International Nutrition Midterm 1
What are the 2 division of Acute Malnutrition
1) Moderate Acute Malnutrition (MAM) 2) Severe Acute Malnutrition (SAM)
What are the 3 Divisions of Undernutrition
1) Acute malnutrition 2) Micronutrient Deficiency 3) Chronic Malnutiriton
Functions of Minerals (and what mineral correlated with that function) (6)
1) Bone Health (Calcium & Phosphorous) 2) Oxygen Transport (Iron in Haemoglobin) 3) Muscle Contraction (Calcium) 4) Nerve functioning and impulses (Sodium and Potassium) 5) Osmotic Balance (Sodium and Potassium) 6) Hormone Components (Iodine)
Functions of Vitamins (7)
1) Cofactors/Co-enzymes of energy production pathways ex. NAD (Niacin/Vitamin-B3) and Riboflavin (Vit-B2) 2) Act as Antioxidants, neutralizing free radicals ex. Vitamin-E and Vitamin-C 3) Mineral Absorption ex. Vitamin-D essential for calcium metabolism and bone health 4) Vision ex. Vitamin-A 5) Hair and Skin Health 6) Blood Clotting ex. Vitamin-C and Vitamins-K 7) Synthesis of Cartilage ex. Vitamin-C
Functions of Fat (10)
1) Insulates the body, helping to keep it warm 2) Acts as a concentrated energy source and a efficient energy source (doesn't take much H2O to store) 3) Aids in nerve conduction 4) Protects internal organs 5) Important component of cell membranes 6) Needed for the absorption of the following vitamins: A, D, E and K 7) Some key hormones are derived from fat 8) Important for Growth 9) Makes food more flavourful since flavours are fat soluble compounds 10) When present in food, it improves the texture
What 3 factors help determine the % of total food every carbohydrates will make up in a diet in a certain population
1) Locale/Geography - ex. Iceland eats a low % of carbs because it is hard to grow grain in their location. 2) Economic Status - poorer countries consume more % carbs since as income increases people can afford to buy more fats and animal proteins 3) Culture - ex. Rice is a staple of many cultures and is a very important part of their cultures diet
Classification of Minerals and what minerals are in what class?
1) Major Minerals: •Calcium, Phosphorous, Potassium, Sulphur, Sodium, Magnesium and Chloride • Present in the body in relatively large amounts • Required in the diet in amounts > 100mg 2) Trace Minerals: • Fe, Mn, Cu, I • Present in the body in relatively small amounts • Needed in the diet in amounts < 100 mg but are critical for survival and health
3 Functions of Carbohydrates
1) Provides Energy - can make up 45-80% of total food energy 2) Provides taste/flavour and sweetness 3) Prevents protein breakdown for energy meaning it spares protein for more important functions
What are the 3 Foods that Provide the Majority of the Worlds Food Energy
1. Rice is the # 1 food energy source around the world 2. Wheat 3. Maize/Corn
2 Types of Carbohydrates
1. Simple Carbohydrates- monosaccharides and disaccharides 2. Complex Carbohydrates- polysaccharides
Functions of Protein (7)
1. Structural components of muscle, bone and cartilage 2. Metabolic and digestive enzymes- this utilizes the highest amount of your daily protein intake! 3. Essential constituent of some hormones ex. Insulin 4. Transporters ex. Haemoglobin, LDL, HDL 5. Immunoproteins or antibodies which are essential to immune function 6. Fluid balance/osmotic balance- proteins in the blood hold water in and maintain osmotic balance. Low protein can lead to osmotic imbalance and cause swelling in the belly and feet 7. Energy (?)- protein is only used minimally as a energy source in physical activity
Describe UNICEF's Conceptual Framework for Malnutrition
3 levels of causes that lead to the manifestation of malnutrition. 1) basic causes 2) underlying causes 3) immediate causes
How many of the amino acids are considered essential? Ans what does it mean?
