NUTRITION EXAM 2

Environmental Causes of Obesity

-As a society we move less, eat more and accept ideas about weight gain more often because it is apart of our social networks -Healthy, affordable food is hard to purchase in some areas

Treating childhood obesity

-Caution must be used when treating overweight and obese children -Caloric restriction can inhibit growth during rapid development phases -General recommendations: weight maintenance is advised gain height and grow into their weight

Why don't diets work?

-Unrealistic and difficult to follow long term -Encourage foods as "good" or "bad" and encourage dieters to eliminate certain foods

The Recommended Dietary Allowance (RDA) for protein for healthy adults (≥19 years of age) who are not athletes is:

0.8 g / kg body weight per day

Water Intake Recommendations for Adults

1-1.5 ml/kcal of energy expenditure (foods and beverages combined) *Requirements vary based on disease state and activity level

Roles of Vitamin C

1. Acts as antioxidant: immune system health 2. Synthesis of collagen: protein that forms connective tissue of tendons, bone, teeth and skin (wound healing and maintenance of blood vessels structure) 3. Facilitates iron absorption in GI

Functions of Vitamin E

1. Antioxidant: neutralize free radicals that can damage cell membranes, DNA, proteins 2. Enhances immune function 3. Required for nerve cell development (in past, supplements recommended to protect against cancer and CVD)

Functions of Vitamin A

1. Crucial to normal vision (early stages of deficiency: night blindness; reversible) 2. Maintenance of healthy cornea tissue (outer layer of eye): short term - dry and damaged cornea; long term - xerophthalmia, permanent loss of vision) 3. Immune Function: disease resistance, particularly for children and production of WBCs 4. Integrity of epithelial cells: found in skin, lungs, and lining of GI tract 5. Cell differentiation: specialized cells develop that perform specific functions 6. Gene Regulation: role in turning genes on and off; indirect role in regulation of metabolism 7. Bone Metabolism: stimulates bone cells that break down inner part of bone - can lead to poor growth in children

Functions of electrolytes

1. Water and electrolyte balance: moved across cell walls by diffusion and osmosis 2. Acid-base balance (pH): maintenance of normal blood pH 3. Nerve Transmission: Na and K are charged when dissolved in water; assist in function of excitable cells in nerves (Na moves in, K moves out) 4. Gastric pH: HCl contain chloride (protein digestion and absorption of some minerals)

Recommended Intakes for Vitamin E

15 mg/day for adults (RDA) 1000 mg/day for adults (UL): may be lower for some populations - increased incidence of brain hemorrhage among smokers who take Vitamin E supplements

AI for Sodium

1500 mg per day (adults up to 50) 1200 mg per day (over 70)

Alexis expends 2200 kilocalories each day. The minimum amount of water that Alexis should consume each day to maintain health is:

2.2 L

UL for Sodium

2300 mg for adults

Protein also supplies energy but is not the primary function (______ kcal/g)

4

Extracelluar water make us ________ of body water and includes interstitial fluid and intravascular fluid

40%

AI for Potassium

4700 mg per day (most Americans eat less)

Intracellular water makes up _________ of body water

60%

Sodium chloride (table salt) is about ______ chloride

60%

RDA for Vitamin A

900 ug/day for men 700 ug/day for women -Increased need for women who are pregnant/breastfeeding (may also be listed in IU)

Adjustable band fits around upper part of stomach (restriction)

Adjustable Gastric Band Procedure

Exercise for weight loss requires a combination of _________ activity to burn calories and ___________ to build muscle.

Aerobic; strength training

Produced by adrenal glands above kidneys Induces kidneys to retain sodium and water

Aldosterone

Amino acids have a central Carbon connected to what 4 side groups?

Amino group Acid group (carboxyl) Hydrogen group R group (side chain) *unique in each different amino acid

Which of the following individuals is at greatest risk of developing a chronic disease?

An individual with a BMI of 28 who carries the majority of their extra body fat around their abdomen

Which of the following statements is TRUE regarding the relationship between body composition, BMI and health?

An individual's body composition and body fat distribution are more accurate indicators of chronic disease risk than is BMI.

