is imperative. |
| Iron (Fe) | 1. a component of hemoglobin and myoglobin. It holds oxygen needed for cellular respiration 2. Worldwide- Iron deficiency is the most common nutrient deficiency. 3. Iron from old blood cells is recycled. Only tiny amounts of iron are normally lost. Bleeding/hemorrhage can lead to iron deficiency. 4. With iron loss, absorption will increase |
| Iron (Fe) continued... | 5. In Iron-deficient anemia: depletion of Fe in red blood cells. RBS appear smaller and lighter. Oxygen carrying capacity is decreased --> irritable, restless, unable to pay attention, fatigue, weakness, apathy, headaches, pallor |
| female athletes | a. iron is lost in sweat b. red blood cell destruction from body impact d. menstruation- loss of blood |
| iron | 6. iron deficiency --> pica: cravings for nonfood substances 7. Increased consumption of Fe is usually not toxic because the body will not absorb it all. However, there are exceptions: alcohol intake enhances Fe absorption. Iron Toxicity --> tissue damage. Rapid ingestion of large amounts--> death |
| Iron | what vitamin enhances Fe absorption? |
| zinc | 1. found in association with foods high in protein 2. important cofactor for many enzymes 3. transported in the blood by the protein albumin 4. deficiency affects growth and maturation, impairs immune function, abnormal taste, abnormal dark adaptation. Zinc is required to produce the active form of vitamin A 5. food sources: shellfish, meats, liver. RDA 12-15 mg/day |
| Deficiency of protein in diet (PEM): extremely serious | 1. muscles (including the heart) atrophy and weaken 2. reduced synthesis of key hormones 3.blood proteins aren't synthesized-vulnerable to infection 4. fluid imbalance-edema 5. electrolyte imbalance- nerve function is inhibited, etc. |
| disease states | 1. protein-energy malnutrition (PEM) - negative protein balance 2. Maramus-severe deprivation of protein and the nutrients (pg 117) 3. Kwashiorkor: protein deprivation resulting in fluid imbalances (pg 118) |
| deficiency of nutritional protein is bad, but so is eating an excess of protein | a. your body does not store excess protein b. it utilizes what it needs, then it must de-aminate the excess in the liver and remove the nitrogen via the kidney. Nitrogen is a harmful waste product. The remaining carbon, hydrogen and oxygen can be made into fat and stored. |
| Excess Protein in the diet: no benefits and may include health risks | 1. link between high meat diets and colon cancer 2. excess protein promotes calcium excretion. 3. excess protein stresses the liver (because it must remove the nitrogen from the molecule) and stresses the kidneys (because the kidneys are responsible for excreting the nitrogen from the body) |
| Excess protein in the diet continued... | 4. protein rich foods are usually high fat foods, thus the person is prone to diseases linked to high fat intake: cardiovascular disease, cancer, obesity 5. Eating a greater proportion of protein may eliminate nutrient rich foods (who grains, vegetables, fruit) from the diet, further increasing the change of disease |
| proteins in foods | to make a body protein-the cell must have all the amino acids available at one time for the processes of transcription and translation to take place |
| essential amino acids | a. amino acids that the body cannot synthesize in amounts sufficient to meet physiological need. b. you must include these in the diet c. histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine |
| conditionally essential amino acids | a. an amino acid that normally is not essential but become so in a disease state when he need becomes greater than the ability of the body to produce it. Example: Glutamine |
| Complete proteins | 1. a complete protein has at least 9 essential a.a. and enough nitrogen to make the other 11. 2. a complete protein is one that contains significant amounts of all the essential amino acids that must be provided to the human body because of the body's inability to synthesize them 3. Examples: most proteins derived from animal foods are complete. Soy s a good source of protein, for vegetarians and vegans or for people who cannot afford meat. |
| mutual supplementation | a. two incomplete proteins are eaten together to supply all of the essential amino acid. b. Examples: grain and a legume, rice and beans, taco with refried beans, pasta salad with chick peas |
| protein sparing | a. dietary protein will not support growth if carbohydrates and fats are missing b. the brain must have carbohydrates to function c. eating carbohydrates is called protein sparing because this allows the body to use carbohydrates for energy and the protein for essential body functions (listed in the previous lines). If one does not eat carbohydrates, protein will be sacrificed for energy. |
| digestions of proteins | a. stomach: pepsin/HCL b. small intestine: pancreatic and intestinal proteases c. absorption of amino acids takes place in the small intestine |
| NUTRITION THROUGH LIFE STAGES | |
| Nutrient needs change | depends on... a. rates of growth b. activity c. other factors Sound nutrition a. aids physical & academic performance b. helps prevent obesity, diabetes, heart disease, cancer & degenerative diseases of adulthood |
| Early & middle childhood | a. after age 1 growth rate slows b. body continues to change rapidly c. bones grow longer; muscles gain size & strength |
| energy & nutrient needs | Childrens appetites a. decline markedly around the first birthday b. thereafter, it fluctuates c. food energy intakes vary from meal to meal d. daily energy remains constant Energy a. needs depend on growth & activity - 1 yr = 800/day - 6 yr = 1600/day -10 yr= 2000/day b. inactive children may become obese c. vegans may have trouble meeting energy needs |
| carbohydrate & fiber | Carbohydrates a. based on glucose use by the brain b. after age 1, glucose use remains fairly constant c. is within the adult range Fiber a. based on energy intakes b. low energy children require less than high energy children |
