Nutrition 1 Exam #1

(CH.2) What philosophy for eating is recommended by nutritionists? refer to: - pg. 38

- "consume a variety of foods balanced by a moderate intake of each food" - consume a variety of foods (variety) - control how much you eat (balance/proportionality) - pay attention to what you eat: chose whole grains, fruits, and vegetable (moderation); there are no exclusively "good" or "bad" foods - stay physically active

(CH.2) Review the 4 nutritional assessment categories refer to: - pg. 59-60 - fig.2-11

- Anthropometric assessment: measurement of body weight and the lengths, circumferences, and thicknesses of parts of the body - Biochemical assessment: measurement of biochemical functions (example: concentrations of nutrient by-products or enzyme activities in the blood or urine) related to a nutrient's function - Clinical assessment: examination of the general appearance of skin, eyes and tongue; evidence of rapid hair loss; sense of touch; and ability to touch and walk - Dietary assessment: estimation of typical food choices relying mostly on the recounting of one's usual intake or a record of one's previous days' intake - environmental assessment: includes details about living conditions, education level, and the ability of the person to purchase, transport, and cook food; the person's weekly budget for food purchases is also a key factor to consider

(CH.2) Review and understand the DRI's refer to: - pg. 61-64 - fig. 2-12, 2-13

- Dietary Reference Intakes (DRIs): term used to encompass nutrient recommendations made by the Food and Nutrition Board of the Institute of Medicine; this includes RDAs, AIs, EERs and ULs - Recommended Dietary Allowance (RDA): nutrient intake amount sufficient to meet the needs of 97% to 98% of the individuals in a specific life stage; an intake slightly above or below the RDA for a nutrient on any given day is no concern; use to evaluate your current intake for a specific nutrient; the further you stray above or below this value, the greater your chances of developing nutritional problems - Adequate Intake (AI): nutrient intake amount set for any nutrient for which insufficient research is available to establish an RDA; AIs are based on estimates of intakes that appear to maintain a defined nutritional state in a specific life stage; used to evaluate your current intake of nutrients but realize that an AI designation implies that further research is required before scientists can establish a more definitive recommendation; standard is based on dietary intakes of people that appear to be maintaining nutritional health; the amount of intake is assumed to be adequate, as no evidence of a nutritional deficiency is apparent - Estimated Energy Requirement (EER): estimate of the energy (kcal) intake needed to match the energy use of an average person in a specific life stage; use to estimate calorie needs of an average person within a specific height, weight, gender, age, and physical activity pattern; note that the EER is based on the "average" person; thus, it can only serve as a starting point for estimating calorie needs - Tolerable Upper Intake Level (UL): maximum chronic daily intake level of a nutrient that is unlikely to cause adverse health effects in almost all people in a specific life stage; used to evaluate the highest amount of daily nutrient intake unlikely to cause adverse health effects in the long run in almost all people (97% to 98%) in a population; this number applies to chronic use and is set to protect even very susceptible people in the healthy general population; as intake increases above the upper level, the potential for adverse effects generally increases; as intake increases the UL, the risk of ill effects increases; the amounts should generally not be exceeded day after day because toxicity could develop; for people eating a varied diet and/or using a balanced multivitamin and mineral supplement, exceeding the UL is unusual - Acceptable Macronutrient Distribution Range (AMDR): range of macronutrient intakes expressed as a percentage of total kcals consumed that provides adequate amounts of vitamins and minerals that makes the foundation of a healthy diet

(CH.2) Review how to effectively use MyPlate for menu planning refer to: - pg. 53-55

