Nutrition Final Test
What are factors that affect weight:
genetics, environment, socio-economic status, mental health, access to health care, education, access to fruits and veggies, diet, physical activity, etc.
What is TEE?
thermic effect of exercise Thermic effect of exercise (TEE): Increase in muscle contraction that occurs during physical activity -Amount of kilocalories you need for TEE depends on the activity performed, duration of activity, and how much you weigh
How is body fat stored?
Most Body Fat is Stored in Adipose Tissue Two types of fat make up total body fat: Essential fat -Essential for the body to function -Women have more essential fat (12%) than men (3%). Stored fat -Found in adipose tissue -Subcutaneous fat is located under the skin. -Visceral fat is stored around the organs in the abdominal area. -Insulates the body from cold temperatures -Protects and cushions internal organs
What is NEAT?
Non-exercise activity thermogenesis (NEAT) -Included under TEE component -The energy expended from activities not considered exercise (e.g. maintaining posture or body position, fidgeting)
Which vitamin needs to be supplemented for infants who are breastfed?
The American Academy of Pediatrics recommends supplementing breast-fed babies with vitamin D Minimum of 400 IU vitamin D per day Give in the form of drops
Should you feed toddlers 3 big meals a day or several smaller meals?
Young Children Need to Eat Frequent, Small Meals and Nutrient-Dense Foods
Which hormones stimulate hunger? Which hormones signal satiety?
-Hunger is controlled by the lateral hypothalamus (ghrelin and Neuropeptide Y and Leptin) -Satiety is triggered by an area in the hypothalamus (Cholecystokinin (CKK) and peptide YY (PYY) and Leptin)
What are some of the key nutrients for pregnant women? What is one of the best ways to make sure they are meeting their nutrient needs? (a prenatal vitamin)
50% increase in needs for folate, zinc, iron, and calcium Folate -Need 600 micrograms daily -Take a supplement or consume folate-rich foods Iron -Needed to make additional red blood cells -Prevents anemia -Essential for fetal growth and development -Needed for the growth of the placenta Zinc and copper -Increased need due to inhibited absorption by iron Calcium and vitamin D -Needed to support fetal bone growth -Prevent low bone mass in the mother Other nutrients -Omega-3 fatty acids, choline, and vitamin B12
What is disordered eating vs. an eating disorder? Who is at risk for an eating disorder?
Disordered eating describes abnormal and potentially harmful eating patterns -Refusing to eat -Compulsive eating -Binge eating -Restrictive eating (dieting) -Vomiting after eating -Abusing diet pills, laxatives, or diuretics Eating disorders are psychological illnesses diagnosed by meeting specific criteria that include disordered eating behaviors and other factors -Most common in young adults and adolescents, predominantly in white upper-middle and middle class families -Increasing among males, minorities, and other age groups -Any of these disorders can occur in any body size
Around what age is it safe to introduce solids to an infant? What are the best foods to start with? How long should you wait before introducing each new food
Doctors recommend waiting until a baby is about 6 months old to start solid foods. Starting before 4 months is not recommended. At about 6 months, babies need the added nutrition — such as iron and zinc — that solid foods provide. It's also the right time to introduce your infant to new tastes and textures. Wait three to five days between each new food to see if your baby has a reaction, such as diarrhea, a rash or vomiting. After introducing single-ingredient foods, you can offer them in combination. best foods to start with -Baby cereal, such as oatmeal, rice, barley. -Sweet potato. -Banana. -Avocado. -Apples. -Pears. -Green beans. -Butternut squash.
How does the energy density of food affect the number of calories we take in?
Foods with a lower energy density provide fewer calories per gram than foods with a higher energy density. For the same amount of calories, a person can consume a larger portion of a food lower in energy density than a food higher in energy density.
Bulimia
Individual consumes larger than normal amounts of food in a short period of time, followed by purging Health consequences -Tears in the esophagus -Tooth decay and gum disease from stomach acid -Electrolyte imbalances -Dehydration and constipation -Impaired normal bowel function through laxative use -Depression and low self-esteem
What is intuitive eating? Be able to name 2 principles of intuitive eating.