Body fat can be stored under abdominal muscle around internal organs ("visceral fat"); associated with increased risk for chronic conditions due to excess fat

Android pattern

Minerals with negative charge

Anions

Foreign substances that enter our bodies and trigger an immune response

Anitgens

Proteins produced by immune system in response to antigen

Antibodies

Released by pituitary gland to signal kidneys to retain water

Antidiuretic hormone

Two hormones that hep maintain hydration

Antidiuretic hormone and aldosterone

The desire to eat (triggered by sight/smell of food)

Appetite

Common function: coenzymes or cofactors in energy metabolism (assist with energy release; w/o enzyme cannot function) Include: Thiamin, Riboflavin, Niacin, Vitamin B12, Folate, Vitamin B6, Pantothenic acid, Biotin

B Vitamins

Candidates for weight loss surgery:

BMI > 40 kg/m^2 BMI > 35 kg/m^2 + related health conditions

Energy metabolism that occurs after waking the morning, at least 12 hours after the last meal; Includes energy functions that sustain life: Breathing Heart beat Brain Liver Kidneys

Basal metabolic rate (BMR)

Condition which heart becomes enlarges, fluid accumulates beneath skin and muscles weaken and atrophy (primarily affects CVD system - Wet; primarily affects nervous system - Dry)

Beriberi

Water intake sources

Beverages Foods Metabolic water: from breakdown of carbohydrates, fats and proteins (1 - 1.5 cups/day)

Measure of weight relative to height (often used to diagnose overweight or obesity) Standard formula= wight in kg/(height in m)^2

Body Mass Index (BMI)

Critical function of water in the body:

Body temperature regulation -Water absorbs body heat -Heat released at skin via sweat

Other minerals that could help BP control

Calcium and Magnesium

Individual units of protein made up of:

Carbon, Hydrogen, Oxygen and Nitrogen (unique to proteins)

BMI and disease risk

Cardiovascular disease Hypertension Type 2 diabetes Stroke Gallbladder disease Osteoarthritis Sleep apnea Respiratory problems Endometrial, breast, prostate and colon cancers

Minerals with positive charge

Cations

Function of Folate

Cell division: required by DNA replication Affects RBC synthesis and CNS formation during fetal development

An anion, more concentrated in extracellular fluid

Chloride (Cl-)

Amino acid contents combined provide all EAA -Grains and legumes -Legumes and nuts/seeds -Grains and dairy products

Complementary proteins

Provide all essential amino acids in amounts needed by body; easily digested and absorbed (animal proteins and soy)

Complete proteins/high quality proteins

Under certain conditions, nonessential amino acids cannot be made by the body. Referred to as __________ amino acids (arginine, cysteine, glutamine, proline, tyrosine)

Conditionally essential

RDA: 400 ug/day for adults (.19); increased requirements for women planning on becoming pregnant, already pregnant or lactating UL: 1 mg folic acid/day

DRIs for Folate

RDA: 16 mg/day (males), 14 mg/day (females) UL: 35 mg/day - based on adverse effects of excess intake from supplements (flushing and tingling sensation)

DRIs for Niacin

Required for elimination of excess amino acids -occurs primarily in liver -keto-acid used for energy production -amino group converted to urea (excreted in urine)

Deamination

Excessive water loss via sweat and vomiting and diarrhea can all cause ____________

Dehydration

Lowest BP reading during cardiac relaxation

Diastolic BP

Increase fruit/veggies (increased K intake) Increase whole grains (increase Mg intake) Low fat dairy (increase Ca intake) Other recommendations: lower saturated fat

Dietary Approaches to Stop Hypertension (DASH) Eating Plan

Diet and lifestyle changes to prevent/control hypertension

Dietary Changes: decrease sodium intake (avoid processed foods, fast foods) Lifestyle: attain or maintain healthy body weight, physical activity

Food Sources of Folate

Dietary sources of folate: orange juice, green leafy vegetables, legumes Dietary sources of folic acid: supplements, enriched grains

Movement from area of greater concentration to area of lesser concentration

Diffusion

Factors that influence vitamin D synthesis

Distance from equator Amount of clothing coverage on body Sun block use Cloud cover or smog Skin color Age

Limitations of BMI

Does not distinguish between fat and muscles mass (athletes) Various ethnicities Sex Elderly

Combination of physiological and psychological signals integrated in hypothalamus of brain

Eating behavior

Develops when blood albumin is low

Edema

Minerals that, when placed in water, become charged particles

Electrolytes

Obesity is caused by positive energy balance (eating more calories than burned)