- MyPlate exemplifies the foundations of a healthy diet you have already learned: variety, proportionality, and moderation to achieve optimal nutrition, remember the following points when using MyPlate to plan your daily menus: - the guide does not apply to infants or children under 2 years of age; daily food plans for children from ages 2 to 8 are based on average height and weight for age and gender - variety is a key to successful implementation of myplate; there is no single perfect food that is absolutely essential to good nutrition; each food is rich in some nutrients but deficient in at least one essential nutrient; likewise, no food group is more important than another and each food group makes an important, distinctive contribution to nutritional intake; choose foods from each food group and also choose different foods within each food group - the foods within a group may vary widely with respect to nutrients and calories; for example: the calorie content of 3 ounces of baked potato is 98 kcal, whereas that of 3 ounces of potato chips is 470 kcal; with respect to vitamin C, an orange has 70 mg and an apple has 10 mg - choose primarily low-fat and fat-free items from the dairy group; by reducing calorie intake in this way, you can select more items from other good groups; if milk causes intestinal gas and bloating, emphasize yogurt and cheese - include plant foods that are good sources of proteins, such as beans and nuts, at least several times a week because many are rich in vitamins (such as vitamin E), minerals (such as magnesium) and fiber - for vegetables and fruits, try to include a dark-green or orange vegetable for vitamin A, and a vitamin-C rich fruit such as an orange, every day; do not focus primarily on potatoes for your vegetable choices; surveys show that fewer than 5% of adults eat a full serving of a dark-green vegetable on any given day; increased consumption of these foods is important because they contribute vitamins, minerals, fiber, and phytochemicals - choose whole-grain varieties of breads, cereals, rice, and pasta because they contribute vitamin E and fiber; a daily serving of a whole-grain, ready-to-eat breakfast cereal is an excellent choice because the vitamins (such as vitamin B-6) and minerals (such as zinc) typically added to it, along with fiber, help fill in common nutritional gaps - include some plant oils on a daily basis, such as those in salad dressing, and eat fish at least twice a week; this supplies you with health-promoting essential fatty acids

(CH.1) What are phytochemicals refer to: - pg. 13

- a chemical found in plants; some phytochemicals may contribute to a reduced risk of cancer or cardiovascular disease in people who consume them regularly - concern that it is being overused in marketing some foods tips for boosting phytochemical content in diet: - use vegetables in main and side dishes - get creative at the salad bar - fresh or dried fruit for snacks away from home - add vegetables to sandwich - vegetarian meals once or twice a week - fruit or vegetable juices instead of soft drinks - put tofu, soy milk, soy protein isolate, and roasted soybeans into meals

(CH.2) Review the My Plate food plan refer to: - pg. 49-50

- a visual representation of the advice contained in the dietary guidelines for americans - myplate serves as a reminder of how to build a healthy plate at meal times and emphasizes the important areas of the american diet that are in need of improvement - increase the relative proportions of fruits, veggies, whole grains, fat-free or low-fat dairy products while simultaneously decreasing consumption of refined grains and high-fat meats - myplate does not display a separate group for fats and oils, as they are mostly incorporated into other foods; myplate food guide recommends limiting solid fats and focusing instead of plant oils, which are sources of essential fatty acids and viamin E the new myplate icon includes five food groups: - fruits and vegetables cover half of the plate; these foods are dense sources of nutrients and health-promoting phytochemicals despite their low calorie contents - grains occupy slightly more than one-fourth of the late; the message to make half your grains whole is stressed throughout accompanying consumer-education materials - the remaining space on the plate is reserved for sources of protein; specifically the dietary guidelines recommend a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas [can count either as vegetables or in the protein foods group]), nuts, seeds, and soy products - a cup of dairy appears next to the plate; depending on personalized calorie recommendations, users should have 2 to 3 cups per day of low-fat or fat-free dairy products or other rich sources of calcium consumer health messages (balancing calories): - enjoy your food, but eat less - avoid oversized portions consumer health messages (foods to increase): - make half your plate fruits and vegetables - make at least half your grains whole - switch to skim or 1% milk consumer health messages (foods to reduce): - compare sodium in foods such as soup, bread, and frozen meals - and choose the food with lower numbers - drink water instead of sugary drinks

(CH.3) Review how to avoid heartburn refer to: - pg. 107-108 - table 3-4

- avoid smoking - avoid large doses of aspirin, ibuprofen, and other NSAID compounds unless a physician advises otherwise - achieve or maintain a healthy body weight - eat small, low-fat meals - limit alcohol consumption - limit consumption of caffeine (example: coffee and some soft drinks) - consume a nutritionally complete diet with adequate fiber - avoid food that worsen symptoms like acidic food (example: orange juice, tomato products), highly spiced foods (example: chili, cayenne, and black pepper), carbonated beverages, chocolate, onions and garlic, peppermint and spearmint - avoid tight-fitting clothing - elevate the head of the bed 6 to 8 inches - avoid eating at least 3 to 4 hours before lying down - wash hands often and follow food safety guidelines

