nutrition and physical activity exam 2

Entire process of blood glucose regulation

After eating: •Pancreas releases insulin •Insulin does 2 things: •1) Tells cells to take up blood glucose •2) Tells liver to store glucose as glycogen When fasting: •Pancreas releases glucagon •Glucagon does 2 things: •1) Stimulates amino acids to be converted into glucose •2) Tells liver to breakdown glycogen into glucose (and put it back into the bloodstream)

Chylomicrons

CHYLOMICRONS •A protein wrapping up a fat globule which enhances absorption •These guys get absorbed via the lymphatic system and then get released into the blood •Chylomicrons allow necessary fat to circulate through the body

Glycemic index

Glycemic index (GI) •Ratio of blood glucose response to a given food •High GI foods cause the pancreas to deliver more insulin •High GI food raises blood glucose more than medium or low GI •Measures the quality/type •Glycemic load (GL) •Measure of both the quality (GI value) and quantity of a carbohydrate in a meal

Obesity nature v nurture

Nature §Identical twins §Similar weights even if raised apart §Genes §Affect metabolic rate, fuel use, brain chemistry, and body weight. §Thrifty metabolism gene §More fat stored to protect against famine Nurture Environmental factors influence weight Eating habits & physical activity are learned Poverty linked to obesity Parents influence what we eat & how much

Energy intake v. expenditure

Need to consume at least enough calories to maintain resting metabolic rate, or the energy required to maintain vital body functions §Energy balance: Energy Input = Energy Output §Energy intake, in the form of food and beverages, matches the energy expended, primarily through basal metabolism and physical activity §Positive energy balance: Energy intake is greater than energy expended §Result: weight gain §Negative energy balance: Energy intake is less than energy expended §Result: weight loss §1 lb. weight loss = approximately 3,500 kcal §Thus, a deficit of 500 calories per day would result in a 1 lb weight loss over 1 week/7 days

Disorders associated with protein deficiency

Phenylketonuria (PKU) •Genetic disease in which tyrosine (non-essential) becomes conditionally essential •Limited ability to metabolize the phenylalanine (essential) to tyrosine (nonessential) •Enzyme used in converting phenylalanine to tyrosine is insufficient •Tyrosine becomes essential (must be obtained from the diet) •Phenylalanine builds up to toxic levels in the blood •Disrupts brain function, leading to mental impairment •Treatment: avoid phenylalanine and consume tyrosine (so basically the opposite of Keto/Paleo diet)

Polysaccharides

Polysaccharides: 10-1000 glucose units Starch: storage form of carbs in plants Glycogen: storage form of carbs in humans Fiber: cannot be digested by humans (thus passes right through the body)

protein turnover

the continuous breakdown and synthesis of body proteins involving the recycling of amino acids

Fat distribution

§Body fat stored primarily in the upper body (android) brings higher risks of obesity-related diseases than lower-body (gynoid) obesity §Android means male & gynoid means female, but these can be interchangeable (e.g. a women can have android obesity) §Android obesity §Associated with insulin resistance & fatty liver, cancer, CVD, diabetes §Encouraged by testosterone & alcohol intake §Gynoid obesity §Encouraged by estrogen/progesterone §Important for reproduction, carries much lower disease risk §Definition: §Waist circumference >40″ for men §Waist circumference >35″ for women

Direct & indirect calorimetry

§Direct calorimetry: person spends 24 hours in an insulated chamber §Measures body heat output §Water surrounds chamber and measures energy loss §Expensive and complex §Indirect calorimetry: measures oxygen intake & carbon dioxide output §Carbon dioxide output predicts energy expended §More common §E.g. a 'Body Gem' as pictured §Also determines what kind calories are used (carbs, fats, etc.)

Lean body mass

§Lean body mass (LBM) •most significant contributor to basal metabolic rate §Persons of the same body weight can have different amounts of LBM and body fat and, therefore, have varying energy needs §Bottom line: weight training is key to keeping your metabolism high

Assessing body composition

§Medical experts use body fat % more than body weight §Acceptable amount of body fat: §Women 23%-31% Men 13%-21% §Obesity based on body fat: §Women over 35% Men over 25%

Omega 3 & Omega 6 fatty acids

•"Essential" because your body doesn't produce it naturally and it is essential to bodily functions •Linoleic acid (an omega-6 fatty acid): found in chicken (leading source), corn oil, sunflower oil •Alpha-linolenic acid (an omega-3 fatty acid): found in flax seeds, walnuts, chia seeds, canola oil, soybean oil, avocado, whole wheat bread, oatmeal •Other fatty acids and regulatory compounds (such as DHA) can be made after you consume these two essential fatty acids •Bodily functions: make hormones, regulate immune response, support vision & nervous system fetal development,& lower inflammation in the body

What happens if We don't eat Carbs?

