inman 2022

acute diarrhea in infants and children

- aggressive and immediate rehydration; replace fluids and electrolytes lost in stool (WHO recommends glucose electrolyte solution) - reintroduce oral intake within 24 hours

vitamin D milk

400 USP units added per quart of milk by feeding the cow vitamin D, irradiating the milk, or adding the vitamin - must be labeled "vitamin D milk"

#3 can

5 3/4 cups

nutritive value of egg

80 calories, 6 g protein, 5 g fat, vitamin A, D, riboflavin

when to add small finger foods (dry cereal)

9-12 months, when pincher grasp develops

Levodopa

B6 and protein decrease effectiveness (take drug in the morning with limited protein

breakeven in number of units sold formula

BE = (fixed cost)/(selling price - variable costs)

cholecystectomy

bile now secreted from liver directly into intestine. limit fat intake for several months to allow liver to compensate. slowly increase fiber to help normalize bowel movements - low fat diet: acute = 30-45 grams; chronic = 25-30%

appropriation bill

bill approving the spending of money

starch structure

composed of amylose and amylopectin

factors affecting social determinants of health

conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes: economic stability, education, social and community context, access to healthy foods and safe neighborhoods, and healthcare

purchase order

completed by the buyer; written records of items ordered and quantities needed

iodine

12.5 - 25 ppm pH < 5

elevated BP

120-129/<80

waxy structures (corn, rice, sorghum) only have

amylopectin

union/shop steward

an employee who represents fellow employees as the union representative - steward does not get extra pay for serving as steward

bromelain

an enzyme in fresh or frozen pineapple that breaks down protein and prevents gelatinization (inactivated by heat 170-180 F)

CSID

congenital sucrase isomaltase disease - diet modification of sucrose, starch, maltose

colonic salvage

anaerobic fermentation and absorption of end-products of carbohydrate, fiber and amino acid breakdown

riboflavin sources

animal proteins (liver, kidney, meat, milk)

methylphenidate (ritalin)

anorexia, weight loss, nausea

anticoagulant

antagonizes vitamin K (intake must be consistent)

health claim

based on authoritative statements from a scientific body "a calcium rich diet may help prevent osteoporosis"

referent power (personality, charisma)

based on desire to identify with or imitate the influencer, how well you are liked

why does age increase tenderness in meat?

because change in muscle protein brought about by enzymes which increase the water-holding capacity of the muscle

zero base budget

begins at 0, mist justify each expense - past dollar allocations are not the basis of projections - planning oriented

cultural sensitivity

being aware of similarities and differences among various cultures as you engage in active communication with other communities

expert power

belief that influencer has some relevant expertise that the subordinate does not; provides credibility; viewed as competent

non-climacteric fruits

best when ripened before harvest (grapes, melon, citrus)

how long does it take for muscle glycogen to be depleted

2-3 hours

functional fiber vs dietary fiber

dietary fiber is always intact in plants whereas functional fiber can be extracted and synthesized - functional fiber is only in CHO but dietary fiber include lignins - functional fiber can be from plants or animals - dietary fiber can only be from plants

sources of glucose

dietary, liver glycogen, products of intermediate metabolism (reconversion of lactic acid and pyruvic acid)

FEP (free erythrocyte protoporphyrin)

direct measure of toxic effects of lead on heme synthesis (leading to anemia) - increased in lead poisoning - lead and Ca compete at plasma membrane for transport

cystic fibrosis

disease of exocrine glands - PERT - high protein, high kcal, unrestricted fat, liberal in salt - supplement zinc, water soluble forms of fat soluble vitamins (A and E)

types of analytical research

experimental model, quasi experimental design, cohort studies, case control studies, cross sectional studies

stages of MI

express empathy develop discrepancy roll with resistance support self efficacy

vacuum packing meat

extends storage life

anasarca

extreme, generalized edema and widespread swelling of skin due to effusion of fluid into extracellular space - this is due to drop in albumin (which maintains osmotic pressure) - seen in heart, liver, renal failure, and extreme protein/calorie malnutrition

level 4 green

extremely thick - spoon, not from cup or straw, not sticky, chewing not required pureed - spoon, not sticky

primary energy source when at rest

fat

significant energy source during low to moderate activity

fat

macronutrients RQs

fat - 0.7 carb - 1.0 protein - 0.8 mixed intake - 0.85

flakiness (baking)

fat cut into coarse particles

tenderness (baking)

fat cut into very small pieces

hepatitis A

fecal-oral transmission (type most directly connected to food)

kefir

fermented by lactobacillus kefir which reduces lactose

most absorbable form of iron

ferrous

halo effect

judge on most noticeable positive trait

lower income adults

interests focus on costs and traditional food habits; oriented toward present and and towards solving current problems

managerial roles

interpersonal, informational, decisional

prealbumin and CRP

inversely related, when CRP decreases, prealbumin increases

table top drill

involves simulated emergency situation to test emergency plans

cultural humility

involves the ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the client/employee

deficiencies after complete gastrectomy

iron, B12, folate, Ca, vitamin D, thiamin, copper may develop

lead poisoning symptoms

irritability, lethargy, anorexia, vomiting, diarrhea, anemia

difference in energy needs between adulthood and elderly

kcal needs decrease, protein needs stay the same, fluids decrease to 25-30 ml/kg - encourage folate-rich foods - may need to supplement B vitamins d/t atrophic gastritis - more vulnerable to toxicity of vitamin A (increased liver storage, decreased clearance from blood)

hypothalamus

key brain structure involved in the control of food and energy intake

excess mixing of quick breads

loss of CO2, overdeveloped gluten - tunnels from top to bottom, tough, heavy product

refeeding

low potassium, mg, phos

cardiac cachexia

low saturated fat, low cholesterol, low trans fat, < 2 grams sodium, high kcal

cori cycle

lactate is released from tissue, transported to liver, and converted back to glucose as pyruvate

where is vitamin K synthesized

large intestine

colloidal dispersion

large particles (protein, cooked starch)

FCC (federal communications commission)

licenses radio and TV

interface

line that forms between two immiscible liquids (oil and water)

histamine toxicity

linked to inadequate refrigeration of tuna, mackerel, mahimahi

syneresis (weeping)

liquid released from a coagulated product - occurs when cooked at too high a temp, or too low a temp for too long a time; creates a tough, watery product

level 3 yellow

liquidized - spoon or cup, no lumps moderately thick - spoon or from cup, no lumps, effort with wide straw

where is glucose synthesized

liver

where is glycogen stored

liver

where are fat soluble vitamins stored

liver and adipose tissue

grade B (canned fruits and veg)

processed (choice)

UTH (ultra high temperature)

processing method for milk, aseptically packaged milk can be stored without refrigeration if unopened

leptin

produced by fat cells in response to food intake, induces satiety (suppresses appetite) and enhances energy expenditure

bile

produced in the liver and stored in the gallbladder

grehlin

produced in the stomach and intestines, stimulates appetite and growth hormone secretion from the pituitary. decreases fat utilization in adipose

cellular respiration

produces CO2, H2O , ATP

beneficence

professionalism: take positive steps to benefit others

net profit

profit shown after ALL expenses have been deducted from sales

gross profit

profit shown after deducting raw food and beverages (cost of sales) from sales (revenue)

cash budget

projects revenue and expenses, showing inflow and output of cash - purpose is to determine if funds will be available when needed

main concern of PN

translocation of bacteria

LDL

transports cholesterol from diet and liver to all cells

BCAAs

valine, leucine, isoleucine

benefits to crossover design

variability is reduces because the measured effect of the intervention is the difference in that participants response to the intervention and control - allows for a smaller sample size - although they are generally longer

gingko biloba

vasodilation - interactions with anticoagulants - avoid pre surgery

vitamin E sources

vegetable oils, whole grains, green vegetables, almonds

holistic health

views mental, physical and spiritual aspects of life closely connected and equally important with regard to treatment approaches

what enhances chromium absorption

vitamin C and niacin

osteomalacia

vitamin D deficiency (diet and sunlight) - vit D and Ca supplements

new food label

vitamin D, potassium, iron, calcium

flour, grain, and cereals are good sources of

vitamin E (germ), thiamin, riboflavin, phosphorus

hemolytic anemia

vitamin E deficiency

molds

warm (77-86 F), damp, dark conditions, grow best on acid, neutral sweet foods

egg substitutes

lower in fat, calories, cholesterol; higher in sodium

formative evaluation

made early or during course of education, can change direction - answers "how should we do it" - client must be involved; focus group, pre-test, pilot test

lithium carbonate

maintain consistent sodium and caffeine - if sodium or caffeine are restricted, lithium excretion decreases, leading to toxicity

Herberg's Two Factor Theory

maintenance vs motivators - examples of motivators = achievement, personal accomplishment, recognition, responsibility, participation in decision making, opportunity to grow and advance

IgE

mediated reaction to normally harmless food protein - potentially allergenic foods, such as eggs and peanuts, should not be restricted in response to an allergen

assembly serve

menu items are purchased prepared and require minimal cooking before service

MOOSE

meta-analysis of observational studies in epidemiology

limiting AA in soybeans

methionine

level 2 pink

mildly thick sippable

level 5 orange

minced and moist - minimal chewing, biting not required, lumps mashed with tongue, avoid hard, dried, tough pieces

Where does the Krebs cycle occur?

mitochondria

sugar - hygroscopic

modifies texture by tenderizing - softens gluten and prevent gluten development by absorbing some of the water that gluten needs

blooms taxonomy

objectives at lower level must be mastered before more complex learning can take place

occurrence sampling

observe random samples (intermittent observations) to determine percentage of time working or idle

thickening ability of starches in order of efectiveness

potato, waxy corn, waxy rice, waxy sorghum, tapioca, wheat (the more protein, the less effective as a thickener)

fixed budget

prepared at one level of sales or revenue (no expected major change in patient or customer count during the year)

echinacea

prevent moderate cold symptoms

carrageenan

prevents chocolate from sedimenting in fat-free milk

equal employment opportunity act

prevents discrimination in employment based on race, color, religion, sex, national origin, political affiliation

selling price

prime cost x pricing factor (markup factor)

relevance or validity

ability to measure the phenomenon it intends to measure

reward power

ability to reward another for carrying out an order, give incentives, praise to reinforce certain behaviors

temperature for canning veg

above 212 F to destroy botulism

ethylene gas

accelerates ripening fo fruits during storage

accrual basis

accounting principle - recognizes revenues when earned and expenses when incurred (regardless of when the actual cash is received or dispersed

intermediate of CHO, protein and fat breakdown

acetyl coA

what prevents enzymatic oxidation?