Intuitive eating (IE) is a way of eating and living that focuses on trusting and listening to our own bodies NOT another diet, no rules The first component is rejecting the diet mentality. It also addresses: -Hunger and fullness -Satisfaction -Respecting your body -Emotional eating -Physical activity Principles -Reject the Diet Mentality -Honor Your Hunger -Make Peace with Food -Challenge the Food Police -Respect Your Fullness -Discover the Satisfaction Factor -Honor Your Feelings Without Using Food -Respect Your Body -Exercise - Feel the Difference -Honor Your Health
Which minerals are of concern for highly active people?
Iron -Necessary for energy metabolism and oxygen transport -Levels may be low due to menstruation in women. Intravascular hemolysis can lead to hemolytic anemia, but is not related to iron status. Likewise, sports anemia is not related to iron status, but rather a dilution of red blood cells due to increased blood volume -Inadequate iron intake may require supplementation Calcium -Reduces risk for injury to bone -Lost in sweat, thus losses may be high in athletes -Supplementation is not recommended unless intake from food and beverages is inadequate to meet the RDA
What is physical fitness? What are the 5 components of physical fitness?
Physical fitness is good health or physical condition as a result of exercise and proper nutrition Physical fitness has 5 components -Cardiorespiratory endurance: ability to sustain cardiorespiratory exercise for an extended length of time -Muscular strength: ability to produce force for a brief period of time -Muscular endurance: ability to exert force over a long period of time without fatigue -Flexibility: range of motion around a joint, improved with stretching -Body composition: the proportion of muscle, fat, water, and other tissues in the body
Body Composition - what is it? How can we assess it?
The ratio of fat tissue to lean body mass (muscle, bone, and organs) Usually expressed as percent body fat
At what age is it ok to introduce cow's milk into a child's diet?
after 6/7 months
Orthorexia
an obsession with "healthy or righteous eating" Often begins with a person's desire to live a healthy lifestyle Characteristics of the individual -Spends most of his or her time thinking about food and how it was prepared, processed, and overall health benefits of the food -Typically does not obsess over calorie content of foods Contributors to healthy food obsession -Eliminates foods based on learning about a negative health effect from eating the food Restrictive nature can develop into anorexia
What is TEF?
thermic effect of food Energy used to process the macronutrients and extract kilocalories from food 10% of kilocalories in food consumed is used for TEF -Meals high in protein have greater TEF than those high in carbohydrate, which have greater TEF than those high in fat TEF is influenced by: -Type of nutrients consumed, composition of a meal, alcohol intake, age, and athletic training status
How do nutrients pass between mother and fetus?
through the placenta
What are some of the social or psychological risks of being obese?
"Overweight" people are treated differently from people at a normal weight -Suffer more discrimination -More likely to be denied job promotions and raises -Females with obesity are less likely to be accepted into college, especially higher ranked colleges -People perceive them as lazy or weak-willed People with obesity have higher rates of suicide and are more likely to use drugs and alcohol Individuals who are underweight are more likely to be at greater risk for: -Irritability -Anger -Depression
What are some good foods to eat 2-4 hours before going for a 5-mile run or playing a soccer game? What about 30 minutes before? When do you want simple carbs vs. complex carbs?
-1 to 4.5 grams carbohydrate per kilogram of body weight 1 to 4 hours prior to exercise ---Consume carbohydrate 15 to 30 minutes before exercise; focus on simple carbohydrates ---Avoid carbonated drinks and high-fiber foods -Consume moderate amounts of protein ----Consume with carbohydrate to promote muscle glycogen synthesis and protein synthesis -High-fat foods should be avoided for several hours before exercise -Simple carbohydrates: Immediately and during exercise -Complex carbohydrates: few hours before exercise
For how long is breastfeeding recommended?
6 months
What are the benefits of consuming foods rich in antioxidants after exercising? What are examples of antioxidants?
Antioxidants protect cells from damage caused by exercise -Intense, prolonged exercise increases production of free radicals -Vitamins E and C protect cells from the damage of free radicals -Supplementation above the RDA does not improve athletic performance or decrease oxidative stress
What does FITT stand for?
Frequency, Intensity, Time, Type
What is mindful eating?
paying attention to our food, on purpose, moment by moment, without judgment
What are some risks that are associated with being underweight?
