Nutrition Chap 1
How do you examine primary deficiency
- check diet history
IF the usual intake falls below EAR
- it is inadequate
Risk factors of diet and health
- persists over time and can cluster
Final- physical signs and symptoms- overt
- physical examination and anthropometric measurement method reveals the overt signs and symptom of the disease
what happens to excess energy
- they become fat
Fat soluble
-A D E F
Nutrient composition in the food What percent is water
60 percent
Diet and health
Food plays vital role in supporting health • Chronic disease - epidemic levels • Multiple factors over multiple years • Leading causes of death
Acceptable Macronutrient Distribution Ranges
i 45-65 percent kcal from carbohydrate ii 20-35 percent kcal from fat iii 10-35 kcal from the protein
Validity
having the quality of being founded on fact or evidence
How to identify fake credentials
dentifying fake credentials: i Accreditation ii diploma mill fraudulent website
Replication
epeating an experiment and getting the same results.
Symptoms of deficient of nutrition:
experience skin rashes ii depression, hair loss, bleeding gums, muscle spasm, night blindness
What are the role of energy yielding nutrient
to provide new raw materal for body tissues and regulating in many activities. i Role of protein- to help regulate activities such as metabolism and digestion.
What does correlation prove:
two variables are associated, not that one is the cause of the other.
what are micronutrients
vitamins and minerals - required only in small amount
What are non energy yeilding nutrients
vitamins, minerals and water
What is subclinical deficiency:
when body uses up the nutrient store and abnormal function starts to happen in the body.
Social interaction
Social interaction: going out eat, meals often social events, sharing food means hospitality, social customs.
organic nutrients are
carbs, proteins, vitamin, lipids
How do you examine secondary deficiecny
check health history
Cohort study
compare people who do and donot have given condition such as disease, closely matching them in age, gender and other variable so that their difference in other factors will stand out. These differences may account for the condition in the group that has it. a People with goiter lack iodine
How is energy measured
a Energy is measured in Kcal - Energy release from C, P, L are measured in calories. b Energy is expressed in 1000 calorie metric unit known as kcal c 100 calorie actually means 100 kcal
example of human intervention or clinical trials
a Heart disease factor improve when men receive oranges daily for 2 months compared with those on low diet vitamin C - even when groups dollow a diet on high sat. fat.
Is water inorganic or organic
inorganic -doesnot have carbon bonds
Example of mineral
iron
Example of lab based invitro
labratory studies find that fish oils inhibit the growth and activity of the bacteria implicated in ulcer formation.
Physical examination- indicate- can indicate more than nutrient deficiency
looking for clues for poor nutrition status. Visual inspection of the hair eyes, finger nails beCause many physical signs and symptoms reflect more than one nutrient deficiency or toxicity or even over-nutrition conditions. Help reveal imbalance.
Human intervention or clinical trials:
1 Researchers ask ppl to adopt a new behavior- for example take vitamin C. these trials help determine the effectiveness of such intervention on the development of the prevention of diseases.
Lab based invitro studies:
1 Researchers examine the effects of a specific variable on a tissue cell or molecule instead of a living organism
positive correlation
Both variables change in the same direction regardless of whether the direction is more or less
Strength of the epidemiological studies
Can narrow down the list of possible causes. can raise a question to pursue through other research
vi Cohort studies:
analyze data, collect them from a selected group of people at interval over certain period of time
Example of cohort study
Data collected periodically over the past several decades from more than 5000 people randomly selected from the town of Framingham, Massachusetts, in 1948 have revealed that the risk of heart attack increases as blood cholesterol increases
Internet:
anyone can publish anything- 1 no guarantee of accuracy, evaluate website- who were when why what Most trustworthy site: US National Library of Medicine's PubMed, which provides free access to more than 20 million abstracts (short descriptions) of research papers published in scientific journals around the world
chronic disease
arise from many factors and over many years
AMDR
b AMDR) People don't eat energy directly; they derive energy from foods containing carbohydrates, fats, and proteins. Each of these three energy-yielding nutrients contributes to the total energy intake, and those contributions vary in relation to one another. The DRI committee has determined that the composition of a diet that provides adequate energy and nutrients and reduces the risk of chronic diseases is:
Weaknesses of the epidemiological studies
- doesn't find cause and effect -Cannot control variables that may influence the development or prevention of various diseases.