| fat & Protein & vitamins | a. no RDA for total fat b. DRI committee recommends -30-40% of energy for children 1-3 yrs -25-35% of energy for children 4-18 yrs c. both protein and V/M needs increase slightly with age d. balanced diet can meet V/M needs. -may need more iron -do not replace protein with too much milk -add iron rich foods -need 10mcg/day vitamin D -can find D in fortified milk, fortified cereal -may need supplement of vitamin D |
| Food patterns for children | a. variety of foods from each food group b. my pyramid - preschoolers- 2-5 yrs. 1200kCal -Kids 6-11yrs, 1800kcal c. Many children have deficient diets -diets of 88% of children 2-9 yrs need improvement -FITS study of 3000+ infants & toddlers 1. Fruits & vegetables were limited 2. most common vegetable = french fries 3. most common fruit= bananas |
| Children's food choices | a. need to be nutritious & appealing b. limit candy, cola & other concentrated sweets - nutrient deficiencies -obesity c. underweight children can have higher calorie foods - ice cream, pudding, whole wheat or enriched crackers or pancakes |
| malnutrition in children | a. prevalent in very low income families b. 12 million children are food insecure c. WIC, school breakfast & rational school lunch program help d. Effects of hunger - short term 1. short attention span 2. irritable 3. apathetic & uninterested - Long term 1. impaired growth & immune system |
| Hunger & school performance | a. children who eat breakfast function better b. no breakfast -poorer concentration -shorter attention span -lower test scores, tardy or absent more often c. low blood glucose |
| iron deficiency | a. deficiency and behavior -causes an energy crisis -affects mood, attention span & learning ability -more conduct disturbances -affects brain before anemia develops b. prevention -need 7-10mg/day -milk intakes must be limited after infancy -eat lean meats, fish, poultry, eggs, legumes -also whole-grain or enriched breads & cereals |
| lead poisoning in children | a. if malnourished, more vulnerable to lead b. mild toxicity -diarrhea, irritability, anemia, and fatigue c. severe toxicity -irreversible nerve damage, paralysis, mental retardation, death |
| food allergies | a. only 6-8% of children under 4 years b. peanut allergies are on the rise c. diminishes with age d. while food protein or large molecule enters the body & acts like an antigen e. antibodies are produced f. Food intolerance - does not involve the immune system |
| food allergies continued | a. asymptomatic & symptomatic allergies - may produce antibodies & have not symptoms - if no antibodies it is not an allergy |
| food allergies | a. immediate & delayed reactions can occur b. anaphylactic shock -tingling in mouth, swelling of tongue & throat -peanuts, tree nuts, milk, eggs, wheat, soybeans, fish, or shellfish -Peanuts are #1 |
| food allergies | |
| Hyperactivity | a. affects behavior & learning in 5-10% of young children b. provide behavior modification, special education, psych counseling, drug therapy c. not caused by increased sugar d. food additives may contribute e. behavioral causes - lack of sleep, overstimulation, too much TV or video games, too much caffeine, lack of physical activity |
| childhood obesity | a. increased dramatically in past 30 years in US -32% age 2-19 overweight -16% are obese 1. BMI of 30> or in 95th percentile - under 2 years 95th percentile = obese; no BMI |
| Genetic & environmental factors | a. parental obesity -doubles the risk -One obese parent = 80% risk -neither parent only 10% risk b. Diet & physical inactivity - convenience foods -TV & video games c. high fructose corn syrup - soft drinks -12oz = 10 increase in sugar d. growth of overweight children - earlier puberty -shorter height - stocky build |
| prevention & treatment | a. limit sugar-sweetened beverages & punches b. eat fruits & vegetables c. watch portion sizes d. Eat low energy density, nutrient dense foods at Cal breakfast and Calcium rich foods e. high fiber foods f. eat as a family g. limit restaurants h. limit TV or other screen time to 2 hours/day i. 60 minutes of moderate to vigorous activity daily |
| Other treatment | a. psychological support b. behavioral changes c. drugs -controversial -orlistat silbutramine d. surgery -physical maturity -BMI>50 or BMI >40 with weight-related health problems -failure in a formal 6-month weight-loss program -ability to adhere to lifestyle changes |
| food choices & eating habits of children | a. Mealtimes at home - should appeal to children's tastes & provide needed nutrients -should also nurture child's self-esteem & well-being -sets the stage for lifelong attitudes & habits b. honoring children's preferences -favor brown peanut butter, white potatoes, apple wedges & bread -like raw vegetables -warm not hot food -mild flavors with no lumps |
| avoiding power struggles | a. don't force to try new foods b. don't offer rewards to try new foods c. don't restrict them from eating favorite foods d. offer one new food at a time e. small amounts f. need5-10 exposures to enhance preference g. new food at beginning of meal |
| The teen years | a. physical changes increase nutrient needs b. meeting emotional, intellectual, & social needs is challenging c. make more choices for themselves d. social pressures -alcohol -extremem body ideals -will try latest fad diet to effect immediate changes |
| growth & development | a. growth speeds up abruptly & dramatically b. adolescent growth spurt -duration of 2.5 yrs -males: 12-13 yrs -females:10-11 yrs c. males - greater muscle & bone -8 inches taller -45 pounds heavier d. females -more fat -6 inches taller -35 pounds heavier |
