| Question | Answer |
| What is nutritionism | the idea that the nutritional value of a food is the sum of all its individual nutrients, vitamins, and other components |
| 3 pernicious myths regarding nutritional science | -nutrients matter more than food
-need expert help
-purpose of eating promotes narrow concept of health |
| What is orothorexia | An unhealthy obsession about healthy eating habits |
| Significance of the 1977 Dietary Goals for US | -told people to eat less beef and dairy
-offended people, changed it to "choose meats poultry and fish that will reduce saturated fat intake (nutritionism)
-were blaming nutrients, not foods |
| 3 reasons to avoid soda | -addictive-empty calorie reactive hypoglycemia
-fructose damages the liver
-acid forming |
| What is parking lot science | Assuming what we can see is more important to look at when actually we may need to look at something else |
| What is zero sum relationship | -eating more of one thing means eating less of another |
| What is epidemiological research | Collects stats and trends in nutrition and patters, causes, and effects of health and disease in defined populations |
| What are Randomized Control Trials | Specific type of experiment to test effectiveness of various types of intervention in a patient population, randomly allocated to receive one or another treatment of study |
| What problems arise when we wish to assess what people eat | -people lie, and cant accurately recall diet over 24 hours |
| What is the problem with the food frequency questionnaire | -very confusing, people only have 24 hour diet recall |
| 4 shifts in food relationships that have occurred in the Western Diet | -adding chemicals
-more processed (fortified) foods
-increased sugar
-increased fat |
| What is food culture | passed on by parents, government, food industry |
| What is food science | What we should be eating based on studies
- whole foods vs refined
-complex vs simplicity
-leaves vs seeds |
| Pollans suggestion to move beyond nutritionism | eat foods that rot and have bugs |
| What are fat soluble vitamins characteristics | -used for absorption and transport
-similar to lipids
-require bile salts
-transport involves chylomicrons
-stored in body lipids
-fat malabsorption conditions |
| What are water soluble vitamins characteristics | -absorption into portal blood
-limited storage in the body except B12
-only stored by binding to enzymes and transport proteins
-excreted in urine when plasma levels exceed renal thresholds |
| 2 types of water soluble vitamins | Vitamin C
Vitamin B-complex |
| B-complex vitamins function | -energy releasing
-hematopoiesis
-others |
| General sources of Fat-Soluble Vitamins | Fish, milk, kale, spinach, eggs, fortified cereal |
| What is vitamin insufficiency | you don't have enough of the vitamin but there are NO symptoms |
| What is vitamin Deficiency | You don't have enough of the vitamin and are showing manifestations |
| What is biomechanical individuality | Everyone is different and needs different things |
| What is RDA and what are problems with its measurement of nutritional status | -Recommended Daily Allowance
-developed using deficiency diseases for large populations
-consumers use it as a means to provide adequate nutrition
-made for populations, NOT individuals. People may need more or less of certain things |
| Which vitamins are Fat Soluble | -Vitamin D
-Vitamin A
-Vitamin K DAKE
-Vitamin E |
| Major Function of Vitamin A | -vision
-regulation of gene expression(cell differentiation)
-immunity
-Growth and Development
-RBC production |
| Vitamin A deficiency symptoms | -Vision problems: night blindness, bitots spots,
xerothalmia(dry eyes), corneal scarring
-Anorexia
-Retarded growth
-susceptibility to infections
-enlargement of hair follicles, keratinization of skin |
| How to convert mcg to IU | 1 mcg= 3.33 IU