9 amino acids are essential amino acids meaning they must be obtained in the diet since they cant be synthesized by the body
Describe sucrose
A disaccharide that is Glucose + Fructose (50:50) - Broken down by sucrase - Found in fruits and vegetables. - Extracted from sugar beets & is the main plant source of disaccharides in western diet - High fructose corn syrup is made from corn and is glucose:fructose ratio of 45:55
Describe Lactose
A disaccharide that is Glucose + Galactose - Broken down by Lactase
Describe Maltose
A disaccharide that is Glucose + Glucose - Broken down by maltase - Found in beer
Vitamin A Deficiency:
A form of Micronutrient Malnutrition Deficiency is a major cause of preventable blindness in children and the elderly in developing countries Widespread economic and social implications Increase risk of disease and death from infection.
Describe 24 Hour Food Recall and what are the advantages and disadvantages?
A type of food recall where a person is interviewed and asked about their diet during the past 24 hours o Advantages- individual can't subconsciously change what they ate, since they already ate it and the person doesn't have to be able to write (verbal interview) o Disadvantages- there is still some level of social desirability, which may hinder the accuracy of the recall. Also consistency of the interview method is key.
What are the 4 Types of Assessment of Individuals
A= Anthropometry B= Biochemical C= Clinical D= Dietary
What is a Carbohydrate
An organic compound composed of single sugar units. Carbo stands for carbon and hydrate stands for water, therefore carbohydrates are hydrates of carbon (CH2O)n
How much of the body is water?
Body is 2/3 water
How was Consumption of large amounts of milk beneficial to nomadic population
Consumption of large amounts of milk was beneficial to nomadic population because milk is nutritionally good (has water, protein, fat and carbs) and its a cleaner, safer source of water than local water sources.
Recommended Acceptable Range of Carbs in North America
DRI (dietary reference intake) suggests that 45-65% of total energy should come from carbs. However less than 25% of energy should come from added simple sugars in the diet.
Describe Cholesterol and its functions (5)
Doesn't have a triglyceride structure. Cholesterol can be synthesized from saturated fatty acids in the body and has very important functions in the body (ex. synthesis of steroid/sex hormones, vitamin D, leukotrienes & bile salts, as well as being vital to cell membrane fluidity.)
Edible Polysaccharides vs Inedible Polysaccharides
Edible refers to complex carbs that can provide energy ex. starch Inedible Polysaccharides refers to complex carbs that do not provide energy ex. cellulose
What is a Vitamin?
Essential organic micronutrients that are present in food. Vita stands for life, and amine stands for nitrogen containing. Not all vitamins contain nitrogen, but the first ones did. We need to obtain vitamins from the diet since they cannot be synthesized in the body or the body cannot synthesize enough. Vitamins are non-energy containing nutrients. They are required in very small amounts and more is not always better.
What is The Importance of higher fat diets in children
Importance of higher fat diets in children is that they need a more concentrated energy source for their growth. Their stomachs are small and therefore filling their stomachs solely with plant foods doesn't provide them with enough energy to sustain their growing rates.
What is the nutrient deficiency associated withThyroid enlargement
Iodine deficiency
What is the nutrient deficiency associated with Pale conjunctiva
Iron (Anemia)
What is the nutrient deficiency associated with Apathy/Low Energy
Iron (anemia)
Difference Between Kwashiorkor and Marasmus
It can be distinguished from kwashiorkor in that kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein. Protein wasting in kwashiorkor may lead to edema.
What are the potential nutrient deficiencies associated with Poor metal Development (irreversible)
Low iron during infancy, or low iodine
Describe Weight-for-Height Assessment and what disease state can it be used to determine
Measures a child's weight in respect to their height. An assessment that can determine acute/present malnutrition (wasting), which just means a person, has low weight for their height. This is a measure of acute malnutrition! How "thin" is the person. Moderate Acute Malnutrition (MAM)- pt falls between 2-3 SD below normal Severe Acute Malnutrition (SAM)- pt falls greater than 3 SD below normal Global Acute Malnutrition ("Wasted")- refers to anyone who is 2 or more standard deviations below the normal weight for height. It's the umbrella term for both MAM and SAM
What is Fat?
Organic compounds containing C, H and O and are insoluble in water. They play a critical role in the health and functioning of the human body.