acid

FTT in children may result from

acute or chronic illness, restricted diet, poor appetite, lack of fiber leading to chronic constipation, diminished intake

ARDS

acute respiratory distress syndrome - provide adequate but not excess kcal - 1.5-2 grams/kg - provide EN formula with EPA and GLA (gamma-linoleic acid), and enhanced levels of antioxidants

adding solids

add solids at 4-6 months, when sitting posture can be sustained and extrusion reflex diminishes (start with iron-fortified rice cereal, then strained fruit/veg

solid in liquid

custard (gel)

methionine converts to

cysteine

decisional roles

entrepreneur, disturbance handler, resource allocator, negotiator

definition of coenzyme

enzyme activators, includes some vitamins

liver enzyme profile

enzyme levels in blood are elevated when tissue damage causes them to leak into the circulation (AST/ALT)

invert sugar

equal parts glucose and fructose

yohimbe

erectile dysfunction - elevates blood pressure

EFAD

essential FA deficiency - give 500 mL of 10% fat emulsion 1-2 x/week - symptom of EFAD petechiae (red spots)

linoleic acid (omega 6)

essential fatty acid - lack creates eczema, poor growth rate, petechiae (red, purple skin spots_

hypoactive bowel sounds

every 15-20 seconds, may indicate paralytic ileus, or peritonitis

nutrition survey

examination of a population group at a particular point in time

when is CHO needed as fuel source during exercise

exercise above 60-65% of maximal oxygen uptake

Vibrio parahaemolyticus, Vulnificus

from raw or undercooked seafood (shellfish, oysters)

carbohydrates in order of sweetness

fructose, invert sugar, sucrose, glucose, sorbitol, mannitol, galactose, maltose, lactose

BUN:creatinine ratio

high = no blood flow to kidneys d/t dehydration, CHF, GI bleed

durum wheat

high in gluten

what increases the need for magnesium

high protein, calcium, vitamin D

GLP-1

hormone released from the intestine in presence of glucose and fat, stimulates insulin synthesis and release

sorbitol

humectant (retains moisture), sweetener, bulking agent, limits molds

acid (vinegar) and salt increase meat tenderness by

increasing water holding capacity

perfomance specification

indicate quality by functioning characteristics of the product (how many dishes washed/minute)

technical specifications

indicate quality by objective and impartial test results (graded food items, gauge of metals) - can cutting

approved brand specifications

indicate quality by specifying a brand name

serum ferritin

indicates size of iron storage pool

stomatitis

inflammation of mouth

gastritis

inflammation of the stomach - anorexia, nausea, vomiting, diarrhea - clear liquids, advance as tolerated, avoid gastric irritants

radiation

infrared waves coming from glowing heat - microwave: standing time is subsequent distribution of heat by conduction when the magnetron is turned off - disadvantage: uneven heat, lack of browning in foods cooked in short time, simmer or stew to tenderize is not possible, limited to small amounts

nitrites

inhibit botulism, make cured meats pink

zinc enhances _____

insulin action

autonomy

integrity in personal and organizational behaviors and practice

steps in problem solving

recognize and analyze the problem, determine workable solutions, gather data, choose solutions, take action, follow-up

anorexia nervosa

recommended initial kcal intake - 1000-1600 (30-40 kcal/kg), but may need to set 100-300 kcal above current level to support compliance

retrogradation

recrystallization of starch - hydrogen bonds that hold the gel together break and reform in an orderly crystalline fashion (giving them a gritty texture) - occurs when there is a high concentration of amylose - accelerated by freezing - example: separation when gravy thaws

primary prevention

reduced exposure to a promoter of disease (early screening for risk factors like diabetes) - health promotion

continuous bread making method

reduces processing time

hydrogenation

reduction process of adding hydrogen (at the double bond) to unsaturated FAs to increase saturation and stability

length for age

reflects long term nutritional status

FTC (federal trade commission)

regulates content of food ads; enforces truth-in-labeling; challenges product claims when product crosses state lines

adolescents

relate to their interests; consider peer pressure and attitudes towards authority

during prolonged exercise

reliance on CHO to provide pyruvate for continues lipid oxidation

kava

relieve anxiety - liver failure, likely very hazardous

saw palmetto

remedy for enlarged prostate - diuretic

case report/case study

report of observations on one subject or more than one subject - describes quantitatively the experiences of a group of cases with a disease or condition in common - helps identify variables important to the etiology, care, or outcomes of a particular condition

gas in solid

sponge cake (suspension)

4 menu item categories

star (high profit and popular), plow horse (high popular, low profit), puzzle (low popular, high profit), dog (low profit and popular)

what are the polysaccharides

starch, cellulose, pectin, glycogen, dextrin

morbidity

state of being diseased

gastrin

stimulates HCl secretion and stomach motility - secreted from g-cell - hormone

prolactin

stimulates milk production

functions of liver

stores and releases blood, filters toxic elements, metabolizes and stores nutrients, regulates fluid and electrolyte balance

collagen

structural park of tendon that surrounds muscle

position (legitimate) power

subordinate acknowledges that the influencer has the right to exert influence due to position (job title)

sugar alcohols and tooth decay

sugar alcohols and sorbitol do NOT promote tooth decay

vitamin D sources

sunlight, egg yolk, fortified milk

keto diet

supplement Ca, D, folate, B6, B12 - MCTs are more ketogenic

justice

supports fair, equitable and appropriate treatment for individuals and fair allocation of resources

health risk appraisal

survey categorizing a populations general health status

fish with highest levels of mercury

swordfish, king mackerel, tile fish, shark

lipogenesis

synthesis, deposition - insulin is an anabolic hormone 1. adipose = most active site: fatty acids + glycerol --> triglycerides (needs NADPH from pentose shunt) 2. liver = synthesizes fat, but should not store fat - to prevent fat accumulation: lipotropic factors (choline) produce lipoproteins which transfer fatty acids out of liver

chylomicron

synthesized in intestine from dietary fat, transports dietary TG from gut to adipose, lowest density: smallest amount of protein

adjusted FTE

takes into account the benefit days and days off

flavor of fruits

tannins cause astringent feeling in mouth (underripe bananas)

inferential statistics

techniques that allow conclusions to extend beyond an immediate data set; what is the probability that the results can be applied to a larger group; what can you infer from the results of your study

penetrometer

tenderness, firmness; baked custards

analytical research

tests hypotheses concerning the effects of specific factors of interest and allows casual associations to be determined (can prove cause and effect) - includes clinical trials, follow-up studies, case control studies

cultural competence

the ability of system to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients social, cultural, and linguistic needs

safe minimum internal temperatures

1. 145 F meat 2. 160 F ground meat 3. 165 F poultry

gold standard for allergy diagnosis

(DBPCFC) double-blind, placebo-controlled food challenges

nitrogen balance forumla

(protein intake/6.25) - (UUN+4)

crohns

- affects terminal ileum - weight loss, anorexia, diarrhea - b12 deficiency leads to megaloblastic anemia - iron deficiency anemia due to blood loss, decreased absorption

pressure ulcers

- 30-35 kcal/kg if malnourished or at risk for malnutrition - stage 1 (1.1-1.2) - stage 2 (1.25-1.5) - stage 3 (1.5-2)

refrigerated storage

- < 40 F all potentially hazardous foods - F/V 40-45 F - meat, eggs, dairy 32-40 F - frozen foods 0- -10 F

factors that aid in vitamin and mineral absorption

- A: bile salts, pancreatic lipase, fat - D: hydroxylated in liver, then in kidney, needs bile salts, acidity of chyme, accompanies Ca, P absorption - riboflavin: phosphorus - B12: ileum, stomach secretions (HCl, intrinsic factor) - iron: HCl, calcium (binds oxalates) - folate: zinc dependent, cleaves polyglutamate to monoglutamate. folic acid in fortified foods and supplements is present as monoglutamate

NHANES

- CDC - ongoing, repeated survey to obtain info on health of American people - evaluates clinical, chemical (hemoglobin, hematocrit, cholesterol), anthropometric, nutritional data (24 hour recall, FFQ) - WWEIA: dietary intake component of NHANES

addisons disease

- adrenal insufficiency - low cortisol (glycogen depletion, hypoglycemia) - low aldosterone (sodium loss, potassium retention, dehydration) - low androgens (tissue wasting, weight loss) - diet = high protein, frequent feedings, high salt

intravenous fat emulsions

10% = 1.1 kca/mL 20% = 2 kcal/mL solutions general limited to 800-900 mOsm

in the colon, malabsorbed CHO and fibers are converted into

- SCFA (acetate, butyrate, propinate, lactate) which stimulates water and sodium absorption in the colon, and provides substrates for energy production - gases: H2, CO2, N, CH4 (methane)

CSFP (commodity supplemental food program)

- USDA - administered by state health agencies - monthly commodity canned or packaged foods - improve health of low-income elderly at least 60 years of age - states may require that participants be at nutritional risk

EFNEP (expanded food and nutrition education program)

- USDA - provides grants to universities that assist in community development - trains nutrition aides to educate the public - works with small groups: teaches skills needed to obtain a healthy diet (how to budget, meal planning, shop, cook) - does NOT provide food

TEFAP (the emergency food assistance program)

- USDA - quarterly distributions of commodity foods by local, public or private, nonprofit agencies, food banks, soup kitchens, homeless shelters - supplements diets of low-income households, short term hunger relief

CACFP (child and adult care food program)

- USDA - supports public and non-public food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers - provides food and education

NSBP (national school breakfast program)

- USDA - entitlement program - breakfast must provide on average over each school week: 1/4 daily recommended levels for protein, calcium, iron, vitamin A, C

SFSP (summer food service program)

- USDA - entitlement program - purpose is to initiate, maintain or expand foodservice programs to children and teens in low-income areas when school is out - reimburses providers for meals served at a central site, 18 and younger - administered by FNS, state educational agencies, public or private nonprofit residential summer camps

WIC

- USDA - not an entitlement program

healthy start

- USDA - reduce infant mortality, improve health of low-income women, infants, children, families

NSLP (national school lunch program)

- USDA and FNS - entitlement program - lunch must provide on average over each school week: 1/3 of the recommended intake for protein, vitamins A, C, iron, Ca

BRFSS (behavioral risk factor surveillance system)

- USDHHS - adults 18+ - telephone interviews collect info on height, weight, smoking, alcohol use, food frequency for fat, fruits, vegetables

YBRSS (youth behavioral risk factor surveillance system)

- USDHHS - grades 9-12 - smoking, alcohol use, weight control, exercise, eating habits

pregnancy nutrition surveillance system (PNSS)