so take whatever the mcg amount is and times it by 3.33 |
| What is vitamin A beta-carotene | -comes from green leafy veggies and is provitamin A
-hard to convert to retinal
-converted to retinol in the body |
| What is preformed Vitamin A | retinal and retinol
(animal fat) |
| What is the tolerable upper intake level of Vit. A for a pregnant woman | 3000 mcg (10,000 IU) |
| Therapeutic applications of Vit. A | -cancer prevention( in animals and cell cultures, human inconclusive)
-infectious diseases
-skin(acne), scalp, and hair disorders
-Gynecologic disorders |
| What is a teratogenic dose of Vit. A | >7500 mcg (25,000 IU) |
| What group of people may be susceptible to beta-carotene toxicity | Smokers |
| How do vitamin D and parathyroid glands function to regulate serum calcium | Parathyroid glands sense serum calcium is low and increase PTH secretion. This goes to the kidney which secretes calcitriol into the small intestine which absorbs more Vit. D |
| Vitamin D short-latency deficiency symptoms | -rickets(failure of bones to mineralize)
-Osteomalacia(adults)
-muscle weakness and pain |
| Vitamin D long-latency deficiency symptoms | -cancer
-autoimmune disease
-cardiovascular disease
-depression |
| Risk factors for vitamin D deficiency | -breast fed infants, lack it =cell differentiation issues,immunity issues
-dark skin
-elderly because their reduced capacity to synthesize Vit. D in skin
-covering or sunscreen when outside
-fat malabsorption
-inflammatory bowel disease
-obesity |
| What is the tolerable upper intake level for vit D in adults | 100 mcg (about 4000 IU) |
| Therapeutic applications of vit D | -osteoporosis
-maintain adequate calcium intake
-help with autoimmune disease: MS, RA, IDDM
-Cancer prevention: inhibits cell proliferation
-hypertension |
| Best assessment for Vit. D | serum 25(OH)D |
| Value that signifies Vit D deficiency | <20 ng/ml (<50 nmol/L) |
| Value that signifies Vit D insufficiency | <30 ng/ml (<75 nmol/L) |
| Problems with having high optimal vit D levels | it could be toxic in some people who don't need that high of dosage |
| Symptoms of Vit D toxicity are the result of what | Hypercalcemia |
| Names of Vitamin E family members | -tocopherols
-tocotrienols
- alpha tocopherol is the only form in humans |
| Vit. E deficiency symptoms | -Neurological: impaired balance and coordination, muscle weakness, peripheral neuropathy, damage to retina
-Hemolysis and anemia
-atrophy of reproductive organs and infertility |
| Risk factors for vitamin E deficiency | -Vit. E is removed by processing
-Consumption of polyunsaturated fatty acids
-requirements increased in urban environments
-Vit C and selenium deficiency: unable to recycle vit E
-premature and newborn infants: difficult absorption |
| Tolerable upper intake level (UL) for vit. E in adults | 1000 mg |
| What is the difference between d-a-tocopherol and dl-a-tocopherol | - d-a-tocopherol is natural isomeric form found in foods
- dl-a-tocopherol is the synthetic form in many supplements |
| Therapeutic applications of vit. E | -cardiovascular disease
-cataracts
-immune function
-dementia
-diabetes
-cancer |
| Symptoms for vit. E toxicity | -nausea
-diarrhea
-flatulence
-impaired blood coagulation |
| Contraindications and cautions for vit. E supplementation | -anticoagulant drugs
-statins + antioxidants
-diabetics |
| what are the 3 forms of vit K | -phylloquinone (K1) found in plants
-menaquinone (K2) synthesized from bacteria
- Menadione (K3) is synthetic form used in animal feed, can form MK-4 |
| Functions of Vit. K | -blood coagulation: essential cofactor in coagulation cascade, balances the 2 opposing sides- clot formation and breakdown
-Vit K cycle: recycles vit K-liver
-Cell growth and regulation: Gas6 is vit K dependent protein
-bone mineralization |
| 3 vitamin K dependent proteins in bone | -Osteo calcin: sythesized by osteoblasts, regulated by vit D
