nutrition
Identify hormones/peptides that may decrease/increase appetite.
DECREASE APPETITE (inhibit) CCK- short term; released with fat; increases satiety (want 20% of cal from fat) PYY- short term; released by small intestine to signal when food is in it Insulin- suppresses hunger Leptin- long term; increases with adipose storage; suppresses food intake Serotonin- eat less after an increase in the brain; makes you sleepy INCREASE APPETITE (stimulate) Ghrelin- short term; increased release 30 min before a meal (on empty stomach) Cortisol- short term; highest in morning (released with low glucose); stress- suppresses or stimulates NPY- stimulates hunger
Indicate dietary/lifestyle factors that influence obesity, cardiovascular disease and their rationale
Dietary/lifestyle influences of obesity -Size of packaged items have increased -Portion sizes have increased -When served more food, individuals will eat more -Eating in restaurants is associated with increased energy intake, body weight, and body fatness -Skipping breakfasts actually increases the risk of obesity because people tend to eat more calories throughout the day -Consuming liquid foods such as liquid meal replacements will lead to higher energy intake -The colors red, orange, and yellow stimulate appetite/hunger, which is why so many fast food restaurants use these colors Dietary/lifestyle influences of cardiovascular disease -increase in age increases risk of CDV -southern diet patterns (lots of fried foods, lot of fats) increase risk -sugary beverages and other sources of added sugars increase risk -low carb diets increase risk -enhance foods with spices decreases risk -maintaining a low blood pressure decreases risk decrease sodium intake to decrease risk -follow DASH eating plan to decrease risk -follow mediterranean diet (replace sat fat with poly and mono) to decrease risk -avoid trans fat to decrease risk
Define the terms related to the Dietary Reference Intakes and interpret the "graphical depiction" describing each. (i.e.- EAR, RDA, AI, and UL)
EAR: estimated average requirement (about 50%) RDA: Recommended dietary allowance (more than 97-98% of population) AI: adequate intake UL: upper tolerable level (highest level that poses almost no risk to almost all individuals)
Identify governmental agencies that regulate food and nutrition (e.g.- FDA, FTC)
FDA, DSHEA, Pharmacological Dose of Dietary Supplements, American Cancer Society, American Heart Association, etc
Compare food allergies to food intolerance.
Food allergy: release of histamines which results in anaphylaxis (blocked airways, etc.) Food intolerance: lack of an enzyme (or not working properly)
Discuss and compare natural sweeteners, naturally occurring sugars, and artificial sweeteners.
Food sources of naturally occurring sugars higher in fiber, vitamins, and minerals A. Added sugar consumption may lead to excessive caloric intake B. Food sources of naturally occurring sugars are more nutrient dense. C. Added sugars compared to naturally occurring sugars may contribute to dental caries. difference between natural, refined, and artificial sweeteners - natural sugars are found naturally in the whole foods or fruits and vegetables such as glucose and fructose - artificial sweeteners are sugars chemically modifies to provide a sweet taste without calories - refined sweeteners are sugar alternatives to provide a sweet taste such as saccharin and aspartame.
Describe lipid digestion/absorption.
I. Chyme squirts into the small intestine II. CCK is released and travels to the pancreas (to release pancreatic lipase), to the brain (to feel satiety), and to the gallbladder (to stimulate and release bile) III. Bile surrounds the . Which is known as the emulsification process to make the water soluble. IV. Pancreatic lipase breaks down the ester linkages of the into one glycerol bound to just one ty acid (a monoglyceride) and two fatty acids. V. The monoglyceride and the two fatty acids will pass into the enterocyte (mucosal cell) through the brush border WITHOUT any transport. VI. The bonds will now be recreated (re-esterification) to form the . again. VII. The . is packaged with a phospholipid, cholesterol, and a protein (this combination is a chylomicron which is a form of a lipoprotein) VIII. The . from your diet is transferred into the lymph system and then to the bloodstream to tissues (specifically the liver).