Acculturation
Process of one cultural group adopting the beliefs and behaviors of another. This can have positive effects (increased variety) and negative effects (rapid diet changes)
What is the nutrient deficiency associated with Hair Color and Texture Changes
Protein Deficiency
What is the nutrient deficiency associated with Bilateral Pitting Edema
Protein Deficiency (sign of SAM)
What is RUTF
Ready to Use Therapeutic Food- high-energy foods which are used for the treatment of severely malnourished people.
What do you call animal vs plant vitamin A
Retinol/Retinal is the animal form Beta-carotene is the plant form (made of 2 retinol molecules)
What is meant by Refined Complex Carbohydrates
The outer covering of a wheat kernel, for example, is cellulose and the edible starch is in the inside. This is why we started to refine the wheat by removing this outer casing.
Describe Dietary Diversity Lists (Food Recall Lists) and whats the major limitation?
There is a long list of different types of food covering all food groups, and the person is interviewed and asked if they have consumed this over the specified time period (typically last 24 hours). Interested in diversity only, so any amount of a food triggers a yes on the yes-or-no list. o Limitation- the list may be missing a food ex. clay
What is the nutrient deficiency associated with Dysphonia (Beri Beri Syndrome)
Thymine
What is the nutrient deficiency associated with Sores that wont heal
Vitamin A
What is the nutrient deficiency associated with eye issues such as Bitot's Spots, Xerosis and xerophthalmia and Keratomalacia
Vitamin A
What is the nutrient deficiency associated with Swollen or bleeding Gums
Vitamin B or Vitamin C
What is the nutrient deficiency associated with skeletal Deformation
Vitamin D
Fortification
addition of vitamins and minerals to foods
Jewish dietary law
based on scholarly interpretations of the Torah and may be strictly followed by orthodox Jews. They can eat only food that is kosher, meaning no pork, only fish with scales and fins etc.
Monosaccharides and what are the 3 types
can pass through the digestive tract wall and into the blood stream without being broken down by digestive enzymes. • Glucose - "blood sugar" • Fructose - "fruit sugar" • Galactose - this monosaccharide is rarely found free in nature. It is only found in the disaccharide lactose
Mono-unsaturated Fatty Acids (MONO)
contain only 1 double bond. These compounds are beneficial to heart functioning. Ex olive oil, canola oil/grape seed oil, and avocado
What are the limitations with Annual Human Consumption
doesn't account for distribution of food within the country nor food wastage/spoilage. Just because there is enough per person available doesn't mean the people are actually getting enough
Annual Human Consumption
estimated by dividing the total amount and type of food available for consumption in a country or region by the total population. If a country's per person consumption of energy or nutrients is below recommended amounts it may be assumed that a substantial portion of the population is undernourished. This is a quick and easy way to estimate nutrition of a population.
Underlying Causes of Malnutrition with examples
factors that affect at the household level ex. Inadequate access to food, treatment of women and children, unhealthy environment, access to healthcare
Immediate Causes of Malnutrition with examples
factors that affect the individual ex. inadequate dietary intake or disease
Basic Causes of Malnutrition with examples
factors that affect the society/community/large group as a whole ex. political instability poverty, social inequality. It's important to note that basic causes do not affect everyone in the community equally. Some minorities may suffer more than others from these basic causes.
Pastoralism
in parallel to domestication of plants, humans began domesticating animals. Pastoralists are herders of domesticated animals (ex. cows, goats, camels, sheep). Meat and milk form the domesticated animals were commonly consumed. Pastoralists were generally nomadic, following their heard across the seasons.
What are the Benefits of Refined Foods
increased shelf life, easier to digest, and easier to cook
What is Growth Based Anthropometric Assessment, and what are 4 ways of doing this type of assesment
indices based on height, weight and age and are compared to WHO standards 1) Weight-for-Height 2) Height-for-Age 3) Weight-for-Age 4) Body Mass Index (BMI)
Describe Waist-to-Hip Ratio
looks at fat distribution in the body. This measure is linked to health outcomes. Increased waist-to-hip ratio indicates a larger % body fat
Describe Height-for-Age and what disease state can it be used to determine
measure a child's height with respect to their age. An assessment that can determine chronic malnutrition (stunting), which is defined as low height for a given age. Stunting is an indicator of malnutrition in early life (during the first 1000 days). o Stunted- pt falls below 2 SD from the normal o Severe Stunting- pt falls below 3 SD from normal
Describe Weight-for-Age and what disease state can it be used to determine
measure a child's weight with respect to their age. This assessment is not as helpful because low weight for age could be due to either chronic of acute malnutrition. Underweight- a child is low weight for their age. Used for growth monitoring using growth charts. Trajectory of the child's growth is important.
