Chapter 2

primary malnutrition

- due to an imbalance between nutrient requirements & nutrient availability

secondary malnutrition

- due to non-diet factors, e.g., illness or drug-related interaction

Clinical assessments

A process of differentiating, defining, and measuring the behaviors, cognitions, and emotions that are of concern medical history visible signs of illness symptoms of disease or malnutrition

Intake levels of sodium that appear to support adequate nutritional status in healthy populations, known as the _______________ for sodium, have been established.

AIs or Adequate Intakes

AMDRs Dietary Reference Committee vs. Dr. Witte's recommendations

AMDR Dr. Witte CHO 45-65% 70-75% Fat 20-35% 10-15% Protein 10-35% 15-20%

The recommendation concerning the percentage range of energy one should obtain from fat is called the _______________.

AMDR or Acceptable Macronutrient Distribution Range

"dining by traffic light"

Aim to crowd your plate at each meal with healthful options (foods in their whole, "as-grown" form), while minimizing foods that contain less healthful components like sodium, added sugar, trans fat, saturated fat, & cholesterol.

"ABCD" methods

Anthropometry Biochemical measurements Clinical assessments Dietary assessment

What vitamins, minerals and/or nutrients do we not reliably get in our food supply, regardless of the type of diet you consume that thus might warrant supplementation?

B12, Vitamin D, Omega 3, Iodine

_______________ are quantifiable measurements, typically taken from things like blood and/or urine, that reflect a nutrient's function.

Biomarkers

_______________ refers to the proportions of fat, water, lean tissue, and mineral (bone) mass that make up your tissues.

Body composition

relationship between metabolism and immune function

Both overnutrition & undernutrition have implications for immune function.

Calories

Calories provide a measure of how much energy you get from a serving of this food.

If 1000 healthy 40-year-old men eat a daily diet supplying their _______________ of iron, then 500 of them, on average, will need to take supplemental iron to meet their physiological requirements.

EAR or Estimated Average Requirement

You would need to know a healthy individual's sex, age, physical activity level, weight, and height in order to determine his or her _______________.

EER or Estimated Energy Requirement

What are the different DRIs

Estimated Average Requirement Recommended Dietary Allowance Adequate Intake Level Tolerable Upper Intake Level

"Calories from Fat" has been added to the new and improved Nutrition Facts Panel because research shows that knowing the amount of fat in a product is more important than knowing the type(s) of fat in it.

False

Dietary Reference Intakes (DRIs)

First established in 1994 in N. America are meant to provide estimates of nutrient requirements in a healthy population.

three main types of allowable claims we discussed regarding packaging

Nutrient-content claims Health claims Structure/function claims

yellow light food

Processed plant food and unprocessed animal food Ex: bread, steak Ideally should be minimized

Nearly all (97%) healthy pregnant women who consume their _______________ of vitamin B6 each day will obtain enough of this nutrient for themselves and their babies.

RDA or Recommended Dietary Allowance

What are the basic components of a nutrition facts panel and how are they interpreted?

Serving Information, Calories, Nutrients, The Percent Daily Value (%DV)

What components are required on food labels?

Statement of identity, or name of the food. Net quantity of contents, or amount of product. Nutrition Facts. Ingredient and allergen statement. Name and address of the manufacturer, packer, or distributor.

The Percent Daily Value (%DV)

The % Daily Value (%DV) is the percentage of the Daily Value for each nutrient in a serving of the food. 5% DV or less of a nutrient per serving is considered low 20% DV or more of a nutrient per serving is considered high

Serving Information

The serving size reflects the amount that people typically eat or drink. It is not a recommendation of how much you should eat or drink.

"Calories from Fat" has been REMOVED FROM the new and improved Nutrition Facts Panel because research shows that knowing the TYPE of fat (i.e., saturated, unsat., trans) in a product is more important than knowing the amount of "fat calories."

True

Both overnutrition and undernutrition have implications for immune function.

True

Structure/function claims made by a food product manufacturer do not require pre-approval by the Food and Drug Administration (FDA).

True

The main idea behind the "Dining by Traffic Light" system is to help you to crowd your plate with healthful options, while minimizing the foods that contain less healthful components like added sugar, excess sodium, trans fat, saturated fat, and cholesterol.

True

To be considered kosher, meat and dairy products cannot be prepared or served together on the same plate.

True

If Jesse chronically consumes more than his _______________ for vitamin A, there is a strong possibility that this will be detrimental to his health.