-May be due to malnutrition, substance abuse, or disease -Higher risk of anemia, osteoporosis and bone fractures, heart irregularities, and amenorrhea -Correlated with depression and anxiety, inability to fight infection, trouble regulating body temperature, decreased muscle strength, and risk of premature death -May be due to malabsorption associated with diseases such as cancer, inflammatory bowel disease, or undiagnosed celiac disease -Also may be due to certain medications, smoking, and substance abuse
What are the health benefits of physical fitness?
-Reduced risk of cardiovascular disease -Improved body composition -Reduced risk of type 2 diabetes -Reduced risk of some forms of cancer -Improved bone health -Improved immune system -Improved mental well being -Improved sleep
How does one maintain weight loss over time?
-Research shows that weight maintainers often tend to eat small, frequent meals and engage in regular physical activity -Often practice weekly self-weighing
What are some of the flaws of the BMI scale?
-There is a correlation between weight and disease, however, this doesn't mean that the weight is causing the disease -The BMI is very imprecise as it does not tell you: -about a person's body composition -what a person's health outcomes will be -It's one data point that we have when assessing health, but often does more harm than good -Research shows that weight stigma is a greater risk to poor health than weight itself -BMI is not a direct measure of percent of body fat -BMI is not accurate for everyone -Poverty is associated with a larger body size -95% of people who go on diets to try and lose weight gain it all back, and often more, within 2-5 years
What is the best way to lose weight? Is there a best way?
A HAES and/or intuitive eating aligned practitioner doesn't view it at as ethical to prescribe weight loss But ultimately an individual has the right to try to pursue weight loss. If one does, here are tips: -Avoid fad diets -Don't try to lose more than 1-2 pounds per week -Modify diet, physical activity, and behavior When it comes to your diet or "pattern of eating," make small, realistic changes Increase physical activity Change habits with behavior modification -Focus on changing eating behaviors that contribute to weight gain or impede weight loss -Keep a food log -Control environmental cues that trigger eating when hungry -Learn how to better manage stress -Try to practice more mindful eating
How can adults influence young children's eating habits?
A variety of food should be offered -A child may need to be exposed to a new food 10 to 15 times (or even more) before accepting it Include young children in food shopping, menu planning, and meal preparation to encourage variety in their food consumption. "Cleaning the plate" ignores natural intuitive eating cues and may encourage overeating. -Children should be allowed to stop eating when they are full.
How does hydration affect your exercise performance? How can you maintain adequate hydration when working out? When is plain water ok? When should you add a sports drink?
Adequate fluid intake optimizes performance and prevents dehydration and electrolyte imbalances Electrolyte imbalance lead to: -Heat cramps -Low blood pressure -Nausea -Edema in hands and feet *Electrolytes can be replaced with food and sports drinks Fluids are needed before, during, and after exercise Some beverages are better than others -Sports drinks contain 6-8% carbohydrate as well as sodium and potassium -Most beneficial for exercise lasting longer than 60 minutes -Water is adequate for exercise that is < 60 minutes Certain beverages are suboptimal for hydration during physical activity -Juice and juice drinks -Carbonated drinks -Alcohol -Caffeine
Energy balance
An energy imbalance can result in weight gain or loss Positive energy balance: Energy intake is more than energy expended Weight gain from increased muscle mass, increased adipose tissue, or both Periods of growth: Pregnancy, childhood, and adolescence Negative energy balance: Energy expended is more than energy intake Food intake is reduced, more energy is expended through exercise, or both may results in weight loss: Fat loss Muscle loss Loss of glycogen or water
What are ergogenic aids? When might creatine be used? What are some of the side effects? What about caffeine?
An ergogenic aid is any substance that is used to improve athletic performance Creatine -Improves athletic performance in high-intensity, short-duration activities such as weight training -Shown to increase muscle strength and muscle mass -Side effects: water retention -Some reports of liver and kidney problems when taken at higher than recommended doses for several months Caffeine -Enhances athletic performance during endurance events -No effect for short-duration events -May increase metabolism of fatty acids for energy and spare glycogen stores
How do we regulate food intake? Appetite vs. Hunger; Satiety
Appetite is the desire to eat food whether or not there is physical hunger. Triggered by factors such as time of day, social occasions, emotions, or the sight or smell of food Hunger and satiety affect the desire to eat and to stop eating -Hunger is the physical sensation associated with the need or intense desire for food. -Satiety is the feeling of ''fullness'' produced by the consumption of food.