(CH.1) What are the 6 classes of nutrients? What are their main characteristics? refer to: - pg. 10-13

- carbohydrate: a compound containing carbon, hydrogen, and oxygen atoms; energy yielding; provide majority of calories in our diet (~4 kcal/gm); exists as simple sugars [carbohydrate composed of only one [monosaccharide] or two [disaccharides] sugar units] and complex carbohydrates [carbohydrate composed of many sugar units [polysaccharide] examples include glycogen, starch, and fiber [substances in plant food not digested by the processes that take place in the human stomach or small intestine; these add bulk to feces; naturally found in foods called dietary fiber]] - lipids: a compound containing much carbon and hydrogen, little oxygen, and sometimes other atoms; energy yielding (~9 kcal/gm); fats and oils (both plant and animal resources); do not dissolve in temperature; animal fats are solid at room temperature (should be limited in our diet because it can raise blood cholesterol) and plant oils are liquid at room temperature - proteins: food and body compounds made up of amino acids [building block of protein containing a central carbon with nitrogen and other atoms attached]; contain carbon, hydrogen, oxygen, nitrogen, and sometimes other atoms in a specific configuration; energy yielding (~4 kcal/gm); main structural material in the body; component of blood cells, enzymes [a compound that speeds the rate of a chemical reaction but is not altered by the reaction; almost all enzymes are proteins but some are made of genetic material], and immune factors; form when amino acids bonded [linkage between two atom, such as that formed by the sharing of electrons] together; dietary sources include animals and plants; most north americans eat up to 2 times as much protein as the body needs to maintain health - vitamins: compound needed in very small amounts in the diet to help regulate and support chemical reactions in the body; enable chemical reactions to occur in the body; fat soluble (A, D, E, and K); water soluble (B's and C); cooking destroys water soluble more readily that fat soluble; contain no useable energy - minerals: element used to promote chemical reactions and form body structures; inorganic [any substances lacking carbon atoms bonded to hydrogen atoms in the chemical structure] substances that do not contain carbon atoms; numerous functions in the body;not destroyed during cooking; major [daily needs are equal to or more than 100 milligrams] and trace minerals [daily needs are less than 100 milligrams]; produce no calories/energy - water: the universal solvent; chemically H2O; the body is composed of about 60% water; acts as solvent [a liquid substance in which other substances dissolve] and lubricant; transports nutrients and waste; medium for temperature regulation; majority of our body weight; recommended intake is 9-13 cups/day; found in foods; provides no calories/energy; body makes some water as a byproduct of metabolism [chemical processes in the body by which energy is provided in useful forms and vital activities are sustained]

(CH.1) Which nutrients provide energy? How is that energy measured? Be sure you can calculate the total kcals in a food and the percentage of the food energy contributed by that nutrient refer to: - pg. 15-16 - nutrition calculation

- carbohydrates, proteins, and lipids (fats) are nutrients that provide energy - humans obtain the energy we need for involuntary and voluntary physical activity from various sources: carbohydrate (4 kcal/gm), fats (9 kcals/gm), protein (4 kcals/gm), and alcohol (7 kcal/gm) [not considered an essential nutrient] - calories (little c): the amount of heat it takes to raise the temperature of 1 gram of water by 1 degree celsius - energy in food is expressed in terms of Calories (capital C) on food labels - little calofie is a tiny measure of heat so food energy is more conveniently expressed in terms of the kilocalorie (kcal), which equals 1000 calories - kilocalorie (kcal) is heat energy needed to raise the temperature of 1000 grams (1 liter) of water 1 degree celsius; also written as Calories (capital C) - 1000 calories = 1kcal = 1 (food) Calorie - the percentage of your total energy intake from carbohydrate, fat, and protein can then be determined by dividing the number of calories from each energy nutrient by the total calories, and then multiplying your answer by 100 to get the percentage example: calculating calories 1 grilled sandwich: - carbohydrate: 46 grams x 4 = 184 kcal - fat: 14 grams x 9 = 126 kcal - protein: 45 grams x 4 = 180 kcal - alcohol: 0 grams x 7 = 0 kcal - total: 184+126+180 = 490 kcal example: percentage of total energy intake 1 grilled sandwich (continued) - calories from carbohydrate = 46 grams x 4 kcal/g = 184 kcal/490 kcal = 0.376 x 100 = 37.6% - calories from fat = 14 grams x 9 kcal/g = 126 kcal/490 kcal = 0.257 x 100 = 25.7% - calories from protein = 45 grams x 4 kcal/g = 180 kcal/ 490 kcal = 0.367 x 100 = 36.7%