Compare Kwashiorkor and Marasmus
Kwashiorkor -Low protein, but adequate calories in the diet -Low albumin causes lots of fluid to accumulate in the abdomen -high risk for infection Marasmus -Also known as cachexia (severe muscle wasting) -Very low protein and very low calories in the diet -Malnutrition -high risk for infection Both- low protein/iron causes anemia which increases risk of infection
Identify the risk for nutritional deficiencies for bariatric surgical patients
Nutritional deficiencies due to inadequate intake, supplementation, or absorption -Protein-energy undernutrition -Vitamin B12 deficiency (no intrinsic factor because food bypasses the stomach) -Iron and thiamine deficiencies -Incidence of depression -Disordered eating habits -Increased rate of alcoholism
Identify the possible causes of obesity as well as health risk associated with obesity.
Overall, Obesity is caused by a long term positive energy balance in the body. Some things that can increase one's chance of having obesity include -genetics: 1 parent- 40 %, 2 parents- 80% -set point: where ones weight typically sits -health: stress cycle, cortisol, thyroid hormone -Environmental: serving sizes, stress, situational circumstances Health Risks -pulmonary disease, non alcoholic fatty liver disease, gynecological abnormalities, cancer, osteoarthritis, coronary heart disease, and stroke
Describe inborn errors of metabolism as related to genes and proteins (e.g.- PKU; MSUD, Hartnup's Disease, etc.)
PKU (Phenylketonuria) -Phenylalanine comes in meat, fish, poultry, eggs, and milk -Phenylalanine would typically be metabolized into tyrosine using phenylalanine hydroxylase -In the absence of phenylalanine hydroxylase, phenylalanine will have a high concentration in the blood and phenylketones will be produced -Aspartame is bad if you have PKU MSUD (Maple Syrup Urine Disease) -Branched chain alpha-t dehydrogenase is an enzyme that metabolizes alpha-ketoacids -Missing these enzymes makes the body unable to process certain amino acids which results in a buildup of harmful substances in the blood and urine Hartnup's disease -Hartnup disease is a condition caused by the body's inability to absorb certain protein building blocks (amino acids) from the diet. As a result, affected individuals are not able to use these amino acids to produce other substances, such as vitamins and proteins.
Explain how pharmacotherapy and surgery for weight loss may increase the risk for nutritional deficiencies.
Pharmacotherapy: -Orlist: blocks pancreatic lipase and prevents digestion of fat reduces 30% of fat intake interferes with absorption of fat soluble vitamins (vit A, D, E) -Sibutramine- serotonin reuptake inhibitor which decreases appetite overall decrease of nutrients, increased risk of anorexia Roux-en-Y Gastric Bypass (RYGB)-- most common surgery; used as last resort -decreases capacity of stomach by 90% which leads to malabsorption -creates tiny pouch and a bypass is made into to jejunum
What are the pro/cons of plant based diets and animal based diets?
Plant based diet: advantages: -high in fiber (fiber is only from plants) -high in phytochemicals -vitamins and minerals -generally lower in saturated fat -less calories per serving disadvantages: -lack some essential amino acids -low vitamin B12 -low iron (heme) & not the form we efficiently use -less protein -low in bioavailable calcium & vitamin D Animal based diet: advantages: -high in vit B12 -high in essential amino acids -high in calcium and vit D (milk) -high protein disadvantages: -lacks fiber -lack phytochemicals -more calories per serving -some high in saturated fat
Define prebiotics and probiotics and their role in digestive health
Probiotics: live microorganisms that provide health benefits to their host (healthy bacteria) Prebiotics: ferementable ingredients that result in changes of composition/activity of microbiota (food for probiotic)
Relate the food group with the nutrient that it primarily contributes to dietary intake in the American Diet (e.g.- Dairy →Calcium, etc).
Proteins- vitamin B12 dairy- calcium (vitamin D) fruits and vegetables- fiber & vitamin c &vitamin a grains- B vitamins
Identify the functions and provide examples of proteins in humans
Regulation -All enzymes are proteins -Some hormones are proteins (insulin, glucagon, CCK, secretin, etc.) -Receptors -Transporters (such as hemoglobin) -Antibodies Energy -Proteins can be used for energy as a last resort Protein examples -Proto-oncogene: a protein; "accelerator pedal" for cell growth -enzymes, transporters, receptors
Recognize the chemical forms of lipids.