What is Body Mass Index (BMI)
measure of weight (in kg) adjusted for height (in m2) For children, BMI values are still new. Need the weight, height and age of the child to determine and compare their BMI
What is Body Composition Anthropometric Assessment and what are 2 ways of doing this type of assesment
measurements that indicate level of body fat which helps overcome the limitations of BMI. Limitation of body composition measurements is that they aren't the most informative assessment. 1) Waist-to-Hip Ratio 2) Mid Upper Arm Circumference (MUAC)
Describe Physical/Clinical Assessment and what are the advantages and disadvantages?
medical history and physical examination used to detect visible signs and symptoms associated with malnutrition. • Advantages- easy, not costly, non-invasive • Disadvantages- by the time visible signs of malnutrition are present, the damage is done and the level of severity is high.
Advantages and Disadvantages of Mid Upper Arm Circumference (MUAC)
o Advantages of MUAC: quick, easy, and infrastructure is small (device is small and easy to manufacture and distribute) o Disadvantages of MUAC: need to be very specific about what part of the arm you measure and the devices can get tampered with and throw off the measurement.
Describe Moderate Acute Malnutrition (MAM) and how do we assess to determine this
o Children are 'moderately' wasted or low weight for their height o Inadequate dietary intake or absorption needed for growth, health and physical activity o May progress to severe acute malnutrition o Increased risk of mortality o Assessed using MUAC and weight-for-height measures
Complementary Proteins
refers to combining two or more foods with incomplete proteins, to form complementary proteins, can provide adequate amounts of all the essential amino acids. Grain and legumes when eaten together form complementary proteins. Should be eaten 7 parts grain to 2 parts legume. Ex. Rice+Beans, Maize+Beans, Roti+Dhal Its important to note that root crops and legumes do NOT equal a complete protein and are not complementary
The Nutrition Transition
refers to global shifts in dietary patterns toward higher intake of saturated fats, sugars, and refined foods, and lower intakes of fiber rich foods, driven by technological advances that have made energy dense, nutrient poor foods cheaply available on global food markets.
Describe Mid Upper Arm Circumference (MUAC) and what disease state can it be used to determine
reflects total body muscle mass (protein status) and is very common in field assessment. The body starts to consume muscle protein when other energy sources are depleted. Can help indicate if acute phase or wasting is occurring (SAM or MAM) o For children less than 5 years • MAM= MUAC of < 12.5cm • SAM= MUAC of <11.5cm
What is a Polysaccharide and describe the 3 types
repeating units of glucose. There are 3 types, which differ in the way the glucose molecules are connected together 1) Starch - the glucose storage form in plants 2) Glycogen - glucose storage form in animals. Stored in mostly and liver. Can store 1000 extra calories as glycogen. 3) Cellulose - plant fibre. Humans cannot break this down and therefore gain little calories from it
Define Nutrient and what are the 6 types?
substances that are necessary for growth and metabolism. There are 6 types of nutrients: protein, fat, carbohydrate, vitamins, minerals, and water
Islam Dietary Laws
the Quran forbids the consumption of pig blood and outlines food that is "halal"
Ethnocentrism
the belief that one's own value system and lifestyle is more appropriate than another.
Metabolism
the general term for all the chemical processes carried out by the cells of the body. It includes catabolism (breaking down molecules) and anabolism (building molecules). All chemical pathways and processes either use or produce energy.
WHO Definition of Nutritional Assessment
the interpretation of information obtained from anthropometric, biochemical, and physical means.