American national trend: -
- eat more meals away from home, larger portion, more sweet drinks. - increased oversized population
How does ethnic preference affect your food choices?
-strongest influence of food choices. People prefer food they grew up eating. -Enjoy eating ethnic food- provides opportunity to celebrate a person's heritage. Developing cultural competence - honors individual preferences and is important for the professionals who help others plan healthy diet.
What are the prominent risk factors
-tobacco -diet and activity patterns -others
Negative
-two variables change in opposite direction
Weaknesses of experimental study
1 Cannot apply results from test tubes or animals to human beings 2 Cannot generalize findings on human beings to all human beings 3 Cannot use certain treatments for clinical or ethical reasons
How does availability of food convenience and economy affect food choices?
1 Consumers who value convenience eat out- donot cook at home, consumer emphasis on convenience limits food choices. 2 Rising food cost: people are buying less highly priced food, buy less expensive brand and cook at home a 80 percent of the consumers are eating at home 3 times a week.
Example of lab based study
Mice fed a high-fat diet eat less food than mice given a lower-fat diet, so they receive the same number of kcalories—but the mice eating the fat-rich diet become severely obese.
Simplest nutrient is
Mineral, which is inorganic because it does not contain carbon
d over nutrition/excess energy symptoms
Obese, heart disease, diabetes. e Sudden nutrient overdose symptoms: i hot flashes, yellowing of skin, rapid heart rate BP or other symptoms
Two types of Surverys
One survey collects data on the kinds and amounts of foods people eat.* The other survey examines the people themselves, using anthropometric measurements, physical examinations, and laboratory tests.**
Importance f paying Attention to UL
Paying attention to UL- useful guiding against overconsumption of nutrient which may occur when ppl use large dose of dietary supplement and fortified food.
lab based Studies
Researchers feed animals special diet that provide, omit specific nutrient and then observe changes in health 2 Test disease causes or treatment in lab where all the condition can be controlled 3 Example:
Symptoms of deficient energy:
thin, loosing muscle tissue, becoming prone to infection and disease.
Formula for energy Density
kcal/gram
you can calculate the percentage of kcalories each of the energy nutrients contributes to the total. To determine the percentage of kcalories
81 fat kcal 4 173 total kcal 5 0.468 (rounded to 0.47) Then multiply by 100 to get the percentage: 0.47 3 100 5 47%
Risk factors for chronic disease
A strong association between disease and risk facrtors= means when the factor present, the livelyhood of the developing the disease will increase. -risk factors persist overtime, early intervention- effective -risk factors clusrter
What does AI reflect
AI reflects the average amount of nutrient group of healthy people consume. Nutrient goal for individual.
How does emotion affect food choices?
Emotion: emotion can affect your food choices and diet. Some people can't eat when they are sad , others eat in response to emotional stimuli. A depressed person may choose to eat rather than calling a friend. 1 Foods influence brain chemistry and the minds respond: a Calm food: carb, alcohol b stimulates: protein and caffeine
Hypothesis
Hypothesis: an unproved statement that explains relationship between 2 or more variable.
lab Tests indicate
Lab Test: 4th way to detect developing deficiency, imbalance or toxicity is to take samples of blood or urine, analyze them in lab and compare the results with normal value for a similar population. Most useful in uncovering early signs of malnutrition before symptoms appear.
c Experimental studies
Test cause and effect relationship between variable. Include lab based studies, animals or in test tube. human intervention of clinical trial
Theory
That integrates various findings and explain complex relationship
national surverys
The National Nutrition Monitoring program coordinates the many nutrition-related surveys and research activities of various federal agencies. The integration of two major national surveys provides comprehensive data efficiently.
problem with national survery
The data provide valuable information on several nutrition-related conditions, such as growth retardation, heart disease, and nutrient deficiencies. National nutrition surveysoften oversample high-risk groups (low-income families, pregnant women, adolescents, the elderly, African Americans, and Mexica
How are national surverys used ?