Sterols -Have a ring structure Triglycerides -These are lipids in which a glycerol backbone is bonded to three fatty acids (through ester linkages). Fatty acids -Have a methyl end (CH3) and carboxyl end (COOH) -Saturated fatty acids: Fully saturated with hydrogen atoms -Unsaturated fatty acids: Has some missing hydrogen atoms, always has at least one double bond between carbons -Monounsaturated fatty acids have only one double bond while polyunsaturated have at least two or more -Omega-6 or Omega-3 fatty acids are named based on how far the first double bond is from the methyl group (ie. an Omega-6 fatty acid has a double bond 6 carbons away from the methyl end) Phospholipids -Contain a phosphorus atom
Know diet and lifestyle factors that can prevent/treat diabetes
Type 2 diabetes- weight loss, eating soluble fiber, decreasing consumption of simple sugars and added sugars, and adding more exercise can help treat diabetes
Explain in detail carbohydrate (mouth and small intestines) and protein digestion and absorption (stomach and small intestines ).
carbohydrate: -amylase in mouth breaks it down to smaller polysaccharides -when enter lumen in intestines, CCK is released and travels to pancreas and pancreatic amylase send back to form maltose (disaccharide). maltose breaks it down -glucose and Na binds to SGLT-1 to bring in to intestine and uses GLUT-2 to go into the body as fully absorbed protein: -release hormone gastrin into blood stream. comes back to bind to receptors of the stomach where HCl and pepcinogen is released -pepsinogen inactive but activates as HCl is binded to the enzyme to form pepsin to polypeptide chains -stomach also releases intrinsic factors that bind to vitamin b12 -polypeptide and b12 squirted to intestine to finish disgestion
Distinguish between observational studies and experimental studies.
experimental studies: intervention of the researcher -randomized controlled trial (gold standard if double blind)(think calcium supplement and incidence of fractures) -these only SUGGEST associations (no cause and effect) -meta analysis: superior to one randomized controlled trial (better than RTC) observational studies: NO action from the researcher -cohort: looks to future (does high blood cholesterol lean to heart disease?) -cross sectional: looks at now(what is happening? why do my two diff subjects have the given outcomes?) -case control: looks at past (think of goiter research)
Recognize and interpret the different types of research studies related to nutrition science.
experimental studies: intervention of the researcher -randomized controlled trial (gold standard if double blind)(think calcium supplement and incidence of fractures) -these only SUGGEST associations (no cause and effect) -meta analysis: superior to one randomized controlled trial (better than RTC) observational studies: NO action from the researcher -cohort: looks to future (does high blood cholesterol lean to heart disease?) -cross sectional: looks at now(what is happening? why do my two diff subjects have the given outcomes?) -case control: looks at past (think of goiter research)
Explain the health benefits of whole grains and fiber and their food sources.
fiber = whole grains and fresh or dried fruits and vegetables SOLUBLE This is fiber that dissolves in water to become gummy or viscous. They are found in barley, oats, beans, soybean, and fruits - lowers blood cholesterol - regulates the use of sugars by slowing glucose absorption - increases satiety INSOLUBLE This is dietary fiber that does not dissolve in water. It is found in fruits, vegetables, whole grains, beans, potatoes, and brown rice. - It prevents constipation - speeds up bowel movements by increasing fecal weight ("laxative effect")
Identify food sources of high protein quality.
highest to lowest quality - Whole eggs (94) -. Milk (85) -. Beef liver (77) -. Beef round (74) -. Fish (69) -. Whole wheat (67) -. Rolled oats (65) -. Whole corn (60) -. Wheat flour (52) -. Peanuts (47)
Determine the dietary fats that may increase or decrease ones risk for CVD (i.e.- Heart Healthy Diet) and/or mortality
increase -saturated fats -trans fat decrease -monounsaturated fats -polyunsaturated fats
Calculate a goal amount (i.e.- number of pounds) for initial weight loss and a goal weight (pounds) for initial weight loss.
lose 10% of body weight in 6 months, to calculate (body weight x .1o) to get how many lbs to lose, to find goal weight subtract lbs to lose from beginning body weight
Define terms related to digestion/absorption and/or clinical correlates: e.g.- mastication, deglutition bolus, chyme, gastrin, salivary amylase, taste receptor cells, Streptococcus mutans, H. pylori, gastroparesis, pepsinogen, aspiration, dysphagia, etc. .......)