Energetics

Speed up chemical reactions Strings of 100 to 1,000 amino acids Unique shape

Enzymes

________ amino acids must be acquired from our diets.

Essential

Fat required for normal physiological functioning

Essential fat

Functions of Vitamin B12

Essential in converting folate into active form Maintains high insulting lining that covers nerve fibers (myelin sheath)

Storage in body: longer period of time, larger amounts, in liver and fat cells Increase likelihood of adverse effects or toxicity

Fat soluble vitamins

Vitamins A, D, E, K

Fat soluble vitamins

Inability to synthesize DNAResults in large, immature RBCs that are fewer in number (microcytic anemia) During pregnancy: -spina bifida: failure of spinal cord to close completely -anencephaly: lack or incomplete development of brain and skull (together known as Neural Tube Defects)

Folate Deficiency

Two forms of Folate (B9):

Folate: naturally occurring form Folic acid: synthetic form, easier to absorb in GI

Which is easier to absorb: folic acid or folate?

Folic acid -Dietary folate equivalent (DFE): unit of measurement used to represent conversion of folic acid to folate

Sources of Niacin

Food sources: milk, eggs, meat, poultry, fish, whole-grain and enriched breads and cereals Also synthesized by body from essential amino acid tryptophan

Unstable compounds with unpaired electron; Attack other molecules with electrons - initiates chain reaction and damages cell membranes, proteins, enzymes and DNA (Vitamin E donates electrons to neutralize) Sources: UV rays, atmospheric pollution, stress, poor diet

Free Radicals

Sources pf Potassium

Fresh fruits and vegetables Legumes Milk Meats Whole grains Salt substitues (KCL)

Food Sources of Vitamin C

Fruits and vegetables (OJ, citrus fruits like limes and lemons, kiwis, strawberries, sweet potatoes, Brussel sprouts) -Vulnerable to heat and oxygen (food preparation affects levels in foods)

Integrity of epithelial cells Bone growth Cell membrane stability Gene regulation Vision Immune function

Functions of Vitamin A

A hunger-stimulating hormone produced by cells lining the stomach when stomach is empty (decreases after eating; increases with weight loss)

Ghrelin

Obesity epidemic is NOT just an issue for the United States and other industrialized societies

Globesity

Functions of Proteins in the Body

Growth/maintenance/repair Body structure and blood Fluid balance Transport Acid base balance Immune function Enzymes Hormones

Fat over muscle and under skin at hips and thighs (subcutaneous fat)

Gynoid pattern

Protection against certain cancers and CVD disease Prevention of bone loss

Health benefits associated with soy consumption

Messengers that help regulate the various systems and functions of the body; made of lipids or proteins (insulin - protein, estrogen - lipid)

Hormones

The need to eat (may be triggered by low blood glucose and low glycogen)

Hunger

>140 systolic BP and/or >90 diastolic BP

Hypertension

Roughly 25% of Americans have high BP: increases risk for coronary heart disease and stroke, may lead to kidney damage 85% due to unknown cause (essential hypertension) Most is treatable with diet and exercise modifications and/or medication

Hypertension

Excess water consumption may lead to water intoxication (dilution of blood electrolytes, particularly sodium)

Hyponatremia

___________ in brain controls body's perceived thirst

Hypothalamus

Do not contain all essential amino acids in amount required by body (ex: legumes, grains, vegetables)

Incomplete proteins

Weight gain causes a __________ of leptin (decrease food intake, increase energy expenditure)

Increase

Excess protein health risks

Increased risk for certain types of cancer (colon, prostate, breast, pancreatic): associated with high intake of animal proteins Kidney disease and kidney stones Can be high in saturated fat (increased risk for heart disease)

_________ control urine and blood composition

Kidney

Characterized by swollen appearance, especially abdomen -Proposed causes: low protein intake, altered gut bacterial populations -Frequent in children being weaned from breast milk to cereal

Kwashiorkor

Include eggs and dairy products but no meat in diet

Lacto-ovo-vegetarians

Include dairy products but no other animal foods in diets

Lacto-vegetarians

At least 50% less sodium than original product

Light in sodium or lightly salted

Must contain <140 mg sodium/serving

Low sodium

Consume mostly whole grains, especially brown rice, in their diets along with vegetables, soy, legumes, fruits and sometimes whitefish, but avoid meat, poultry, eggs and dairy

Macrobiotic vegetarians

A form of protein energy malnutrition that is caused by inadequate protein and calorie intake is:

Marasmus

Condition of starvation characterized by emancipation or skeletal appearance -Causes: inadequate protein and calorie intake

Marasmus

Not energy yielding Involved in metabolic processes Assist in providing energy

Micronutrients

Thirst, some lack of mental clarity and mild fatigue

Mild dehydration

Reduced athletic ability

Moderate dehydration

Is obesity a problem for only adults?