| teen years | a. energy & nutrient needs -vary depending on rate of growth, gender, body composition & physical activity b. obesity -highest in african american females & hispanics of both genders c. vitamins -need more vitamin D to increase calcium absorption -10mcg/day d. Iron - increases for both genders at age 14 or at adolescent growth spurt e. calcium - requirements peak -need more milk |
| food choices & health habits | a. teens have irregular eating habits b. rely on quick snacks or fast foods c. drink soft drinks instead of milk or juice d. many skip breakfast e. need to have nutritious, easy to grab food in the refrigerator - meats for sandwiches - low-fat cheeses -fresh raw vegetables & fruits -fruit juice & milk |
| teen eating habits | a. snacks -1/4 of daily energy -most are too high in saturated fat & sodium & low in fiber -also low calcium, iron and vitamin A b. Beverages - frequently drink soft drinks with lunch, supper, and snacks 1. linked to weight gain 2. caffeine may become a problem -milk consumption is decreased |
| teen nutrition | 1. Eating away from home a. 1/3 of all meals are not eaten at home b. other meals need to consist of -fresh fruits/vegetables -lean meats/legumes 2. peer influence a. teens are making their own nutrition decisions b. peer influence is great during this time in their lives |
| NUTRITION THROUGH THE LIFE SPAN LATER ADULTHOOD | |
| Later adulthood Nutrition & longevity | a. past food choices influences longevity b. U.S. population is graying c. People over 85 are the fastest growing age group |
| aging of U.S. population | a. life expectancy -1900=47 years -now = 78 years b. due to advances in medical science & improved nutrition upper limit of longevity is 130 years c. study of aging in the youngest scientific discipline d. aging -20-30% genetic -70-80% lifestyle |
| Slowing the aging process | a. healthy habits -adequate sleep -well-balanced meals -healthy weight -physical activity -not smoking -moderate alcohol b. restriction of kcalories - 805 of usual intake may decrease body weight, body fat, blood pressure, and increase HDL cholesterol -include fruits, vegetables, whole grains, legumes and olive oil |
| physical activity | a. a powerful predictor of mobility in later years b. promotes healthy weight, flexibility, endurance & balance. c. tones, firms and strengthens muscles d. should be undertaken daily |
| nutrition & disease prevention | a. helps prevent obesity, diabetes, and cardiovascular disease b. prevents deficiency diseases c. variety may protect against some cancers d. moderate sugar prevents dental caries e. fiber helps prevent constipation & diverticulosis f. moderate sodium may prevent HTN g.adequate calcium protects against osteoporosis |
| nutrition related concerns | a. cataracts -age-related thickening of the lens of the eye -can lead to blindness -risk factors: oxidative stress & obesity b. Macular degeneration -leading cause of blindness in person over 65 - risk factor: oxidative stress from sunlight -omega 3 fatty acids may be protective |
| arthritis | 1. Osteoarthritis a. most common b. painful welling of joints c. interventions - weight loss aerobic activity -weight training 2. Rheumatoid arthritis a. immune system attacks bone coverings b. interventions - vegetables -olive oil -omega 3 fatty acids -low saturated fat |
| The aging Brain | a. blood supply decreases b. number of neurons diminishes - cerebral cortex: affects hearing and speech - hindbrain: affects balance & posture |
| aging brain | a. nutrient deficiencies -need vitamins and minerals for neurotransmitter functioning - some losses may be diet related |
| alzheimer's disease - a disease of plaques and tangles | a. most prevalent form of senile dementia b. gradually lose... -memory and reasoning -ability to communicate -physical capabilities -life itself c. risk factors - free radicals -elevated blood homocysteine -obesity -high blood pressure - diabetes |
| Physical changes of aging that affect nutrition | 1. sensory changes a. vision decline b. decline in tate acquity c. diminished sense of smell 2 Gastrointestinal changes a. less saliva, gum disease, tooth loss b. Delayed stomach emptying, reduced gastric secretions -atrophic gastritis -decreased intestinal motility 3. change in body composition 4. hormones a. less insulin |
| energy & nutrient needs | a. energy needs decline with aging -5% per decade -lean body mass diminishes -BMR slows -select nutrient-dense foods b. sarcopenia -loss of muscle mass c. protein, fiber and fat - needs stay same as young adults |
| water | a. total body water decreases with age b. dehydration is a risk c. do not seem to feel thirsty or notice mouth dryness d. fluid needed - women 9 cups/day -men 13 cups/day e. dehydration can promote -urinary tract infections -pneumonia -pressure ulcers -confusion -disorientation |
| vitamins | 1. vitamin D deficiency a. drink little milk b. limited exposure to sunlight c. capacity of skin & kidneys to produce active Vitamin D is decreased 2. Vitamin B12 deficiency a. stomach acid decreases b. Atrophic gastritis -malabsorption of B12 4. Folate a. medical conditions & medications can compromise status |
| Minerals | 1. iron a. anemia less common than in younger adults b. deficiency -chronic blood loss -poor absorption 2. Zinc a. commonly low b. can depress appetite 3. calcium a. needed throughout life to prevent osteoporosis b. calcium AI for late adulthood - 1200mg/day |
| food choices and eating habits | a. most older people are - independent -socially sophisticated -mentally lucid -fully participating members of society b. spend more money per person on foods to eat at home c. need easy-to-opensingle-serving packages with easy to read labels |
| eating habits | a. individual preferences are important for older adults b. meal setting - need companions -men living alone are at risk for malnutrition |
| Other | a. depression -more common with advancing age -affect food intake and appetite -many losses - feel powerless b. risk factors for malnutrition -disease, eating poorly, tooth loss, economic hardship, reduced social contact, multiple medication, involuntary weight loss, needs assistance with self-care, elderly older than 80 |
