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