NO, childhood obesity is an epidemic in some areas of the world and on the rise in others

Does the body have a water storage mechanism?

NO, losses must be replaced from consumption of water

Nitrogen excretion exceeds intake or intake is inadequate to meet body's needs (occurs during AIDS, cancer, starvation, low calorie diets)

Negative nitrogen balance

Microscopic structures that filter blood; 1 million in each kidney

Nephron

Compound (neurotransmitter) that increases food intake and blood glucose levels, promoting the storage of energy in fat cells

Neuropeptide Y

Found in two chemical forms: Nicotinamide and nicotinic acid Used to release energy from macronutrients (almost every metabolic pathway uses one of two niacin-containing coenzymes: NAD and NADP) Used in synthesis of fatty acids

Niacin (B3)

Leads to Pellagra (symptoms: diarrhea, dermatitis, dementia, death) Major problem in southeastern US in early 1900s through 1930s (fat back, grits and molasses)

Niacin Deficiency

One of few water-soluble vitamins to have toxicity symptoms Overconsumption of supplements or fortified foods: "_________ flush" (3-4x RDA; redness of face, arms and legs; temporary condition), can result from high doses of nicotinic acid prescribed for cholesterol reduction Other concerns: liver injury

Niacin Toxicity

Nitrogen consumed vs. nitrogen excreted (basis of many nutrition recommendations)

Nitrogen balance

DRIs for Vitamin K

No RDA No UL Men >19: 120 ug/day (AI) Women >19: 90 ug/day (AI) Pregnant, lactating: 90/day (AI)

________ amino acids are normally made in adequate amounts by our bodies

Nonessential

<120 systol BP and <80 diastolic BP

Normal

Complete, high protein source Low in saturated fat and cholesterol B-vitamins, calcium, potassium, Vitamin A, iron -Other bioactive compounds: isoflavones (act as phytoestrogens)

Nutritional composition of soy protein

Movement of water across membrane from area with fewer particles to area with more particles

Osmosis

(adults) softening of bone caused by decalcification

Osteomalacia (Vitamin D deficiency)

Condition associated with decreased bone mass and bone density that can result in increased risk of bone fracture -Greatest risk: older age, women, being underweight, tobacco use, physical inactivity

Osteoporosis

Physical activity recommendations

Overall health: moderate activity 30 minutes, 5 days/week Maximum cardiovascular benefit: vigorous activity for minimum 20 minutes/session

Energy expenditure through voluntary physical effort, include daily activities, exercise or physical labor; Energy needed for muscle contraction -Factors influencing energy burned: body weight and muscle mass utilized, duration, intensity, fitness level, type of activity

Physical activity

Other factors besides food and activity CHOICES that could affect weight:

Physiological Psychological Lifestyle behaviors Social and economics

Inadequate intake of the electrolyte potassium may result in:

Poor nerve transmission Hypertension

Nitrogen intake exceeds excretion (occurs during growth, recovery from illness, and during pregnancy)

Positive nitrogen balance

Appears to relax blood vessels which decreases BP (recommended to increase intake)

Potassium

Primary intracellular cation

Potassium (K+)

Ready to use and found in animal-based or fortified foods (ex: fortified milk, cheese, cream, butter, eggs, liver)

Preformed Vitamin A

120-139 systolic BP or 80-89 diastolic BP

Prehypertension

Value assigned to proteins that accounts for protein quality and digestibility (based on scale of 0-100)

Protein Digestibility-Corrected Amino Aid Score (PDCAAS)

Free amino acids become part of amino acid pool

Protein breakdown

Disorder that occurs with inadequate protein and/or energy consumption -Most common nutrient deficiency in hospital and nursing home populations in US -Greater concern internationally (infants and young children most susceptible) -Most lethal form of malnutrition (WHO)

Protein energy malnutrition (PEM)

Requires presence of essential amino acids in adequate amounts (limiting amino acid: present in lowest amount relative to body's needs)

Protein synthesis

Protein synthesis and protein breakdown

Protein turnover

Converted to active form as needed (ex: beta-carotene) and found in plant-based foods (ex: green leafy vegetables, orange and red produce - apricots, cantaloupe, carrots, sweet potatoes, pumpkins)

Provitamin A

Should you take beta-carotene supplement?