| nutrition for older adults | a. food assistance programs -older americans act nutrition program -OAA nutrition program -SNAP -meals on wheels -senior farmers market nutrition program b. Meals for singles - may not have storage for a lo of food - food may go bad before eaten -may have limited income -need to be creative & choose wisely |
| nutrition through the life span: pregnancy and infancy | |
| nutrition to prior to pregnancy | 1. achieve & maintain a healthy body weight 2. choose an adequate & balanced diet 3. be physically active 4. avoid harmful substances |
| prepregnancy weight | underweight or overweight before pregnancy presents medical risks |
| underweight | 1. high-risk of having a low-birthweight baby 2. low-birthweight a. more risk for disease b. 40 times more likely to diet in first month 3. long-term effects on baby a. risk for obesity & hypertension later in life b. lower adult IQ c. short stature d. educational disadvantages |
| overweight & obesity | 1. babies a. are larger b. twice as likely to have neural tube deficits c. greater risk of heart defects 2. mom a. more likely to need labor induced b. may need c-section c. more postpartum hypertension, infection & gestational diabetes |
| healthy support tissues | 1. pregnancy nutrition needs to support growth of a health placenta 2. placenta a. supply depot b. waste-removal system 3. umbilical cord 4. pipeline from placenta to fetus 5. amniotic sac a. surrounds baby b. cushions it with fluids |
| the events of pregnancy | 1. newly fertilized ovum called a zygote 2. implants in uterine wall 3. placenta begins to grow 4. crucial time period 5. adverse influences a. smoking b. drug abuse c. malnutrition 6. can lead to a. failure to implant b. neural tube deficits |
| the embryo & fetus | 1. embryo develops into a fetus 2. at 8 weeks fetus has a. complete CNS b. beating heart c. fully formed digestive tract d. well-defined finger & toes e. beginning facial features 3. last 7 months a. grows 50 times heavier & 20 times longer 4. pregnancy a. 38-42 weeks duration 5. infant a. average weight 6 ft. - 7.9 pounds |
| critical periods | a. development of each organ takes place at a certain time (critical period) b. effects of malnutrition at a critical period are irreversible c. early malnutrition impairs heart & brain d. later malnutrition impairs the lungs |
| effects of malnutrition | a. nervous system defects of the embryo b. child's poor dental health c. adolescent's & adult's vulnerability to infection d. higher risk of diabetes, hypertension, stroke, or heart disease |
| nutrient needs | 1. energy (kcalories) a. additional 340 in 2nd trimester b. additional 450 in 3rd trimester c. select nutrient dense foods 2. carbohydrates a. 174 grams or more/day b. fiber for constipation 3. protein a. additional 25 gms/day b. protein supplements are discouraged 4. fats a. little room for oil, margarine & butter b. need essential fatty acids |
| special interest | 1. folate a. role in cell reproduction b. increased from 400 to 600 mcg/day c. prevents neural tube deficits - spina bifida - anencephaly d. supplements, fortified foods or both 2. Vitamin B12 a. needed to assist folate in manufacture of new cells b. found in animal products c. vegans need fortified foods or supplements |
| nutrients for bones | a. need vitamin D, calcium, phosphorus, magnesium b. intestinal absorption of calcium doubles early in pregnancy c. final weeks, more than 300 megs are transferred to fetus d. increase milk products e. may need supplements f. calcium fortified soy milk & orange juice |
| iron | 1. absorption of iron increases threefold 2. fetus draws heavily on mother's stores 3. daily supplement a. 30 mg iron b. 2nd & 3rd trimester 4. iron-rich food a. liver, oysters b. red meat, fish c. dried fruits d. legumes e. dark green vegetables 5. vitamin C-rich foods enhances absorption |
| zinc | a. needed for DNA, RNA & protein synthesis b. deficiency predicts low-birthweight c. found in foods of high-protein content d. iron interferes with zinc absorption therefore, may need zinc supplements |
| nutrient supplements | 1. prenatal supplements provide more a. folate b. iron c. calcium 2. reduce risks of a. preterm delivery b. low-birthweight c. birth defects 3. needed for a. those with poor diet b. high-risk pregnancies c. multiple fetuses d. cigarette smokers e. alcohol & drug abusers |
| weight gain | 1. essential for healthy pregnancy 2. normal-weight woman a. 3 1/2 pounds first trimester b. 1 pound/week thereafter c. single fetus: 25-35 pounds |
| physical activity | 1. very important a. improves her fitness b. facilitates labor c. helps to prevent or manage gestational diabetes d. reduces psychological stress 2. low-impact activities 3. avoid a. activities with potential for falls or being hit by others b. saunas c. steam rooms d. whirlpools |
| other concerns | 1. morning sickness a. comes from hormonal changes in early pregnancy b. mild queasiness to rehabilitating nausea c. smells often trigger it 2. heartburn a. fetus puts pressure on woman's stomach b. acid may back up 3. constipation a. high-fiber diet b. physical activity c. plentiful fluids |
| problems in pregnancy | 1. preexisting diabetes a. glycemic control becomes difficult 2. gestational diabetes a. usually resolves after the birth b. often leads to surgical birth and high infant birthweight 3. hypertension a. pre-existing -risk of low-birthweight infant -separation of placenta b. transient - usually resolves after the birth |
| preeclampsia | 1. symptoms a. hypertension b. protein in the urine 2. usually first pregnancy 3. after 20 weeks 4. may experience convulsions a. eclampsia b. needs prompt medical attention |