(CH.3) Review cellular structure refer to: - pg. 79 - fig. 3-1

- cell: basic structural and functional component of life - different types of cells are specialized to perform particular functions - components : cell membrane and organelles - cell membrane: holds cellular contents (cytoplasm and organelles) together; regulates flow of substances in and out of cell; cholesterol is a part of each cell membrane; phospholipid bilayer; protein structures act as transport vehicles and function as enzymes that facilitate chemical processes - cytoplasm: a combination of fluid material and organelles within the cell, not including the nucleus; energy for use by the cell can be produced by chemical processes that occur in the cytoplasm; this contributes to the survival of all cells and is the sole energy production in red blood cells; this energy production is called anaerobic metabolism because it does not require oxygen - mitochondria: convert food energy from energy-yielding nutrients (carbohydrate, protein, and fat) into a form of energy that cells can use; this is an aerobic process that uses the oxygen we inhale as well as water, enzymes, and some vitamins and minerals - cell nucleus: contains genetic material responsible for controlling actions that occur in cell; chromosomes contain genes made up of deoxyribonucleic acid (DNA); DNA is a "code book" that contains directions for making substances, specifically proteins, the cell needs; this code book remains in the nucleus of the cell and sends its information to other organelles by way of a "messenger" molecule called ribonucleic acid; the information stored on the DNA in the nucleus is copied onto the RNA through the process of transcription and then moves out to the cytoplasm through pores in the nuclear membrane; RNA carries the transcribed DNA code to protein-synthesizing sites called ribosomes; there the RNA template is used in the process of translation to make a specific protein; this process is known as gene expression - endoplasmic reticulum: organelle composed of network canals running through the cytoplasm; part of the endoplasmic reticulum contains ribosomes; involved in lipid synthesis, detoxification of toxic substances, calcium storage release in the cell - golgi complex: cell organelle near nucleus that processes newly synthesized protein for secretion or distribution to other organelles - lysosomes: cellular organelle contains digestive enzymes for use inside cell for turnover of cell parts; digest worn-out or damaged cell components - peroxisomes: cell organelle destroys toxic products within cell; contains enzymes that detoxify harmful chemicals; contain a protective enzyme called catalase; prevents excessive accumulation of hydrogen peroxide in cell

(CH.3) Review how to avoid constipation refer to: - pg. 110

- eating foods with plenty of fiber (such as whole-grain, breads, cereals, and beans), along with drinking adequate fluid to avoid dehydration, is the best method for treating mild cases for constipation; fiber stimulates peristalsis by drawing water into the large intestine and helping form a bulky, soft fecal output; dried fruits are a good source of fiber and therefore can also help stimulate the bowel; additional fluid should be consumed to facilitate fiber's actions in the large intestine; also people with constipation may need to develop more regular bowel habits; allowing the same time each day for a bowel movement can help train the large intestine to respond routinely; relaxation facilitates regular bowel movements, as does regular physical actvity

(CH.1) Review factors that can influence your food choices refer to: - pg.4-7

- flavor, texture, and appearance - early influences - routines and habits - advertising - restaurant dining - time and convenience - economics - nutrition

(CH.1) What are the leading nutrition-related causes of death in the U.S refer to: - pg. 9-10 - fig. 1-3

- heart disease - cancer - stroke - diabetes - hypertension - alzheimer's disease - kidney disease

(CH.3) Review what can cause ulcers refer to: - pg. 109

- helicobacter pylori - NSAIDs

(CH.1) Understand the roles that hunger, appetite, satiety play on regulating eating behavior refer to: - pg.7

- hunger: the primarily physiological (internal) drive to find and eat food, mostly regulated by internal cues to eating - appetite: the primarily psychological (external) influences that encourage us to find and eat food, often in the absence of obvious hunger - satiety: state in which there is no longer a desire to eat; a feeling of satisfaction; regulated by the brain