Provitamin A is not toxic Beta-carotene may help to prevent heart disease and cancer Increased risk of lung cancer in smokers Health professionals do not recommend beta-carotene supplementation for the general public

DRIs for Protein

RDA: 0.8 per kg of body weight (high-quality protein) AMDR: 10-35% *Needs increase for injury, illness, pregnancy, competitive athletes

DRIs for Vitamin C

RDA: 90 mg/day (males), 75 mg/day (females) Increased needs for smokers (used to protect body against damaging compounds in tobacco smoke) - require additional 35 mg/day

Recommended 400 IU/day for infants (AI) and 600 IU/day for ages 1-70 (RDA) Requirement increases as we age: 800 IU/day for adults over 80 (RDA) -decrease in ability to convert into active form -decrease likelihood of adequate exposure to sunlight

Recommended Intakes of Vitamin D

At least 25% less sodium than original product

Reduced sodium

Calories burned while sitting or sleeping; make up most of calories burned in a day (less restrictive)

Resting energy expenditure (REE)

Transporter of nutrients through bloodstream

Retinol-binding protein

3 different chemical forms of Vitamin A

Retinol: most active form, stored in liver Retinal Retionic acid (also B-carotene)

RDA: 1.3 mg/day (males), 1.1 mg/day (females) No UL Food sources: milk, enriched breads, cereals, and pasta (destroyed by UV light and irradiation)

Riboflavin

Part of coenzymes: Flavin mononucleotide (FMN) and Flavin adenine dinucleotide (FAD) Function: energy release from macronutrients - FAD is an "electron shuttle"

Riboflavin (B2)

Frequently occurs in conjugation with other water-soluble vitamin deficiencies Results in: inflammation of membranes -sore throat -cracks in corners of mouth -swollen, glossy tongue -skin rashes -hypersensitivity to light

Riboflavin Deficiency

Disease in children characterized by softening and deformity of long bone; Inability to deposit calcium in newly formed bone -Malformation of skull, rib cage and ends of long bones

Rickets (Vitamin D deficiency)

Vitamin D deficiency in children can result in ________________, while in adults a deficiency can lead to _____________________.

Rickets; osteomalacia

Small pouch created from stomach causing part of small intestine to be bypassed (restriction and malabsorption)

Roux-en-Y Gastric Bypass

Occasionally eat meat and seafood, yet predominately practice a vegetarian diet

Semivegetarians/flexitarians

Theory that the body is programmed to gravitate toward particular weight (metabolism may adjust up/down to ensure weight is neither gained nor lost)

Set Point Theory

Cramping and heat exhaustion (if water loss continues, hallucination and heatstroke occur)

Severe dehydration

High amounts may increase risk of hypertension in some people (required on food labels)

Sodium

Primary cation in extracellular fluid

Sodium (Na+)

Rarely occur Sodium loss accompanied by loss of body water (shock-like symptoms; blood volume decreases and veins collapse) Water intoxication (can result in condition associated with low sodium in blood: hyponatremia)

Sodium Deficiencies

Must contain<5 mg sodium/serving

Sodium free

Transport substances across cell walls

Sodium-potassium pump

Fat in adipose tissue, tissue under the ski and fat that "pads" essential organs

Storage fat

_________________ are one of the largest sources of added sugar in the diet (adolescents who eliminated from diet in one year gained an average of 4 pounds less than their peers)

Sugar-sweetened beverages (SSBs)

Additional source of protein for specific populations (vegetarians, highly active people, underweight people) -Grains and nuts/seeds -Legumes and dairy products -Dairy products and nuts/seeds

Supplemental proteins

High rates of insufficiency in US: 90% of ethnic populations with dark skin, 75% of caucasian population Possible link to chronic disease: heart disease, respiratory infections, diabetes, hypertension

Supplementing Vitamin D

Peak pressure generated when the heart contracts and forces blood to move

Systolic BP

2 components of BP readings

Systolic and Diastolic

Which of the following statements regarding the DASH diet is INCORRECT?