- USDHHS - low income, high risk pregnant women - maternal weight gain, anemia, pregnancy behavioral risk-factors (smoking, alcohol), birthweight, counts number of women who breast feed - identify and reduce pregnancy-related health risks

alcoholic liver disease

- alcohol is converted into acetaldehyde and excess hydrogen which disrupts liver metabolism - hydrogen replaces fat as fuel in the kreb's cycle, so fat accumulates in liver leading to a fatty liver, and in blood, raising TG levels - shift in NADH/NAD ratio inhibits beta-oxidation of fatty acids and promotes TG synthesis - associated with malnutrition - supplement thiamin and folic acid - increased need for magnesium

Clostridium perfringens

- anaerobic - surface of meat and poultry, humans GI tract - avoid by cooling foods in shallow pan, keep cold foods below 40 F, keep hot foods above 140 F, reheat to 165 F - cafeteria bug

prothrombin time

- anticoagulants prolong PT - evaluates clotting adequacy; change in vitamin K intake will alter rate

epilepsy

- anticonvulsants (phenobarbital and phenytoin) interfere with Ca absorption - take drug with folate - EN decreases bioavailability of phenytoin so hold TF at least 2 hours

tertiary prevention

- as disease progresses, intervention to reduce severity, manage complications - cardiac/stroke program - rehabilitation efforts

tropical sprue

- bacterial, viral, parasitic infection - chronic diarrhea, malnutrition, deficiencies of B12 and folate due to decreased HCl and intrinsic factor - high kcal, high protein, B12 and folate supplementation

ulcerative colitis

- begins in the rectum - chronic bloody diarrhea, weight loss, anorexia, electrolyte (Na, K) disturbance, dehydration, anemia, fever, negative nitrogen balance

E. coli

- bloody stool - onset 3-8 days after ingestion, lasts 5-10 days - rare or raw ground beef, uncooked fruits and veg, raw milk, unpasteurized apple juice

Clostridium botulinum

- botulism - anaerobic, deadly, rare, unusually resistant to heat - found in soil, water, plants, humans GI tract - if heat is not adequate in canning, spores produce toxins under anaerobic conditions - spores destroyed in an acid - 4-36 hours: weakness, double vision, paralysis, may be fatal - do not give honey to infants

gastroparesis

- can be caused by surgery, diabetes, viral infections, obstructions - moderate to severe hypoglycemia: detrimental effects on gastric nerves - small frequent meals, pureed foods, avoid high fiber, avoid high fat, avoid caffeine, mint, alcohol, carbonation - bezoar formation may occur (undigested material found in the GI tract)

nontropical sprue

- celiac disease - no wheat, rye, oats, barley, bran, graham, malt, bulgur, couscous, durum, orzo, thickening agents - ok: corn, potato, rice, soybean, tapioca, arrowroot, carob bean, guar gum, flax, amaranth, millet, teff, quinoa

riboflavin deficiency

- cheilosis - cracked lips - angular stomatitis - mouth corner cracks, sore throat - magenta tongue

prader willi

- chromosome 15 depletion - elevated ghrelin - does not sense satiety - hypogonadism, muscle hypotonia, FTT, short stature

IBS

- chronic abdominal discomfort, altered intestinal motility, bloating - goals: adequate nutrient intake, tailor pattern to specific GI issues - avoid gas forming foods and swallowing air during eating - use food diary to track intake, emotions, environment, symptoms - low FODMAP diet - work with client to alleviate stress during eating - peppermint (has methanol, smooth muscle relaxant) may relax lower esophageal sphincter, reducing reflex, cramping, pain

lipoproteins

- chylomicron (diet derived), largest, mostly TG - VLDL about half TG - LDL, smaller, mostly cholesterol - HDL, rich in protein

Delphi Technique

- consensus of experts - designed to probe expert minds in a series of written interviews from which some consensus is sough - participants do not meet

chronic diarrhea in infants and children

- consider 40% calories from fat, balanced with limited fluids - restrict or dilute fruit juices with high osmolar loads (apple, grape)

soluble fibers

- decrease serum cholesterol by binding bile acids converting more cholesterol into bile - reduce blood glucose - fruits, vegetables, legumes, oats, barley, carrots, apples, citrus fruits, strawberries, bananas

descriptive research

- describes state of nature at a point in time - generates hypotheses regarding determinants of a condition or disease - provides baseline data and monitors changes over time - establishes associations among factors, but does not allow casual relationships to be determined (doe snot prove cause and effect)

HIV/AIDS

- diarrhea, malabsorption, nausea, vomiting, weight loss - preserve LBM - nutrition needs: BEE x 1.3 for asymptomatic - protein = 0.8 for asymptomatic, 1.2-2 if wasting - food and water safety - NRTI drugs can lead to anemia, loss of appetite, nausea, dysphagia - HALS (HIV induced lipodystrophy syndrome): 1. high cholesterol, high TG, insulin resistance, changes in body fat distribution 2. significant loss of LBM can be obscured by edema and HALS 3. increase in dietary fiber needed to decrease insulin resistance, reducing risk of fat deposition

lactose intolerance

- due to lactase deficiency - normally lactase splits lactose into glucose and galactose. in its absence lactose remains intact, exerting hyperosmolar pressure. water is drawn into the intestine to dilute the load causing distention, cramps, diarrhea. bacteria then ferment the undigested lactose, releasing CO2 - detected by hydrogen breath test - lactose tolerance test: oral dose of lactose (up to 50 grams) after a fast. if intolerant of lactose, blood glucose will rise < 25 mg/dL above fasting (flat curve), if tolerant of lactose, the rise would be above 25 mg/dL (normal curve)

galactosemia

- due to missing enzyme that would have converted galactose-1-PO4 into glucose-1-PO4 - diet = galactose and lactose free - no organ meats, MSG extenders, milk, lactose, galactose, whey, casein, dry milk solids, curds, calcium or sodium caseinate, dates, bell peppers - OKAY = soy, hydrolyzed casein, lactate, lactic acid, lactalbumin, pure MSG

ulcer

- likely cause: H. pylori - drug therapy: antacids, antibiotics - diet: as tolerated, well-balanced, avoid late night snacks - omit gastric irritants: cayenne and black pepper, large amounts of chili powder, avoid excess caffeine and alcohol

fat metabolism

- end products: monoglycerides, diglycerides, glycerol, fatty acids - absorbed directly into portal blood: glycerol (water-soluble), SCFA (< 12 carbons), some phospholipids - mono, diglycerides, LCFA combine with help of bile salts (acting as wetting agents) to form micelles. bound to protein to form lipoproteins (chylomicron); penetrate intestinal mucosa, travel through lymph, into the thoracic duct into the blood

at risk pregnancy

- failure to gain 4lb/month in last half pregnancy - <16, >35 - < 12 months between pregnancy - highest risk adolescents-need extra iron, Ca, Iron, zinc

case control studies

- focus on specific disease - those with a disease are compared with a group without the disease, but otherwise similar in characteristics - both groups recall past behaviors, to study how the groups differ

dumping syndrome

- follows a gastrectomy (Billroth I, II) - cramps, rapid pulse, weakness, perspiration, dizziness - REACTIVE OR ALIMENTARY HYPOGLYCEMIA

operating budget

- forecast of revenues, expenses, and profit for a specific period of time - first step: forecast sales or revenue (income portion) - then budget expenditures (labor, food, operating expenses) related to the projected level of income

staphylococcus aureus

- found in humans: nose, hands, intestines, cuts, sores - enters through handling or contact with contaminated surface - grows best at 70-97 F; resists drying, freezing; not destroyed by cooking - reheated foods, high in protein, meat, poultry, eggs, milk products, stuffing - 1-7 hours after ingestion: nausea, vomiting, pain, diarrhea, no fever - avoid by washing hands, chill food quickly, cool foods in shallow pans

blind check receiving method

- give clerk blind invoice or purchase order listing incoming merchandise but omitting quantities and weights - receiving clerk inserts these numbers into the order on the basis of a check of the delivery - forces clerk to make serious check of delivery - takes longer and costs more in labor

national labor relations act (wagner act)

- guaranteed right to organize and join labor unions - gave union the right to be the bargaining agent

lupus (SLE)

- have have dietary deficiencies of iron, folate, calcium, fiber, B12 - may have anemia but does not correlate with iron intake - may show symptoms of celiac disease

secretin

- hormone - secreted by duodenum, stimulates flow of pancreatic juice (bicarb) and water into the duodenum - inhibits gastric acid secretion

shigella

- human intestinal tract, water polluted by feces; bare hands and flies - cold mixed salads, raw veg, watermelon - 12-50 hours after ingestion: blood diarrhea, abd pain

trauma

- hyperglycemia, hyperinsulinemia - little or no ketosis, increase glucagon to increase glucose production from AAs - hypovolemia, decreased cardiac output, drop in body temperature - fluid and sodium retention, potassium excretion, loss of nitrogen, zinc, sulfur, phos - 25-30 kcal/kg - 1.2-1.5 g/kg

acute pancreatitis

- hypermetabolic, hyperdynamic state increasing BMR - put pancreas at rest, withhold all feeding, maintain hydration - progress as tolerated to easily digested foods with a low fat content (pancreas secretes lipase) - elemental EN into jejunum may be tolerated

TBI

- hypermetabolism, hyperglycemia, insulin resistance, protein wasting - EN to small bowel is best option - 140% REE - 1.5-2 g/kg

burns

- immediately replace fluids and electrolytes - 20-25% protein (1.5-2 g/kg, 1.2 g/kg if < 10% BSA) - vitamin C supplementation, water soluble vitamins - zinc for wound healing

contingency approach (fielder)

- in both highly favorable and highly unfavorable situations, a task-oriented leader is more effective - in moderately favorable situations, a relationship-oriented leader tends to be more effective

glycolysis

- in cytoplasm - produce pyruvate for the Kreb's cycle by breaking down glucose, with or without oxygen, into pyruvate or lactate - glucose enters the cell and binds to phosphorus in the presence of magnesium to form glucose-6-phosphatase; proceeds to pyruvic acid

acute viral hepatitis

- inflamed liver - jaundice, anorexia, nausea, fatigue - increase fluids to prevent dehydration - 50-55% CHO to replenish liver glycogen and spare protein - protein: 1-1.2 g/kg: cell regeneration - provide lipotropic agents to convert fat into lipoproteins for removal from liver ( choline, methionine, betaine, folic acid, B12) - small frequent meals - encourage coffee (antioxidant) - MV with B complex, C, K, zinc