| avoid | 1. medicinal drugs a. no over the counter b. no medicines not prescribed c. no aspirin or ibuprofen in last 3 months 2. herbal supplements a. almost none have been tested for safety during pregnancy 3. drugs of abuse a. cross the placenta b. impair growth & development 4. environmental contaminants a. lead & mercy b. avoid certain types of fish |
| avoid continued... | 1. foodborne illness a. listeriosis - can cause miscarriage, stillbirth - severe brain injury , other infections to fetus and newborn 2. vitamin-mineral a. many are toxic in excess b. need care with vitamin A 3. dieting a. hazardous during pregnancy 4. sugar substitutes a. use in moderation 5. caffeine a. limit to one cup coffee or two 12-oz colas |
| alcohol | 1. fetal alcohol syndrome a. irreversible brain damage b. mental retardation c. facial abnormalities d. vision abnormalities 2. no amount is safe |
| nutrition of the infant | a. affects. later development b. sets the stage for eating habits c. provide a nurturing, relaxing environment |
| nutrition of the infant continued | 1. weight doubles by 4-5 months 2. triples by 1 year 3. BMR is very high 4. need a. 100 kcalories/kg/day b. adequate vitamin A, D and calcium c. dose of vitamin K at birth |
| breast milk | 1. energy nutrients a. carbohydrates -lactose -enhances calcium absorption b. lipids -generous amount of essential fatty acids c. protein - alpha-lactalbumin -easily digestible 2. Vitamins & Minerals a. Vitamin D supplement needed - if breastfed - if not on vitamin D- fortified formula 3. Lower in sodium 4. highly absorbable iron & zinc |
| benefits of breast milk | 1. immunological protection a. colostrum (premium substance) b. maternal immune factors c. enzymes that offer protection 2. infant has less a. stomach & intestinal disorder b. middle ear infections c. respiratory illness 3. allergy protection |
| formula composition | a. similar to breast milk b. offers no immunity c. standards have been set d. all need to be iron fortified e. are special formulas for allergies & lactose-intolerance f. risks of over-dilution & contamination |
| transition to Cow's milk | 1. not appropriate in first year 2. 1-2 years needed whole milk 3. 2-5 years can transition to lower fat 4. cow's milk a. is a poor source of iron b. higher in calcium but lower in vitamin C (inhibits iron absorption) |
| introducing first foods | a. first foods can be introduced between 4-6 months b. can sit with support & movements |
| foods to provide iron & vitamin C | a. breast milk & iron-fortified formula b. iron-fortified cereals c. meat & meat alternatives d. fruits & vegetables for vitamin C |
| physical readiness | a. 4-6 months swallow solids b. 8-12 months -can handle finger foods -begins to teeth - hard crackers can be introduced |
| infant feeding | 1. gallery-cauing foods a. introduce foods one at a time b. rice cereal first c. wheat last 2. choice of foods a. baby foods b. slenderized table foods 3. foods to omit a. sweats of any kind b. no canned vegetables -high in sodium c. honey - risk of botulism d. foods that cause risk of choking 4. foods at 1 year a. same foods as rest of family |
| looking ahead | 1. introduce a variety of nutritious foods 2. don't force to finish food & drink 3. avoid food as a. a reward b. comfort for unhappiness c. deprivation for punishment |
| WEIGHT MANAGEMENT | |
| the majority of our nation is overweight why??? | |
| our environment | a. ready availability of fast food, junk food and processed food: all of which is fating and does not provide nutrients that the body needs. b. Children have been shown to spend more of their 'own' money on junk food than on anything else (clothing, toys, music, jewelry, etc.) |
| our environment continued... | a. fast food is everywhere and highly marketed. b. fast food is generally inexpensive. The most expensive component of the fast food is the packaging, so manufacturers can afford to give the public large portions. c. fast food comes in large portions. People perceive they are getting a good economical value, but their body is suffering. d. fast food is high in fat and sugar, low in good nutrients |
| environment | 1. learned behavior a. think bad to week one of this course. What were all the reasons listed for why people eat? Very few of these reasons have to do this the physiological drive of hunger. |
| Environment continued... | 1. lack of physical activity: our nation is designed around convenience. a. computers to communicate on, shop from, work from etc. b. drive through for coffee, fast food or banking etc. So we don't have to get out of the car. c. remote controls for TV, commuter games, music, etc. so we don't have to get up and move around d. very few people have physical labor as part of their jobs. |
| environment continued... | 1. corn is a highly subsidized crop by the government As a consequence, many farmers grow it. We can not eat all that they grow. a. it is made into high fructose corn syrup. This is found in almost any processed food product- just check your labels b. it is not good for you |
| high fructose corn syrup | is the principle form of 'added sweetener' to food products in America |
| what other factors contribute to how we manage our weight besides the environment that we are exposed to... | 1. genetics a. identical twin studies. Even when identical twins are reared by different families, they usually have the same weight. So environment is important but so is genetics |
| Genetics | a. genetics influence the way we store fat. When identical twins were given an extra 1000 Cal a day for 100 days, so pairs gained less than 10 lbs, whereas others gained up to 30 lbs. b. Genetics also influence how we burn Cal. The differences in BMR between individuals are greater than what can be explained by age, gender or body type |
| set point theory | a. genetics b. this theory proposes that the body maintains a certain weight like it does with temperature. c. to maintain this weight the body will adjust it's metabolism whenever it gains or looses weight to bring it back to the original weight. |