(CH.1) What is an essential nutrient refer to: - pg.8

- in nutritional terms a substance that, when left out of a diet, leads to signs of poor health - the body either cannot produce this nutrient or cannot produce enough of it to meet its needs - if added back to a diet before permanent damage occurs, the affected aspects of health are restored - macronutrient: a nutrient needed in gram quantities as a diet; provide calories (examples: carbohydrates, protein, lipids/fat) - micronutrient: a nutrient needed in milligram or microgram quantities in a diet; do not provide calories (examples: vitamins, minerals, water (water is considered a micronutrient)) nutrients can be assigned to three functional categories: 1. those that primarily provide us with calories to meet energy needs (expressed in kilocalories/kcal) 2. those important for growth, development, and maintenance 3. those that act to keep body functions running smoothly

(CH.3) Review the endocrine system refer to: - pg. 89-91

- major components: endocrine glands (example: pituitary, thryoid, adrenals); hypothalamus; pancreas - functions: regulates metabolism, growth, and reproduction by producing and releasing hormones

(CH.2) Understand the concepts of malnutrition, overnutrition, and undernutrition refer to: - pg. 57

- malnutrition: failing health that results from long-standing dietary practices that do not coincide with nutritional needs - overnutrition: a state in which nutritional intake greatly exceeds the body's needs; in the short run, overnutrition may cause only a few symptoms; if an excess intake continues, some nutrients may accumulate to toxic amounts which can lead to serious disease; the most common form of overnutrition in developed nations is an excess intake of calories that leads to obesity; the gap between desirable intake and overnutrition is the smallest for vitamin A and the minerals calcium, iron, and copper; thus, if you take nutrient supplements, keep a close eye on your total vitamin and mineral intake from both food and supplements to avoid toxicity - undernutrition: failing health that results from a long-standing dietary intake that is not enough to meet nutritional needs; once availability of a nutrient falls sufficiently low, biochemical evidence indicates that the body's metabolic processes have slowed or stopped; at this state of deficiency there are no outward symptoms; thus it is termed a subclinical deficiency [stage of disease or disorder not severe enough to produce symptoms that can be detected or diagnosed]; a subclinical deficiency can go on for some time before clinicians are able to detect its effects; eventually clinical symptoms will develop where clinical evidence of a nutritional deficiency (perhaps the skin, hair, nails, tongue, or eyes) can occur within months but may take years to develop; often clinicians do not detect a problem until a deficiency produces outward symptoms - the common term malnutrition can refer to either overnutrition or undernutrition; neither state is conducive to good health - it is possible to be both over overnourished (consume excess calories) and undernourished (consume too few essential vitamins and minerals) at the same time

(CH.3) What is nutrigenomics? Nutrigenetics? refer to: - pg. 102-103

- nutrigenomics: study of how food impacts health throughout its interaction with our genes and its subsequent effect on gene expression; nutrition affects gene expression - nutrigenetics: study of the effects of genes on nutritional health, such as variations in nutrient requirements and responsiveness to dietary modifications; genes influence nutritional health; nutrient requirements; efficiency of absorption, metabolism, or nutrient excretion (lactose intolerance)

(CH.2) Understand how the number of servings for foods in the MyPlate plan is determined? How can you estimate serving sizes? refer to: - pg. 50-52 - fig. 2-7

- on www.ChooseMyPlate.gov you will find an interactive tool that estimates your calorie needs and and suggests a food pattern based on your age, gender, height, and weight; these daily food plans provide useful information for each food group, including recommended daily amounts in common household measures - modified daily food plans are also available for preschoolers, pregnant or breastfeeding mothers, and those who are interested in losing weight - the recommended numbers of servings are given in cups for vegetables, fruits, and dairy foods; grains and proteins are listed in ounces - pay close attention to the stated serving size for each choice when following your daily food plan to help control calorie intake to estimate serving sizes: - a golfball = 2 tbsp measure (example: 2 tbsp salad dressing, peanut butter, margarine, etc.) - a tennis ball = 1/2 to 2/3 measure (example: baked potato, small/medium fruit, ground or chopped food, bagel, english muffin - a deck of cards = 1/2 to 3/4 cup (example: 3 ounce meat, poultry, or fish) - a baseball = 1 cup (example: large apple or orange, 1 cup ready-to-eat breakfast cereal)

