NUTR 223 Final Exam

B6, B12, Folate (Understand the roles these vitamins have in the potential etiology of cardiovascular disease; understand anemias specific to each vitamin)

- B6: helps with homocysteine metabolism; deficiency causes microcytic hypochromic anemia (low concentration of hemoglobin in RBC) - B12 (riboflavin): important for carb, fat, and protein metabolism; deficiency can impair endurance capacity; symptoms of deficiency: weakness, anemia, confusion, cheilosis, stomatitis, glossitis - Folate: required for growth, maintenance, and repair of all tissues within the body; homocysteine metabolism; requires B12 for activation

Recommended treatment for eating disorders

- anorexia: stop weight loss, establish regular eating patterns, restore lost weight, resolve psychological issues - bulimia: reduce and eventually eliminate binging and purging, establish regular eating patterns and a structured eating plan, regular exercise, address nutritional/medical/psychological problems - binge eating: similar treatment to that of bulimia

Binge Eating Disorder (personality traits; weight pattern)

- at least one episode of binging per week for at least three months followed by: eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food despite not feeling hungry, eating alone out of embarrassment and feeling disgusted with oneself

Beta- carotene (food vs supplement connection; toxicity issues)

- beta-carotene from food sources has shown a reduced risk in developing cancer, but beta-carotene supplements do not show the same data - not converted to retinol efficiently enough to cause toxicity - excess intake will cause hypercarotenemia, which is an orange pigmentation under the skin due to beta-carotene buildup

Understand synthesis to active form of calcium and vitamin D—what organs are involved

- calcium: ??? - vitamin D: skin is exposed to ultraviolet light, 7-dehydrocholesterol is converted to previtamin D3, which is then converted to vitamin D3 which diffuses from the skin to the blood, the liver then converts vitamin D3 to 25-(OH)D3, which is converted to the active form of vitamin D3 in the kidneys

Vitamin K (synthesis and who is prone to deficiency and why; nutrient drug interactions (Coumadin))

- catalyzes reactions necessary to make proteins for bone and tooth development - necessary for blood clotting - causes for deficiency: diseases that cause lipid malabsorption (vitamin K is fat-soluble), prolonged antibiotic use (kills bacteria in the large intestine that helps produce vitamin K) - coumadin prevents blood clots in individuals with CVD (decreases the activity of vitamin K); a sudden increase or decrease in vitamin K can affect the action of coumadin

How is the absorption of nonheme iron impacted by diet?

- chemical modification is required before absorption - vitamin C and stomach acid both aid in reducing ferric iron to ferrous iron - use of antacids may impact absorption

Iodine (understand relationship to thyroid gland; Understand hormonal regulation of blood iodine; Difference between goiter/cretinism)

- component of two thyroid hormones (T3 and T4) - when blood iodine concentration is low, the pituitary gland releases TSH, which triggers the release of thyroid hormones from the thyroid gland - goiter: iodine deficiency in children and adults due to low levels of T3 and T4 - cretinism: infant is born to iodine-deficient mother; symptoms include mental retardation, poor growth, and an increased risk of mortality

How does the DASH diet help with HTN?

- dietary approach to stop hypertension - low in fats and sodium, high in fruits, vegetables, dairy fat products

Female Athlete Triad (relationship to osteoporosis)

- disordered eating - osteoporosis - amenorrhea - low levels of body fat lead to amenorrhea and diminished estrogen levels which then leads to weak and brittle bones with an increased risk of stress fractures and osteoporosis

Difference between disordered eating and eating disorders

- disordered eating: irregular eating, consistent undereating and/or consistent overeating - eating disorder: extreme disturbance in eating behaviors that can result in medical or psychological consequences and dangerous weight loss; most often arises from physical, psychological, and social issues

Vitamin C (understand deficiency state; how it acts as an antioxidant; what is its role in iron absorption)

- donates electrons to stabilize free radicals and reactivates vitamin E - important for collagen synthesis - deficiency: scurvy; symptoms include pinpoint hemorrhages, bleeding gums, impaired wound healing, bone pain and fractures, fatigue, diarrhea, psychological problems - converts ferric iron (Fe3+) to ferrous iron (Fe2+) in the intestinal lumen

Thiamin (relate to deficiency state and understand why the alcoholic is prone to deficiency)

- energy substrate coenzyme for carbohydrate metabolism - required to convert pyruvate to acetyl-coA - needs are increased with exercise and a high-carb diet - deficiency impairs endurance performance - deficiency: glucose cannot be metabolized into energy; alcohol inhibits absorption and increases excretion

Vitamin A/Beta-Carotene (functions and forms)

- essential for dismantling old bone so new larger bones can form, aids in vision, cell differentiation, and immune function - retinoids and carotenoids - retinoids: most potent form, stored in liver, retinal and retinoic acid - carotenoids: found in foods of plant origin, beta carotene, splits in liver to form retinol

Antioxidant vitamins (function and understanding of free radicals and how they relate to disease)

- formed by certain metabolic processes (digestion/absorption and immune system fighting infections) and certain environmental factors (pollution, excess sunlight, toxic substances, - free radicals look for electrons/other compounds, antioxidants donate an electron, creating a stabilized free radical - free radicals form within the phospholipid bilayer, and damaged lipid molecules are unable to maintain the integrity of the cell