| lipoprotein lipase | a. enzyme (how do you know this by just looking at the name?) b. the activity of this enzyme promotes fat storage. c. people with high lipoprotein lipase activity are very efficient at storing fat. d. obese people have a much higher LPL activity than lean people, hence when hey eat the same amount of cal, obese people can store the cal much more efficiently. |
| leptin | a. protein that acts as a hormone. b. produced and secreted by fat cells. c. Within the DNA of the fat cells is a genet that has been identified as the 'obesity gene'. This gene codes for the production of leptin in fat cells. d. since leptin is a hormone it is par of a negative feed back process |
| leptin continued.. | a. normally, when someone gains fat, leptin is produced. b. leptin acts on the hypothalamus c. this cause suppressed appetite and increased energy expenditure and thus fat loss. So this is your body's homeostatic mechanism for maintaining body weight constant. The opposite is also true. |
| leptin continued... | a. in the majority of fat people, they are producing high amount of leptin. b. some have people make a non-functioning receptor. This is a genetic defect. So there are no receptors to respond to the leptin to turn the desire to eat off. c. in other heavy people, the receptors on the cells in the hypothalamus have been over-stimulated by this hormone and have become resistant to it. So there is no mechanism to shut off the appetite. |
| leptin | in very rare instances, the ob gene malfunctions and does not produce enough leptin. These people loose weight when given daily injection of the hormone leptin. |
| ghrelin | a. produced by stomach cells b. a protein hormone that also works on the hypothalamus. c. gherkin triggers the desire to eat. Generally formed when the stomach is empty. After eating the production of Ghrelin dramatically decreases. d. There is also a direct correlation between the amount of Ghrelin produced and the amount of Cal ingested. |
| fat cell development | a. if fed, the size of fat cells can expand 6-10X their original size and then divide b. obesity reflects the number of fat cells and the size of those fat cells. c. number of fat cells normally increases during childhood and puberty and then usually levels off d. prevention of obesity is most critical during the growing years. |
| childhood obesity | a. the incidence of childhood obesity has dramatically increased over the last three decades b. unprecedented amount of children are being diagnosed with adult diseases that accompany obesity: Type II diabetes, hypertension followed by cardiovascular disease. c. why: predominately environment is too blame. Fast food and processed food are always available. More foods consumed with high fructose corn syrup. Sedentary behaviors: Children are sitting in front of screens watching or playing video games etc. |
| fat cell development | a. when a person loose weight, the fat cells shrink in size, but not necessarily in number. b. therefore, the cells will not secrete leptin, thus the body is given the signal to eat, and weight is easily re-gained. |
| loosing weight | 1. over the counter weight los pills and supplements a. if it sounds to good to be sure, then it's not true. b. this is a huge industry because people are looking for a quick fix and they spend about 2 billion dollars a year trying to get it. The only thing that is happening here is that industry makes a profit c. natural herbs are not safe. they do not have to go through FDA approval. Manufactures do not have to show efficacy or safety. |
| aggressive treatments of life threatening medical conditions of obesity | a. risks of being overweight are greater than the risks of the obesity treatment. b. there are no drugs that can be used that have no side effects. Sometimes the side effects can be quite serious. c. surgery: gastric bypass and gastric banding |
| helpful strategies to loose weight | a. adequate energy (eat at least 10 cal per lb of your current body weight to ensure enough cal for BMR) b. nutritional adequacy: eat nutrient dense foods (vegetables, whole grains, fruit)- these foods will make you feel full c. center meals and snacks on nutrient dense foods d. adequate water e. weight-bearing exercise to build lean body tissue (muscle)- the more muscle you have the higher your BMR, the more Cal you burn. |
| helpful strategies to loose weight continued... | f. physical activity--> increases BMR and just plain burns cal - reduces stress - enhances brain activity - choose activities you will do g. spot reducing does not work. no exercise removes fat from a particular area - you need an overall weight- loss pain - you can tone the muscles in a specific area - ex. doing a lot of sit ups will tone the abdominal muscles, but will not remove fat from the abdominal area |
| helpful strategies to loose weight continued... | h. behavior modification - becoming aware of behaviors (keep a journal of what you eat, when you eat, how you feel when you're eating it) -make small changes at a time - applying behavior modification principles: find alternative was to deal with situations - maintain weight if at all possible. |
| eating a completely instinctive behavior for animals- serves an extraordinary number of psychological, social and cultural purposes for humans. | |
| the media and industry know this. the dieting industry is huge. we spend billions of dollars for anythings that promises hoe to deliver us to this path of perfection. | |
| eating disorders | 1. characteristics of disordered eating a. restrained eating b. unusual eating rituals c. binge eating d. fear of fatness e. distortion of body image f. obsession with body image g. purging h. laxative abuse, enemas i. diuretic abuse j. excessive exercise |