(CH.2) Know the diet principles for moderation. What is energy density? refer to: - pg. 41

- pay attention to portion sizes - .plan your day's diet so that you do not overconsume any nutrients - energy density = kcal content/weight of food - foods high in water and fiber are often low in energy density - energy density is a comparison of the calorie (kcal) content of a food with the weight of the food - an energy dense food is high in calories but weighs very little (example: potato chips) - a food low in energy density has few calories but weighs a lot (example: orange) - foods with lots of water and fiber (low energy dense foods) contribute few calories even though they help one feel full - foods with high energy density can help people with poor appetites, such as some older people, to maintain or gain weight

(CH.1) Review the scientific method. What is epidemiology? Review research experimental design. refer to: - pg. 17-18 - fig. 1-5

- step 1: observations made and questions asked - step 2: hypothesis generated - step 3: research experiments conducted to test hypothesis - step 4: results evaluated by other scientists and reported as in a publication - step 5: follow-up experiments conducted to confirm or extend findings - step 6: hypothesis accepted or rejected - epidemiology: the study of how disease rates vary among different population groups; includes cross-sectional, case-control [a study in which individuals who have a disease or a condition, such as lung cancer, are compared with individuals who do not have the condition] - experimental studies: laboratory based studies include animal studies and human intervention or clinical trials; have control groups; use placebos-sham treatment; most run as blind studies [subjects are unaware of whether they are the experimental or control group [participants in an experiment who are not given the treatment being tested]] - double-blind study: an experimental design in which neither the participants nor the researchers are aware of each participant's assignment (test or placebo) or the outcome of the study until its completed; an independent third party holds the code and the data until the study has been completed

(CH.2) What is nutrient density? refer to: - pg. 40-41

- the ratio derived by dividing a food's nutrient content by its calorie content; when the food's contribution to our nutrient need for that nutrient exceeds its contribution to our calorie need, the food is considered to have a favorable nutrient density - increase nutrient-dense foods and beverages (example: fruit, vegetables, whole grains, fat-free or low-fat milk products) - nutrient density = nutrient content/kcal content - lower foods high in certain types of fat, sugars, cholesterol, salt, and alcohol - match energy intake with energy expenditure - nutrient density of a food is determined by comparing its protein, vitamin, and mineral content with the amount of calories it provides - the higher a food's nutrient density is, the better it is as a nutrient source

(CH. 2) Review what must be included on a food label, including the ingredient list refer to: - pg. 66-67 - fig. 2-13

- total calories (kcal) - calories from fat - total fat - saturated fat - trans fat - cholesterol - sodium - total carbohydrate - fiber - sugars - protein - vitamin A - vitamin c - calcium - iron - nutrients: these nutrients must appear on most labels; labels of food that contain few nutrients, such as candy and soft drinks, may omit some nutrients; some manufacturers list more nutrients; other nutrients must be listed if manufacturers make a claim about them or if the food is fortified w them - serving size: serving size is listed in household units (and grams). Pay careful attention to serving size to know how many servings you are eating - servings per container: the number of servings of size given in the serving size above that are in one package of the food - % daily value: this shows how a single serving compares to the DV; recall that the DV's for fat, saturated fat, cholesterol, protein, and fiber are based on a 2000-calorie diet - sugars DV: there is no % daily value for sugar, limiting intake is the best advice - protein DV: % daily value for protein is generally not included due to expensive testing required to determine protein quality - daily value footnote: this footnote appears on many labels; it is omitted when there is too little space on the label to print it; the footnote reports the DVs used to compute the daily value for a 2000 and 2500 calorie diet - nutrient claims such as "good source" and health claims, such as "reduce the risk of osteoporosis," must follow legal definitions a quick guide to nutrient sources: - % daily value - 20% or more = rich source - 10%-19% = good source

(CH.3) Review the anatomy and physiology of the digestive tract refer to: - pg. 92-101 - fig. 3-8, 3-10, 3-12, 3-13