mastication: chewing deglutition: swallowing gustation: tasting chyme: gastrin: salivary amylase: streptococcus mutans: H. plyori: gastroparesis: pepsinogen: aspiration: dysphagia: aguesia: loss of taste (like covid)
Compare types of vegetarianism and discuss the pros/cons of each one related to nutrient requirements/concerns (i.e.-potential nutrient deficiencies).
nutrients of concern for vegetarians: fiber, calcium, vitamin D, vitamin B-12, and protein -semi-vegetarian: excludes red meats (beef, pork); includes eggs, chicken, fish, & dairy -lacto-ovo-vegetarian: excludes any animal flesh; includes eggs & dairy -ovo-vegetarian: excludes dairy products & animal flesh but consumes eggs -lacto-vegetarian: excludes eggs & all animal flesh; includes dairy -vegan: excludes all animal products
What are the 5 basic tastes and associated chemicals
sweet: aldehydes sour: acidic, H+ ions salty: sodium (nacl) bitter: alkaloids, nitrogenous umami: monosodium, glutamate
Compare the nutritional value of whole grains to refined (processed) grains.
whole grain: - bran (fiber, trace minerals, B vitamins) -endosperm (carbs and proteins) -germ (nutrient rich core) refined grain -ONLY has endosperm (carbs and proteins) -if talking about enriched grain, it had to unnaturally put iron and other minerals into it.
Compare type 1 diabetes to type 2 diabetes.
· Type 1: Body doesn't produce insulin (10%) o Typically diagnosed as a child o BMI <25 o Autoimmune attacks beta cells · Type 2: Malfunctioning insulin receptors so cells cannot respond to the presence of insulin (90%) o Insulin Resistance o Fat cells produce cytokines which lead to inflammation that attacks insulin receptors o Typically diagnosed as an adult o Strong genetic link
Explain glucose update by the muscle cell (i.e.- insulin, insulin receptors, GLUT4, etc).
- Amylose enters the intestine (duodenum) through the SGLT1 transporter. It breaks apart into glucose and glucose. - The glucose in your blood stimulates the pancreas to release insulin. - Glucose stimulates the [insulin dependent] glucose transporters (GLUT4) in the skeletal muscles to translocate the insulin receptors to the cell surface. This allows insulin to bind to the insulin receptors in the muscle. - Glucose also travels to the liver and turns into glycogen and produces ATP. Thus, decreasing blood glucose levels.
describe protein digestion/absorption
- Proteins broken into polypeptides squirt into the small intestine as chyme. -CCK stimulates the pancreas to release enzymes (enteropeptidase, trypsinogen and other proteases) into the small intestines. - In the brush borders, the enterokinase enzyme activates trypsinogen into trypsin. - Trypsin activates other protease enzymes. - Polypeptides are broken down into single amino acids and di/tri/tetra-peptides which pass through the amino acid transport. - Peptides are broken down into amino acids in the enterocyte by peptidase. -Amino acids are transported in the blood vessels to tissues.
Identify the risk and benefits of popular diets for weight lost such as low carb diets, intermittent fasting diets, etc.
-Benefits of intermittent fasting include some evidence that it increases longevity and lowers risk of obesity and cancer, risks include becoming nutrient deficient -Benefits of low carb include some weight loss during first 6 months, risks include side effects like headaches and constipation, increased in saturated fat which increases LDL levels
Identify factors that may increase or decrease basal metabolic rate (energy expenditure).
-Increase: Muscle mass, exercise, thyroid hormone -Decrease: Age, Nutritional state, and genetics
Know how exercise is effective for weight loss.
-Increases BMR -Increasing mitochondrial activity -Increase in oxidative capacity
Identify nutrients required for red blood cell synthesis
-Iron and Vitamin B-12 -RBCS use carbs as a source of energy since they don't have a mitochondria
Explain the mechanism of ketogenic diets and weight loss and identify the adverse effects associated with low carbohydrate diets.