Streptococcus

- intestinal contents of humans and animals - caused by poor hygiene, ill handlers, destroyed by cooking - 50-113 F - milk, eggs, potato salad, food held at room temperature for hours - 2-60 days: fever, diarrhea

group or co-op purchasing

- involves union of separate units (hospitals), not related to a single management, for joint purchasing - economic advantage of large volume products

short bowel syndrome

- jejunal: normal balance of CHO, protein, fat; avoid lactose, oxalates, large amounts of concentrated sweets; vitamin, mineral supplements - ileal: limit fat, use MCT (does not require bile salts, needs less intestinal surface area), supplement fat-soluble vitamins (ADEK), Ca, Mg, Zn, parenteral B12 followed by monthly injections if more than 100 cm of terminal ileum is removed; drink at least 1 liter more than their ostomy output per day

SNAP (supplemental nutrition assistance program)

- largest food assistance program - entitlement program

hepatic failure (end stage liver disease)

- liver function decreased to 25% or less - ammonia accumulates - apathy, drowsiness, confusion, coma (portal systemic encephalopathy) - treatment 1. increase protein to 1-1.5 g/kg - modest protein intake if protein sensitive hepatic encephalopathy 2. 30-35 kcal/kg 3. 30-35% calories as fat with MCT if needed 4. lactulose (hyperosmotic laxative that removes nitrogen); neomycin (antibiotic that destroys bacterial flora that produce ammonia)

schilling test

- looks for intrinsic factor - used to diagnose pernicious anemia

urea cycle disorders

- low protein diet - unable to synthesize urea from ammonia (ammonia accumulation)

heart failure MNT

- low sodium, DASH diet, 1-2 L fluid - 1.1-1.4 g/kg - 22-24 kcal/kg - evaluate thiamin status - DRI folate, Mg, multivitamin with B12

treatment for IBD (crohn's and UC)

- maintain fluid and electrolyte balance; antidiarrheal agent (sulfasalazine) - acute crohns flare up: bowel rest, parenteral nutrition or minimal reside - acute UC: elemental diet may be needed to minimize fecal volume - energy needs according to current BMI, limit fat only if steatorrhea - water soluble and fat soluble vitamins; iron, folate; assess Ca, Mg, zinc - watch lactose - frequent feedings - high fat may improve energy balance - MCT may improve bowel damage (easy to oxidize) - protein at each meal, chewable MV - when IBD is in remission or under control, high fiber to stimulate peristalsis

serum albumin

- maintains colloidal osmotic pressure - hypoalbuminemia associated with edema, surgery - levels above normal range likely due to dehydration

glucose-6-phosphatase

- may lead to synthesis of glycogen - needed for liver glycogen to release glucose (maintains proper BG levels) - muscle cells do not have

total lymphocyte count

- measures immunocompetence - moderate depletion 900-1800, severe depletion < 900 - decreased in protein-calorie malnutrition

PKU

- missing phenylalanine hydroxylase (would convert phenylalanine into tyrosine) - tyrosine become essential - restrict PHE (low protein) - high CHO diet can lead to dental carries

norovirus

- most common - caused by poor hygiene - found in human feces, transmitted through contaminated water, human contact, vegetables fertilized by manure, ready to eat food - vomiting, nausea, diarrhea in 24-48 hours - lasts 1-2 days

lactose free diet

- no animal milk or milk products, no whey - calcium and riboflavin supplements are recommended - yogurt and small amounts of aged cheese may be tolerated - OK: lactate, lactalbumin

feeding america

- non-governmental - largest domestic hunger relief organization in the US (food banks, shelters, soup kitchens)

standard polymeric formula

- normal GI function - lecithin may be added as emulsifier - isotonic (osmolality is close to that of blood) - cheapest - FOS (prebiotics) may be added to help resist C.Diff

Campylobacter jejuni

- one of most common causes of gastroenteritis - intestinal tract of cattle, sheep, pig, poultry - raw or undercooked meat or poultry, raw milk, raw veg - prevent cross contamination between raw and cooked foods

cross-sectional studies/prevalence

- one time data collection counting all of the cases of a specific disease among a group of people at a particular time - snap shot look at one point in time; describes current, not past or future events

centralized purchasing

- personnel in one office does all purchasing for all units in that organization - cost effective, time saving

cirrhosis

- protein deficiency leads to ascites, fatty liver, impaired blood clotting - ascites occurs when blood cannot leave the liver - low serum albumin may be due to dilution factor - esophageal varices occur when blood can't enter the liver: portal HTN - 0.8-1.2 g/kg; in stress 1.5 g/kg - 25-35 kcal/kg - fat is preferred fuel in cirrhosis; MCT if needed, < 30 grams fat if malabsorption - include omega-3 - low fiber if varices are present - B complex vitamins, C, Zn, Mg, monitor need for A and D - zinc involved in conversion of ammonia to urea, increased loss in urine

hiatal hernia

- protrusion of a portion of the stomach above the diaphragm into the chest - S/S heartburn - small, bland feedings; avoid late night snacks, caffeine, chili powder, black pepper

protein catabolism

- pyridoxine is needed 1. deamination (splitting off of NH2 by hydrolysis in liver) 2. NH2 is converted into ammonia (NH3) which is toxic 3. most of the ammonia is converted to urea and excreted through the kidneys 4. some is converted into purine, and some is used to make nonessential AAs through transamination 5. the remaining carbon chain is a ketoacid: it can be oxidized for energy

salmonella

- raw and undercooked meat and poultry, eggs, raw dairy, seafood, melons - destroyed by pasteurization - GI tract of humans and animals, water, soil; spread by food handler

secondary prevention

- recruiting those with elevated risk factors into treatment program (setting up employee gym) - reduce impact of a condition that has already occurred - risk reduction, slow progress to restore healthy

chronic pancreatitis

- recurrent attacks of epigastric pain of long duration - PERT (needed to prevent fat malabsorption) - MCTs do not require pancreatic lipase - in severe, prolonged cases, PN may be needed - at avoid pain: avoid large meals with fatty foods, alcohol

serum creatinine

- related to muscle mass; measures somatic protein - may indicate renal disease, muscle wastage - increased with kidney damage - decreased related to liver, muscle, diet

BUN

- related to protein intake - indicator of renal disease -

adult diarrhea

- remove the cause; replace lost fluids and electrolytes especially those high in sodium and potassium - decrease gastric motility: avoid clear liquids and other foods high in lactose, sucrose, fructose; avoid caffeine, alcohol, high fiber - thicken consistency of stool: banana flakes, apple powder, pectin sources - repopulate the GI tract with normal flora (pre and probiotics) - prebiotic components (pectin, fructose, oats, whole grains) which promote growth of healthy bacteria; fructooligosaccharides: onion, garlic, banana, artichoke, asparagus, chicory - probiotics: sources of bacteria used to reestablish bacterial gut flora 1. fermented dairy foods (yogurt, kefir, aged cheese) 2. fermented foods with beneficial live cultures (kimchi, miso, tempeh, sauerkraut) - stimulate GI tract with low fiber, low-fat, lactose-free if needed

bacillus cereus

- spores found in soil, dust, grains, rice, flour, cereal, - aerobic - N/V/D - fried rice, starchy foods, mixed foods, meats, milk, veg, fish

digestion in stomach

- start of proteolysis (break down of proteins) by protease pepsin and HCl - limited continuation of starch hydrolysis by salivary amylase

insoluble fiber

- stool bulk - legumes, wheat bran, fruits, vegetables, whole grains

Listera monocytogenes

- symptoms in 2-30 days - may harm fetus - deli meats, hot dogs, coleslaw, raw milk, soft cheese - grows between 34-113 F

MNT HTN

- thiazide diuretic may deplete potassium - salt restriction <2300 mg - DASH diet - mediterranean diet (resveratrol, in skin on red grapes, may lower BP)

serum transferrin

- transports iron to bone marrow - serum level controlled by iron storage pool (rises with iron deficiency) - can be determined from TIBC - not useful as a measure of protein status

homocystinurias

- treatable disorder of AA metabolism - severe elevations of methionine and homocysteine and excessive excretion of homocysteine - associated with low folate, B12, B6

cooling leftovers

- two stage process - total cool time of 6 hours - cool quickly from 135-70 within 2 hours - cool from 70-40 within an additional 4 hours

osteoporosis

- type 1 (menopausal) type 2 (age related > 70) - asian and white at risk - hormone replacement therapy, weight baring exercise, vitamin D (400-800 mg) and Ca (>1200 mg) - take Ca carbonate with food

PERT (program evaluation and review technique) and CPM (critical path method)

- used for effective planning and control of the functions of management - shows relationships among phases of project - shows what activities must await completion of other tasks and which activities can be performed concurrently - need sequencing requirements, estimate of time for each activity - critical path (longest pathway through) determines the minimum time for completion (helps determine labor costs)

elemental formula

- used with malabsorption - all predigested, LCT snd MCT, vitamins, minerals, electrolytes - low to no residue, don't need pancreatic enzymes

reactive or alimentary hypogylcemia

- when rapidly hydrolyzed CHO enters the jejunum, water is drawn in to achieve osmotic balance - this causes a rapid decrease in the vascular fluid compartment and a decrease in peripheral vascular resistance - blood pressure drops and signs of cardiac insufficiency appear - about two hours later, the CHO is digested and absorbed rapidly - blood sugar rises, stimulating an overproduction of insulin, causing a drop in blood sugar blow fasting

retinol binding protein

-circulates with prealbumin; shortest half life - binds and transports retinol

ready-prepared

-cook-chill -cook-freeze -food are prepared on site, then frozen/chilled for later use -has 9 points of critical control points

PRISMA

-randomized control trials -evidence-based minimum set of items for reporting systematic reviews & meta-analyses

which age group has the highest BMR

0-2 years

water activity (aw) that limits microorganism growth is

0.70-0.90

about 2.3 of all observations in a normal distribution lie within _______ SD of the mean

1

rate of weight gain during pregnancy

1 #/month for first trimester, 1#/week every week thereafter

breakeven in sales volume (amount of money you need to bring in to break even)

1 - (fixed costs)/(variable costs/sales)