1. mouth: chews food; saliva; produced by salivary glands; moistens food with saliva and lubricates food with mucus; release small amount of starch-digesting (amylase) and fat-digesting (lipase) enzymes; initiate swallowing reflex; creates bolus [moistened mass of food that moves from the mouth through the esophagus to the stomach] 2. esophagus: allows movement of food from pharynx (back of mouth) to stomach; epiglottis prevents food from entering trachea; lower esophegal sphincter (gastroesophageal sphincter or the cardiac sphincter) prevents backflow of stomach contents into esophagus move food to stomach by peristalsis (swallowing); no mechanical or chemical digestion 3. stomach: store, mix, dissolve, and continue digestion of food; dissolve food with secretions; kill microorganisms with acid; release protein-digesting (pepsin) and fat-digesting (lipase) enzymes; lubricates and protects stomach with mucus; regulate emptying of dissolved food into small intestine; produce intrinsic factor for vitamin B-12 absorption; creates chyme [watery mixture of partially digested food and digestive secretions] 4. liver: produces bile [a liver secretion stored in the gallbladder and released through the common bile duct into the first segment of the small intestine; it is essential for the digestion and absorption of fat] to aid fat digestion and absorption; excretion of metabolic wastes 5. gallbladder: store, concentration, and later release bile into the small intestine 6. pancreas: secrete sodium bicarbonate and enzymes for digesting carbohydrate (amylase), fat (lipase), and protein (trypsin, and chymotrypsin); produce enzymes, hormones, and bicarbonate 7. small intestine: 3 parts (duodenum, jejunum, and llenum) chyme passes from stomach into small intestine (duodenum); pancreas releases pancreatic juice (bicarbonate and pancreatic enzymes); gallbladder releases bile; small intestinal cells produce some enzymes; 8. large intestine: absorb sodium, potassium, water, some minerals, and vitamins; no villi or enzymes, 5 segments (cecum, ascending colon, transverse colon, descending colon, sigmoid colon); contains rectum and anus; components of feces [mass of water, fiber, tough connective tissues, bacterial cells, and sloughed intestinal cells formed in the large intestine and excreted through the anus] were water, undigested fiber, tough connective tissues (from animal foods), bacteria, and dead intestinal cells; large bacterial population (>500 different species) containing probiotics [microorganisms that reside in large intestine and provide health benefits] and prebiotics [substances that increase growth of probiotic microorganisms] absorption from the small intestine: - villi: fingerlike protrusions that participate in digestion and absorption of food - new intestinal absorptive cells are constantly produced in crypts of small intestine - microvilli: extensive folds on the mucosal surface of the absorptive cells; increase surface area x 600 - absorptive cells (enterocytes): intestinal cells that line villi and participate in nutrient absorption mechanisms of nutrient absorption: - passive diffusion: diffusion of nutrients across the absorptive cell membranes - facilitated diffusion: uses a carrier protein to move nutrients down a concentration gradient - active absorption: involves a carrier protein as well as energy to move nutrients (against a concentration gradient) into absorptive cells - phagocytosis and pinocytosis: forms of active transport in which absorptive cell membrane forms an indentation that engulfs a nutrient to bring it into cell

(CH.3) Review the cardiovascular and lymphatic system refer to: - pg. 84-87

Cardiovascular system: - major components: heart/blood and blood vessels - functions: transports nutrients, waste, gases and hormones throughout the body; plays role in immune responses; aids in body temperature regulation - hepatic portal circulation: portion of circulatory system using large vein (portal vein) to carry nutrient rich blood from capillaries in intestines and portions of the stomach to liver Lymphatic system: - major components: lymph/lymphocytes, lymphatic vessels, lymph nodes, spleen, thymus - functions: removes foreign substances from blood and lymph; maintains tissue fluid balance; aids fat absorption; provides defense against pathogens; formation of white blood cells