The DASH diet includes the increased consumption of dairy products, increasing one's dietary intake of selenium.

The process of burning calories as you digest, absorb, transport, store and metabolize food (body burns about 10% of calories from meal); Diet can have mild influence (little higher for protein)

Thermic effect of food (TEF)

________ deficiency occurs in malnourished individuals (Beriberi) and alcoholics (Wernicke-Korsakoff syndrome)

Thiamin

First individual B vitamin identified Part of coenzyme thiamin pyrophosphate (TPP): assists in metabolism of carbohydrates and some amino acids (conversion of pyruvate to acetyl CoA, Kreb's cycle) Assists in function of nerve and muscle cell activity

Thiamin (B1)

RDA: 1.2 mg/day (males) and 1.1 mg/day (females) No UL: no adverse effects with excess consumption Food sources: pork, whole grains, fortified breakfast cereals, enriched grains, peanuts

Thiamin (B1)

Body's perceived need for water; Triggered by: -Water levels in blood decrease and solute concentration increases -Perception of thirst lags behind when body first needs water

Thirst

Soy protein food sources

Tofu, tempeh, soy nuts, textured soy, soy dairy products

Lean tissue mass + fat mass + water

Total body mass

Transfer of amine group from one molecule to another to create an amino acid

Transamination

Why do people choose to become vegetarians?

Treatment of animals Hormones and antibiotics Environmental impact Health Religion

BMI = under 18.5

Underweight -Consequences: decreased overall energy, respiratory complications, heart irregularities, infertility, delayed wound healing, weakened immune system, osteoporosis

No salt added to recipe - does not ean sodium free

Unsalted or no added salt

Water loss sources

Urine Feces Insensible losses (sweating and air expiration)

Omit all animal products from diets, including dairy and eggs

Vegans

Part of stomach removed (small stomach = less room for food/restriction)

Vertical Sleeve Gastroectomy

Must contain < 35 mg sodium/serving

Very low sodium

Vitamin A stored in fat tissue and liver for long time; Symptoms: liver damage and birth defects

Vitamin A Toxicity

Contains mineral cobalt as part of structure Synthesized by bacteria and other micoorganisms Found naturally only in foods of animal origin (in protein) Stored in body in significant amounts Requires IR for absorption

Vitamin B12

RDA: 2.4 ug/day for adults No UL Naturally occurring sources: animal-based foods (milk, cheese, meat - esp. organ meats, poultry, seafood) Fortified foods: ready-to-eat cereals, soy products, supplements

Vitamin B12

Nutrients of concern for vegetarians (particularly vegans)

Vitamin B12 Zinc Iron Calcium Vitamin D Protein

As we get older, for which of the following vitamins is it recommended that we consume the synthetic form from supplements rather than the naturally-occurring form?

Vitamin B12 (cobalamin)

Must be released from dietary protein before absorption: occurs in stomach (HCl and pepsin) After release, bound by protein secreted in stomach (IF: protects from degradation until absorption) Absorption occurs in lower ileum

Vitamin B12 Absorption

Can result in Macrocytic anemia (pernicious anemia: if lack of IF) -Conditions that reduce IF: genetic defect, aging, portion of stomach removed (Roux-en-Y surgery, stomach cancer)

Vitamin B12 Deficiency

Key function: synthesis of nonessential amino acids (transamination) Other functions: synthesis of glucose and some types of lipids; production of serotonin; hemoglobin synthesis (deficiency can lead to anemia)

Vitamin B6

RDA: 1.3 mg/day for adults (15-50 years old) UL: 100 mg/day Food sources: beef liver, meats, poultry, salmon, baked potatoes, bananas, watermelon, navy and pinto beans

Vitamin B6

Occurs with deficiency of other B vitamins Deficiency symptoms: anemia, depression, dermatitis, convulsions, weakened immune response Toxicity symptoms: numb feet, loss of hand sensation, nerve damage that progresses to inability to walk (many not reversible)

Vitamin B6 Deficiency and Toxicity

All of the following are fat soluble vitamins EXCEPT:

Vitamin C

Importance in diet for 1800s sailors Scurvy: deficiency; bleeding gums, tooth loss, poor wound healing, small hemorrhages on skin

Vitamin C (ascorbic acid)