#300 can

1 3/4 cups

branched fraction

1,4 and 1,6 a glucosidic linkages (amylopectin)

storage time for fresh poultry, ground meat, fresh fish, shellfish

1-2 days

protein RDA for children/adolescents

1. 1-3 y/o: 13 grams 2. 4-8 y/o: 19 grams 3. 9-13 y/o: 34 grams 4. males 14-19 y/o: 52 grams 5. females 14-19 y/o: 46 grams

average kcal for infants

1. 108 kcal/kg for 0-6 mo 2. 98 kcal/kg for 7-12 mo

summary of digestion in the mouth

1. CHO - enzyme = amylase - action = starch --> dextrin --> maltose 2. Fat - action = mechanical 3. protein - action = mechanical

dietary sources of glucose

1. CHO 2. 58% protein - glucogenic AAs 3. 10% fat - glycerol

summary of digestion in the stomach

1. CHO - action = starch --> dextrin --> maltose 2. fat - action = mechanical 3. protein - proteolysis begins - pepsinogen + HCl = pepsin - pepsin acts on protein --> proteose, peptones

summary of digestion in the small intestine

1. CHO - enzyme = pancreatic amylase - action = starch --> dextrin --> maltose - enzyme = sucrase - action = sucrose --> fructose + glucose - enzyme = maltase - action = maltose --> glucose + glucose - enzyme = lactase - action = lactose --> glucose + galactose

informational role

1. Monitor 2. Disseminator 3. Spokesperson

crystal inhibitors (keep crystals small and smooth)

1. acid (cream of tartar, vinegar) - sugar and acid combine to promote inversion (hydrolysis) of sucrose - end products are equal amount of glucose and fructose (invert sugar) 2. fat (chocolate milk) 3. protein (milk, egg whites, gelatin)

steps of bargaining (union)

1. bargaining between union steward and management 2. if that fails: mediation - neutral person helps settle differences; decision not binding 3. if that fails: arbitration - hearing to dissolve a dispute during an impasse; decision is usually binding

non-insulin medications

1. biguanides: metformin (glucophage) - suppress hepatic glucose (increase muscle uptake) - deficiencies can lead to anemia or peripheral neuropathy - weight neutral - low risk of neuropathy 2. DPP-4 inhibitors: saxagliptin (Onglyza), sitagliptin (Januvia) - allows endogenous GLP-1 to stay active longer, reduced glucose released by the liver overnight and between meals - weight neutral 3. SGLT-2 inhibitors: canagliflozin (invokana), dapagliflozin (Farxiga), empagliflozin (Jardinace) - more glucose is excreted in urine - weight loss - consider for patients with T2D and CKD 4. GLP-1 receptor agonist: - enhances insulin excretion - suppress postprandial glucagon secretion - weight loss 5. thiazolidinediones - increase insulin sensitivity in muscle - weight gain 6. sulfonylureas - stimulates pancreas to release more insulin - may lead to hypoglycemia - weight gain

role of sugar in gelatinization

1. competes with starch for the water needed for gelatinization 2. increases translucency, reduces viscosity, and gel strength 3. if too much sugar is used, consistency is thin

7 steps of HACCP analysis

1. conduct hazard analysis 2. determine CCP 3. establish critical limits 4. monitoring procedures 5. correct actions 6. verification procedures 7. record-keeping and documentation protocols

steps in program planning

1. develop mission statement 2. set goals 3. set objectives 4. develop plan 5. budget development

COPD

1. emphysema - alveoli lose elasticity; thin cachectic, often older - difficulty exhaling 2. chronic bronchitis - excess mucus production, chronic productive cough COPD symptoms: weight loss, emaciation, anorexia - avoid overfeeding (35 kcal/kg) to avoid excess CO2 production - routine use of high fat, low CHO formula is not warranted - small frequent meals that are nutrient dense - vitamin D supplementation if needed

steps in controlling/evaluating

1. establish qualitative and quantitative standards (what is expected to happen) 2. measure performance 3. compare to standard 4. take corrective action

enzymes/secretions for fat digestion

1. gallbladder - bile salts (emulsifies fat) 2. pancreas - lipase (TG --> FFA, glycerol) - cholesterol esterase (cholesterol --> cholesterol esters) - phospholipase (phospholipids --> lysolecithin, FFA)

flavor of vegetables

1. glutamic acid found in young vegetables (used in form of salt/MSG) 2. sulfur - onion, cabbage

tissue stores of glucose

1. glycogen from muscle and liver 2. fat from adipose tissue 3. cellular mass (protein stores) 4. gluconeogenesis

flavanoids - red, blue, purple (anthocyanins)

1. greatly affected by changes in pH 2. soluble in water 3. bright red in acid 4. bluish in alkaline

potatoes

1. have a phenolic compound that causes color changes in raw, peeled, or bruised potatoes - green color under skin: due to chlorophyll that develops when potato is exposed to light during storage - starch changes to sugar during storage (changes in taste, color, texture). old potatoes taste sweeter, cook to a darker brown, and are softer in texture

FDA food code temperatures

1. hold frozen 0- -10 2. transport hot 165-170 3. do not hold between 40-140 4. reheat to 165 for 15 seconds within 2 hours 5. hold cold at 40 or less 6. ideal temp for pathogen growth 70-125

pigments - green (chlorophyll)

1. insoluble in water 2. olive green in acid (pheophytin) 3. bright green in alkaline (chlorophyllin) (mushy: break down of hemicellulose)

hormones that control BG level

1. insulin (fosters glycogenesis, lipogenesis) - pancreatic beta cells 2. glucagon - induces glycogenolysis (glycogen --> glucose) - pancreatic alpha cells 3. glucocorticoids - induces gluconeogenesis - protein --> glucose 4. epinephrine (adrenal medulla) - stimulates sympathetic nervous system - stimulates liver and muscle glycogenolysis - decreases release of insulin from pancreas during catabolic stress 5. growth hormone, ACTH (adrenocorticotropic) - insulin antagonists

transitional feeding (tapering PN)

1. introduce a minimal amount of full-strength enteral feeding 30-40 mL/hr to establish GI tolerance 2. begin taper PN when EN meeting 33-50% needs 3. when patient receiving 60% EER via EN discontinue PN

pigments - yellow, orange (carotenoids)

1. least affected by changes in pH 2. insoluble in water 3. little effect in acid or alkaline solution 4. lycopenes - antioxidant, phytochemical (tomatoes)

nutrition intervention for drug addiction

1. moderate or discontinued sugar intake - sugar ingestion releases dopamine - sugar cravings are typical - results in mood fluctuations and weight gain - stable glucose levels are shown to decrease drug cravings and reduce relapse potential 2. moderate or discontinued caffeine - caffeine reduces meal stability by inducing fight or flight 3. increased complex carbs, protein and fiber with moderate to low fat intake 4. regular meals and 1-3 snacks/day 5. 30-35 kcal/kg, 1-2 g/kg, encourage fluid intake, especially water

enzymes/secretions for protein digestion

1. pancreas - trypsin (protein, proteose, peptone --> polypeptide) - chymotrypsin (proteose, peptone --> poly and di peptide) - carboxypeptidase (polypeptide --> dipeptides, AAs) 2. intestine - aminopeptidase (polypeptide --> peptide, AAs) - dipeptidase (dipeptides --> AAs)

steps in menu planning

1. plan dinner meat or entree for entire cycle 2. luncheon entree or main dishes 3. starch item appropriate with entree 4. salads, accompaniments and appetizers 5. desserts for both lunch and dinner 6. breakfast and other items

mechanical dishwashing stages

1. pre-rinse, pre-wash: 110-140F -liquefies fat, removes food before hot water coagulates protein 2. wash 140-160F (lower temp. leads to greasy dishes) 3. rinse 170-180F sanitizes; booster heater - to raise temp. of regular hot water -if heater not working then dishes will NOT be sanitized -add a drying agent to prevent water-spots 4. air-dry 45 seconds

qualitative research (often precedes other research)

1. purpose - explore a phenomenon of interest as a prelude to theory development (what specific characteristics are associated with being an effective counselor) 2. generates narrative data (rather than numerical data or numbers) collected through interviews, observations, questionnaires; may use focus groups (delphi)

types of descriptive research

1. qualitative research 2. case report, case study or case series 3. surveys 4. correlation studies or ecological studies

flavanoids - colorless or yellow to white (anthoxanthins or flavones)

1. soluble in water 2. colorless in acid (bleaching effect) 3. yellow in alkaline or when cooked in an aluminum pan (flavones chelate aluminum)

three compartment sink

1. wash, 110-120 F 2. rinse, warm water 3. sanitize, 170 F for at least 30 seconds, or use chemical solution for 1 minute in lukewarm water (75 F)

use of milk in food prep

1. when milk is heated, whey precipitates out on the bottom of the pan or on the surface of the milk 2. to prevent curdling, add an acid slowly and agitate - an acid precipitates casein

activity factors

1.2 - sedentary 1.3 - active 1.5 - stressed

relief workers

1.55 employees necessary for everyday coverage of full-time positions

"lite, light"

1/3 fewer calories or 50% less fat

#10 can

13 cups

stage 1 HTN

130-139/80-89

stage 2 HTN

140/90

quaternary ammonia

150-400 ppm pH 7

water needed during PA

16 oz for every 1 lb body weight lost

#2 can

2 1/2 cups

when to start measuring age and sex specific BMI

2 y/o

normal birthweight

2500-4000 grams

weight gain during pregnancy

28-40 # for underweight 25-35 # for normal weight 15-25 # for overweight 11-20 pounds for obese *target is to achieve lower limit

#2 1/2 can

3 1/2 cups

"low fat"

3 grams or less per serving

storage time for steaks, chops, roasts

3-5 days

storage time for fresh eggs in shell

3-5 weeks - raw yolks, whites 2-4 days

Full oxidation of 1 molecule of glucose yields ___ ATP

38

chlorine solution

50 - 90 ppm pH <8

how much of protein can be converted to glucose

58%

when to add large finger foods (teething biscuit)

6-8 months, when food can be secured with palmer grasp

vitamin D precursor

7-dehydrocholesterol, a cholesterol found on the skin

VLBW

< 1500 g

"gluten free"

< 20 ppm

LBW

< 2500 g

mark up factor

= 100/food cost percentage

adult RDA for protein

> 19 males: 56 grams > 19 females: 46 grams

delphi technique

A decision-making technique in which group members do not meet face-to-face but respond in writing to questions posed by the group leader.