•1) The liver releases glycogen to raise blood sugar (but this can only last for 18 hours) •2) If no food or no carbohydrates are consumed, the body starts breaking down protein and fat for energy •Thus, the Dietary Guidelines suggest we consume 45-65% of our calories from carbs. •RDA is 130 grams per day for adults. • •Conversely, what is the purpose of a marathon runner 'carb loading' prior to a race?

Essential & non-essential amino acids (food sources of both)

•20 different amino acids make up all proteins (these contain nitrogen) •9 essential amino acids: we have to get these from our diet (think: it is 'essential' that I eat foods with 'essential aminos') •3 of these are branch-chain amino acids (branching carbon backbone) •Leucine, isoleucine, and valine •High amount in whey protein from milk •May enhance performance for weight training •11 nonessential amino acids •After you eat the essential ones, your body uses enzymes to make non-essential ones

Types of diabetes

•3 Types: Type 1, Type 2, Gestational (during pregnancy) •Blood sugar above 125 ml per deciliter •Symptoms: extreme thirst, frequent urination, weight loss, sugar in urine, brain or vision changes •Type 1 •5-10% of all cases of diabetes are this type •usually diagnosed in childhood (age 10-14), but could occur in adulthood (in those cases it is usually due to an infection and/or immune response which damages the pancreas' ability to produce insulin) •Beta cells of the pancreas makes little to no insulin •Treatment: insulin & diet therapy

& Disaccharides

•Also known as simple sugars •Sucrose (Glucose + Fructose): found in sugarcane, sugar beets, honey, maple syrup, table sugar • •Lactose (Galactose + Glucose): found in milk products • •Maltose (Glucose + Glucose): found in alcohol & malted beverages; also you get maltose when the body is breaking down thousands of glucose units •When you digest starch, maltose is a product •Even if we have two sugar units bound together, we cannot absorb that. It needs to be broken down all the way to monosaccharides.

Nutritive & artificial sweeteners

•Americans consume avg of 20 tsp of added sugars per day (recommendation is 6-9 tsp per day) •HFCS (High Fructose Corn Syrup) •Cheaper & sweeter than sugar; makes food more shelf-stable •No different than sugar regarding endocrine & metabolic processing (both contribute to obesity) •Brown sugar, raw (less refined), agave nectar, maple syrup, honey •Agave nectar: slightly more calories than sugar, but doesn't spike the blood glucose as quickly as sugar b/c it has a low amt of glucose & a high amt of fructose •Sugar alcohols (sorbitol & xylitol) and artificial sweeteners •Mouth bacteria cannot break it down (thus doesn't give you cavities) •Only 2.6 kcal per gram, so doesn't raise the blood sugar much •May cause gas/bloating/diarrhea

Protein turnover

•Amino acids in cells are used to form body proteins such as muscle, antibodies, hormones •During a 24-hour period, an adult turns over about 250 grams of protein, but is very efficient in that the body recycles many of the amino acids •Typical protein consumption from food: 65-100 grams •If protein intake is low for long period: •Rebuilding and repairing body proteins will slow down •Muscles, blood proteins, and vital organs will lose protein and decrease in size or volume

Aspartame (Nutrasweet)

•Aspartame (Equalâ, NutraSweetâ) •Composed of phenylalanine, aspartic acid, and methanol. •180 to 200 times sweeter than sucrose. •Complaints of sensitivity include headaches, dizziness, seizures, nausea, and so on. •Warning label for phenylketonuria (PKU) •*PKU: metabolic condition where a person can't breakdown amino acids

Glycogen: storage

•Carbs exist in 2 forms in the body: 1) Blood Glucose, 2) Glycogen •Glycogen: a carbohydrate made of multiple glucose molecules •Storage form of glucose in humans •Synthesized (and stored) in the liver and muscles (we need glycogen to complete our Cross Fit workouts); INTENSE exercise depletes these stores quickly