-Matrix GIa protein(MGP): found in bone, cartilage, blood vessels, prevents calcification of soft tissue, cartilage, and bv
-Protein S: synthesized by osteoblasts, role is unclear |
| How does warfarin affect vit. K | Depletes active Vit. K recycling |
| Symptoms of Vit. K deficiency | -prolonged bleeding, easy bruising
-impaired bone mineralization and/or remodeling |
| Why is Vit. K deficiency uncommon in adults | -ubiquitous in foods
-active vit K cycle
- activity of colonic bacteria |
| Who is susceptible to vit K deficiency bleeding and what is the treatment | new borns, inject K1 to all newborns |
| Tolerable upper intake level for vit K in adults | none recommended, 120 mcg male and 90 mcg females |
| Therapeutic applications of vit. K | -vascular calcification: aortic calcifications associated w/ lower vit K1 intake
-hemorrhagic disease of newborns (HDN) |
| What is the effect of various forms of vit. K on osteoporosis | -epidemiological support for decreased risk of fracture
-undercarboxylated osteocalcin |
| General symptoms of Vitamin B deficiency | -tired, weakness, tachycardia, easy bruising, photophobia, fissure tongue, sore throat |
| Vitamin B1 (Thyamin) functions | -energy metabolism: dehydrogenase enzymes
-nerve AP
-transketolase: enzyme thats a good marker for B1( pentose phosphate pathway)
-DNA/RNA synthesis |
| Deficiency symptoms of Vitamin B1 (Thyamin) | -Beri-beri: dry-nerves, wet-heart, cerebral-brain |
| Susceptible to Vitamin B1 (Thyamin) deficiency | Pregant, breast feeding, alcoholics, athletes |
| Upper limit of Vit. B1 | NONE |
| Therapeutic applications of Vit. B1 | -cataract prevention
-cancer
-alzheimers |
| Functions of Vit. B2 (Riboflavin) | -redox reactions(antioxidant reactions)
-ETC
-drug metabolism |
| How does Riboflavin affect glutathione function | -the enzyme glutathione reductase needs FAD to recycle glutathione
-FAD is a flavo-coenzyme that requires B2
-you need B2 to get FAD, and FAD to recycle glutathione |
| Tolerable upper intake of Vit. B2 (Riboflavin) | NONE |
| What is the symptom of excess riboflavin intake | Nuclear urine (bright urine) |
| Effect and dose of riboflavin for migraine headache | 400mg/day for 3 months
-should reduce the frequency and number of headache days |
| Types of Vit. B3 (Niacin) | -nicotinic acid: main thing
-niacinimidea: derivative of nicotinic acid; has an amide group
- boh are co-enzyme forming |
| Functions of Niacin (B3) | -cellular metabolism for over 200+ enzymes
-help form NAD and NADH
-DNA repair, cellular signaling, and blood sugar regulation |
| Deficiency of Niacin (B3) | -Pellagra-late stage deficiency
- symptoms: dermatitis, diarrhea, dementia, death |
| How is Niacin related to tryptophan | -NAD can be synthesized from tryptophan |
| Tolerable Upper intake of Vit. B3 (Niacin) | 35mg for flushing |
| Therapeutic applications of Vit. B3 (Niacin) | -cancer prevention
-beta cell protection in type 1 diabetes
-mental illness |
| Use of Niacin in CV disease and types of niacin and toxicity | -nicotinic acid only!!
-3g/day for 6 years increased HDL levels, decreased lipoprotein A, increased bouyant LDL, and decreased mortality/morbidity |
| Active form of Pyridoxine (Vit. B6) | pyridoxal-5-phosphate |
| Functions of Pyridoxine (B6) | -transamination
-nervous system functions
-gluconeogenesis
-steroid hormone inhibition |
| Tolerable Upper limit of Vit. B6 (Pyridoxine) | 100 mg
-prevents sensory neuropathy |
| Therapeutic applications of Pyridoxine (B6) | -birth control side effects
-PMS
-morning sickness |
| Role of Pyridoxine in the Homocystine Metabolism | -it converts homocystine to cystine to decrease risk of heart disease |
| Potential Toxicity of Pyridoxine (B6) | -flushing
-GI issues
-increased uric acid levels
-liver toxicity at 750mg/day |
| Compare and Contrast Folic Acid (B9) and Folate | -Folic acid: synthetic but stable and in all supplements
