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Nutrition HO-15 Midterm Review


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Nutrients

  • Nutrients

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


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Nutrients

  • Nutrients - Organic

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


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Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


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Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates 4 calories/g

    • Fat 9 calories/g

    • Protein 4 calories/g

    • Vitamins

    • Minerals


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Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


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Nutrients

  • Nutrients - Energy Yielding

    Muffin 280 calories (45 g)

  • 15 g CHO 15X4 = 60 calories

  • 20 g fat 20X9 = 180 calories

  • 10 g protein10X4 = 40 calories

    280 calories


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Recognizing a healthy diet

  • Adequacy - getting enough

  • Balance - proportionality

  • Moderation - nothing in excess

  • Variety - wide selection

  • Calorie Control - not too much or too little


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Research

  • Double blinded study

  • Placebo controlled

  • Intervention

  • Epidemiologic


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Research

  • Double blinded study

  • Placebo controlled

  • Interventional

  • Epidemiologic

Gold Standard: Double Blind Placebo Controlled Randomized Clinical Trial


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Nutrient Density

  • Muffin # 1

    • 280 calories

    • 20 g fat (15 g saturated fat)

    • 10 g sugar

    • Less than 2% daily value: Fe, Ca, Vit. A & C

  • Muffin #2

    • 200 calories

    • 15 g fat (2 g saturated fat)

    • 4 g sugar (10 g whole grain CHO)

    • 10-15% daily value: Fe, Ca Vit. A & C


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Macronutrients

Percent of Total Calories

Carbohydrates45-65%

Fat20-35%

Protein10-35%

(10-15%)


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Macronutrients

Example:

Carbohydrates45%

Fat30%

Protein25%

TOTAL 100%


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Phytochemicals

  • Biologically active substance in plants

  • Non-nutrient

  • May protect against chronic disease

  • Anti-oxidants

  • Example: Soy, chocolate, flaxseed, tomatoes, garlic, wine, tea


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Mouth

Stomach

Liver

Gallbladder

Pancreas

Small Intestine

Colon


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Mouth - chews, mixes food with saliva

Stomach -

Liver -

Gallbladder -

Pancreas -

Small Intestine-

Colon -


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver -

Gallbladder -

Pancreas -

Small Intestine-

Colon -


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver - makes bile

Gallbladder -

Pancreas -

Small Intestine-

Colon -


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver - makes bile

Gallbladder - stores bile

Pancreas -

Small Intestine-

Colon -


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver - makes bile

Gallbladder - stores bile

Pancreas - secretes digestive enzymes

Small Intestine-

Colon


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver - makes bile

Gallbladder - stores bile

Pancreas - secretes digestive enzymes

Small Intestine-enzymes break down fat, protein, CHO & absorbed

Colon -


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Mouth - chews, mixes food with saliva

Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein

Liver - makes bile

Gallbladder - stores bile

Pancreas - secretes digestive enzymes

Small Intestine- enzymes break down fat, protein, CHO & absorbed

Colon - fluid and minerals absorption & some fiber fragments absorbed


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Storage Organs

When we eat too much……

  • Carbohydrate - it is stored as

  • Fat - it is stored as

  • Protein - it is stored as


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Storage Organs

When we eat too much……

  • Carbohydrate (glucose) - it is stored as

    • glycogen in liver and muscle

    • fat in adipose cells

  • Fat - it is stored as

  • Protein - it is stored as


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Storage Organs

When we eat too much……

  • Carbohydrate (glucose) - it is stored as

    • glycogen in liver and muscle

    • fat in adipose cells

  • Fat - it is stored as

    • Fat in adipose cells

  • Protein - it is stored as


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Storage Organs

When we eat too much……

  • Carbohydrate (glucose) - it is stored as

    • glycogen in liver and muscle

    • fat in adipose cells

  • Fat - it is stored as

    • Fat in adipose cells

  • Protein - it is stored as

    • Fat in adipose cells

      • Note: protein is not stored in the body


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Carbohydrates

  • Simple or Complex?


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Carbohydrates

  • Simple or Complex?

Simple!


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Simple Carbohydrates

Monosaccharides

Disaccharides


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Complex Carbohydrates

Starch

Fiber

Glycogen

fiber

glycogen


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Fiber


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Which part of the wheat kernel

Has fiber?