The resulting wealth of information from the national nutrition surveys is used for a variety of purposes. For example, Congress uses this information to establish public policy on nutrition education, food assistance programs, and the regulation of the
Nutrition
The science of the nutrition in foods and their action within the body. The study of human behavior related to food
Similarity between AI and RDA
They Both serve nutrient intake goal for individual
How to calculate available energy from food:
To calculate the energy available from a food, multiply the number of grams of carbohydrate, protein, and fat by 4, 4, and 9, respectively. Then add the results together. For example, 1 slice of bread with 1 tablespoon of peanut butter on it contains 16 grams carbohydrate, 7 grams protein, and 9 grams fat: 16 g carbohydrate 3 4 kcal/g 5 64 kcal 7 g protein 3 4 kcal/g 5 28 kcal 9 g fat 3 9 kcal/g 5 81 kcal Total 5 173 kcal
Nutrient composition in the food What percent is fat
man- 18-21 women 23-26 and remainder is carb, protein
News:
often tell lopsided story, testimonials, tight deadlines, limited understanding, current and controversial, tells what sells
Certified nutritionist, certified nutritional consultant , certified nutrition therapist
- Lack creditions of RD
What are food choices mostly based on
- highly personal based on a complex interaction of genetics, behavior, social interaction rather than an awareness of nutrition importance on health
UL: tolerable upper intake level
- max daily amount of a nutrient that appears safe for most healthy people and beyond which there is an increased risk of adverse effect.
Physician and other healthcare professionals
- med school training in nutrition is limited.
An usual intake between RDA and EAR
- more difficult to acesses, the intake may be adequate bit chance are greater or equal to that of inadequacy
What are the water soluble vitamins
-B and C
functional foods
-foods that contain bio active components that provide health benifit beyond their nutrient composition.
risk factor cluster
-multiple riskf actor work synergesically to increase the risk of disease dramatically. intervention that focuses on one risk factor often benefit other as well. - a person physically inactive may be obsese, have heart prob, have high BP -all risk factors associated with heart disease
What are the factors food choices are based on
-personal preference -habit -ethnic preference -social interaction -Availability, convenience, economy -positive-negative association -emotions -values -body image
Why is AI used
A value guide for nutrient intake when an RDA cannot be determined. For Some nutrients such as vitamin K, there are insufficient scientific evidence to determine EAR- which is needed to get RDA. Which is why A is established instead of RDA.
What are energy yielding nutrients are
Carb, protein and fat
Validity of information- who is providing information?
People who specialized in clinical nutrition should provide information.-Qualified nutrition expert such as Registered Dietitian
Public Health Dietitians
Who work in the government funded agencies such as health department or clinic, play a key role in the delivery of nutrition services to people in the community . -help plan, coordinate and evaluate food assistance program, act as consultant to other agencies, manage finance.
Randomization
a process of choosing the members of the experimental and control groups without bias.
cultural competence
having awareness and acceptance of cultures and the ability to interact with people of diverse culture
purpose of the EAR
the EAR are most appropriately used to develop and evaluate nutrition programs for groups such as schoolchildren or military personnel. T
Adequate intake:
the avg daily amount of a nutrient that appear sufficient to maintain a specified criterion.
How does body image affect food choices?
- people eat food that will improve their physical health and avoid food that are detrimental -nutrition and health benefit- make food that will improve their health
Leading Cause of Death in the USA
-Heart Disease, Cancer, chronic Lung disease stroke
chronic diseases and examples
-slow progression and long duration. -heart disease, diabetes and cancer
Diatec technician registered:
Assist registered dietitians in both administrative and clinical responsibilities. They are educated under the guidance of registered dietitian.