Scurvy: (severe deficiency) improper formation of collagen Anemia: poor iron absorption -Signs: bleeding gums, loss of appetite, small hemorrhages on skin, impaired growth, weakness, scorbutic rosary in infants

Vitamin C Deficiency

UL = 2000 mg/day Supplementing greater than 1000 mg/day: diarrhea and bloating

Vitamin C Toxicity

Human body makes _______ with adequate exposure to sunlight through series of steps. -Cholesterol in skin combines with UV rays -Converted into precursor Eventually makes it way to kidneys (converted to active form D3)

Vitamin D

Classified as vitamin, hormone and steroid Functions: Regulation of calcium metabolism -stimulates cell os small intestine to produce calbindin (calcium-binding protein that increases calcium absorption) -stimulates kidneys to conserve calcium (decrease urinary calcium excretion) -stimulates calcium release from bone

Vitamin D (cholecalciferol)

Few foods are naturally concentrated: cod liver oil, sardines, shrimp, salmon, liver, mushrooms exposed to UV light Fortified foods provide majority of dietary needs: milk or margarine, cereals, juices (cheese and yogurt often NOT fortified)

Vitamin D Food Sources

Toxicity is not common Occurs from overuse of supplements Symptoms: nausea, vomiting, diarrhea, possible calcification of soft bones Food fortification is strictly regulated

Vitamin D Toxicity

Fat soluble vitamin primarily found in cell membrane Not a single compound, but a group of compounds (tocopherols): alpha, beta, gamma, delta

Vitamin E

*Rare Most likely to occur in: premature infants (insufficient stores) Anemia may result due to RBC fragility and subsequent rupture Other symptoms: loss of muscle coordination and reflexes, muscle weakness, reproductive failure and impaired vision

Vitamin E Deficiency

As a fat soluble vitamin, it can be toxic Signs: headache, nausea, blurred vision, reduced sexual function in men, accelerated signs of aging, inflammation of mouth, chapped lips, fatigue, GI disturbances, muscle weakness, increased bleeding

Vitamin E Toxicity

Primary function: blood clotting - activates proteins required to make fibrin (forms blood clots); also required for synthesis of bone protein osteocalcin

Vitamin K

Primary deficiency rare in adults Highest risk: newborns - relatively sterile GI tract at birth, breast milk is poor source (single dose given at birth) Other risk factors: prolonged antibiotic use

Vitamin K Deficiency

Nonfood source: bacteria in large intestine (most significant source for humans) Food sources: green vegetables (spinach, kale, cruciferous vegetables), green fruits (avocado, kiwi), some vegetable oils

Vitamin K Sources

Categories of micronutrients

Vitamins (organic) and Minerals (inorganic)

Consists of 2 hydrogen atoms (slightly +) and 1 oxygen atom (slightly -) bonded together which causes a shift in charge among individual atoms -Allows for attraction to other molecule -Other charged substances can dissolve it

Water

Composition of urine

Water and electrolytes Urea and creatinine

Storage in body: short period of time, not generally stored in large quantities Decrease likelihood of toxicity Greater risk of deficiency

Water soluble vitamins

Vitamin C, Thiamin, Riboflavin, Niacin, Pantothenic acid, Pyridoxine, Biotin, Folate & Cobalamin

Water soluble vitamins

Include vitamins C and B Less toxic tan fat soluble Adverse effects when take in large quantities (3-4x RDA): extreme supplemental use (ex: using excess vitamin C supplements to treat cold)

Water-Soluble Vitamins

When a person gan weight in the form of fat, both the size and number of fat storing cells ________ increases

adipocytes

The kidneys help maintain hydration in the body by adjusting the amount of water and sodium lost in the urine. This occurs in response to the release of which hormone:

aldosterone

Building blocks of proteins

amino acids

An example of an individual experiencing negative nitrogen balance is:

an individual with severe skin burns

Proteins in blood maintain optimal balance between fluid inside and outside ______ and __________ (Albumin)

cells; blood vessels

Dr. C visited Lupe Tortilla for a Tex Mex meal last night. She ordered rice and beans; therefore, she consumed a:

complementary protein source

Drug therapy often used as _________ of weight loss treatment. Recommended when person is extremely obese or life-threatening complications exist (not a permanent solution and ineffective w/o diet, physical activity and behavior modification)

component

Weight loss causes a __________ of leptin (increase food intake, decrease energy expenditure)