What is gastric bypass surgery? What are some of the risks involved?
As with any surgery, gastric bypass carries some risks. Complications of surgery include infection, blood clots, and internal bleeding. Another risk is an anastomosis. This is a new connection created in your intestines and stomach during the bypass surgery that will not fully heal and will leak. Gastric bypass surgery refers to a technique in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both.
What about women who consume fortified cereal + prenatal vitamin + fortified orange juice? Is there a risk of going over the recommended nutrients?
Avoid consuming too much vitamin A and vitamin D Can be toxic in high amounts
How is total daily energy expenditure (TDEE) calculated? - BMR - Thermic effect of food (TEF) - Thermic effect of exercise (TEE) and non-exercise activity thermogenesis (NEAT)
BMR: 50-70% TEF: 10% TEE: 20-35%
Basal metabolic rate (BMR) vs resting metabolic rate (RMR): What is the difference and which is usually used?
Basal metabolic rate (BMR): Amount of energy spent to meet the body's basic physiological needs Factors that influence BMR -Lean body mass -Age -Gender -Body size -Genes -Ethnicity -Emotional and physical stress -Thyroid hormone levels -Nutritional state -Environmental temperature -Caffeine and nicotine intake *Note: because BMR is difficult to measure, resting metabolic rate (RMR) is often used
What are some of the benefits of classifying obesity as a disease? What are some of the downsides?
Benefits to declaring it a disease -Provides a warning of the potential health hazards of being overweight -May make it easier for individuals to get insurance coverage for treatment -More research funding may be allocated to addressing the obesity problem in the United States Downside to declaring it a disease -It may encourage more use of drugs and medical procedures to address the epidemic rather than encouraging lifestyle changes -Negative psychological or social stigma -May lead to medical bias -Increased risk of eating disorders -Fosters diet culture
What is BMI? Is BMI a good indicator of health? Why or why not?
Body mass index (BMI) calculates body weight in relation to height. BMI is not an accurate way of determining health as it does not look at the whole picture.
When does morning sickness usually occur? What herb has been shown to help alleviate morning sickness?
Can occur at any time of the day Ginger may reduce nausea and vomiting
How are carbs, fat, and protein used during exercise? How do intensity and duration affect the use of glucose and glycogen? How does it affect the use of fat?
Carbohydrate -is the Primary Energy Source During High-Intensity Exercise -Source for working muscles ~2,600 kilocalories of glycogen are stored in the body -Depletion of glycogen stores during exercise ----High intensity: 20 minutes ----Low intensity: 90 minutes -Muscle glycogen is the preferred source for muscle cells, but liver glycogen is also used ----Blood glucose is the energy source for the brain -Use of glucose and glycogen is affected by: ---Intensity of the exercise ---Duration of the exercise ---Conditioning -Carbohydrate requirement depends on exercise duration Fat -is the Primary Energy Source During Low-to-Moderate Intensity Exercise -Source of energy is from: -Factors that affect use of fat during exercise --Intensity ------Low-intensity exercise uses free fatty acids in the blood from stored adipose tissue -------Moderate-intensity exercise uses more free fatty acids from muscle triglycerides and less from the adipose tissue --Duration -----20+ minutes of low-to moderate-intensity exercise uses the greatest amount of fat --Conditioning -----Highly trained individuals use more fatty acids for energy -Amount of fat needed for exercise -----25 to 35% of kcals from fat Protein -is Primarily Needed to Build and Repair Muscle -Exercise increases cortisol, which stimulates protein turnover -Small amounts of protein are used for energy during activity -When kilocalorie intake and carbohydrate stores are insufficient, the body relies on protein -If protein breakdown exceeds protein synthesis, muscle atrophy can occur -Recreational exercisers meet their protein needs (0.8 g/kg) with a balanced diet -Endurance athletes and those doing significant resistance/strength training may need more protein; this need can be met with a balanced diet
How does fat distribution affect health? (Apple vs. Pear Shape) How do we measure this? (waist circumference)