| II. population affected | a. 90% of those who have eating disorders are women between the ages of 12 and 25 years. b. very prominent in college populations c. increasing numbers of boys, men, and older women are presenting with these disorders d. athletes which require extremely low body fat |
| III. female athlete triad | a. disordered eating . amenorrhea c. osteoporosis d. (decreased bone density) |
| ANOREXIA- starvation- Pem | weights at least 15% below what is considered normal for others of the same height and age. Misses at least 3 consecutive menstrual cycles. Intense fear of gaining weight. Refuses to maintain a normal weight. Believes he or she is overweight though in reality is dangerously thin. |
| anorexia | dangers of being too thin... a. decrease BMR b. decrease lean tissue c. decrease growth and development d. atrophy of heart tissue e. decrease BP f. electrolyte imbalance g. impaired immune response h. anemia i. impaired digestive function |
| anorexia treatment | a. multidiscipline approach b. diet: first restore a healthy weight (usually requires hospitalization) c. psychological therapy, behavioral therapy, support groups |
| anorexia death | a. 5% of patients die while in treatment b. the mortality rate from anorexia is 12 times higher than the annual death rate due to all other causes of death among females ages 15-24 yrs in the general population. c. the most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide |
| bulimia nervosa | a. an estimate 1.1-4.2% of all females have bulimia nervosa in their lifetime. b. of all diagnosed cases of bulimia nervosa, 35% are men. c. DEFINITION: Recurrent episodes of binge eating. characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode. d. recurrent inappropriate compensatory behavior in order to prevent weight gain e. personal self evaluation is excessively influenced by body shape and weight. |
| bulimia nervosa typical profile | a. affects more men than anorexia b. well educated c. early 20s d. close to ideal body weight e. high achiever f. strong dependence on parents g. considerable social anxiety h. aware of the consequences of their behavior i. ashamed of their behavior j. feelings of inadequacy and unable to control eating k. any type of rejection --> depression --> bulimia episode |
| bulimia nervosa | binge eating a. compulsive b. periodic, secretive c. night d. consume >1000 cal food in a short period of time e. food --> high fat, sweet food |
| bulimia nervosa | purge- vomiting is extremely negative to health because: a. fluid and electrolyte imbalances b. metabolic alkalosis --> apathy, confusion muscle spasms c. irritation and erosion of the esophagus, pharynx and teeth (cavities) d. calluses on the index finger |
| bulimia nervosa treatment | a. gain control and establish regular eating patterns. b. behavioral modification techniques c. psychotherapy and support groups d. antidepressant medication, such as Prozac, may also benefit the client |
| Energy Metabolism | How do we make it? How do we use it? |
| Metabolism | Metabolism is a general term for all the chemical reactions that occur in the body. |
| Metabolism | 1) Metabolism has two general types or reactions: A) Catabolism: breakdown reactions of the three nutrients which release energy B) Anabolism: using these breakdown products to build the body's required molecules which require energy |
| Carbohydrates | 1) Breakdown (catabolism) of carbohydrates to glucose (waste by-product: CO2) 2) Review of Glucose breakdown forming ATP or energy: a) glycolysis: 2 Kern cycle (to Citrict acid cycle) b) Electron transport chain (oxidative phosphorylation) 3) The brian and nervous system can only use glucose as a fuel |
| Fats | 1) Fat: made of glycerol and fatty acids (see next slide) 2) glycerol (5% of the molecule) broken down (catabolism) to Peru ate which then can be either: A) be converted to acetyl Co A Kern Cycle ATP (catabolism relaseasin energy) B) may be converted to glucose (anabolism) gluconeogenesisq |
| Fat | Three Fatty Acids: 1 glycerol (triglyceride) |
| Fat Catabolism | 1) Fatty acids (95% of molecule) broken down by a process called Beta oxidation A) to acetyl Co A to enter the KReb Cycle to make ATP or B) Ketone Bodies-(acidic waste by-products) |
| Fat Catabolism | The conversion of glycerol to glucose is not enough to supply the nervous system!! In the absence of carbohydrates, the body will break down body protein for conversion to glucose. Breakdown of fat and protein results ina lot of toxic wast products which lower metabolism. |
| Proteins: Made of amino acids | 1. Primary function: be used in anabolic reactions to build body tissues 2. If the other two nutrients are lacking, protein can be used for energy in catabolic reactions |
| Breakdown of Protein | PRotein is Deaminated in the liver (removal of N group) BUN (blood urea nitrogen) a test to see how well the liver is functioning. Nitrogen must be removed from the blood, it is a toxic waste product. (Which organ removes the nitrogen from the body?) |
| Breakdown of Protein | After deamination, the rest of the molecule: 1. Some a.a.) can be converted to private-gluconeogenesis-glucose 2. ( other a.a.) can be directly converted to -acetyl CoA and enter the Kreb cycle-ATP |
| 2 Ways that the body expends energy | 1) Basal Metabolism-cellular work 2) Voluntary muscle-(skeletal) work |
| Energy Balance | Basal Metabolism: The energy needed to maintain life when the body is at rest. A) the amount of Calories needed to do the work of the cell (about 2/3 of your total Cal intake) These are the amount of Cal needed just to sustain life) B) BMR: Rate at which the body expends energy for maintenance activities Table 6-1 |
| Basal Metabolic Rate | A) BMR can be increased by Increasing skeletal muscle mass (Or lean body tissue) B) BMR will decrease with a loss of skeletal muscle mass induced by fasting. The protein is used to make glucose for the nervous system. |