Dietary Assessment and name the different types
the measurement/estimate of food consumption and how it relates to needs. Food intake may be converted to energy and nutrients and evaluated in relation to recommendations. Can help to figure out causalities of nutritional deficiencies. There are 3 types of dietary assessment: 1) Food Records 2) Food Recall & Food Recall Lists 3) Food Frequency Lists
Definition of Anthropometric Assessment:
the science of measuring the human body and its parts. This includes both growth (height and weight assessment) and body composition (assessment using % body fat)
Disaccharides and what are the 3 types
these are digested/broken down into monosaccharides before they can be absorbed from the digestive tract and into the blood stream. 3 types: • Sucrose - "table sugar" • Lactose - "milk sugar" • Maltose
Famine Food
these are foods that are eaten as a last resort to people who are starving. It includes things such as cornhusks and banana leaves. These "foods" do not actually provide any energy and instead just fill the stomachs of the people. When a population resorts to eating these things it is a sign of famine.
Macronutrients and which nutrients are considered macronutrients
these are the nutrients that provide energy and are needed in large amounts. There are 3 macronutrients: Fat, Protein, & Carbohydrates
What are the Limitations of BMI measurements
they don't take into account body composition. It also is just a statistical measure and is only correlated with health outcomes, no causative relationship.
Describe Biochemical Assessment and what are the limitations?
used primarily to detect sub-clinical deficiencies (ex. anemia) or to confirm a clinical diagnosis. A sample is taken (often blood) and levels of a certain chemical compound are measured. Most common Biochemical assessment done in the developing world is Iron/serum ferritin/Haemoglobin assessment. Another includes Vit-A/serum retinol level. • Limitation- Cost, doesn't represent the whole picture of what is going on, invasive, difficult to do in the environment (often done in dusty, dark spaces), against some cultural beliefs (blood associated with satanic rituals) and its difficult to keep samples since they need to be kept in very specific condition during transportation.
Negative Energy Balance
when energy expenditure outweighs the food intake. When this occurs there is not enough calories to maintain growth and weight.
Positive Energy Balance
when food intake is more than energy expenditure. When we intake more calories than we need, it is stored in the body and causes a gain in weight
Describe Acute Malnutrition
• 'Present' malnutrition resulting from an inadequate intake of energy and/or protein, often in combination with infection. Infections may lead to malabsorption, 'anorexia' (lack of appetite) or altered metabolism increasing confounding consequences of a limited dietary intake. • Among children under 5 years of age, classification not MAM or SAM is based on anthropometric or clinical indicators discussed in Section 2.
What is a Mineral?
• A inorganic micronutrient • Minerals in food reflects soil content. Mineral in the soil may be naturally present or added via fertilizers and are taken up via plant roots. • Make up 45 of the body's total weight • Minerals found in animal tissues are present in higher concentrations and are more bioavailable than minerals found in plant foods.
Essential Fatty Acids
• A type of PUFA that the body cannot synthesize, and thus must be obtained in the diet. • Very important in the functioning of the body and are involved in blood clotting, inflammatory processes and early brain development. • Examples are omega-3 and omega-6 fatty acids, which are found in fatty fish (salmon, tuna, sardines), canola oil or soybean oil.
Major Dietary Sources of Protein
• Animal- includes dairy, eggs, fish, meats, blood, flesh, bugs etc. • Non-Animal- these are not complete proteins when eaten on their own
Major Food Sources of Fat
• Animals- flesh and organs, dairy products, lard • Plants- vegetable oils, margarine, nuts & seeds, and to a lesser extent, in vegetables and grains.
What happened during the Agricultural Revolution and when did it occur
• Around 10,000 years ago there was a change from foraging to agriculture/domestication of plants • Domestication of plants caused a dramatic change in the way people lived and what people ate. Caused a switch from a wide variety of foods to a small number of domesticated crops • The domestication of cereal grasses (ex. wheat in the Middle Eastern regions) was at the base of modern civilization as humans settled around the growing of cereal. • Settlements grew in areas of agriculture
Benefits and disadvantages of the industrial revolution
• Benefits of Industrial Revolution- pasteurization and refrigeration lead to less microorganisms in the food (safer to eat), and transportation led to more varied diets. • Disadvantages of Industrial Revolution- people began eating more refined sugars, rapid change in the human diet, and increase in consumption of high calorie, easy to consume food.
How to assess for Kwashiorkor's Malnutrition
• Best way to access for this type of malnutrition is through clinical assessment. This is because Kwashiorkor's Malnutrition is characterized by fluid retention so anthropometry isn't useful (will not be low weight). Dietary assessment is also important in assessment.