Other 'jobs' of lipids

•Cholesterol: building block for bile •Help absorb fat soluble vitamins (A, D, E, & K)- you don't need a whole lot of fat, but some is important for these vitamins to get absorbed •The human brain is made of 60% lipids (fat) •Phospholipids & cholesterol: make up the of myelin sheath surrounding nerve cells • Phospholipids: form the lipid bilayer in cells with hydrophilic heads & hydrophobic tales so that material can pass through the water both inside and outside the cell

Complementary dietary proteins

•Complementary Protein: when we combine 2 or more incomplete proteins to make a complete protein with all 9 essential amino acids Examples: Beans (low in essential amino acid, methionine) & Rice (high in methionine •Key point: you can eat complementary proteins throughout the day (no need to consume them in the same meal)

complex carbohydrates

•Complex carbohydrates: polysaccharide (contain 10-1000 glucose units) •Called 'complex' because they are 'complex' for the body to break down (so you feel 'fuller' for longer) •Two key complex carbohydrates are: •1) starches (digestible) •2) fiber (not digestible) Firework vs. candle analogy

conditionally essential amino acids

•Conditionally essential amino acids: during growth, after surgery, during some illnesses, some nonessential amino acids can become essential for a brief period because the body can't make enough to meet demand • •Arginine (ARR-ja-NEEN): some consider this semi-essential because this one is made by the body normally, but sometimes it can become essential in periods of rapid growth (the body can't make enough to keep up with the demands, so we must get this from food) •

Types of peptide bonds

•Dipeptides: 2 groups; Tripetides: 3 groups; Oligopeptides: 4-9 groups; Polypeptides: 10 or more groups •Most proteins are polypeptides: 50 to 2,000 groups of amino acids

Fat cell properties

•Don't dissolve in water •Yield 9 kcal per gram (energy dense) •Fats (solid at room temp) and oils (liquid) • •Generic term that includes: •Triglycerides •Phospholipids •Sterols

And of course.... Fat stores energy for later

•Energy stored mainly in form of triglycerides (energy dense) •Fat: yields 9 kcal per gram •Ability to store fat is essentially limitless Adipose cells •can increase about 50 times in weight! •contain about 80% lipid and only 20% water and protein •if amount of fat to be stored exceeds ability of existing cells to expand, the body forms new adipose cells

Characteristics & benefits of grains

Barley Highest in fiber; very slow cooking. Barley fiber may lower cholesterol even more effectively than oat fiber. Look for whole barley, hulled barley, or hull-less barley. Buckwheat High levels of the antioxidant rutin and a high level of protein; gluten-free. Rutin improves circulation and prevents LDL cholesterol from blocking blood vessels. Corn Known for its sweet flavor; gluten-free. Highest level of antioxidants of any grain or vegetable. Avoid labels that say "degerminated" and look for the words whole corn. Oats High in protein. Oat fiber is especially effective in lowering cholesterol. Steel-cut oats contain the entire oat kernel. Quinoa Rich in high-quality protein; gluten-free. Quinoa contains complete protein, with all the essential amino acids. Rice Many whole-grain varieties, including brown, black, purple, or red. Brown rice is lower in fiber than most other whole grains but rich in nutrients. White rice is refined; gluten-free. One of the most easily digested grains; ideal for those on a restricted diet or those who are gluten intolerant. Brown rice, and most other colored rice, is always whole grain. Rye Very high level of fiber. Rye promotes a rapid feeling of fullness. Look for whole rye or rye berries in the ingredient list. Wheat Contains large amounts of gluten, a stretchy protein that enables bakers to create risen breads. Look for the term whole wheat.

Metabolic rate & factors that impact BMR

Basal Metabolic Rate (BMR): minimal calories body uses to maintain life when fasting Resting Metabolic Rate (RMR): " " NOT fasting (this figure is slightly higher than BMR)

Forms of energy output

Basal Metabolism: energy you are spending to maintain life 4 general forms: 1) Basal Metabolism: uses the most calories in the body (60-80% of your energy output!) 2) Physical Activity (15-30% of energy) •Exercise-induced thermogenesis (EAT): energy burned during intentional exercise (15-30%) •Nonexercise activity thermogenesis (NEAT): three main components: body posture, ambulation, and other spontaneous movements such as fidgeting 3) Thermic Effect of Food (TEF): how much energy it takes to digest/absorb/process food (8-15%) •A 'tax' on food •Lean protein (chicken/egg whites) have highest TEF due to it being difficult to break down amino acids 4) Adaptive Thermogenesis: production of heat in response to changes in dietary patterns or environmental temperature (Very minor energy output)

