Agenda

1. Agenda • Test!!! Exam 2 • You have 1 hour • Any questions before we start? • You need to bring in 2 fresh fruits to lab on Thursday • Lecture

2. Lecture 13: Current Nutritional Status Will Brown 02/21/2012

3. Quick review • What are the 6 classes of nutrients? • Carbohydrate • Lipid • Protein • Vitamins • Minerals • Water Energy yielding nutrients;Macronutrients Micronutrients

4. Carbohydrates • Two main categories • Simple; mono and disaccharides • Glucose, fructose, sucrose, and maltose • Complex; aka: polysaccharides • amylopectin, amylose and fiber • Yield 4 kcal/g of energy • Main energy source of carbs in the body is glycogen • Some starch digestion occurs in the mouth but most is done in the small intestine • RDA is 130 g/day • Some argue against eating a lot of carbs • Blood glucose is maintained with a narrow range of 70-100 mg/dL

5. Monosaccharides glucose, fructose, galactose Disaccharides Sucrose glucose+fructose Lactose glucose+galactose Maltose glucose+glucose

6. Polysaccharides Starches Made in plants Digestible Glycogen Made by animals Stored in muscle + liver Fiber Made in plants Indigestible Amylose Straight chain Pectins Soluble Amylopectin Branched Cellulose Insoluble

7. Lipids • Three main categories-Triglycerides, Phospholipids, Sterols • Do not dissolve in water-hydrophobic • Yield 9 kcal/g of energy • Digestion takes place primarily in Small Intestine • Carried in the blood stream by lipoproteins • Two essential fatty acids in the diet are linoleic acid and alpha-linoleic acid • No RDA for fats but plant oils should comprise 5% of total calories • Fat intake should be around 30-35% of total calories • Less if at risk for cardiovascular event - ~20%

8. Triglycerides • Backbone of glycerol • Three fatty acid chains • Can be saturated or unsaturated

9. Phospholipids • Backbone of glycerol • One of the fatty acids replaced with phosphorus containing group • Lecithin is a phospholipid

10. Sterols • Looks nothing like the other lipids • Consists of a multi-ringed structure • Forms the basis for hormones such as testosterone and estrogen • The body can make all it needs • Cholesterol

11. Proteins • Made from 20 different amino acids • 9 Essential - must be eaten • 11 Non-essential – body can produce • Yield 4 kcal/g • Amino acids are bonded together (peptide bond) to form long chains of proteins • Structure determines function – four types of structure • Animal products are rich sources of protein • Some plant sources are good as well; beans & legumes • Digestion begins in the stomach – then proceeds in the SI • Most body components are made of protein • RDA is 0.8 g/kg of body weight

12. What are Amino Acids? OH H H AcidGroup AmineGroup O = C – C – N – H R Functional Group

14. Amino Acid Requirements • Adults = 11% of total proteins must be essential AA • Infants through preschool = 40% of protein must be essential AA • Later childhood = 20% • A typical diet has 50% of protein as essential AA

15. Vitamins • Two main categories • Fat soluble – A, D, E and K • Water soluble – B family, C and choline • Carbon compounds that yield no energy by themselves but are required for metabolism • Each vitamin has different RDA and toxicity levels • Fat soluble usually have narrower therapeutic window • If you are taking supplements, pay attention to the amount you are taking in

16. Minerals • Two main categories • Major; need >100 mg/day • Trace; need < 100 mg/day • Animal sources are most bioavailable sources • Each has a different RDA and Toxicity levels • Again, supplements should be taken with caution • Cover a broad spectrum of functions • Water balance, enzyme cofactors • Minerals compete for bioavailbility

17. What a plate should look like.

18. What does the average plate look like? • RDA • >15% Protein • <30%Fat • >55% Carbs

19. But what about the quality of food? • Carbs • A 2008 study determined that 10% of American calories came from HFCS • Average Americans eat 50% of their meals from fast food • Most included hamburger, fries and soda; all of which contain refined carbohydrate • Protein • Most Americans get protein from animal products which are high in saturated fat • Most hamburgers are made with 80/20 beef which is 20% fat • Fat • Average trans fat is 5.8 g/day • American diet is also high in saturated fat

20. What do we eat when we eat? • In 2004 • 46 slices of pizza 66.6 pounds of beef87.7 pounds of chicken21.4 gallons of milk 31.2 pounds oGrains: 6-11 servingsVegetables: 3-5 servingsFruit: 2-4 servingsDairy: 2-3 servingsMeats: 5-7 meat oz. Discretionary fat: use sparinglyAdded sugars: use sparingly • FDA recommendations • Grains: 6-11 servingsVegetables: 3-5 servingsFruit: 2-4 servingsDairy: 2-3 servingsMeats: 5-7 meat oz. Discretionary fat: use sparinglyAdded sugars: use sparingly • The average person eats… • Grains: 6.8 servingsVegetables: 3.0 servingsFruit: 1.6 servingsDairy: 1.7 servingsMeats: 5.3 meat oz. Discretionary fat: 62.1 gramsAdded sugars: 22.9 teaspoons

22. Diet Planning Basics • Eat a variety of different foods • Not just different food groups but also within food groups • Balance your choices between each of the food groups • Grains • Vegetables • Fruits • Milk • Meat & Beans • Oils

23. Diet planning Basics • Pay attention to portion size • The portions at most restaurants are 2 or 3 portions of any given food • A super-sized Coke from McDonald’s is 42 oz. • That is 3.5 servings of soda • Eat nutrient dense foods • A comparison of how many essential nutrients are present compared to how many calories are present • Be cautious of energy dense foods • Foods that are high in calories relative to their weight • For example: fried foods, fat-free snacks, and cookies

24. Nutritional States • Desirable nutrition • You have enough of the nutrient to support normal function • Undernutrition • Intake is less than needed for normal function • Prior to symptoms you can have subclinical deficiency • Anemia • This can be long term • Clinical symptoms can eventually develop unless undernutrition is addressed

25. Nutritional States • Overnutrition • Consuming a nutrient beyond what is needed • Excess fiber leading to intestinal irritation • Most common in America is calories • Can happen quickly with certain vitamins and minerals when taking suppements

26. How do we determine what we need? • 5 areas to assess to understand one’s nutritional status • Anthropometric test-body measurements such as body weight, wrist circumference • Biochemical-measures biochemical function related to a nutrient’s function; ie: enzymatic activity • Clinical-examination by doctor • Dietary assessment-analyze diet over the course of many days • Environmental assessment-background information such as weekly food budget, living conditions, education level, etc. • Your book calls these the ABCDEs nutritional assessment

27. Nutritional Assessment and Reality • Clinical symptoms can lag behind malnutrition • B-12 deficiency can develop over years • Heart attack might be the first symptom of cardiovascular disease • Osteoporosis is a condition that can develop over decades • Most clinical symptoms can be attributed to number of different things • Diarrhea • Dizziness