What are the 7 Major Carbohydrate Containing foods in the Human Diet
• Cereals/Grains • Sweeteners ex. sugar or honey • Root crops ex. potatoes • Pulses • Vegetables • Fruit • Milk products
Clinical Symptoms of Kwashiorkor's Malnutrition
• Clinical Symptoms Edema/swelling caused by accumulation of watery fluids in the tissues. The edema starts in the extremities and then moves to the abdomen. Other symptoms include weakness, skin infections, rash, changes in hair color, apathy, anorexia
Complete protein vs incomplete
• Complete Protein- provides all 9 essential amino acids ex. animal foods • Incomplete Protein- missing or low in at least 1 of the essential amino acids ex. protein found in carbohydrates/plants The Limiting Amino Acid- the AA in a incomplete protein that limits protein synthesis (the one that is lacking)
What is Protein?
• Compounds composed of C, H, O and N. • Proteins are constructed from one or more chains of amino acids. • Proteins are broken down in the GIT and the individual amino acids are absorbed • There are 20 different amino acids that are used to synthesize proteins • A protein is made from approximately 200-300 amino acids • Protein makes up 16% of total body weight of a lean adult • Excess AA's are broken down in the liver and excreted in the urine. You do not store excess AA in the muscle.
Micronutrient Malnutrition
• Diet lacks one or more micronutrients (minerals or vitamins) • AKA "hidden hunger"
Basic causes of Vitamin Deficiency:
• Dietary Supply is inadequate • Disease or infection is impairing absorption and subsequently increases the need. These diseases/infections could include diarrhea, intestinal worms etc.
Describe Fruit
• Examples include banana/plantains (1% protein), oranges, pineapple, guavas, durian, avocado • Some are a source of fat such as avocados, olives, and durian, while other such as plantains have no fat content at all • Contain mono- and di-saccharides which is what makes them sweet • Contain vitamins • Plantains are a staple crop of many countries in Africa and have a nutrient content similar to root crops
Describe Vegetables
• Examples include carrots, pumpkin, leafy greens • Contain starch and some simple sugars, but have very little protein. • May provide vitamins and minerals as well
Describe Milk Products
• Examples include milk, yoghurt ghee, and cheese • Contain simple sugars (lactose), protein, fat, vitamins and minerals (provides a lot of nutrients!) • Ghee is the cooking fat of south Asia • Population around the Kenya-Somalia border (the Somali Pastoralists) have existed eating solely camel's milk for many years. They get all 6 essential nutrients from it.
Describe Root Crops
• Examples include potatoes, yams, cassava/tapioca, sweet potatoes • Contain only 1-2% protein making them not interchangeable with cereals. • Places which grow cassava instead of maize have higher levels of protein deficiency • Staple crop of west Africa because it's a good energy source and grows well
Describe Sweeteners
• Examples include sugar and honey • Sweeteners make by 10-12% of the worlds food energy. This number is higher in places like the USA and lower in places such as Africa • Contain mostly just carbohydrate and very little protein • International organizations recommend mother add sweeteners to a young child's food cause it provides energy/calories and helps children eat more (since it tastes better)
Describe Pulses/Legumes
• Examples of legumes includes groundnuts (ex. peanuts), lentils, chickpeas • Contain more than 20% protein • These are very important sources of protein and fat in many places in the world • Groundnuts are 45% protein and soybeans are 35% protein
How do we Classify Vitamin and what vitamins fall into what class?
• Fat Soluble- These are vitamins A, D, E and K (AKA "DEAK"). These vitamins require fat for their absorption and transport. Excess is stored in fatty tissues and is not easy excreted. • Water Soluble- These are vitamins C, folate and the B-family of Vitamins (thiamine, niacin, riboflavin, B6, B12). These vitamins are easily absorbed and excess is excreted easily.
How many calories per g in fat, carbs and protein?