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Which part of the wheat kernel

has fiber? Bran

Which part of the wheat kernel has starch?


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Which part of the wheat kernel

has fiber? Bran

Which part of the wheat kernel has starch? Endosperm

Which part of the wheat kernel has nutrients & protein?


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Which part of the wheat kernel

has fiber? Bran

Which part of the wheat kernel has starch? Endosperm

Which part of the wheat kernel has nutrients & protein? Germ

Which part of the wheat kernel is not edible?


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Which part of the wheat kernel

has fiber? Bran

Which part of the wheat kernel has starch? Endosperm

Which part of the wheat kernel has nutrients & protein? Germ

Which part of the wheat kernel is not edible? Husk


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  • List the appropriate sequence of events which happen after you eat a plain white bagel:

    • I. Starch starts to breakdown into maltose in the mouth

    • II. Maltose breaks down into glucose in the small intestines

    • III. Glucose is absorbed from the small intestines into the bloodstream

    • IV. The pancreas secretes insulin in response to high blood glucose

    • V. Insulin transports glucose from the bloodstream into cells

    • VI. Blood glucose decreases


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Insulin & Glucose

insulin

glucose

Insulin receptor

Glucose transported across cell


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Diabetes (Type I & II)

  • Onset


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Diabetes (Type I & II)

  • Onset

    • Type I - typically childhood

    • Type II - typically adulthood - recently seen developing in childhood


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Diabetes (Type I & II)

  • Cause

    • Type I -

    • Type II -


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Diabetes (Type I & II)

  • Cause

    • Type I - autoimmune disease, insulin secreting cells impaired

    • Type II - acquired, insulin resistance, obesity, genetics, diet


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Diabetes (Type I & II)

  • Insulin secretion

    • Type I -

    • Type II -


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Diabetes (Type I & II)

  • Insulin secretion

    • Type I - no natural insulin

    • Type II - enough or too much insulin


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Lipids

Triglycerides (TG)

  • ≈95% of all lipids in foods and the human body

  • Phospholipids

    • For example, lecithin

  • Sterols

    • For example, cholesterol

  • P


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    Fats


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    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat


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    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat

        25 g X 9 calories/g = 225 calories


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    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat

        25 g X 9 calories/g = 225 sf calories

        225 sf calories / 500 calories =

        .45 = 45%


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    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat

        25 g X 9 calories/g = 225 calories

        225 calories / 500 calories = .45 = 45%

        45% of the calories in the burger are from saturated fat


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    LDL and HDL

    • What is LDL?

    • What is HDL?

      They are not actually cholesterol!

      But people consider them cholesterol


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    LDL and HDL

    • What is LDL?

      • Low density lipoprotein

      • Transports cholesterol to tissues

    • What is HDL?

      • High density lipoprotein

      • Scavenges cholesterol

        and brings it back to liver


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    LDL and HDL

    • How do you lower LDL?

    • How do you increase HDL?


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    LDL and HDL

    • How do you lower LDL?

      Lower your intake of saturated fat and trans fat

    • How do you increase HDL?

      Exercise


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    Trans Fats


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    Essential Fatty Acids

    • Saturated fatty acid?

    • Monounsaturated fatty acid?

    • Polyunsaturated fatty acid?


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    Essential Fatty Acids

    • Saturated fatty acid?

    • Monounsaturated fatty acid?

    • Polyunsaturated fatty acid?


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    Structure of Proteins

    • How do proteins differ from fats and carbohydrates in structure?


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    Structure of Proteins

    Peptide Bond


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    Structure of Proteins


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    Roles of Proteins

    Protein Functions

    • Enzymes

    • Hormones

    • Precursors (neurotransmitters/vitamins)

    • Antibodies

    • Fluid Balance

    • Buffers

    • Blood Clotting

    • Provide Energy


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    Protein digestibility

    • Which types of proteins are best absorbed by the body?


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    Protein digestibility

    • Digestion and absorption

      • Animal sources: ≈ 90+%

      • Legumes: ≈ 80%-90%

      • Grains: ≈ 70%-90%

      • Moist heat increases digestibility

      • Dry heat decreases digestibility


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    Complementary Proteins

    Amino acids from one protein source complement the amino acids from another protein source to form a complete protein.