-Folate: in leafy raw veggies, not as stable and not as effective |
| Functions of Folic Acid (B9) | -one carbon metabolism: methylation
-cell growth
-nucleic acid and amino acid synthesis** |
| Role of Folic Acid in Homocystine Metabolism | -synthesis of methionione from homocysteine |
| Who is susceptible to folic acid deficiency | Pregnant, active, alcoholics |
| Symptoms of Folic Acid (B9) deficiency | -increased homocysteine levels
- atrophy and inflammation of mucous membranes
-birth defects |
| Upper Tolerable Limit of Vitamin B9 (Folic Acid) | 1000 mcg |
| How do genetics affect folate requirements | depending on genetics, you might have a different type of enzyme |
| What is the role of folic acid in disease prevention | -neural tube
-CV disease prevention
-cancer |
| Toxicity of Folic Acid | Folic acid and B12 increased mortality in patients with heart disease |
| How is Cobalamin (B12) different from the other B vitamins | it is large, complex, and contains cobalt |
| Functions of Cobalamin (B12) | -cofactors for methionine synthase and coenzyme A mutase
-HEMOGLOBIN SYNTHESIS
-folate metabolism, production of succinyl-CoA, homocysteine recycling |
| Cobalamin (B12) susceptible deficiency people | -surgical resection
-vegans
-alcoholics |
| Discuss the absorption of cobalamin in the GI tract | intrinsic factor attaches onto B12 in the small intestine and gets absorbed by the ilium |
| Characteristic symptoms of deficiency of Cobalamin (B12) | -anemia
-numbness
-memory
-dementia
-disorientation |
| Upper Tolerable Limit of Vitamin B12 (Cobalamin) | NONE |
| What is the role of Cobalamin (B12) in disease prevention | -decreased risk of heart disease
-breast cancer
-neural tube defects |
| Therapeutic applications of Cobalamin (B12) | -alzheimers
-depression
-allergies
-PNS disorders |
| Functions of Pantothenic Acid (B5) | -forming coA and acetyl-CoA
-energy metabolism
-FA and AA synthesis |
| Upper Tolerable limit of Pantothenic Acid (B5) | NONE |
| Therapy using B5 (Pantothenic Acid) | -helps with wound healing
-helps with high cholesterol |
| Functions of Biotin (B7) | -required by all living organisms
-attached at all active carboxylase sites
-acetyl-CoA and pyruvate carboxylase |
| Symptoms of B7 (Biotin) deficiency | -hair loss
-immunodeficiency
-numbness, tingling
-flaky skin with red patches around nose and mouth |
| Upper Tolerable limit of Biotin (B7) | NONE |
| Therapeutic applications of Biotin (B7) | -birth defects
-diabetes
-brittle nails
-hair loss |
| Functions of Vit. C | -collagen synthesis
-carnintine synthesis: getting fat into the mitochondria
-NXT synthesis
-antioxidant
-blood clotting |
| Vit. C deficiency symptoms | -scurvy
-sand paper skin
-impaired wound healing |
| Upper Tolerable limit (TUI) of Vit. C | 2000mg |
| Disease prevention of Vit. C | -coronary heart disease: 400mg/day
-stroke, cancer, cataracts, decreased uric acid for gout, and lead toxicity |
| Therapeutic applications of Vit. C | -CV disease: 500mg/day
-cancer: 10g/day
- helps with colds
-osteoporosis |
| Toxicity concerns with Vit. C | -only occurs in really high doses
-genetic mutations, birth defects, cancer, kidney stones, loose stools |
| Increases risk of calcium deficiency | -loss of gastric acid secretion
-menopause
-magnesium deficiency
-magnesium excess |
| Upper limit of Calcium | 2000mg |
| Ca RDA of adullts 51-70 years old | -males 1000mg
-females1200mg |
| Function of Calcium | -blood clotting
-cell signaling
-structural functions |
| Calcium Deficiency symptoms | -osteoporosis
-muscle cramping and spasm
-increased irritability of nerve cells |
| Therapeutic applications of Calcium | -oseoporosis
-HTN
-Colon Cancer |
| Toxicity of Calcium | -Only from supplements
-Kidney stones
-Hypercalcemia
-milk alkaline |
| Dietary components that interfere with calcium | -protein intake
-phosphorus