-No carbs → no insulin response so we would be unable to store fat -So instead your body just starts breaking down fats and cannot store them so long term you have high blood lipids which increase your LDL cholesterol and increase your risk of heart disease -Keto can cause muscle wasting as amino acids are used to make glucose for Red blood cells. -Results in quick, non-sustainable weight loss --people usually gain the weight back after about 6 months
Discuss the safety and efficacy of fish oil supplements
-Not recommended for the general population --Risk outweigh the benefit -Populations who should take fish oil under MD supervision --Those with high cholesterol --Recent heart attack or stroke
Know the benefits of GMOs
-Pest- Resistance: less damage by insects, virus, and bacteria (corn) -Delayed Ripening: shipped with less damage (tomatoes) -Miniature size: improve eating quality (watermelon) -Cold-Resistance: withstand freezing and thawing- isolated gene from fish (strawberries) -Growth Hormone Added: reaches market weight sooner (salmon) only animal product approved for GMOs -Genetically engineered beef: stem cells from cow can grow 20,000 lbs→ require less cows -no evidence of an increased or decreased risk for cancer
Provide examples of the most effective behavioral therapy strategies for weight loss and maintenance.
-Self-monitoring; the most important strategy in weight loss -Stimulus control; removing stimuli from the environment that can trigger unhealthy behaviors -Goal setting; setting attainable goals -Social support; individuals who reinforce healthy behaviors
Explain how excessive body fat (BMI >25) can increase ones risk of type 2 diabetes
-The more excess weight you have the more you become insulin resistant, which means your body has a harder time being able to convert blood sugar into energy -This means that you will have a higher blood sugar, because you are unable to convert it into energy. -body fat causes insulin resistance because with increased body fat there are increased amounts of inflammation and inflammation is caused by cytokines and macrophages and these things impair the effectiveness of insulin.
Identify the etiology (causes) of type 1 and type 2 diabetes
-Type 1 diabetes is genetics and -type 2 is causes primarity by obesity.
Know the "bottom line" of popular diets
-all diets had a calorie reduction compared to usual diet -weight loss was only effective during the first 6 months due to lack of self- adherence -popular diets are difficult to sustain and evidence is lacking regarding long term effects
Identify reliable and accurate sources (e.g.-websites) for nutrition, health, and disease information.
-always look for .gov or .edu
Relate a specific type of research study that was used to make a guideline, recommendation, or government regulation. (e.g.- cohort study high saturated fat and blood cholesterol associated with heart disease; case-control study → fortification of iodide, etc. )
-case control looked at goiter in people in the military which stemmed from iodide -cohort looked at people who had high and low blood cholesterol to see if it lead to heart disease or not. study proved there was a correlation
Identify the hormones (e.g. - insulin, CCK) and their functions in the digestion or cell metabolism.
-cck - This is a hormone that sends messages to the pancreas (to release enzymes), gallbladder (to release bile), and the brain (to feel full). -insulin - A hormone secreted by the pancreas (B cells) that converts glucose into glycogen in response to elevated blood sugar levels. When released, it lowers blood glucose levels. -glucagon - A hormone secreted by the pancreas (A cells) that promotes the breakdown of glycogen to glucose in the liver when blood glucose is low. When released, it raised blood glucose levels
Define the following terms: emulsification, re-esterification, ester bond, glycosidic bond, peptide bond, hydrolysis, condensation, and complementation.
-emulsification - The breakdown of fats in the duodenum into smaller droplets, which provides a larger surface area on which the enzyme pancreatic lipase can act to digest the s into fatty acids and glycerol. Essentially this process makes them water soluble -Re-esterification - The process of reattaching a fatty acid to glycerol -Ester bond - A condensation bond that makes a triglyceride by attaching fatty acids to a glycerol backbone. -glycosidic bond - A type of covalent bond that joins a carbohydrate (sugar) molecule to another group, which may or may not be another carbohydrate. Its formation involves the loss of a water molecule (condensation/dehydration). its breakdown involves the addition of a water molecule (hydrolysis) -peptide bond - A covalent bond between two amino acids -hydrolysis - when water is added, one molecule gains a hydroxyl group (OH) while the other receives the other H -condensation - forms new linkages and an H2O molecule -complementation - the process of combining proteins from different sources so that they collectively provide the proportions of amino acids required to meet the body's needs (and get all 9 essential amino acids). traditionally combine two vegetable proteins (such as legumes + grains)
Explain how nutrients can help prevent the progression of heart disease.