Protein quality

Protein quality: measure of how many essential amino acids a food source contains •High-quality (complete) proteins: contain ample amounts of all nine essential amino acids & are easier to digest than plant protein (e.g. animal sources) •Lower quality (incomplete) proteins: low in or lack one or more essential amino acids (e.g. plant sources) Two exceptions: quinoa & soybeans

Function of amino acids in the body

Repackaged amino acids used in the body for: •Keratin (hair/skin/nail protein) •Collagen (structural protein in ligaments) •Enzymes (these are all made of proteins!) •Hormones (insulin, etc.) •Makes up a key part of blood (hemoglobin) •Antibodies •Energy: this is NOT the body's preferred fuel source •

Dietary fat absorption & transport

Small intestine: where majority of fat digestion/absorption happens Pancreatic lipase: main digestive enzyme for fat Carrying Lipids in the Bloodstream •Most dietary fats are absorbed into the lymphatic system, which eventually empties into the bloodstream •Water and oil (fat) do not mix easily, and blood is mostly water •We need to uniquely package these fats as lipoproteins so they can be transported around the body •Lipoprotein: •Core: lipids (i.e. fat) •Shell: protein, phospholipids & cholesterol There are 4 major lipoproteins, but the star of the show?

Vegan & vegetarian diets

Vegetarian Diet •Rationale: ethics, religion, economics, and health, environment •Positives: •limits saturated fat & cholesterol intake •encourages high intake of complex carb, magnesium, fibers, Vitamins A, E, & C •Decreases risk of CVD, colon cancer, obesity Lowers BMI (typically)

BMI

body mass index §BMI: uses weight/height/sex §Doesn't recognize elite athletes (muscle weighs more than fat) §Doesn't take into account frame size (wrist circumference) § Underweight Severe thinness Moderate thinness Mild thinness <18.50 <16.00 16.00 - 16.99 17.00 - 18.49 Normal 18.50 - 24.99 Overweight Pre-obese ≥25.00 25.00 - 29.99 Obese Obese class I Obese class II Obese class III ≥30.00 30.00 - 34.99 35.00 - 39.99 ≥40.00

Types of lipoproteins

chylomicrons, VLDL, LDL, HDL Lipoprotein Primary Component Key Roles Chylomicron Triglyceride (comes from fat in food) Carries dietary fat from the small intestine to cells VLDL (very low density) Triglyceride (made by liver) Carries lipids AWAY from the liver LDL (low density) Cholesterol (made mostly by liver) Carries lipids AWAY from the liver HDL (high density) Protein (made by liver) Returns lipids TO the liver (which is where the liver can remove them from the body) •Lipoprotein: •Core: lipids (i.e. fat) •Shell: protein, phospholipids & cholesterol There are 4 major lipoproteins, but the star of the show?

Fat isn't all Bad!

•Fat promotes satiety (feeling of fullness) by slowing digestion •Consuming monounsaturated fat (such as olive oil) while eating a salad will allow your body to better absorb the vitamins & minerals •Full-fat foods can be more satisfying, and thus an individual may consume less overall calories (e.g. excellent chocolate/cheese) •Fat carries flavors & improves the texture of food •Some companies try to make foods have 'less fat' but they then add back more sugar/sodium (it is difficult to remove fat and sugar) •Artificial or 'engineered fat' like Olean® (olestra) can cause major digestion/absorption issues

Kinds of fatty acids

•Fatty acids: long chain of carbons bonded together •Saturated fatty acids (stearic acid): •Solid at room temp •Generally from animals (e.g. butter) •'Saturated' because the structure has the max number of hydrogen bonds & is saturated •Unsaturated fatty acids: •Liquid at room temp •Generally from plants (e.g. sunflower oil) •'Unsaturated' because there is at least 1 double carbon bond (so not fully 'saturated' with hydrogen) on the carbon chain •Monounsaturated: fatty acid with only 1 double bond on the carbon chain Polyunsaturated: fatty acid with 2 or more double bonds

Phospholipids

•Glycerol + 2 fatty acids + phosphorus-containing compound •Similar to triglycerides (same glycerol backbone), but 2 fatty acids instead of 3 • •Biggest job: they make cell membranes Soluble in water & fat

Cardiovascular Disease (CVD)