UL or Tolerable Upper Intake Level

red light food

Ultra-processed foods and processed animal foods Ex: cookies, chips, soda Ideally should be avoided

Overweight

a condition in which a person is heavier than the standard weight range for his or her height

Nutritional status assessment includes: dietary assessment clinical assessment biochemical assessment anthropometric assessment all of these

all of these

Nutrient-content claims

are FDA-regulated These claims describe the level of a nutrient or dietary substance in the product, using terms such as good source, high, or free. ex: fresh frozen (foods that were quickly frozen while still fresh

Estimated energy requirements (EERs)

are average intakes needed to maintain weight in a healthy person of a particular: age, sex, weight, height, & physical activity level • based on established calculations

Dietary reference intakes (DRIs)

are estimates of nutrient requirements in a healthy population

Structure/function claims

are not approved by the FDA statements that characterize the relationship between a nutrient or other substance in a food and its role in the body ex: Dietary Supplements, conventional foods

Recommended Dietary Allowance (RDA)

are recommended goals for individuals. - nutrient-intake goals for individuals • average intake level of a nutrient thought to meet the nutrient requirements for 97% of healthy individuals in specified life stage and sex - purposes • prevent nutrient deficiencies • promote optimal health (no longer about preventing deficiency) - can only be established for nutrients with EARs - does not distinguish between natural, additive or supplemental forms of nutrients

daily dozen

beans, berries, other fruits, cruciferous vegetables, greens, other vegetables, flaxseeds, nuts and seeds, herbs and spices, beverages, exercise

Undernutrition

consuming too little of a nutrient can lead to deficiencies

Overnutrition

consuming too much of a nutrient overnutrition can lead to obesity, nutritional toxicity, and/or other adverse health consequences

relevance of the "daily dozen" to our daily health & well-being

everything we should ideally strive to include in our daily routine for optimal health and longevity

what makes food kosher?

has to be on the approved list and blessed by a group of authorized rabbis

relationship between malnutrition and immune function

immunosuppression, susceptibility to infection

relationship between overnutrition and immune function

immunosuppression, susceptibility to inflammatory disease

Exam Room Live interview

interview of cardiologist Dr. Freeman that we listened to in class, he spoke of how malnutrition is correlated with cardiovascular disease.

Adequate Intake Level (Al)

levels set are when data is lacking for EARs (and thus, no RDA is set). - amount of a nutrient that meets the physiological requirements of 50% of the healthy population of similar individuals - nutrient intake goals for individuals - lack of research to support an RDA because lacking an EAR (more research needed on a nutrient that only has an AI) - no RDAs for infants 0 to 6 months of age; only AIs

Undernutrition and overnutrition are both examples of underconsumption nutritional toxicity overconsumption nutritional deficiency malnutrition

malnutrition

relationship between normal nutrition and immune function

normal immune function

nutritional toxicity

overconsumption of a nutrient that results in dangerous toxic effects

Anthropometry

physical dimensions & composition - height, weight, waist circumference - body composition - body mass index (BMI) = weight in kg divided by height in m2

Acceptable macronutrient distribution ranges (AMDRs)

ranges of intakes for each class of energy source that are associated with reduced risk of chronic disease while providing adequate intakes of essential nutrients

glycemic index

ranking of food based on the way it affects sugar levels in the blood

nutritional status

refers to the state or condition of one's nutrition the health of a person as it relates to how well his or her diet meets that person's individual nutrient requirements

Estimated Average Requirement (EAR)

reflect a population's average need. - meet requirements of half the healthy individuals in each life stage & sex - not all nutrients have EAR values- it not appropriate to use EAR for individuals

Tolerable Upper Intake Level (UL)

reflect safe maximal intakes. - highest level of usual daily nutrient intake likely to be safe/pose no risk of adverse health effects - *note: not all nutrients have an UL • insufficient research • lack of UL does not indicate that high level of consumption is safe

Health claims

require FDA approval statements that characterize the relationship between a nutrient or other substance in a food and a disease or health-related condition ex: "Calcium may reduce the risk of osteoporosis"

nutritional adequacy

required amount of nutrients needed to meet physiological needs - different depending on sex, age, physical activity level, genetics

Nutrients

shows you some key nutrients that impact your health. Nutrients to get less of: Saturated Fat, Sodium, and Added Sugars Nutrients to get more of: Dietary Fiber, Vitamin D, Calcium, Iron, and Potassium.

malnutrition

state of poor nutrition due to an imbalance between nutrient requirements & nutrient availability Stunting, Wasting, Overweight

food composition tables

tables that list the exact number of calories, grams of fat, milligrams of sodium and other nutrients commonly found in foods

immune function

the body's normal ability to fight infection and illness with antibodies and lymphocytes

metabolism

the combination of chemical reactions through which an organism builds up or breaks down materials

Dietary assessment

the evaluation of a person's dietary intake • retrospective dietary assessment - 24-hour recall - food frequency questionnaire • prospective dietary assessment - diet record

Stunting

the failure of children to grow to a normal height for their age due to severe and chronic malnutrition

The nutrition facts panel

the label on a food package that contains the nutrition information required by the FDA

Wasting

the tendency for children to be severely underweight for their age as a result of malnutrition

How can doctors help reduce the cardiovascular and cardiometabolic morbidity and mortality associated with poor nutrition?

they should follow nutritional adequacy for each person separately

ways in which we describe nutritional status

undernutrition vs. overnutrition

green light food

unprocessed plant foods whole grains, beans, legumes, nuts Best choice

Biochemical measurements

• blood, urine - biological markers