• Fat- 9 calories/gram • Carbohydrates- 4 calories/gram • Protein- 4calories/gram
What is the Internal Perspective of looking at Food Culture and name examples
• Food culture developed in response to a set of internal beliefs or values (Religious, spiritual and ideological) • Examples: Judaism and Islam wide variety of dietary laws Hindu not killing cows
What is the External Perspective of looking at Food Culture and name examples
• Food culture developed in response to external conditions people encountered in their environment (materialistic) • Development of dietary laws may have originally been written from an externalist perspective ex. People who did not eat pork may have been healthier because they didn't pick up the parasite trichinosis or protecting people from getting sick from shellfish consumption. • Another example is the Masai keeping their cows alive because they have benefit from this action. They use the dung for houses and fuel, and drink the blood and milk from the cows.
Food Culture
• Food habits or food culture are not biologically determined but are learned through socialization. • Includes what food they consume, how they prepare food, who they eat with, how we eat, effects of food on health etc. • Food culture involved change • The developments of food habits can be looked at through 2 perspectives: internal and external
Describe Unsaturated Fatty Acids and name the 2 devisions
• Have 1 or more double bonds/ points of unsaturation in their chemical structure Polyunsaturated Fatty acids and mono-unsatrated
Describe Saturated Fatty Acids
• Have no double bonds so can pack tightly together. This tight packing makes them solid at room temperature. • Found in both plant food and animal food • In western world, its thought of as the "bad fat" • Examples include butter, cheese, ghee, palm oil, coconut oil
Kwashiorkor's Malnutrition who it affects
• It's a Ghanaian word that loosely translates to "disease that inhabits the first child when the second child is born" since it is often seen when a mother stops breastfeeding her older child when she gives birth to a new one. • Kwashiorkor's Malnutrition is typically seen around the ages of 1-3 years (age when children switch to a non-milk diet). • The reason adults don't usually get this type of malnutrition is because they require less protein consumption per body weight than kids.
What are the 2 clinical forms of Severe Acute Malnutrition (SAM)
• Kwashiorkor • Marasmus
Lactose Intolerance and importance to international nutiriton
• Lactase enzyme levels vary significantly by age and ethnicity • Certain populations have lower levels of the enzyme lactase such as Asians and black Africans making them pre-disposed to lactose intolerance. • Used to give milk powder as part as humanitarian aid, however if given to people who are lactose intolerant it can make matters worse. This is because if it isn't broken down it can pass into the lower GIT where bacteria can ferment it. Water is attracted into the lower GIT leading to gas, bloating and potentially diarrhea, which will lead to mal-absorption.
Advantages of Traditional Diets
• Less processed sugars • Culturally appropriate and fits within the specific place (has logic behind it) • Traditional diets often combine legumes and grains to make complementary proteins
Disadvantages of Traditional Diets
• No diversity in the diet • Might not be as resilient to drought the famine • Certain food habits and taboos may developed that are not good form a health perspective. ex. No avocados for children in Rwanda, Avoid eggs in pregnancy in Zambia, Avoid eggs in kids in Sierra Leone
What happened during the Industrial Revolution and when did it occur
• Occurred in the 18th century and caused a even more dramatic change in what people ate • Technological advances occurred in transportation, refrigeration and food processing • Beginning around 1900, whole grains were routinely refined and refined sugar became commonplace
Pathway/Steps toward dieing from Kwashiorkor's Malnutrition
• Pathway: when dietary protein is low, the body begins to digest its own tissue supply of amino acids so it can build the proteins that are essential for life (heart & lungs). Loss of function follows a proprietary system, where you shut off the least important systems first. Loss of function occurs in the following order 1) Hair- will become brittle and loose its color 2) Skin Maintenance- rashes and infections develop 3) Immune System- antibodies are degraded potentially leading to diarrhea and other infections 4) Blood- blood proteins are broken down leading to osmotic imbalances and edema 5) Fat Metabolism- fat stays in the liver clogging it up causing cells to die. People who have Kwashiorkor's Malnutrition die of liver failure.