•High LDL (from genes & diet/smoking/high blood sugar) àplaque in blood vesselsà atherosclerosis (narrowing of blood vessels)à •Myocardial infarction (heart attack): death of part of heart muscle •Cerebrovascular accident (stroke): death of part of brain tissue, typically due to a blood clot •Leading cause of death in North America •610,000 people die each year from CVD •735 people have heart attacks in the US (25% of people don't survive their 1st heart attack) •Women typically lag behind men 10 years in developing CVD

Polysaccharide: glycogen

•Highly branched polysaccharide (thus more sites for enzyme action) •Made by any animal that has muscle & a liver, including us •When we eat a meal that has carbs and it's more than we need for energy at the moment, we store the excess in our liver & muscles •Energy stored as glycogen: about 1,800 kcal •Liver: about 400 kcal for blood glucose •Muscles: about 1,400 kcal for muscle use •Even though animal cells make glycogen, by the time you get to eat a piece of chicken there's no more glycogen left because it breaks down right after the animal is killed. That's why protein foods are not a source of carbs.

Types of lactose maldigestion

•Issues with dairy are due to the body not making enough lactase (the enzyme that breaks down lactose) •Primary lactose maldigestion: Lactase reduction due to genetics (appears early) •Secondary lactose maldigestion: Reduction due to specific cause for a short time period, diarrhea •Severe cases are called lactose intolerance (East Asian, West African, Jewish & Greek people most likely to have insufficient lactase) •Soy milk/yogurt is considered 'dairy' but not almond/rice milk (because soy milk is most like dairy milk)

foods dont have HDL and LDL

•Key point: only after the body processes a food can you measure LDL/HDL •Diet has a small influence on cholesterol (but not as big as most people think) •80-85% of your cholesterol comes from the liver (genetics), only 20% from your food •Saturated fat in the diet has been shown to raise LDL •The body typically does a good job of regulating these lipoproteins; if you eat a high fat meal, the liver will produce more HDL to compensate Men tend to have lower HDL # than women

Lecithin

•Lecithin: used as an emulsifier to keep lipid and water mixtures, like salad dressing, from separating • •Lecithin in egg yolks is what allows oil & water to mix together when making a cake

Monosaccharides

•Most common monosaccharides in food: •1) Glucose: the MAJOR monosaccharide in body (glucose in the blood is blood sugar) •2) Fructose (fruit sugar): found in fruit, honey & high-fructose corn syrup (HFCS) •Converted into glucose in the liver *Excess fructose may form fat •3) Galactose: usually found bonded to glucose in lactose (milk sugar) •Converted to glucose in the liver •Made from glucose in the mammary gland during milk production- which is why a nursing mama doesn't have to drink milk to produce milk/lactose!

Sterols

•Multi-ringed structure •Cholesterol: a type of sterol found only in foods of animal origin •The liver makes all the cholesterol you need •Usually if you consume some cholesterol, your liver will produce less (a natural balance) •Phytosterols (plant sterol): a sterol found in foods from plants •Ironically, they actually lower blood cholesterol (they compete with bad cholesterol (LDL) in small intestine absorption) •Food sources: seeds, beans, nuts, peas, lentils

OMEGA 3 fatty acid intake

•Omega-3 fatty acids in seafood (EPA and DHA) help to: •Regulate body processes •Promote heart & brain health •Reduce the inflammation •Excessive omega-3 fatty acid intake •Can cause bleeding and hemorrhagic stroke (brain bleed) •General recommendation: consume seafood 1- 2 x per week •Plant sources of Omega 3: walnuts, flaxseed, chia seeds

structure liver

•Once digested, the glucose moves from the gastrointestinal tract to the liver via the hepatic portal vein. Then: •Option 1: releases glucose into bloodstream for transport to brain, muscles, kidneys, and adipose tissues {ship it out} •Option 2: produces glycogen for storage of carbohydrate {store it as glycogen} •Option 3: produces fat when carbohydrates are consumed in high amounts and overall calorie needs are exceeded {store it as fat}

forming proteins

•Peptides link amino acid chains together to form proteins •When you see peptide, think 'protein linkage' •Dipeptides: 2 groups; Tripetides: 3 groups; Oligopeptides: 4-9 groups; Polypeptides: 10 or more groups •Most proteins are polypeptides: 50 to 2,000 groups of amino acids Think of Amino Acids like the building blocks of protein

Prediabetes

•Prediabetes or 'impaired fasting:' diagnosed if blood glucose is 100-125 ml per deciliter or HbA1c is 5.7% to 6.4% •No 'cure' for diabetes but you can help prevent this by eating better quality carbs, exercising, & maintaining a healthy weight