Energy yielding nutrients
Carb: 4 kcal/gram protein 4 kcal/gram fat- 9 kcal/gram Alcohol- not a nutrient- yields energy 7kcal/gram
Stage in the development of nutrient deficiency - primary vs secondary nutrient deficiency:
Primary - caused by inadequate diet secondary: caused by problems inside the body
How do scientist and food industry use this info
Scientists use the information to establish research priorities. The food industry uses these data to guide decisions in public relations and product development. The Dietary Reference Intakes and other major reports that examine the relationships between diet and health depend on information collected from these nutrition surveys. These data also provide the basis for developing and monitoring national health goals
Healthy People
a national public health initiative under the jurisdiction of the US Department of Health and Human Services (DHHS) that identifies the most significant preventable threats to health and focuses efforts toward eliminating them.
Energy yielding nutrients depend on
amount of macronutrient composition
What happens when you have primary or secondary deficiency
e body begins to use up its stores of iron. At this stage, the deficiency might be described as a subclinical deficiency. It exists as a covert condition, and although it might be detected by laboratory tests, outward signs are not yet apparent. Declining nutrient stores( subclinical) and function inside the body (covert) )
What are the function of vitamins
facilate energy release, also all bodily function requires assistance from vitamin. Don't yield energy vulnerable to destruction, heat and light organic, donot provide energy , they facilate the release of energy from macro nutrient
How to recognize nutrition misinformation?
find out who is providing the information. The "who" behind the information is not always evident, though, especially in the world of electronic media. Keep in mind that people create websites on the Internet, just as people write books and report the news. In all cases, consumers need to determine whether the person is qualified to provide nutrition information.
How does values affect food choices?
food choices may reflect religious belief, political view and environmental concern. -Christians donot eat meat on friday during lent -jewish law-
Recommended Dietary Allowence
- recommended to meet the needs of most healthy people -a goal of dietary intake for individuals. Amount greater than daily do not harm, but less than daily may be bad for health. Less than RDA can lead to deficiency
function of food
- taken into the body to yield energy and nutrient needed for maintenance of life , growth and repair of tissues
If a persons intake falls above RDA
- the intake is properly adequate because the RDA needs meet the need of almost all people
Cross- sectional Study
Researchers observe how much food and what kind of food a group of people eat and how healthy those are. Their finding identify factors that might influence incidence of a disease in various population. Example: many people in mediterianiean region drink more wine and eat fat from oliveoil- however, have lower disease of heart than northern Europeans or americans
How does positive and negative association affect food chocies?
food for happy occasions such as birthday - have cakes, ice creams and those are associated with happy positive while if you eat something when you are sick- you associated with negative association
b Who should provide information?
i Registered dietitians-has educational background needed to deliver reliable nutrition advice and care- degree and clinical internship- national exam , maintain up to date knowledge.
anthropometric measurements indicate
iii anthropometric measurement - height and weight to take the identity record to compare to the height and weight with the standards specific for gender and age or previous major on the same individual. 1 Can indicate a person's overall nutrition status but provide little info about specific nutrient intake
Estimated Average requirement (EAR)
-Average amount sufficient for half f the population. -The average daily amount of a nutrient that will maintain specific biochemical or physiological function in half of the population of a given gender or group.