factors that aid vitamin and mineral absorption

A: bile salts, pancreatic lipase, fat D: hydroxylated in liver, then in kidney; needs bile salts, acidity of chyme; accompanies Ca, P absorption riboflavin: phosphorus B12: ileum, stomach secretion (HCl, intrinsic factor) folate: zinc dependent, cleaves polyglutamate to monoglutamate - folic acid in fortified foods and supplements is present in monoglutamate

egg grading

AA, A, B - done by candling

what weight to use with mifflin

ABW ALWAYS

eligibility for bariatric surgery

BMI of 40+ or BMI of 35+ with comorbidities

components of MI

Engaging Focusing Evoking Planning

FIFO vs LIFO

FIFO: - based on last price paid multiplied by number of units on inventory - uses most recent prices so tends to price inventory high LIFO: - uses oldest price paid for an item in inventory - usually underestimates value of inventory

fresh produce grading

Fancy, extra #1, #1, combination, #2

if linoleic acid replaces CHO

HDL increased, LDL decreases

tyramine

HTN if taken with MAO inhibitor - restrict aged, fermented, dried, pickled, smoked, spoiled foods

main intracellular cation

K+

foods high in iron

Liver, kidney, beef, dried fruit, dried peas and beans, nuts, leafy green vegetables, fortified whole grain products

main extracellular cation

Na+

postprandial/reactive hypoglycemia

Overstimulation of the pancreas or increased insulin sensitivity; blood glucose falls below normal 2-5 hours after eating (<50 mg/dL) - goal is prevent marked rise in BG that would stimulate more insulin - avoid simple sugars, 5-6 small meals per day, spread intake of CHO throughout the day, protein at RDA levels

oxaloacetate

Oxaloacetate is a four carbon molecule that combines with Acetyl CoA in the Krebs Cycle to form citric acid. This citric acid then loses two carbons as carbon dioxide, to form oxaloacetate again, so that the Krebs cycle can begin again.

medicare part a

Provides basic protection for medical, surgical and psychiatric care costs based on diagnosis-related groups(DRGs)

_______ is needed for the transport of AAs

Pyridoxine

family medical leave act

Requires employers with 50 or more workers to grant up to 12 weeks of unpaid leave a year to allow workers to take time off to help care for a new baby or an ill family member without fear of losing their jobs - upon return are guaranteed an equal job but not the exact same job

food synergy

The additive influence of food and constituents which when eaten have a beneficial effect on health

prevalence

The number or proportion of cases of a particular disease or condition present in a population at a given time (% of population)

incidence

The number or rate of NEW cases of a particular condition during a specific time

medicare part b

The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies

VLDL

Transports endogenous TG from liver to adipose tissue

centralized delivery

Trays set up close to production in one kitchen

decentralized delivery

Used where distance from kitchen to patient is great -bulk food delivered; trays set up in serving areas -duplication of equipment, employees, supervisors

what can unions negotiate

Working conditions, vacations, and holidays.

nominal group technique

a decision-making method that begins and ends by having group members quietly write down and evaluate ideas to be shared with the group

meta analysis

a formal, define system that combines the results of numerous small studies to increase the strength of belief in the observed effect - studies are of similar design, have defined inclusion and exclusion criteria, and are published peer-reviewed studies

serotonin

a neurotransmitter. low levels increase carbohydrate appetite

health belief model

a person must perceive the severity and their susceptibility to the threat for the threat to be a motivating factor

McClelland's Theory of Needs

a theory that states achievement, power, and affiliation are three important needs that help explain motivation

coulis

a thin puree of fruit of vegetable, sugar and water used as a sauce

functional medicine

addresses the whole person, not just symptoms, and looks at underlying cause of disease, engaging patient and practitioner in a partnership for therapy

flexible budget

adjusted to various levels of operation with varying levels of sales or revenue throughout the year (changes in patient or customer count) - closing a floor for renovation - gives dollar range for low to high levels of predicted activity

propofol

administered in oil, 1.1 kcal/mL

advocacy

aggressive form of action; plead cause of a group - know facts and arguments for and against the issue - be realistic, usually results in compromise - lobbying, activities aimed at influencing public officials and legislators

most glucogenic AA

alanine

sorbitol physical properties

alcohol from glucose; absorbed more slowly than glucose by passive diffusion; converted into fructose; excess may cause diarrhea

old baking powder is more

alkaline, causing a loss of thiamin in baked goods

saturated fat

all available bonds of carbon chain are filled with hydrogen; solid and hard at room temperature

union shop

all members must join the union after being hired (illegal in public sector)

conventional production system

all preparation is done on preemies where meal are served; food are prepared and served the same day

agency shop

all workers must pay agency fee, but not required to join union

thyroxine

also called thyroid hormone, regulates metabolism and rate of cellular oxidation - stimulates liver glycogenolysis, gluconeogenesis (raises blood sugar)

st. johns wart

antidepressant, serotonin enhancing - reduces effects of anticoagulants, avoid with antihypertensives, oral contraceptives, some statins - avoid combination with spironolactone, thiazide and loop diuretics, hypertensives

ginger

antiemetic - interactions with anticoagulants

BHA and BHT

antioxidants for fatty products

marinol

appetite stimulant

megastrol acetate

appetite stimulant

dextroamphetamine (adderall)

appetite suppressant

to change degree of dispersion

apply heat or beat

consultative leader

asks for input, but makes final decision alone

net worth ratios

assess ability to meet long term debt, solvency - total assets and total liabilities; debt to asset ratio

liquidity ratio

assess ability to meet short term debt -current assets and current liabilities

"organic"

at least 95% organic products

scalar principle

authority and responsibility flow in a direct line vertically from the highest to lowest echelons: clear and unbroken lines

transactional leaders

autocratic

statins

avoid grapefruit, decreased LDL, TG, increased HDL

vitamin D and human milk

baby needs 400 IU supplementation from birth (if fed formula, may need supplement if formula is not fortified)

calcium function

blood clotting, cardiac function, nerve transmission, smooth muscle contractibility

osteocytes

bone cells

semi variable costs

both a fixed and variable component - a portion of the cost will remain fixed regardless of changes in sales volume - labor, maintenance, utilities - these are divided into fixed and variable components before doing break-even analysis

nominal group technique (delbecq)

brainstorming - has a leader - participants silently generate ideas on the topic - group ranks items in priority order - vote for final decision

flours in order of more to least protein

bread, all purpose, pastry, cake

how does an acid stiffen an egg white foam

by tenderizing the protein and allowing it to extend more easily

bureaucratic leader

by the book, follows procedures to the letter

fish canned with bones, oysters, shrimp are a good source of

calcium

valerian root

calms nerves - avoid with liver disease

egg storage

can be stored in refrigerator at 40-45 F for 3-5 weeks - when held in fridge too long, there is a loss of CO2, making the egg more alkaline

open shop

can join the union or not

most unsaturated oil

canola

vitamin A precursor

carotene

passive diffusion

carrier-facilitated - water soluble nutrients - higher to lower concentration

commissary production system

centralized procurement and production with menu items sent to satellite service centers - menu items in bulk

copper is attached to

ceruloplasmin

CCK

cholecystokinin - released from duodenum when fat enters - contracts gallbladder releasing bile, stimulates pancreas - hormone

fire extenguishers

class A - ordinary combustible materials, wood, paper, cloth class B - flammable liquids, gases, greases class C - live electrical fires

performance test (evaluation strategy)

client asked to complete tasks based on learning objectives (works well in clinic/community)

motivational interviewing

client-centered method for enhancing intrinsic motivation, guides rather than directs, and does not give advice to the client

3 diagnostic domains

clinical, intake, behavioral-environmental

suspension which separates upon standing

clumps of molecules (fat, uncooked starch)

most saturated and least saturated

coconut oil, canola oil

pantothenic acid

coenzyme A, energy synthesis of FAs

cohort studies

cohort - any group whose members have something in common - cohort of healthy people followed through time to see fi they develop a specific disease - sometimes called incidence studies tracking the frequency of new cases (newly diagnosed) of a disease

integrative medicine

combines evidence based complementary therapies with conventional (allopathic) treatments to address the social, psychological, and spiritual aspects of health and illness

IRB (international review board)

committee established to review and approve research involving human subjects to ensure it is conducted within all ethical and federal guidelines

CONSORT

common criteria for clinical trials

correlational studies

compare frequency of events (or disease rates) in different populations with the per capita consumption of certain dietary factors (correlation between fish consumption and breast cancer incidence)

invoice

compare invoice against purchase order first, then items against invoice

specific gravity

compares lightness of products (egg white foams)

steatorrhea

consequence of malabsorption - normal stool fat 2-5 grams; > 7 grams is indicative of malabsorption - determine cause and treat - high protein, high complex CHO, fat as tolerated, vitamins (especially fat soluble), minerals, MCT (rapidly hydrolyzed in the GI tract)

reliability

consistency or reproducibility of test results

nutrition surveillance

continuous collection of data - use height, weight, hematocrit, hemoglobin, serum cholesterol

CQI

continuous quality improvement - ideal that systems and performance can always improve - not an end point in quality efforts, uses outcome assessment - focuses on the individuals or the organization

hyperactive bowel sounds

continuous, high-pitched, tinkling sounds may indicate diarrhea or intestinal obstruction

gluconeogenesis

conversion of non-carbohydrate sources into glucose (from glycerol (fat) and amino acids)

good heat conductors

copper, black cast iron, aluminum

inventory turnover rate

cost of sales (food cost or COGS)/ average inventory cost - high ratios indicate a limited inventory is being kept - low ratios indicate large amounts of money are tied up in stock

cost of sales

cost of the raw food and beverages sold

absolute FTE

counts productive hours (hours actually worked)

child nutrition reauthorization

covers NSLP, SBP, CACFP, SFSP, SMP, WIC

farm bill

covers national and international nutrition education, research, funding

state of turgor

crispness of fruits and vegetables due to the osmotic pressure of water-filled vacuoles

alpha linolenic acid (omega 3)

critical for retinal function and brain development - deficiency results in neurological changes (numbness, blurred vision) - comes mostly from EPA/DHA (fish oil) and walnuts, flaxseed canola - decreases hepatic production of TG

six sigma

data driven approach for improving quality by removing defects and their causes - achieving six sigma means there is very little variation in a process - define, measure, analyze, improve, control