Vitamin B12 (Unique requirements for absorption; How might this impact deficiency; Food source of vitamins must be taken into account for certain dietary patterns; What vitamin influences its activation; What are deficiency symptoms; Role in neurological status; Anemia)

- found only in animal foods - requires intrinsic factor for absorption (frees B12 from food) - requires folate for activation - deficiency: pernicious anemia; inability to absorb B12; most common cause is autoimmune atrophic gastritis; anemia similar to that of folate deficiency - helps maintain myelin sheaths that provide insulation for neurons - deficiency symptoms include irregular muscle actions, impaired reflexes, possible paralysis and death

Iron (understand the difference between heme and non-heme iron)

- helps accept, carry, and release oxygen in the cells - heme iron: bound to a heme group; ferrous iron; Fe2+; more absorbable and more bioavailable - nonheme iron: ferric iron; Fe3+

Folate (importance to females; How does this vitamin affect development (i.e. what is the function of this vitamin); How does this vitamin relate to growth/development; Anemia)

- important to women who are pregnant or planning to become pregnant - folate deficiency can lead to neural tube defects ranging from slight problems in the spinal cord to mental retardation; diminished brain size

What contributes to night blindness?

- inadequate amounts of retinal to re-form rhodopsin

What is the relationship of ionic state of non-heme to absorption?

- ionic state impacts absorption; must be converted to to heme iron for absorption

Anorexia Nervosa (personality traits; weight pattern)

- irrational fear of gaining weight, disturbance in body weight or size, significantly low body weight due to restriction of energy intake - most likely caused by a distorted body image that overestimates body fatness - two types: restricting and binge eating/purging - signs and symptoms: rigid dieting/restricting food intake/food rituals, complaints of bloating while eating and being fat while actually thin, dramatic weight loss, weighs oneself frequently, exercises obsessively, complaints of feeling cold, irregular or cessation of menstruation

Vitamin D (Good understanding of its function as a hormone and how it impacts blood calcium)

- kidneys convert to the active form of vitamin D as a response to the parathyroid hormone - vitamin D helps with calcium absorption

Sodium (role in fluid electrolyte balance; relationship to blood pressure; impact of food processing)

- major extracellular cation; helps absorb glucose and amino acids; aids in muscle and nerve function - high intake raises blood pressure - often used in excess as a preservative in processed foods

Potassium (role in fluid electrolyte balance; relationship to blood pressure; impact of food processing)

- major intracellular cation; aids in transmission of nerve impulses and muscle contraction - high potassium decreases blood pressure - unprocessed foods are the best sources of potassium

What type of anemia is associated with iron deficiency?

- microcytic hyperchromic anemia: small pale red blood cells, inability to produce enough heme, decreased ability to carry oxygen, decreased ATP synthesis

Niacin (relate to deficiency state and understand why the alcoholic is prone to deficiency; address the relationship of this vitamin to cardiovascular disease; what is the precursor of this vitamin; what is the deficiency state)

- precursor is tryptophan - more bioavailability in animal products - aids in ATP synthesis in the ETC, and aids in beta oxidation - high doses have been shown to lower LDL and increase HDL - deficiency state: pellegra - at risk populations: those with corn-based diets, alcoholics

Bulimia Nervosa (personality traits; weight pattern)

- recurrent episodes of binge eating followed by compensatory behavior; both occur at least once per week for three months or longer - compensatory behaviors can either be purging (vomiting, use of laxatives/diuretics/enemas) or non-purging (excessive exercising or fasting) - more prevalent than anorexia; more prevalent ED in men; most common in women - food is not consumed for nutritional value; nearly 1,000 extra calories are consumed - may be multiple binges in one day - common binge foods include easy to eat foods, low fiber foods, foods with smooth textures, and high fat/high carb foods

Deficiency state of Calcium and vitamin D: Differentiate between child/adult

- rickets: calcium/vitamin D deficiency in children; consequences include an enlarged head, joints, and ribcage, a deformed pelvis, and bowed legs - osteomalacia: adult version of rickets; consequence is common fractures

How are smokers impacted by antioxidant vitamins? What are specific recommendations for smokers for vitamin C and beta-carotene?

- smoking introduces oxidants that deplete the body's vitamin C levels - recommended RDA + 35 mg/day - smokers who take beta-carotene supplements are at an increased risk of developing cancer (increased risk of lung cancer for longterm high dosing)

Zinc deficiency symptoms; impact on growth/development

- symptoms: growth retardation and sexual organ immaturity, poor immunity, taste alterations, decreased appetite - needed for DNA/RNA synthesis - helps stabilize structures of proteins that regulate gene expression

Riboflavin (know above issues with good understanding of deficiency state and why)

- used to make two coenzyme forms for the electron transport chain - important role in ETC, CAC, beta oxidation, and oxidative phosphorylation - important for carb, fat, and protein metabolism - deficiency can impair endurance capacity - symptoms of deficiency: weakness, anemia, confusion, cheilosis, stomatitis, glossitis - at risk population: children lacking dairy products and meat, alcoholics, the elderly

Calcium (Understand role in bone health, peak bone density)

- vital to bone mineralization - peak bone density is reached at age 30 - bioavailability decreases after age 50 - bioavailability of supplements depends on form (calcium carbonate has a higher bioavailability than calcium gluconate)