-inflammation lowered by omega 3's -oxidative stress lowered by Vitamins A, C, and E as well as antioxidants -hypertension lowered by calcium and potassium (raised by sodium so avoid this) -homocysteine turned into methionine via folate and Vitamin B12, methionine is much less harmful than homocysteine -LDL lowered by Soluble fiber as well as plant stanols/sterols -Membrane fluidity increased by MUFA and PUFA -Blood clots lowered by omega 3's
Describe Sources of Food and Nutrition Misinformation
-internet is the highest for nutrition misinformation -some animal studies CANT relate to humans (ex: vitamin c deficiency is fine in animals but NOT humans) -dietary supplements not monitored by FDA - no such thing as natural(people can make it whatever they want) -keto diets arent good because if you are too low on carbs, you have higher risk of death
Identify foods that contain high concentrations of phytochemicals, bioactive substances, and/or nutrients.
-phytochemicals: broccoli, berries, soy nuts, carrots, celery, spinach rainbow of plant foods -bioactive substances: seeds, fruits, veggies, healthy fats and oils, whole grains, legumes -nutrients: non-fat and low-fat dairy, seafood, fruits and veggies, whole grains
Identify simple sugars (mono/disaccharides) and complex carbohydrates (e.g.- amylose, amylopectin, glycogen, fiber).
-simple carbs = monosaccharides (such as glucose, fructose, and galactose) and disaccharides (such as sucrose (G+F), lactose (G+Ga), and maltose(G+G)) -complex carbohydrates = oligosaccharides (such as inulin, fructo-oligosaccharides, and raffinose) and polysaccharides (such as amylose, amylopectin, glycogen, , and cellulose)
Know functions of carbohydrates.
1. Energy (ATP) 2. DNA/RNA synthesis 3. Spares proteins/prevents breakdown of proteins 4. Prevents ketosis 5. Storage form of carbs → glycogen 6. [only if exceeds total kcal per day from excess glucose] Triglyceride synthesis
Know the carbohydrate requirement that is necessary to prevent ketosis and fuel the CNS (brain).
130 g/d to fuel CNS 50 g/d to prevent ketosis
Use a food label (e.g.- kcal; excellent/good/poor source, etc.) to determine whether it would be recommended for certain health conditions.
<5%: poor daily value10-19%: good daily value>20%: excellent daily value-example: if someone has high blood pressure, it would be smart for them to only eat the food item that had 4% of the daily value
Explain how soluble fiber may help lower blood cholesterol levels (hint: enterohepatic circulation)
A. This is fiber that dissolves in water to become gummy or viscous. They are found in barley, oats, beans, soybean, and fruits - lowers blood cholesterol - regulates the use of sugars by slowing glucose absorption - increases satiety B. interferes with the enterohepatic circulation of bile, thereby causing more LDL cholesterol from the blood to be used by the liver. This may lower "bad" cholesterol in the blood. (good thing) C. The liver uses cholesterol to recycle bile. Thus, this decreases the LDL in our blood. However, not all bile is recycled. Soluble fiber will bind to bile so that in the ileum it becomes feces and gets secreted. Thus, soluble fiber lowers your LDL "bad" cholesterol more.
Calculate protein requirements (Given: Wt. or UUN).
Athlete: 1.2-2g per kg body weight General pop: 0.85g per kg body weight (UUN+4) times 6.25 to get amount needed for sick patients
Calculate and interpret BMI (Given: Ht. and Wt.).
BMI = body weight (kg)/ height (m)^2 BMI also = [weight (lb) x 703.1]/ height (in)^2
Explain the rationale and guidelines of caloric restriction, exercise, and behavior modification for weight loss therapy.
Calorie Restriction -at least 1000 calories otherwise BMR will decrease -10% over 6 months to maintain weight loss and not relapse -45-65% carbs, 10-35% protein, and 20-35% fat, adequate carbs to protect proteins, proteins needed for synthesis, and some fat needed to induce satiety and keep person from overeating Exercise guidelines and rationale -150-299 minutes per week to maintain weight and reap health benefits -300 plus minutes per week to loss and keep weight off as well as reap health benefits -muscle training should be done at least twice a week -all of these help increase mitochondrial activity and creation, increase insulin sensitivity, and increase GLUT transporters Behavior guidelines -self monitoring, positively related to weight loss -low calorie, low fat (but enough fat to induce satiety), calorie deficit is ultimately how one loses weight -eat breakfast daily, helps prevent overeating later -regular physical activity, helps override the body lower in ing the BMR