Central obesity (android obesity) (apple) -Excess visceral fat in the abdomen -Increases risk for heart disease, diabetes, and hypertension -Visceral fat releases fatty acids that travel to the liver, causing insulin resistance, increased LDL, decreased HDL, and increased cholesterol. Gynoid obesity (pear) -Excess fat around the thighs and buttocks -More common in women than men
Binge
Characterized by recurrent episodes of binge eating without purging or regard to physiological cues May eat for emotional reasons -Leads to out-of-control feeling while eating and physical and psychological discomfort after eating May eat in secret and feel ashamed about the behavior Health consequences -May increase risk of high blood pressure, high cholesterol, heart disease, type 2 diabetes, and gallbladder disease
A healthy lifestyle is important before, during, and after pregnancy. Be familiar with some of the key points for each of these. For example, regarding: Caffeine use, Alcohol, Drugs, Medications, Botanicals/Herbal Supplements, Seafood consumption, Folic acid, Mother's weight, Mother's activity/exercise level, Mother's age, Mother's socio-economic status
Consume adequate folic acid -Reduces risk for neural tube defects -Needed for new cell synthesis -Recommendation: 400 micrograms daily Eat safe fish -Some fish have high levels of methylmercury -Limit albacore tuna to no more than 6 oz weekly Consume moderate amounts of caffeine -Limit caffeine intake: <200 mg per day Avoid cigarettes, alcohol, and illicit drugs -Smoking increases the risk of: ----Infertility, a low birth weight baby, stunted growth or intellectual development, and sudden infant death syndrome (SIDS) Avoid botanicals -Not enough research has been done to determine their safety Manage chronic conditions -Diabetes, hypertension, PKU, or sexually transmitted disease can increase maternal and fetal complications if not controlled before conception -Medications may be contraindicated during pregnancy, so prepregnancy counseling is essential
What are some optimal foods to eat after exercise? How soon after exercise should you try to eat? Why is it so important to eat a combination of protein and carbohydrates after a workout?
Consume carbohydrates to replenish muscle and liver glycogen -It is most effective 30 to 45 minutes after exercise Consume protein and carbohydrate to increase muscle protein synthesis -Low-fat chocolate milk is a low-cost option to provide whey protein and carbohydrate to assist in recovery A high-carbohydrate, moderate-protein, low-fat meal should be consumed within 2 hours
eating disorder recovery
Effective treatment requires an experienced multidisciplinary team approach, including: -Psychological professionals -Medical professionals -Nutrition professionals As some eating disorders can be life-threatening, a physician should closely monitor treatment A Registered Dietitian Nutritionist can help someone with an eating disorder establish normal eating behaviors Nutritional approaches include: -Meal planning -Using food journals -Identifying binge triggers, safe and unsafe foods -Recognizing hunger and fullness cues Full recovery from eating disorders is possible and most successful when the disorder is treated in the early stages
What are some foods/products/drinks that are good to consume during a long run or soccer game?
Exercise lasting more than one hour -Begin eating food shortly after the start of exercise to maintain blood glucose levels, delay glycogen depletion, and reduce fatigue Recommended foods -Sports drinks, bars, and gels -Limit or avoid fructose (fruit sugar); may cause GI distress -Consuming carbohydrates and protein improves net protein balance for endurance athletes
What are some of the risks of dieting?
Focuses on and values weight, shape, and size over wellbeing -Thin is desirable and healthy Promotes over restrictive or rigid eating patterns -Claims to be in the name of health, but in reality are about weight, shape, or size -Eating a certain way is "Good" or "Bad"
What factors have contributed to the rise in childhood obesity?
Genetics: A small percent of cases Overconsumption of kilocalories Sedentary lifestyle Family environment Environments outside the home Advertising and peer influence
What is gestational diabetes? What are some risk factors?
Gestational diabetes occurs when a woman develops high blood glucose levels during her pregnancy Risk factors -Being overweight -Being over 25 years old -History of higher-than-normal blood glucose levels -Being Hispanic, African-American, Native American, or Pacific Islander -Previously gave birth to a very large baby or a stillborn baby -Having had gestational diabetes in the past
How does someone gain weight?