decrease

Potential health benefits of vegetarianism

decreased risk for heart disease and obesity

Vitamin B12 absorption ______ with age (decrease of IF, decrease of HCl secretion, decrease ability to release from dietary protein) *Age >50 recommended to take supplements

decreases

Jill would like to reduce the amount of sodium in her diet. Foods typically high in sodium that Jill should limit are:

deli meats and cheese

The population group at greatest risk of having insufficient Vitamin D (cholecalciferol) levels in their bodies is:

elderly adults

Deficiencies in _______ can be caused by inborn errors in metabolism and have non-genetic causes (illness, inadequate nutrition, medications)

enzymes

Water is ____________ and consumption is required everyday.

essential

________ and _______ may contribute to excess kcal (fat and sugar)

fast food; convenience

The functions of protein in the body include:

form protective barriers against foreign particles as part of immune system assist with maintenance of acid/base balance act as enzymes to speed up metabolic reactions maintain fluid balance assist with transport of nutrients

A protein's structure can be changed by:

heat, acid, enzymes, agitation, alcohol (denaturing an egg or stomach acid denaturing proteins we eat)

The physiological need to eat that is triggered when blood glucose levels drop is:

hunger

A common condition in marathoners and other endurance athletes that may result from overconsumption of water, is known as:

hyponatremia

Recommendations that are effective for long-term weight management and/or weight loss are:

implementing small, moderate lifestyle changes that incorporate smaller portion sizes and regular physical activity to balance energy intake with energy expenditure

Body fat usually _________ with age and women should have a _______ body fat percentage than men

increases; higher

An individual on a vegan diet may have difficulty consuming sufficient amounts of which of the following nutrients:

iron

Energy production is the ________ efficient function of proteins (no major storage form for immediate use)

least

Hormones released by fat cells to signal brain that the body has had enough to eat (decreases food intake and increases energy metabolism); Long-term weight control

leptin

Body uses protein for energy as last resource if energy intake from carbohydrates and fat is _____. (breaks down muscle and amino acids use for energy)

low

Natural chloride content of most food is ______

low

Which of the following amino acids must we consume in our diet?

lysine

Acids and bases are constantly produced from by-products of body's _________

metabolic processes

The microscopic structures that filter blood and assist in maintaining water balance in the body are:

nephrons

BMI = 18.5 - 24.9

normal

BMI = over 30

obese

BMI = 25 - 29.5

overweight

If an individual has a BMI of 26, then the individual would be classified as being:

overweight

Body works to maintain ______ (acid-base balance) in tight range. -Proteins act as buffers -Neutralization of acidic and basic conditions

pH

Different proteins are composed of unique sequences of amino acids linked together by __________

peptide bonds

The component of total energy expenditure that an individual has the most control over is:

physical activity

The main symptom of vitamin K deficiency is:

poor blood clotting

Correct amino acid sequence allows for:

predictable structure and function

Main dietary source of sodium is ___________. (for taste and/or as a preservative; very little from naturally occurring sodium)

processed foods

Calories/energy is expended in three ways:

resting energy expenditure (REE) physical activity thermic effect of food (TEF)

Which of the following weight loss surgeries is most likely to result in nutrient malabsorption and increased risk of nutrient defiencies?

roux-en-Y gastric bypass

Proteins form body's first barriers against immune invaders, such as _______ and _______

skin; mucus (present in respiratory system and intestine)

Dr. C visited Potato Shack last night for dinner. She ordered a baked potato loaded with cheese and ham. Therefore, her meal was high in____________ and ____________.

sodium and potassium

Incorrect amino acid sequence allows for:

structure changes or error in function (ex: sickle cell anemia)

Vitamin B6 (pyridoxine) is important for the body due to its role in:

synthesis of nonessential amino acids via transamination

resting energy expenditure (REE) + physical activity + thermic effect of food (TEF)

total energy expenditure

The majority of water loss each day occurs via:

urine

__________ is primary path for water loss and excretion of metabolic waste and regulation of extracellular fluid composition

urine

Proteins have ______-repelling and ______-attracting ends which allows for interaction with fat and water (ex: lipoproteins)

water

kcal consumed > kcal expended

weight gain

kcal consumed < kcal expended

weight loss

Kcal consumption = kcal expended

weight maintenance

The recommendations for treating children who are overweight or obese are:

weight maintenance as the child gains height