-Oxalates (spinach, rhubarb)
-Phytic acid
-Sodium
-Alcohol |
| Magnesium Function | -energy
-synthesis of nucleic acids and glutathione
-cell signaling
-structural function
-ion transport across cell membrane
-wound healing |
| UL Magnesium | 350 mg loose stool |
| RDA Mg in Adults | male >31 420mg
female > 31 320mg |
| Magnesium Deficiency symptoms | -hypomagnesia: neuro, personality, cramping, spasm
-Chronic kidney failure: Mg cannot be excreted efficiently |
| Therapeutic applications of Magnesium | -Cramping
-spasm
-asthma
-diabetes |
| Toxicity of Magnesium | -Hypermagnesemia: low bp, loose stool, arythmea
-kidney disease- <1g/day |
| Function of Potassium | -energy
-cell signaling
-pyruvate kinase |
| Potassium amounts recommended | adults, male and female over 19 is 4700mg |
| Source of Potassium | unprocessed fruits and veggies |
| Potassium deficiency issues | hypokalemia: fatigue, spasm/cramp, arrhthmias |
| risk of becoming potassium deficient | alcoholics, diuretics, any BP pill |
| Therapeutic applications of Mg | -HTN
-Osteoporosis by maintaining Ca |
| Toxicity of Potassium | -Tingling
-Arrhythmias
-Diuretics
-BP pills
-decrease aldosterone |
| Recommended intake of Potassium vs average intake | Recommended= 4700 mg/day
- avg male 3100mg
-avg female 2300 mg |
| Upper limit of sodium | 2300 mg |
| Upper limit of Salt | 5800mg |
| Adults recommended amount of salt and sodium | Sodium is 1300mg
Salt is 3300 mg |
| Excessive sodium leads to what | increased ECF volume |
| Function of sodium | -membrane potential
-maintain blood volume and pressure |
| Deficiency of sodium | -not due to decrease of intake
-Hyponatremia: cerebral edema |
| Increases risk of sodium deficiency | -sodium loss(vomit, diarrhea)
-excercise
-sweating |
| Therapeutics of Sodium | -restriction
-gastric cancer
-HTN
-Osteoporosis |
| Toxicity of Sodium | -Hypernatremia: excess water loss+decrease water intake, possible kidney failure |
| Average salt recommendation to average salt intake | recommend 7800mg for men, intake 11,800mg
recommend 5800 mg for woemn, intake 7800mg |
| What is the DASH diet and what were the results of the trials | -diet high in fruits, veggies, whole grains, poultry, fish, nuts, and low fat dairy products substantially lower BP to SAD
-higher in K and Ca-Na levels kept constant
-effect of salt reduction was greater in control diet than DASH diet |
| Upper Limit of Iron | 45mg |
| Recommended Iron amounts for Infants7-12 months | 11mg |
| Recommended Iron amounts for Adults 19-50 years | Males- 8mg
Females- 18mg
Pregnancy- 27mg |
| Iron characteristics | -2/3 body iron is functional form
-remainder stored in bone marrow and liver
-powerful oxidant and potentially harmful
-Copper increases iron absorption |
| Function of Iron | -O2 transport and storage
-Enzyme function: antioxidant, pro-oxidant,DNA synthesis |
| Iron deficiency symptoms | -Microcytic hypocromic anemia
-fatigue
-Rapid HR
-Fever
-Spoon shaped nails
-Impaired physical work capactiy
-inability to maintain body temperature |
| Therapeutics of Iron | -fatigue
-poor intellectual development
-lead toxicity
-restless legs |
| Toxicity of Iron | -largest case of poisoning in children under 6
-Hemochromatosis: iron overload leads to CVD, cancer, stained teeth, dark stools |
| Who is susceptible to iron deficiency | -Infants 6 months to 4 years
-pregnancy
-adolescents
-vegetarians
-intense exercise
-chronic blood loss
-gastric bypass |
| What is the most common deficiency in the US | Iron deficiency |
| What enhances iron absorption | Vitamin C, Organic acids, meat, fish, poultry |
| What inhibits iron absorption | phytic acid, polyphenols, soy protein |
| Upper limit of Zinc | 40mg |
| Recommended Zinc intake adults above 19 | Males 11mg
Females 8mg |
| Function of Zinc | Catalytic role in 100+ enzymes
-regulatory role
-structural role |
| Deficiency of Zinc symptoms | -zinc/copper imbalance