Protein Requirements
• RDA (Recommended Daily Allowance) in North America is 0.8 g/kg of complete protein for adults AKA 56 grams for a 70kg adult • RDA for infants is 1.5 g/kg • RDA die children aged 1-3 years is 1.1 g/kg • RDA during pregnancy and lactation is 1.1 g/kg • The average Canadian intake of protein is 100 grams per day • Recommended acceptable range of protein as a % of energy in North America is 10-30% of total energy
What is meant by Protein Quality
• Refers to the ability of protein to support growth and maintain body tissue. High quality protein has all 9 essential amino acids (complete protein)
Fat Intake Requirements
• The WHO/UN recommends adults consume ≥ 15% of their daily energy intake in fats, and this recommendation increases to ≥ 20% for women of childbearing age. • In many developing countries this standard is not met and instead levels are as low as 8-10% • In North America, the Recommended Acceptable Range of fat intake is: Adult (19+): 20-35% 4-18 years: 25-35% Children less than 4years: 30-40%
Describe Cereals/Grains
• The edible seeds of domesticated grasses • Examples of cereals include: Rice, Maize, Wheat, millet, sorghum, teff, quinoa • Maize meal + water is the stable dish of both Latin America (corn tortillas) and African (ugali) • All cereals provide approximately an equal amount of energy • All cereals contain approximately 10% protein and are a major source of dietary protein for people in countries where grains are a staple • Different gains contain differing amounts of iron (wide range). Sorghum containing the most iron
Describe a Food Frequency List/Questionnaire
• The individual is asked how often they ate a particular food or list of foods across a period of time. • Useful for foods that are not consumed frequently but that may provide key nutrients or for understanding how often these particular foods are consumed • The list of foods is often very specific, and is targeted for determining the status of a particular nutrient ex. List of Vit-D containing foods can be used to determine Vit-D status of the person. • Too complex and time consuming to be used to get information about the diet as a whole • Important thing to remember is that they are used to determine HOW OFTEN person eats SPECIFIC FOODS of interest
What is Food Recall and what are the 2 types
• The individual is asked to recall what they ate across a period of time or read a list of foods. • Done in a interview format Types: 1) 24 Hour Food Recall 2) Dietary Diversity Lists (Food Recall Lists)
Describe Food Records and the limitations
• The individual records all foods consumed across a period of time (ex. 24 hours, 3 days, 7 days) • Done is a written format • Need to capture the variation of a diet, so in Ethiopia, a 24 hour record is probably fine • Limitations- o Literacy- the person partaking in the food record must be able to write o Compliance- if compliance is not 100% then accuracy is affected o When people know they are being investigated they may change their diet
How many essential minerals are there?
• There are 15 essential Minerals
Describe Marasmus Malnutrition (how it occurs, what age is affected, symptoms, and assessment)
• Translates loosely to "to waste away" • This is the disease of starvation → due to not enough calories • Can occur at any age • Clinical Symptoms: Loss of buccal cheek fat, Weak heart, Muscles wasted, Slow metabolism, No fat to insulate against the cold, Apathy for serious cases • Assess using anthropometry (weight for height)
Functions of Water
• Transport of nutrients and waste • Digestion, absorption, circulation (vascular system is 90% H2O) and excretory functions • Regulates Body Temperature
3 reasons why we do nutrition assessment
• Treat- need to access what's going on during ongoing issues such as times of famine so that you can properly treat the issue. • Development of Intervention Programs- need to know the specific deficiencies of a population and why its occurring so you can design specific intervention to help treat their specific needs • Research- should not do research solely for the sake of curiosity, need to also help the people
Types and Classifications of Fats
• Triglycerides- dietary fats consist mainly (about 95%) of triglycerides which are fats that can be split into glycerol and 3 chains of fatty acids (chains of C, H and O) • Fatty acids can be split into 2 groups: 1) Saturated Fatty Acids 2) Unsaturated Fatty Acids a) Polyunsaturated b) Monounsaturated Fats are always mixtures of saturated and unsaturated fatty acids so they are classified according to which fatty acid is present in largest amounts. There are non-triglyceride fats ex. cholesterol
What are the different BMI ranges for adults?
• Under-nutrition: <18.5 kg/m2 • Normal: 18.5 kg/m2 - 25 kg/m2 • Overweight: 25 kg/m2 - 30 kg/m2 • Obese: > 30 kg/m2
Poly-unsaturated Fatty Acid (PUFA)
• contains more than 1 double bond and is liquid at room temperature. Ex. Vegetable Oil