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    Wasting

    • When the amine group has been removed, it means the amino acid has been wasted


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    Protein Energy Malnutrition


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    Protein Energy Malnutrition

    Marasmus

    Chronic protein and energy deficiency

    Severe wasting

    Matchstick arms


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    Protein Energy Malnutrition


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    Protein Energy Malnutrition

    Kwashiorkor

    Protein malnutrition

    Acute onset (1-3 yr)

    Edema (legs/belly)

    Fatty liver


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    DRI Protein

    • DRI protein: example

      • 130 lb sedentary 35 yr female

      • 130 lb X 1kg/2.2 lb = 59 kg


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    DRI Protein

    • DRI protein: example

      • 130 lb sedentary 35 yr female

      • 130 lb X 1kg/2.2 lb = 59 kg

      • 59kg X 0.8g/kg = 47g protein/day


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    DRI Protein

    • DRI protein: example

      • 130 lb sedentary 35 yr female

      • 130 lb X 1kg/2.2 lb = 59 kg

      • 59kg X 0.8g/kg = 47g protein/day

      • 47g X 4 cal/g = 188 calories

      • 188 cal/1800 calories = 10 % total calories


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    DRI Protein

    • DRI protein: example

      • 130 lb sedentary 35 yr female

      • 130 lb X 1kg/2.2 lb = 59 kg

      • 59kg X 0.8g/kg = 47g protein/day

      • 47g X 4 cal/g = 188 calories

      • 188 cal/1800 calories = 10 % total calories

      • 10-15% of total calories from protein-most Americans

      • 10-35% of total calories


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    What are the main functions of Vitamin A?

    .


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    What are the main functions of Vitamin A?

    • Vision

    • Growth and maintenance

      • body linings and skin

      • For growth of bones and teeth

    • Immune defenses


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    • What happens in Vitamin A deficiency?


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    • What happens in Vitamin A deficiency?

    night blindness

    Keratinization


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    Can toxicity develop from Vitamin A? Beta-carotene?


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    Can toxicity develop from Vitamin A?

    • Vitamin A? YES

    • From supplements or fortified foods

    • Beta-carotene? NO


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    What are the roles of Vitamin D in the body?


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    What are the roles of Vitamin D in the body?

    Regulation of blood calcium and phosphorus levels

    • raises blood calcium levels


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    Vitamin D Deficiency

    What happens in Vitamin D deficiency?


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    Vitamin D Deficiency

    RICKETS

    But most people are not receiving ENOUGH vitamin D because of the lack of sun exposure


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    What are the best sources of Vitamin D?


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    What are the best sources of Vitamin D?

    • Sunlight

    • Fortified milk

    • Cream, butter (small amounts)


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    What is the main function of Vitamin E?


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    What is the main function of Vitamin E?

    • Antioxidant:

    • quenches free radicals

    • protects cellular structures from oxidative damage


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    What is the main function of Vitamin K?


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    What is the main function of Vitamin K?

    • Synthesis of blood clotting proteins

      • Interferes with function of blood thinners

    • Synthesis of bone proteins

      • Adequate intake may reduce risk of hip fracture


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    What are the roles of Vitamin C in the body?


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    What are the roles of Vitamin C in the body?

    • Maintenance of connective tissues

      • Formation of collagen

    • Cofactor in the production of carnitine

    • Antioxidant

    • Restores Vitamin E to it’s active form

    • Supports the immune system

    • Boosts Iron absorption


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    What condition develops in Vitamin C deficiency?


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    Vitamin C Deficiency

    Scurvy


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    • Does not prevent colds

    • Vitamin C reduces histamine


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    What is the main function of the B vitamins?


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    What is the main function of the B vitamins?

    • part of coenzymes

      • Energy metabolism

      • New cell synthesis


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    Thiamin deficiency results in what condition?


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    Thiamin deficiency results in what condition?

    • Beriberi (affects nerves)

      • Loss of sensation in the hands and feet

      • muscular weakness

      • advancing paralysis


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    What condition develops in Niacin deficiency?


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    What condition develops in Niacin deficiency?

    • Pellagra

      • Diarrhea

      • Dermatitis

      • Dementia

      • Death


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    • Source of Niacin

      • Tryptophan can be converted to niacin

      • Tryptophan is in most proteins


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    Folate Deficiency

    What condition results from folate deficiency in pregnancy?


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    Folate Deficiency

    Neural tube defects

    Fortification of food is important - Most women don’t know they are pregnant for weeks


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    What condition results from Vitamin B12 deficiency?


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    What condition results from Vitamin B12 deficiency?

    • Pernicious Anemia

    Is Pernicious Anemia more likely to develop from lack of intake or malabsorption?

    • Malabsorption

    • Absorption of Vitamin B12 requires intrinsic factor (IF)


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    Who is at risk for Pernicious anemia?


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    Who is at risk for Pernicious anemia?

    • Elderly - most at risk

    • Strict Vegetarians

    • Vitamin B12 is only found in animal sources


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    Can Vitamin B6 can be toxic from supplements?


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    Can Vitamin B6 can be toxic from supplements?Yes!

    • A single B6 supplement can deliver 2 grams of the vitamin, the equivalent of

      • 3,000 bananas

      • 3,800 chicken breasts

    • Toxicity UL: O.1 gram

      * numb hands and feet


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    Calcium

    What other function does calcium have besides formation and maintenance of bone structure?


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    Calcium

    • Nerve transmission

    • Transport of ions

    • Blood pressure

    • Blood clotting

    • Muscle contraction

      Most abundant mineral in the body


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    Which mineral assists with muscle relaxation?


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    Which mineral assists with muscle relaxation?

    Magnesium


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    Which mineral is part of RNA and DNA?


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    Which mineral is part of RNA and DNA?

    • Phosphorus

    • Part of phospholipids

    • Buffer

    • Release of energy

      • A T P

      • adenosine tri phosphate

    P


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    What is the main extracellular cation?

    What is the main intracellular cation?


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    What is the main extracellular cation?

    What is the main intracellular cation?

    Note: Chloride is an anion - intake is as NaCl(table salt)


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    Sodium

    • Most people get too much much sodium

    • Usually from processed foods and fast food

    • Excess sodium does not cause hypertension - but increases risk


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    Potassium

    • fluid and electrolyte balance, cell integrity, heartbeat

    • Diets high in potassium help decrease the risk of hypertension


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    • Which mineral is needed for some proteins to assume their functional shape?

      • makes the proteins strong

      • through certain bonds


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    • Which mineral is needed for some proteins to assume their functional shape?

      • makes the proteins strong

      • through certain bonds

    • Sulfate


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    • Which mineral is a component of thyroxine?


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    • Which mineral is a component of thyroxine?

      • Iodine

    • Thyroxine regulates what?


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    • Which mineral is a component of thyroxine?

      • Iodine

    • Thyroxine regulates what?

      • metabolism


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    Iodine Deficiency

    Iodine deficiency can cause?


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    Iodine Deficiency

    Iodine deficiency can cause?

    • Goiter

    • Iodine deficiency can cause cretinism

      • irreversible mental and physical retardation


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    Iron Absorption

    What two forms are iron absorbed in?

    What is the absorption rate?


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    Iron Absorption

    What two forms are iron absorbed in?

    What is the absorption rate?

    • Heme (~23%)

      • Animal sources

    • Non- heme (2-20%)

      • Plant and

      • animal sources

    Iron

    heme


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    Increasing iron absorption

    • MFP factor

      • Found in Meat, Fish, Poultry

    • Vitamin C


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    Iron Inhibitors

    • Tannins

      • Found in tea and coffee

    • Calcium and phosphorus

      • Milk

    • Phytates

      • Found in the fiber of legumes and whole-grain cereals, breads


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    Iron in Meals

    Roast beef sandwich on whole grain bread

    Scrambled eggs with a cup of coffee

    Spinach salad with a glass of orange juice

    Iron fortified whole grain cereal with low fat milk


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    Zinc

    • Important in:

      • wound healing

      • immune function


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    Fluoride

    Deficiency = dental carries

    Toxicity = Fluorosis


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    Chromium

    Works with insulin to regulate blood glucose


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    Which mineral is an antioxidant?


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    Selenium

    A mineral which is an antioxidant

    Note: Vitamin C & E are also antioxidants


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    THE END


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