-acrodermatitis enteropathica
-impaired taste
-poor wound healing |
| Therapeutics of Zinc | -impaired growth and development
-weak immune function
-common cold
-diabetes
-macular degeneration |
| Toxicity of Zinc | -Copper deficiency at doses of 60mg/day
-GI distress at 50-150mg/day |
| What is the most abundant intracellular trace element | Zinc |
| Relationship between Zinc and Copper | High Zinc interferes with copper bioavailability- 10 to 1 ratio |
| Upper limit of Copper | 10,000 ug |
| Recommended Copper amounts for Adults 19 and above | Males 900ug
Females 900ug |
| Function of Copper | -Energy
-MAO
-Melanin
-Epinephrine synthesis
-Superoxide dismutase |
| Deficiency of Copper symptoms | -Anemia
-Loss of pigmentation
-Impaired growth
-Osteoporosis |
| Therapeutics of Copper | -immune function
-osteoporosis |
| Toxicity of Copper | -Tightly regulated in water supply
-zinc deficiency
-Wilson's disease
-Liver damage with long term use |
| Chromium upper limit | None |
| Recommended Chromium in adults 19-50 years | Males 35 ug
Females 25 ug |
| Deficiency of Chromium symptoms | -impaired glucose tolerance
-endurance exercise can cause it
-elevated cholesterol and TG
-Peripheral neuropathy |
| Therapeutics of Chromium | -impaired glucose tolerance and diabetes
-diabetes
-CVD |
| Toxicity of Chromium | -hexavalent(VI) toxic vs trivalent(III) non toxic
-impaired liver function |
| Difference between hexavalent chromium and trivalent chromium | -hexavalent is toxic: derived from trivalent by heating alkaline ph
-readily reduced to chromium III in acidic stomach
-Trivalent is non toxic |
| Iodine Upper Limit | 1100 ug |
| Iodine Recommended limit in adults 19 and above | males 150 ug
females 150ug |
| Food sources of Iodine | -iodized salt
-dried seaweed
-potato with skin, baked if in iodine soil |
| Funcion of Iodine | thyroid hormone synthesis |
| Iodine Deficiency symptoms | -cretinism
-hypothyroid
-goiter
-Fibrocystic breast condition |
| Risk that can lead to Iodine deficiency | -decreased selenium
-goitrogens
-soil deficiency |
| What happens in Iodine deficiency | Iodine-induced hyperthyroidism (IHH)
-happens at 150-200ug/day |
| what happens in iodine sufficiency | -elevated TSH, hypothyroidism
-happens at 1700-1800ug/day |
| Therapeutics of iodine | -hypothyroid
-radiation-induced thyroid cancer
-fibrocystic breast condition |
| Toxicity of Iodine | -hypothyroid
-hyperthyroid
-thyroid cancer |
| What is the most prevalent cause of preventable mental retardation in the world | Iodine- widespread efforts to iodize salts |
| What increases the risk of iodine deficiency | -soil deficiency in inland areas
-pregnancy and lactation
-Goitrogens block uptake or use of iodine (tobacco, soybeans) |
| Upper limit of Selenium | 400ug |
| Recommended amount of Selenium in adults 19 and up | Male 55ug
Female 55ug |
| How does iodine interact with selenium | -selenium deficiency exacerbates iodine deficiency
-selenium is required for T4 to T3 conversion |
| Function of Selenium | Selenoproteins: Glutathione peroxidases, Iodothyroninedeiodinases |
| Deficiency of Iodine can lead to | -increased risk of cancer
-weak immune system
-sign of deficiency is Kashin-beck disease and Keshan disease |
| Therapeutics of Selenium | -can help prevent cancer
-CVD
-Viral infection |
| Toxicity of Selenium | -Brittle nails
-GI problems
-garlic breath |
| Upper limit of Flouride | 10mg |
| Recommended amount of Fluoride for infants and adults | infants .01mg
male adults 4mg
female adults 3mg |
| Function of Fluoride | -Tooth structure
-bone metabolism: stimulates osteoblast activity |
| Deficiency of Fluoride may lead to | increased susceptibility to dental caries |
| Therapeutics of Fluoride | -caries
-possibly osteoporosis |
| Toxicity of Fluoride | -Dental fluorosis
-Skeletal fluorosis
-poising at 5mg/kg of bodyweight |