Nutritional genomics

•Primary function of our genes= produce proteins •Nutrition can both affect and be affected by an individual's genetic makeup •Nutritional genomics: interactions between nutrition and genetics •Nutrigenetics: how your genes affect how your body responds to certain nutrients (e.g. some people genetically have a higher requirement for folate due to genetic variations) {how genes influence how our body handles food} •Nutrigenomics: how nutrients/minerals/phytochemicals may influence gene expression (e.g. some foods can influence the type of proteins that you make) {how food influences our genes}

Function of fat in the body

•Provides energy •About 1/2 the energy used by the body at rest and during light activity comes from fatty acids •Remainder derived mostly from carbohydrates • •Structural components of each cell •Insulates body & protects organs •Regulate cellular processes •Sophisticated endocrine organ! •Makes leptin (hormone which tells you that you are full) Makes estrogen

DIAAS

•Scientific rating system for assessing the quality of protein (announced in 2013 by the UN Food & Ag Organization) •Determines amino acid digestibility in small intestine & measures the amounts of amino acids absorbed by body •Differentiates protein sources by ability to supply amino acids for body use •Examples: beans & rice are 60 individually, but 80 when combined •Excellent sources have a DIASS of 75+

Simple carbohydrates

•Simple carbohydrate: sugar •Called 'simple' because they are 'simple' for the body to break down for quick energy •Two key simple carbohydrates are: •1) monosaccharide=1 sugar unit •2) disaccharide=2 monosaccharides (sugar units joined together)

Types of fiber

•Soluble or viscous fiber: dissolves or absorbs water •Forms a gooey gel in the GI tract which slows down absorption of carbs in your food- this prevents sugar 'crashes' •Binds to cholesterol and prevents it from being absorbed well (hence why high fiber foods can lower cholesterol) •Makes you feel 'full' so you don't over eat J •Insoluble or nonfermentable fiber: does not dissolve in water nor easily metabolized by intestinal bacteria •This moves like a freight train through the GI tract, never breaking down (this forms most of feces) •There is a combo of soluble & insoluble fiber in any type of fiber food you eat; fiber doesn't provide energy

splenda and stevia (truvia)

•Splenda •600 times sweeter than sucrose •Stevia (Truvia) •200-400 times sweeter than sucrose •Provides no energy

Starch

•Starch: made by plants; 3,000 or more monosaccharides •Amylose •long, straight-chain •20% of starch in vegetables, beans, breads, pasta, and rice •Amylopectin •Highly branched chain •80% of starch in foods •The body easily breaks these two down using the enzyme, amylase •Root vegetables such as potatoes, yams, and tapioca are high in amylopectin starch

Protein as an Actual Energy Source

•The body prefers to use carbs & fats for energy because the process of breaking those down is SO much easier than protein •Without enough carbs, the liver produces glucose from amino acids •In starvation, amino acids from muscle are converted to glucose •When completing a very difficult workout, the body also tends to break down amino acids to use for energy •So, yes, protein (amino acids) can be broken down to yield ATP (energy), but the body prefers to use carbs/fats • •KEY POINT: If you eat TOO much protein, your body can store this as fat (it isn't like diamonds- the more, the better)

Structure of triglycerides

•Triglycerides: 3 fatty acids bonded to a glycerol 'backbone' •Most common form of fat in our food & in our bodies

type 2

•Usually begins after age 30 (90%-95% of diabetic cases are type 2) •Insulin receptors on cell surfaces (i.e. muscle/fat) become insulin resistant •The pancreas produces insulin, but the cells ignore it. That then makes the pancreas overcompensate and produce MORE insulin, which results in the beta cells of the pancreas losing the ability to produce insulin. •Associated with obesity (especially with abdominal & upper body fat) •Risk factors: ethnicity, age, obesity, family history •Treatment: weight loss, oral meds, insulin, diet therapy

vegan n more

•Vegan: ONLY plant foods •Requires complementary proteins •Natural childbirth analogy •Nursing babies & children need calcium, B-12, etc. (if lactating mom is a vegan, this could bring on developmental delays for baby) •Possible nutrient deficiencies: •Vitamin B-12 •Iron •Vitamin D •Zinc •Calcium •Omega-3 fatty acids •Fruitarian: fruits, nuts, honey, and vegetable oils •Lactovegetarians: plant and dairy products •Lacto-ovovegetarians: plant products, dairy, eggs •Flexitarian: semi-vegetarian