(CH.2) Review the 2015 Dietary Guidelines refer to: - pg. 43-45 - fig. 2.2

The following 5 guidelines are the foundation of the 2015-2020: 1. follow a healthy eating pattern across the lifespan: all the food and beverage choices matter; choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce risk of chronic disease 2. focus on variety, nutrient density, and amount: to meet nutrient needs within calorie limits, choose a variety of nutrient dense foods across and within all food groups in recommended amounts 3. limit calories from added sugars and saturated fats and reduce sodium intake: consume an eating pattern low in added sugars, saturated fats, and sodium; cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns 4. shift to healthier food and beverage choices: choose nutrient-dense foods and beverages across and within all food groups in a place of less healthy choices; consider cultural and personal preferences to make these shifts easier to accomplish and maintain 5. support healthy eating patterns for all: everyone has a role in helping to create and support healthy eating patterns in multiples settings nationwide, from home to school to work to communities

(CH.2) Review how to evaluate nutrition information refer to - pg. 64

The following suggestions should help you make healthful and logical nutrition decisions: 1. Apply the basic principles of nutrition along with the 2015-2020 Dietary Guidelines for Americans and related resources to any nutrition claim, including those on websites. Do you note any inconsistencies? Do reliable references support these claims? Beware of the following: - testimonials about personal experience - disreputable publication sources - promises of dramatic results (rarely true) - lack of evidence from other scientific studies 2. Examine the background and scientific credentials of the individual, organizations, or publication making the nutritional claim. Usually, a reputable author is one whose educational background or present affiliation is with a nationally recognized university or medical center that offers programs or courses in the field of nutrition, medicine, or a closely allied specialty 3. Be wary if the answer is "yes" to any of the following questions about a health-related nutrition claim: - Are only advantages discussed and possible disadvantage ignored - Are claims made about "curing" disease? Do they sound too good to be true? - Is extreme bias against the medical community or a traditional medical treatments evident? Health professionals as a group strive to cure diseases in their patients, using what proven techniques are available. They do not ignore reliable cures - Is the claim touted as a new or secret scientific breakthrough 4. Note the size and duration of any study cited in support of a nutrition claim. The larger it is and the longer it went on, the more dependable its findings. Also consider the type of study: epidemiology versus case-control versus double-blind. Check out the group studied; a study of men or women in Sweden may be less relevant than one of men or women of mind that "contributes to," "is linked to," or "is associated with" does not mean "causes." 5. Beware of news conferences and other hype regarding the latest findings. Much of this will not survive more detailed scientific evaluation 6. When you meet with a nutrition professional, you should expect that he or she will do the following: - ask questions about your medical history, lifestyle, and current eating habits - formulate a diet plan tailored to your needs, as opposed to simply tearing a form from a tablet so you could apply to almost anyone - schedule follow-up visits to track your progress, answer any questions, and help keep you motivated - involve family members in the diet plan, when appropriate - consult directly with your physician and readily refer you back to your physician for those health problems a nutritional professional is not trained to treat 7. Avoid practitioners who prescribe megadoses of vitamin and mineral supplements for everyone 8. Examine product labels carefully. Be skeptical of any promotional information about a product that is not clearly stated on the label. A product is not likely to do something not specifically claimed on its label or package insert

(CH.1) Review the nutrition and weight status objectives from healthy people 2020 refer to: - pg. 23-24 - table 1-4

the overarching goals of Healthy People 2020 are to: - attain high-quality, longer lives free of preventable disease, disability, injury, and premature death - achieve healthy equity, eliminate disparities, and improve health of all groups - create social and physical environments that promote good health for all - promote equality of life, healthy development, and healthy behaviors across all life stages a healthful diet is described as one that includes: - consuming a variety of nutrient-dense foods within and across the food groups, especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk products, and lean meats and other protein sources - limiting intake of solid fats, cholesterol, added sugars, sodium (salt), and alcohol - limiting intake of calories to meet needs for calories nutrition and weight status categories and objectives (category 1: healthier food access): 1. increase the number of states with nutrition standards for child care 2. increase the proportion of schools that offer nutritious foods and beverages outside of school meals 3. increase the number of states that have incentive policies for food retail outlets to provide foods that are encouraged by the 2015-2020 dietary guidelines for american 4. increase the proportions of americans who have retail access to foods recommended by the 2015-2020 dietary guidelines for americans nutrition and weight status categories and objectives (category 2: health care and worksite settings): 5. increase the proportion of primary care physicians who measure patients' body mass index (BMI) 6. increase the proportion of physical office visits that include nutrition or weight counseling or education 7. increase the proportion of worksites that offer nutrition and weight-management classes and counseling