Goal is to gain muscle, not all fat. Methods to do this -Add 500 kilocalories to daily energy intake. In theory this should add about one pound of extra body weight per week -Choose more energy-dense foods -Add an extra meal or large snack to your day -Include regular exercise and resistance training
What are growth charts? What do they show?
Growth charts determine a child's rate of growth compared with national standards for age and sex. Monitor height and weight Place child in a percentile Sudden changes below the 10th percentile or above the 80th percentile are a concern.
How do fat cells form and expand?
Growth of fat cells (adipocytes) occurs in two ways. -Can expand to store more fat (hypertrophy) -Once filled to capacity, stimulate the production of more fat cells (hyperplasia)
What is Health at Every Size (HAES)?
Health at Every Size (HAES) -A movement that shifts the focus from weight management to health promotion -Affirms a holistic definition of health, which cannot be characterized as simply the absence of physical or mental illness, limitation, or disease HAES includes the following basic principles: -Respect - body, age, ethnicity, etc -Critical Awareness - challenge assumptions; value body knowledge and lived experiences -Compassionate Self-Care - finding joy in moving one's body and being active; intuitive eating approach
What are some of the benefits of breastfeeding?
Lactation is the production of milk in a woman's body after birth -The infant suckling at the mother's breast stimulates milk production -Prolactin: stimulates milk production -Oxytocin: releases milk for infant to receive through the nipple "letdown response" Breast-feeding -Mother provides food that is uniquely tailored to meet her infant's nutritional needs in an easily digestible form Right after birth -Breast milk contains colostrum, a yellowish fluid that is lower in fat but higher in protein, vitamin A, minerals, and immune factors Four to seven days after birth -Breast milk is high in lactose, fat, and B vitamins and lower in fat-soluble vitamins, sodium, and other minerals At six to seven months -Breast milk has less protein Protects against infections, allergies, and chronic disease Reduced childhood obesity risk Brain development Breast-feeding Provides Physical, Emotional, and Financial Benefits for Mothers
Anorexia
Life-threatening disorder characterized by self-salvation and excessive weight loss Fear of getting fat, fear of eating certain foods Some individuals exercise excessively to control weight Health consequences -Electrolyte imbalances -Drop in heart rate and blood pressure, weakness and fatigue, hair loss -Slowing of the digestive process -Inadequate nutrient intake and possible deficiencies -Inability to regulate internal body temperature
Who does the Supplemental Nutrition Program WIC help? How does it help?
Low-income mothers may need food assistance Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Designed to ensure that pregnant women and mothers of young children have access to nutrition information and nutritious foods
How should you feed a picky eater?
Offer variety of food items within preferred food type, gradually wean child from food item
OSFED/EDNOS
Other Specified Feeding or Eating Disorders A serious, life-threatening, and treatable eating disorder Includes all those individuals who did not meet strict diagnostic criteria for anorexia nervosa or bulimia nervosa but still have a significant eating disorder Previously known as EDNOS (Eating Disorder Not Otherwise Specified)
What is RED-S? What is the female athlete triad? What is amenorrhea?
RED-S -A combination of interrelated health conditions including: ---Low energy availability ---A variety of physiological impairments -------Metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular function, along with reduced psychological health ---Reduces the performance of the athlete ---May have serious medical and psychological consequences Female athlete triad -Syndrome of the three interrelated conditions occurring in some physically active females ---Low energy availability - from discorded eating Unintentionally low kilocalorie intake Diagnosed anorexia nervosa or bulimia ---Amenorrhea -------Absence of three consecutive menstrual cycles ---Decreased bone density or osteoporosis Stress fractures are common
What are some of the key nutrients that toddlers need?
Recommendations for kids ages 2 years or older are to eat at least 2 daily servings of fruit and at least 3 daily servings of vegetables. Emphasis is on dark green, red, and orange vegetables. Eat a rainbow!
For someone who wants to lose weight, what is a healthy weight loss goal?
less than 2 pounds per week or 5-10% of body weight over 6 months