NCP (national consumer panel)

data helps manufacturers understand consumer preferences on specific brands; enables retailers to stock the right item assortment for their local markets

strategic planning

decisions about intended future outcomes, and how success is measured and evaluated

methotrexate

decrease folate

oral contraceptives

decrease folate, B6, C

thiazide diuretics

decrease potassium and magnesium, absorb calcium

elderly

decreased attention span; audience participation to maintain interest; control questions to stay on topic; consider written material

adding bran _____ volume of end product

decreases (b/c bran= heavy, weighs down structure)

thalassemia

defective hemoglobin synthesis resulting in microcytic, hypochromic short lived RBC - may develop iron overload - dont avoid iron rich foods - managed with transfusions - provide folate and zinc

autocratic leader

demands obedience, most control, full responsibility, crisis control

loop diuretics

deplete thiamin, potassium, magnesium, calcium, sodium

isoniazid (treats TB)

depletes pyridoxine (B6)

standards of professional performance

describes a competent level of behavior in the professional role - provisions of services - applications of research - communication and application of knowledge - utilization and management of resources - quality in practice - competence and accountability

standards of practice

describes in general terms a competent level of nutrition care practices as shown by the NCP, for those working in direct patient care - includes standards of care for diabetes, oncology nutrition, behavioral health, nutrition support, management of food and nutrition systems, sports dietetics, education of dietetic practitioners, pediatric nutrition, nephrology

summative evaluation

designed at planning stage but conducted at the end - post-test - considered final; purpose may be grading, or evaluation of progress

grade A (canned fruits and veg)

desserts, salads (Fancy)

performance budgeting

details what it costs to perform an activity (how much to supervise the trayline)

weight for length

detects short term changes in nutritional status

quick-cooking cereals have ______ added

disodium phosphate

non-maleficence

do no harm

dextrose infusion rate

don't exceed 0.36 g/kg/hour

xerostomia

dry mouth

dry storage

dry, cool, dark, well-ventilated, clean - separate room for cleaning supplies - 50-70 degrees - circulation of air removes moisture and odors - cartons and bags on shelves at least 6" above floor, away from walls - 50-60% humidity - fresh fruits and veg require highest humidity at 85-90%

xerophthalmia

drying of eye surfaces including the conjunctiva; also known as dry eye

food borne infections

due to activity of large numbers of bacteria carried by food into the GI tract

brown color of evaporated milk

due to caramelization of lactose in canning

why do wheat flours spoil quickly

due to fat in germ

stainless steel

durable, wears well

black cohosh

ease menopause symptoms - interactions with anticoagulants, effects statins

EOQ

economic order quantity - attempts to find the quantity that minimizes both purchasing and inventory costs, determines the order size that is most economical - to decrease costs, place orders as seldom as possible by ordering larger quantities - when the cost of placing na order aligns with the cost of holding the items, EOQ is obtained

basic ingredients of quick bread

egg and flour

qualified health claim

emerging evidence of a relationship, but not conclusive. requires a disclaimer "evidence suggests but does not prove that..."

participative leader

emerging trend in management. encourages workers to participate in decision-making - uses quality circles: small group of employees who meet regularly to identify and solve problems

disodium phosphate

emulsifier; prevents fat separation and add smoothness with manufacturing processed cheese

interpersonal roles

figurehead, leader, liaison

purchase requisition

first document used in the purchasing process, internal form used to request items from the purchasing manager

calories for pregnant/lactating moms

first trimester = +0 additional kcal second trimester = +340 kcal third trimester = +450 kcal mo 1-6 = +330 kcal mo 7-12 = +400

pastry

flour, fat, liquid, salt - when using margarine or butter instead of oil or lard, add more (butter and margarine have less fat)

scientific management

focus on physical aspects of the job (assembly lime, manufacturing)

food cost percentage formula

food cost percentage = daily food cost/daily income

osteoblasts

forms bone

difference between human milk and formula

formula has more protein, more iron, but lacks antibodies - both have 22 kcal/oz

folate sources

fortified cereal, liver, kidney, leafy green vegetables, citrus fruits, lentils, beans

elastin

found in ligaments, cartilage; yellow color - resistant to heat, little change in cooking

choline

found in most lecithins, a lipotropic factor, which helps prevent the accumulation of fat in the liver

how is gluten made

from gluten and gliadin through hydration and mixing

the older americans act

funds nutrition programs in the community

green colors in meat are due to

further myoglobin breakdown (oxidation)

billroth I

gastroduodenostomy - attaches the remaining stomach to the duodenum

billroth II

gastrojejunostomy - attaches the remainder of the stomach to the jejunum - when food bypasses the duodenum, the secretion of secretin and pancreozymin by the duodenum is reduced - these hormones normally stimulate the pancreas, so there is now little pancreatic secretion (leading to steatorrhea) - calcium (most rapid absorption in duodenum) and iron absorption (requires acid) are adversely affected

collagen is hydrolyzed to ___ and softens in heat

gelatin

wilsons disease

genetic condition, copper builds up in liver, brain, and cannot be eliminated properly

functional properties of gluten

gives elastic properties, forms framework, holds in leavening agent

poor heat conductors

glass, stainless steel

baby friendly hospital initiative

global effort to increase incidence and duration of breast feeding - hospital must show it implements ten steps to successful breast feeding

starch

glucose chains, 50% CHO intake ONLY YIELDS GLUCOSE

systems approach

goal is to be viewed as an open system (interacting with external forces; change in one part affect many other parts) - interdependency of parts - integration - synergy - dynamic equilibrium - equifinality - permeability of boundaries

middle and upper income adults

goal-oriented; consider activities they can't relate to as a waste of time

kaizen philosophy

good changes suggests making continuous and small incremental improvements in process on a daily basis

vitamins and minerals in milk

good source of calcium, phosphorus, riboflavin, vitamins A, D LOW in iron and vitamin C

thiamin sources

grains, wheat germ , pork, liver

solid in liquid

gravy (sol)

democratic leader

guides and encourages the group to make decisions

roux

half fat, half flour

bread flour

hard wheat, strong gluten, more protein

solanine

harmful, bitter-tasting substance that appears as a greenish color on potatoes that are exposed to light

QUOROM

has proposed quality standards for the review and monitoring of systematic reviews and meta-analysis of randomized trials

conduction

heat moves from one particle to another by contact

convection

heated air moved with fan

pro forma statement

hypothetical, projected expected income, expenditures and profit

FATTOM

ideal conditions for microorganism growth - food, acidity, temperature, time, oxygen, moisture

first step of marketing

identify a need that is not being filled (market niche)

canning

if pH is low <4.5, use boiling water if pH is high >4.5 use pressure canning

foodborne intoxication

illness caused by toxin in food prior to consumption

blanching

immersion in boiling water for a short period of time

ginseng

immunity, endurance - interactions with anticoagulants

cyclosporine

immunosuppressant hyperlipidemia, hyperglycemia, hyperkalemia, hypertension

abnormal fat metabolism

inadequate CHO (starvation, uncontrolled diabetes) results in incomplete fat oxidation and buildup of ketones (which serve as fuel for muscle and brain, but disturbs acid/base balance)

when using buttermilk in place of regular milk

increase amount of baking soda

work simplification procedures

increase productivity and decrease costs - purpose: eliminate unnecessary parts of the job and those that add no value - looks at smallest parts of the job (hand movements, steps taken)

B6 (pyridoxine)

increase protein intake = increase need for B6

thiamin

increased intake of CHO = increased need for thiamin - needed in metabolism of pyruvate

loss leaders

items priced lower to draw people in, in hopes that they will purchase other items at normal markups

structure function claim

may be used without FDA regulation "fiber maintains bowel regularity"

garlic

may decrease cholesterol, blood pressure - interactions with anticoagulants

milk thistle

may help protect liver

peter principle

may promote someone to a level of incompetence

curcumin (turmeric)

may reduce inflammation

liquid in liquid

mayo (emulsion)

direct calorimetry

measures heat produced in a respiration chamber, limited usefulness

indirect calorimetry

measures oxygen consumed and CO2 excreted using a portable machine

line-spread test

measures viscosity of liquids or semi-solid foods that flow on a flat surface

viscosimeter (viscometer)

measures viscosity of liquids that flow; measures the flow on an incline plane or a rotational basis

carryover cooking

meat continues to cook for about 10 minutes, raising internal temperate 15-25 degrees

zinc sources

meat, liver, eggs, fish

phosphorus sources

meat, milk, poultry, eggs, fish, cheese

B6 sources

meat, wheat, corn, yeast, pork, liver, ready-to-eat cereals

FDA approve emulsifiers

monoglycerides, diglycerides, lecithin, disodium phosphate

active transport

most nutrients (glucose, amino acids, Na, K, Mg, Ca, Fe) - sodium pump: uphill pimping from lower to higher concentration, across a membrane against an energy gradient; needs energy from ATP

food costs

most readily controlled item, subject to the greatest fluctuation

oxytocin

moves milk through ducts

myofibrils

muscle composed of bundles of fibers

closed shop

must be a member of union before being hired (illegal in public sector)

main contributor to meat color

myoglobin

NCCIH

national center for complementary and integrative health - yoga, meditation, herbs and botanicals, traditional healing practices

indicators of dehydration

nausea, dizziness, sunken eyes, fever, hyperventilation, excessive sweating, concentrated urine, dry inelastic skin, increase BUN, tachycardia, headache, fatigue, decreased appetite, rapid weight loss

bacteria

need abundant moisture and neutral foods, 63-113 F

coercive power

negative side of reward power, ineffective in motivating behavior change, may create resistance

bicarbonate in digestion

neutralizes stomach acid/acidic chyme - secreted from the mucous neck cells (from the pancreatic ducts)

nyctalopia

night blindess

"low sodium"

no more than 140 mg Na per serving

"low calorie"

no more than 40 kcal per serving

dry heat cooking

no water involved, for tender cuts near backbone (loin, sirloin)

nominal variable

non-ordered - variables that fit into a category with no special order (marriage, sex, race)

prepared and perishable food programs (PPFPs)

nonprofit programs that link sources of unused, cooked and fresh foods with social service agencies that serve the hungry

objective test (evaluation strategy)

not well-suited for clinic or community setting (multiple choice)

federal register

notices of public hearings, proposed and final rules, agency decisions, published weekly; lists changes in USDA food programs (most helpful)

finish (luster) of metals

numbered 1-7; higher numbers, higher polish, finish, luster #4 grind - standard

most monounsaturated and least monounsaturated

olive oil, coconut oil

unsaturated fat

one or more double bonds - one double bond = monounsaturated - two double bonds = polyunsaturated

one dozen oranges yields?

one quart of juice

hang time for EN

open systems = 8 hours closed systems = 24-48 hours

ordinal variable

ordinal scale - observations compared with each other that are put in a ranking or scale of some sort

lipolysis

oxidation forms acetyl CoA which enters Kreb's cycle - growth hormone, glucagon (insulin antagonist) - glucocorticoids, thyroxine, epinephrine, ACTH - increase rate of fat oxidation

hawthorne effect

positive response due to the attention that participants receive

coenzymes for cellular respiration

pantothenic acid, thiamin, riboflavin, niacin

transformational leaders

participative

Statuatory Benefits

payment required by law to ensure income in event of unemployment, injury or death (must be provided)

stabilizers/thickeners

pectin, cellulose, gelatin, gum, agar

essential AAs

phenylalanine, valine, tryptophan, threonine, isoleucine, methionine, histidine, leucine, lysine

lecithin

phospholipid found in egg yolk, helps to stabilize emulsifications

what decreases zinc absorption

phytates and copper

isoflavones

phytochemical - anthoxanthins in soybeans (lowers cholesterol)

basic functions of management

plan, organize, staff, direct, control/evaluate

capital budget

plant facilities, equipment, cost of improvements and repairs (service, maintenance contracts), expansions, replacements, long term - includes expenditures whose returns are expected to last beyond one year