| Compute your estimated energy requirements | Using the "How to" on p. 139 as a guide. Determine your estimated energy requirements and record your calculations in bio-metrics assignment. |
| Another calculation used to project the number of Calories one needs to eat. This is the equation used in hospitals | Harris-Benedict Equations Table 16-2 (pg. 432) A) Women: BEE=655 + (9.6 x weight in kg) + (1.7 x height in cm)-(4.7 cage) B) Men: BEE=66 + (13.7 x weight in Kg) + 5 x height in cm)- (6.8 x age) |
| An easy method to calculate the amount of Cal you should eat in one day.activ | 1) Multiple your weight in KG by 24 hours= Cal/day. This is your basal amount of Cal to eat, just to support life. Take this number and multiple it by 1.6 (if you are moderately active) to get the total number of approximate Calories that you should eat each day. 2) Ex. 125 lbs/2.2 Kg/lb=56.8 Kg X 24=1364 Cal (basal amount used for cellular processes) X 1.6 (activity factor) -2182 Cal per day to maintain this weight. 3) To loose weight either eat less Calories than this (never drop below the basal amount |
| The Body's Energy Budget | Feasting (Eating too much!!): anabolic reactions A) Energy from any good can make your fat! B) Dietary fat, as compared with dietary carbohydrates and protein, is very easy for the body to store as fat. C) Alocohol delivers Cal and slows down the body's use of fat for fuel favoring fat storage. |
| Fact acts like an organ. | 1) Fat promotes the inflammatory response. 2) Chronic inflammation leads to other disorders-CV disease |
| Fat acts like as an organ | 1) Releases chemicals that influence insulin resistance-ex. Tumor necrosis factor alpha (TNF-u)- resisted 2) Contribute to the development of Diabetes |
| Central Obesity | 1) the apple profile, where fat collects around the abdomen is the most dangerous health-wife 2) this is more common with men 3) there is also a genetic predisposition for this type of weight gain |
| Fasting( Eating too little) | |
| Fasting/Starvation | 1. Energy Deficit-Cellular work is a priority. The body will do whatever it can to provide energy for cellular metabolism because it is the basis for your survival. Body protein from all organs will be screificed to form ATP. |
| Fasting/Starvation | 2. Glycogen: First stored energy source to be utilized 3. Fats cannot provide enough glucose to the brain. Therefore during a fast, body protein tissues always break down to some extent. |
| Fasting/Starvation | 4. Slowed metabolism: the body will attempt to preserve itself by reducing energy output and slowing metabolism. The amount of fat lost is less than when some food is supplied to the body. |
| Fasting/Starvation | 5. **Fasting is not a good way to loose weight. A) wasting of body protein (Which is the main tissue to burn calories) B) immune system is impaired. C) Lower metabolism D) Disturbances in fluid, electrolyte and pH balance |
| Body Weight and Composition | Weight reflects composition; proportions of bone, muscle, fat and fluid can change in quality and quantity. |
| Measure your own body fat | 1) There is an electrical impedance scale in the nursing skills lab. Weigh in-in bare feet. You must be well hydrated or the scale will tell you that you have more fat than you actually do. 2) For skin fold measurements: use skin fold calipers to measure body fat. |
| Body Composition | Body Fat. Absolute Minimum Male 13%-21%. 5-10% Female 23-31%. 15-20% |
| Vitamins | 1) required in small amounts 2) essential for life 3) they do not yield energy but assist in releasing energy from Carbs, fats, and protein. 4) they also participate in many other essential chemical reactions of the body. |
| It is best to ingest vitamins from Whole Foods NOT supplements | |
| Water Soluble vitamins | 1) Vitamin C and the B vitamins 2) Soluble in water- so they are found in the watery compartments of food and the body 3) easily absorbed and excreted by the body 4 only reach toxic levels in the body if high levels of supplements are taken |
| Vitamin C | |
| Functions of Vitamin C | 1. Collagen f rotation (Connective tissue)-walls of blood vessels, tissue healing, bone formation, skin, etc. 2. Antioxidant removes damage oxidizing agents |
| Antioxidant: a compound that protects other compounds from oxygen by itself reacting with oxygen | Oxygen triggers the formation of compounds known as Free-Radicals: highly reactive molecules with unpaired electrons that causer destructive damage in cellular molecules. Free radical damage is believed to cause cancer, heart diesease and aging. |
| Functions of Vitamin C | 3. Amino acid metabolism 4. Stress response: the need for Vitamin C is increased during stress (such as: infections, wound healing, exposure to cold); 5. Reduce fold symptoms-possible antihistamine |
| Deficiency-Scurvy (of 10 mg) | Symptoms: A) gum bleed B) poinpoint hemorrhages C) wounds fail to heal D) anemia E) Infections F) Muscle and bone wasting |
| Toxicity/controversial (TUL 2000mg) | Symptoms A) Nausea B) Abdominal cramps C) Diarrhea D) CAn also interfere with the efficacy of certain medicines |
| Withdrawal reactions (Vitamin C) | Body may limit absorption and increase exertion when subjected to continual mega-doses. If the person suddenly reduces intake to normal, it takes time for the body to readjust and hence may go into a deficiency |
| Vitamin C doubles to triples the absorption of iron (Fe) from foods eaten at the same time | |
| B Vitamins | 1) Many of these vitamins serve as co-enzymes in the body's metabolic reactions. Hence they aid in the release of energy from Carbs, fat and protein 2) 8 different B vitamins |
| Generalized functions for the B vitamins | 1) Thiamin-Energy metabolism 2) Riboflavin-Energy metabolism 3) Niacin-Energy metabolism 4) Biotin-Eenrgy metabolism 5) Pantothenic acid-Energy metabolism 6) B6-Energy metabolism 7) Folate-New cell growth 8) B12-cell growth and neuronal function |
Created by:
Megansensky