(EER) Estimated energy requirement
-Average dietary energy intake that will maintain energy balance in a person who has a healthy body weight and level of physical activity. -a EER: average Daily intake that will maintain the energy balance in a person who has a healthy body weight and level of physical activity. Key to energy recommendation- balance. Enough food energy is needed to sustain a healthy and active life, but too much can lead to weight gain and obesity.Apply to average Daily intake b Goal intended to meet through diet. Recommendation- not minimum level or upper level nor optimal level. c Each DRI catagory serves a unique purpose Estimated Energy Requirement (EER): the average dietary energy intake that maintains energy balance and good health in a person of a given age, gender, weight, height, and level of physical activity
Symptoms of malnutrition
-Diarhhea -Skin rashes -fatigue -others
Dietary intake reference standards are defined for
-Energy, nutrient, other dietary comp, physical activity. -collaborative effort of USA and canada -may be diff for specific groups
8 red flags that identify nutrition
-Satisfaction gauranteed -quick and easy fix -natural -one product does it all time tested or new found treatment paranoid accusations personal testimonials meaningless medical jargons
Inaccuarate Vs accurate view of nutrient Intake
-The RDA or AI for a given nutrient represents a point that lies withtin the rate of appropiate and reasonable intake between toxicity and deficiency -both recomendation have enough to provide reserev in terms of short term dietary inadequacy but not so high as to approach toxicity - nutrient intake above and below this may be harmful
Define calrorie
-Units by which energy is measured. Energy provided by food are measured in kcal. 1000 calorie is 1 kcal kcal- amount of heat needed to raise the temperature 1 degree Celsius
Acceptable Macronutrient Distribution Ranges (AMDR) and how they relate to a healthy diet
-a Acceptable macronutrient distribution (AMDR). Adequate energy and nutrient. Reduce the risk of chronic disease
How does preference influence food choice
-based on taste- sweet or savory -food high in fat are prefered -curry spices- indian- hot pepper mexican -Genetic may influence the taste preference . The hormones of pregnancy may influence food craving
How is nutrient used for energy
-breaking bonds- to release energy -storage for excess energy - needed for metabolism- metabolism for building body tissue, regulation of bodily activities
What are macro nutrients
-carb, fat , protein- body need in large amount - to release energy
Nutrient Assessment ( Individual level)
-deficiency or excess leads to malnutrition. Under nutrition or over nutrition.
What are the two types of studies researchers do
-epidemiological -experimental
Vitamins - two types
-fat soluble and water soluble
four assessment methods are used to detect energy and nutrient deficiencies and excesses.
-historical information -antrhopometric -lab test -physical examination
minerals
-inorganic -indestructible -put together to form structures such as bones and teeth -influence fluid balance and distribution -lead- dangerous mineral
Epidemiological studies:
-research the incidence, distribution and control of diease population. -there are three types of epidemiological studies- cross sectional, case control and cohort studies.
Nutrient Assesment of population:
-set priorities and guidelines that increase quality and years of healthy life. Eliminate health disparity. Goal for next 10 years.
Correlation
-shows association, can be positive negative or may not have any correlation. - relation between two various or more -daily vitamin C intake and the number of colds: =positive means- more vitamin and more colds negative means - more vitamin and less cold
What does historical information reflect
1 Health history reflects a person's medical record and may reveal disease that may interfere with the person's ability to eat or the body's use of nutrient. SES: financial inability to buy foods or inadequate kitchen facilities in which to prepare them. Social factors such as marital status, ethnic background, and educational level also influence food choices and nutrition status. A drug history, including all prescribed and over the-counter medications, may highlight possible interactions that lead to nutrient deficiencies (as described in Highlight 17). light 17). A diet history that examines a person's intake of foods, beverages, and dietary supplements may reveal either a surplus or inadequacy of nutrients or energy.
What is the Difference between AI and RDA
1 RDA is based on scientific evidence to expect that the needs of all healthy people will be met. 2 AI must rely on scientific judgement because their evidence is lacking. AI are more tentative than the RDA value
What are strength of the experimental study
1 can control conditions ( for most part) 2 can determine the effects of a variable 3 Can apply some findings on human beings to some groups of human beings
What are the 6 classes of nutrient
1. carbohydrates, 2. lipids 3. proteins 4. vitamins 5. minerals 6. Water
What are the three functional foods:
1. whole foods: simplest functional food 2. fortified food: food with added nutrients that provide health benefit- such as orange juice with vitamin C added 3. modified food : modified to make healthier