NSI (nutrition screening initiative)

promote nutrition and improve nutritional care for the elderly to identify nutritional problems early - DETERMINE checklist: disease, tooth loss, economic hardship, reduced social contact, multiple medications, involuntary weight loss/gain, needs assistance in self care, elder years above 80 - level 1: screen identifies those who need more comprehensive assessments - level 2: screen provides more specific diagnostic info on nutritional status

ephedra

promote weight loss - rapid heart rate, headaches - very likely hazardous

mold inhibitor

propionate, sodium benzoate (soda)

sensitivity

proportion of afflicted individuals who test positive

specificity

proportion of non-afflicted identified as non-afflicted

how is BMR measured

protein bound iodine (PBR), measures the activity of the thyroid gland - when PBR is elevated, so is BMR

enzymes

proteins, organic catalysts that control reaction

papain

proteolytic enzyme from papaya that will prevent gelatinization

ripening of fruits and vegetables

protopectin --> pectin (ripe fruit) --> pectic acid (overripe fruit)

grade C (canned fruits and veg)

puddings, pies (standard)

first control in the receiving process

purchase order

catabolism of protein

pyridoxine is involved - the remaining carbon chain is a ketoacid; it can be oxidized for energy

what happens in the krebs cycle

pyruvic acid is broken down into carbon dioxide in a series of energy-extracting reactions

gold standard for clinical nutrition studies

randomized controlled trials

error of centra tendency

rate everyone as average

leniency of error

rate everyone higher than they deserve

mortality

rate of death

prime cost method

raw food cost + labor cost involved in making the item

surveys

research designed to describe and quantify characteristics of a defined population; defined timeframe; pinpoints problems

osteoclasts

resorbs and removes bone

RMR

resting metabolic rate, more frequently measured than BMR - similar outcomes as mifflin

too much sugar in baked good

results in coarse cells, thick walls, a shiny crust and a crumbly product

HDL

reverse cholesterol transport; moves cholesterol from cells to liver and excretion

food least likely to cause allergy

rice

climacteric fruits

ripen post-harvest (peach, pear, banana, apple tomato)

wholesomeness of meat shown by

round purple stamp "USDA inspected and passed"

nonnutritive sweeteners

saccharin, aspartame, acesulfame K, sucralose, neotame, stevia - provide minimal to no energy and must be approved by the FDA

most polyunsaturated oil

safflower

best source of linoleic acid

safflower oil

most polyunsaturated and least polyunsaturated

safflower oil, palm kernel oil

fat with highest/lowest smoke point

safflower/butter

winterized oils

salad dressings; won't crystallize when cold, clear (not cloudy) - corn, soy, cottonseed oils are winterized

equifinality

same or similar output can be achieved by using different inputs or by varying the transformation process

low energy chemical dish machine

saves energy- no booster heater; water temp at 140F with regular tap water

hedonic rating

scale; facial hedonic (smiling faces) - affective

tryptophan is a precursor for

serotonin and niacin

master schedule

serves as overall plan; days on and off, vacations; basis for developing weekly schedules

fair labor standards act

set a minimum wage and maximum workweek, outlawed child labor

hyperemesis gravidarum

severe nausea and vomiting, acidosis, weight loss - bed rest, small amounts of frequent CHO, correct fluid and electrolyte imbalance

very poor

short term planners

cooking frozen fruit/veg

shorter cooking time than fresh due to being blanched prior to freezing

balance sheet

shows financial condition as of a particular date (static) - lists assets (goods and products owned) - cash, inventory, accounts receivable (amounts owed to you) - lists liabilities - amounts owed to others - assets = liabilities + capital (equity, owner's interest) - analyzes operational effectiveness. quick way to view financial condition

income statement

shows operating results over a period of time (dynamic) - presents the income (revenue), expenses and profit (or loss or break-even) over the course of the budget period - analyses operational effectiveness

sweet acidophilus milk

skim milk plus lactobacillus acidophilus bacteria which reduces lactose

level 1 grey

slightly thick thicker than water, can flow through straw

true solution

small particles (sugar, salt)

pregnancy induced HTN

sodium restriction not recommended - proposed association between PIH and calcium deficiency - more frequently found in women with lack of prenatal care, poor diets, poor protein and Ca intakes - S/S: HTN, edema, proteinuria, rapid weight gain after 20th week

level 6 blue

soft, bite sized - able to chew bite-sized pieces, knife not required

cake flour

softest wheat, least and weakest gluten, least amount of protein

cholesterol absorption

some absorbed with bile salts, most absorbed with cholesterol esterase; converted into cholesterol esters and excreted by the liver as bile

simple diffusion

some water and electrolytes - higher to lower concentration: intestine to blood to lymph

comfrey

soothe nerves - irreversible liver disease

sugar alcohols

sorbitol, manitol, xylitol - functional as humectants (hold water), and emulsifiers, extending shelf life - 40-100% as sweet as sucrose, resistant to digestion, contribute fewer calories - absorbed more slowly than other calories, can cause diarrhea

CP

spastic form - low kcal, high fluid, high fiber non spastic form - high kcal/pro, finger foods

taft hartley act

specified unfair labor practices of the union

vitamin K sources

spinach, kale, broccoli, leafy green vegetables

synergy (group decision making)

the groups product (decision) is superior to what the most resourceful individual within the group could have produced by working alone

Maslow's Hierarchy of Needs

the higher human needs (social, self esteem, self realization/actualization) are motivators - advanced training leads to job enrichment

overrun

the increase in volume from freezing and whipping ice cream

objective measure of quality in custards

the larger the % sag, the more tender the gel

structure of FAs

the location of the first double bond, counted from the methyl end of the fatty acid, is designated by the omega sign

most digestion is completed by

the middle of the jejunum; nutrients absorbed including amino acids, fatty acids, glycerol, simple sugars, minerals, vitamins

pellagra

the niacin-deficiency disease, characterized by diarrhea, dermatitis, dementia, and eventually death

diverticulosis

the presence of diverticula - related to constipation and lifelong intra-colonic pressures - high fiber diet

complete digestion and absorption of food takes place in

the small intestine

flavor profile method, descriptive flavor analysis profile (DFAP)

trained panel analyzes and records the aroma and flavor in great detail

gelatinization

the swelling that occurs when starch is heated in water close to the boiling point

theory Z

the value of the company is the people - follows consensus decision making

pork is a good source of

thiamin

beriberi

thiamin deficiency, characterized by muscle weakness, foot drop, memory loss, tachycardia

as energy expenditure increases, the need for __________, ___________, _________, and ____________ increases

thiamin, niacin, ribloflavin, pantothenic acid

vitamins and minerals found in meat, poultry, fish, meat alternatives

thiamin, niacin, riboflavin, iron, copper, trace minerals

vitamins needed for pyruvate --> acetyl CoA

thiamin, niacin, riboflavin, pantothenic acid, magnesium, lipolic acid

level 0 white

thin, water flow through straw

production schedule

time sequencing of events required to produce a meal; employee assignments and menu items; quantity to prepare and the timing (what to do when)

quasi experimental design

time series: series of measurements at periodic intervals before the program begins and after the program ends - shows whether measurements before and after the program are a continuation of previous patterns or whether they indicate a noteworthy change

if linoleic acid replaces saturated fat in the diet

total cholesterol decreases, HDL decreases

gelatin is missing which AA

tryptophan - low in methionine and lysine

phenylalanine converts to

tyrosine

hyperbilirubinemia (babies)

unconjugated bilirubin levels are elevated in first week of life as a result of the breakdown of red blood cells, or decreased intestinal mobility - encourage 9-12 feedings per day of human milk or formula to promote hydration and intestinal motility

what may an RQ of < 7 suggest

underfeeding, use of ketone bodies

oxidative rancidity

uptake of oxygen at a double bond in an unsaturated fat (soybean oil very susceptible)

hydrolytic rancidity

uptake of water - occurs at room temperature leading to flavor changes in butter (saturated fat)

how to get a clear, shiny, translucent white sauce

use cornstarch as a thickener

lean method

use less human effort, less space, less capital, and less time to make products exactly as the customer wants with few defects

induction

use of electrical magnetic fields to excite the molecules of metal cooking surfaces - burner has no open flame

prime vending

use single vendor for majority of purchases, saves time and money

sponge method

used to mix yeast doughs; causes proofing time (final rise time) is shortened

ANOVA (analysis of variance)

used when several (three or more) products compete against one another - tool used to evaluate validity

affective sensory evaluation of food

used with untrained panelists; determine preference, acceptance or opinions of a product

TQM

uses PDCA (plan, do, check, act) - problem solving technique for coordinating process improvement - focuses on the organization as a whole

traditional (incremental, baseline) budget

uses existing budget as a base and projects changes for the ensuing year in relation to the current budget

experimental model

uses experimental and control groups - experimental group receives the program or treatment - control group may receive a placebo

yeasts

water, energy, acid medium in oxygen, 77-86 F

large intestine absorbs

water, salts, vitamin K, B12, thiamine, riboflavin

definition of FTT in infants

weight for age that falls below the 5th percentile on multiple occasions or weight deceleration that crosses two major percentiles on a growth chart

Elavil (antidepressant)

weight gain, increased appetite

lorcaserin

weight loss med approved for long term use (2 yrs) - agonist against serotonin, enhances satiety

phentermine

weight loss med approved for long term use (2 yrs) - appetite suppressant, releases norepinephrine

orlistat

weight loss med approved for long term use (2 yrs) - lipase inhibitor, take with diet 30% kcal as fat, vitamin supplements

diverticulitis

when diverticula become inflamed as a result of food and residue accumulation and bacterial action - clear liquids, low fiber or elemental, gradual return to high fiber

differential diagnosing

which of many problems with similar symptoms is the correct diagnosis

egg whites at room temperature...

whip more quickly and yield a larger volume due to lower surface tension

gas in liquid

whipped egg whites (foam)

angel food cake

without cream of tartar: tough, yellow, small - cream of tartar contributes to tender crumb, large volume, maintains white color

vitamin A sources

yellow, orange fruits; dark leafy greens; cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato