Nutrition HO-15 Midterm Review
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Nutrition HO-15 Midterm Review


Nutrients

  • Nutrients

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


Nutrients

  • Nutrients - Organic

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates 4 calories/g

    • Fat 9 calories/g

    • Protein 4 calories/g

    • Vitamins

    • Minerals


Nutrients

  • Nutrients - Energy Yielding

    • Water

    • Carbohydrates

    • Fat

    • Protein

    • Vitamins

    • Minerals


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


Recognizing a healthy diet

  • Adequacy - getting enough

  • Balance - proportionality

  • Moderation - nothing in excess

  • Variety - wide selection

  • Calorie Control - not too much or too little


Research

  • Double blinded study

  • Placebo controlled

  • Intervention

  • Epidemiologic


Research

  • Double blinded study

  • Placebo controlled

  • Interventional

  • Epidemiologic

Gold Standard: Double Blind Placebo Controlled Randomized Clinical Trial


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


Macronutrients

Percent of Total Calories

Carbohydrates45-65%

Fat20-35%

Protein10-35%

(10-15%)


Macronutrients

Example:

Carbohydrates45%

Fat30%

Protein25%

TOTAL 100%


Phytochemicals

  • Biologically active substance in plants

  • Non-nutrient

  • May protect against chronic disease

  • Anti-oxidants

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


Mouth

Stomach

Liver

Gallbladder

Pancreas

Small Intestine

Colon


Mouth - chews, mixes food with saliva

Stomach -

Liver -

Gallbladder -

Pancreas -

Small Intestine-

Colon -


Mouth - chews, mixes food with saliva

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

Liver -

Gallbladder -

Pancreas -

Small Intestine-

Colon -


Mouth - chews, mixes food with saliva

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

Liver - makes bile

Gallbladder -

Pancreas -

Small Intestine-

Colon -


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 -


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


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 -


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


Storage Organs

When we eat too much……

  • Carbohydrate - it is stored as

  • Fat - it is stored as

  • Protein - it is stored as


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


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


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


Carbohydrates

  • Simple or Complex?


Carbohydrates

  • Simple or Complex?

Simple!


Simple Carbohydrates

Monosaccharides

Disaccharides


Complex Carbohydrates

Starch

Fiber

Glycogen

fiber

glycogen


Fiber


Which part of the wheat kernel

Has fiber?


Which part of the wheat kernel

has fiber? Bran

Which part of the wheat kernel has starch?


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?


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?


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


  • 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


Insulin & Glucose

insulin

glucose

Insulin receptor

Glucose transported across cell


Diabetes (Type I & II)

  • Onset


Diabetes (Type I & II)

  • Onset

    • Type I - typically childhood

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


Diabetes (Type I & II)

  • Cause

    • Type I -

    • Type II -


Diabetes (Type I & II)

  • Cause

    • Type I - autoimmune disease, insulin secreting cells impaired

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


Diabetes (Type I & II)

  • Insulin secretion

    • Type I -

    • Type II -


Diabetes (Type I & II)

  • Insulin secretion

    • Type I - no natural insulin

    • Type II - enough or too much insulin


Lipids

Triglycerides (TG)

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

  • Phospholipids

    • For example, lecithin

  • Sterols

    • For example, cholesterol

  • P


    Fats


    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat


    Percent of Calories from Fat

    • Hamburger

      • 500 calories

      • 25 g saturated fat

        25 g X 9 calories/g = 225 calories


    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%


    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


    LDL and HDL

    • What is LDL?

    • What is HDL?

      They are not actually cholesterol!

      But people consider them cholesterol


    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


    LDL and HDL

    • How do you lower LDL?

    • How do you increase HDL?


    LDL and HDL

    • How do you lower LDL?

      Lower your intake of saturated fat and trans fat

    • How do you increase HDL?

      Exercise


    Trans Fats


    Essential Fatty Acids

    • Saturated fatty acid?

    • Monounsaturated fatty acid?

    • Polyunsaturated fatty acid?


    Essential Fatty Acids

    • Saturated fatty acid?

    • Monounsaturated fatty acid?

    • Polyunsaturated fatty acid?


    Structure of Proteins

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


    Structure of Proteins

    Peptide Bond


    Structure of Proteins


    Roles of Proteins

    Protein Functions

    • Enzymes

    • Hormones

    • Precursors (neurotransmitters/vitamins)

    • Antibodies

    • Fluid Balance

    • Buffers

    • Blood Clotting

    • Provide Energy


    Protein digestibility

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


    Protein digestibility

    • Digestion and absorption

      • Animal sources: ≈ 90+%

      • Legumes: ≈ 80%-90%

      • Grains: ≈ 70%-90%

      • Moist heat increases digestibility

      • Dry heat decreases digestibility


    Complementary Proteins

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


    Wasting

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


    Protein Energy Malnutrition


    Protein Energy Malnutrition

    Marasmus

    Chronic protein and energy deficiency

    Severe wasting

    Matchstick arms


    Protein Energy Malnutrition


    Protein Energy Malnutrition

    Kwashiorkor

    Protein malnutrition

    Acute onset (1-3 yr)

    Edema (legs/belly)

    Fatty liver


    DRI Protein

    • DRI protein: example

      • 130 lb sedentary 35 yr female

      • 130 lb X 1kg/2.2 lb = 59 kg


    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


    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


    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


    What are the main functions of Vitamin A?

    .


    What are the main functions of Vitamin A?

    • Vision

    • Growth and maintenance

      • body linings and skin

      • For growth of bones and teeth

    • Immune defenses


    • What happens in Vitamin A deficiency?


    • What happens in Vitamin A deficiency?

    night blindness

    Keratinization


    Can toxicity develop from Vitamin A? Beta-carotene?


    Can toxicity develop from Vitamin A?

    • Vitamin A? YES

    • From supplements or fortified foods

    • Beta-carotene? NO


    What are the roles of Vitamin D in the body?


    What are the roles of Vitamin D in the body?

    Regulation of blood calcium and phosphorus levels

    • raises blood calcium levels


    Vitamin D Deficiency

    What happens in Vitamin D deficiency?


    Vitamin D Deficiency

    RICKETS

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


    What are the best sources of Vitamin D?


    What are the best sources of Vitamin D?

    • Sunlight

    • Fortified milk

    • Cream, butter (small amounts)


    What is the main function of Vitamin E?


    What is the main function of Vitamin E?

    • Antioxidant:

    • quenches free radicals

    • protects cellular structures from oxidative damage


    What is the main function of Vitamin K?


    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


    What are the roles of Vitamin C in the body?


    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


    What condition develops in Vitamin C deficiency?


    Vitamin C Deficiency

    Scurvy


    • Does not prevent colds

    • Vitamin C reduces histamine


    What is the main function of the B vitamins?


    What is the main function of the B vitamins?

    • part of coenzymes

      • Energy metabolism

      • New cell synthesis


    Thiamin deficiency results in what condition?


    Thiamin deficiency results in what condition?

    • Beriberi (affects nerves)

      • Loss of sensation in the hands and feet

      • muscular weakness

      • advancing paralysis


    What condition develops in Niacin deficiency?


    What condition develops in Niacin deficiency?

    • Pellagra

      • Diarrhea

      • Dermatitis

      • Dementia

      • Death


    • Source of Niacin

      • Tryptophan can be converted to niacin

      • Tryptophan is in most proteins


    Folate Deficiency

    What condition results from folate deficiency in pregnancy?


    Folate Deficiency

    Neural tube defects

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


    What condition results from Vitamin B12 deficiency?


    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)


    Who is at risk for Pernicious anemia?


    Who is at risk for Pernicious anemia?

    • Elderly - most at risk

    • Strict Vegetarians

    • Vitamin B12 is only found in animal sources


    Can Vitamin B6 can be toxic from supplements?


    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


    Calcium

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


    Calcium

    • Nerve transmission

    • Transport of ions

    • Blood pressure

    • Blood clotting

    • Muscle contraction

      Most abundant mineral in the body


    Which mineral assists with muscle relaxation?


    Which mineral assists with muscle relaxation?

    Magnesium


    Which mineral is part of RNA and DNA?


    Which mineral is part of RNA and DNA?

    • Phosphorus

    • Part of phospholipids

    • Buffer

    • Release of energy

      • A T P

      • adenosine tri phosphate

    P


    What is the main extracellular cation?

    What is the main intracellular cation?


    What is the main extracellular cation?

    What is the main intracellular cation?

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


    Sodium

    • Most people get too much much sodium

    • Usually from processed foods and fast food

    • Excess sodium does not cause hypertension - but increases risk


    Potassium

    • fluid and electrolyte balance, cell integrity, heartbeat

    • Diets high in potassium help decrease the risk of hypertension


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

      • makes the proteins strong

      • through certain bonds


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

      • makes the proteins strong

      • through certain bonds

    • Sulfate


    • Which mineral is a component of thyroxine?


    • Which mineral is a component of thyroxine?

      • Iodine

    • Thyroxine regulates what?


    • Which mineral is a component of thyroxine?

      • Iodine

    • Thyroxine regulates what?

      • metabolism


    Iodine Deficiency

    Iodine deficiency can cause?


    Iodine Deficiency

    Iodine deficiency can cause?

    • Goiter

    • Iodine deficiency can cause cretinism

      • irreversible mental and physical retardation


    Iron Absorption

    What two forms are iron absorbed in?

    What is the absorption rate?


    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


    Increasing iron absorption

    • MFP factor

      • Found in Meat, Fish, Poultry

    • Vitamin C


    Iron Inhibitors

    • Tannins

      • Found in tea and coffee

    • Calcium and phosphorus

      • Milk

    • Phytates

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


    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


    Zinc

    • Important in:

      • wound healing

      • immune function


    Fluoride

    Deficiency = dental carries

    Toxicity = Fluorosis


    Chromium

    Works with insulin to regulate blood glucose


    Which mineral is an antioxidant?


    Selenium

    A mineral which is an antioxidant

    Note: Vitamin C & E are also antioxidants


    THE END


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