Summer 2013 Midterm Review
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Summer 2013 Midterm Review Presentation Transcript

  • 1. Nutrition HO-15 Midterm Review We’ll begin the review at 9:00 AM
  • 2. Midterm • a mix of multiple choice, true false and matching. 57 questions • is worth 15% of your total grade 150 points • everyone takes a different exam. draws from a pool • you will have 100 minutes to take the exam is timed will be available for one week can only be accessed and submitted ONCE.
  • 3. Nutrients Water Carbohydrates Fat Protein Vitamins Minerals
  • 4. Nutrients - Organic Water Carbohydrates Fat Protein Vitamins Minerals
  • 5. Nutrients – Energy Yielding Water Carbohydrates - 4 calories/g Fat – 9 calories/g Protein - 4 calories/g Vitamins Minerals
  • 6. Nutrients – Energy Yielding
  • 7. Nutrients • Nutrients - Energy Yielding Muffin 280 calories (45 g) • 15 g CHO 15X4 = 60 calories • 20 g fat 20X9 = 180 calories • 10 g protein 10X4 = 40 calories 280 calories
  • 8. Recognizing a healthy diet Adequacy - getting enough Balance - proportionality Moderation - nothing in excess Variety - wide selection Calorie Control - not too much or too little
  • 9. Research Case Study Laboratory Double blinded study Placebo controlled Interventional Epidemiologic
  • 10. Research – Gold Standard Randomized Double Blinded Placebo Controlled interventional Trial
  • 11. Research Designs A 55 year old female is given a supplement of Vitamin E and is observed over 3 month to evaluate the effects on her heart health? What type of study is this?
  • 12. Research Designs A 55 year old female is given a supplement of Vitamin E and is observed over 3 month to evaluate the effects on her heart health? What type of study is this? Case Study
  • 13. Research Designs 200,000 individuals had their LDL, HDL and cholesterol measured at baseline and again at 10 years. Diets were evaluated with a food frequency questionnaire. The number of heart attacks was the primary end point. At 10 years, correlations were made between diet, cholesterol and heart attacks. What type of study is this?
  • 14. Research Designs 200,000 individuals had their LDL, HDL and cholesterol measured at baseline and again at 10 years. Diets were evaluated with a food frequency questionnaire. The number of heart attacks was the primary end point. At 10 years, correlations were made between diet, cholesterol and heart attacks. What type of study is this? Epidemiologic
  • 15. Nutrient Density Muffin # 1 Muffin #2 280 calories 20 g fat (15 g saturated fat) 10 g sugar Less than 2% daily value: Fe, Ca, Vit. A & C 200 calories 15 g fat (2 g saturated fat) 4 g sugar (10 g whole grain CHO) 10-15% daily value: Fe, Ca Vit. A & C
  • 16. Macronutrients Percent of Total Calories Carbohydrates 45-65% Fat 20-35% Protein 10-35% (10-15%)
  • 17. Macronutrients Example: Carbohydrates 45% Fat 30% Protein 25% TOTAL 100%
  • 18. Phytochemicals Biologically active substance in plants Non-nutrient May protect against chronic disease • Example: Soy, chocolate, flaxseed, tomatoes, garlic, wi ne, tea Anti-oxidants
  • 19. Importance of Exercise
  • 20. ACSM Guidelines • Or Do moderately intense cardio 30 minutes a day, 5 X week • And Do vigorously intense cardio 20 minutes a day, 3 X week 8 -10 strength-training exercises 8 - 12 repetitions of each exercise 2/week.
  • 21. Benefits of Exercise more restful sleep improved bone density lower risks of chronic disease higher quality of life
  • 22. Mouth Stomach Liver Gallbladder Pancreas Small Intestine Colon
  • 23. Mouth - chews, mixes food with saliva Stomach - Liver - Gallbladder - Pancreas - Small Intestine- Colon -
  • 24. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - Gallbladder - Pancreas - Small Intestine- Colon -
  • 25. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - makes bile Gallbladder - Pancreas - Small Intestine- Colon -
  • 26. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - makes bile Gallbladder - stores bile Pancreas - Small Intestine- Colon -
  • 27. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - makes bile Gallbladder - stores bile Pancreas - secretes digestive enzymes Small Intestine- Colon
  • 28. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - makes bile Gallbladder - stores bile Pancreas - secretes digestive enzymes Small Intestine- enzymes break down fat, protein, CHO & absorbed Colon -
  • 29. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - makes bile Gallbladder - stores bile Pancreas - secretes digestive enzymes, secretes insulin & glucagon Small Intestine- enzymes break down fat, protein, CHO & absorbed Colon - fluid and minerals absorption & some fiber fragments absorbed
  • 30. Storage Organs – when we eat too much CHO Where? Where? Fat Where? Protein Where?
  • 31. Storage Organs – when we eat too much CHO Glycogen Fat Fat Where? Protein Where?
  • 32. Storage Organs – when we eat too much CHO Glycogen Fat Fat Fat Protein Where?
  • 33. Storage Organs – when we eat too much CHO Glycogen Fat Fat Fat Protein Fat N o t
  • 34. Carbohydrates • Simple or Complex?
  • 35. Carbohydrates • Simple or Complex? Simple!
  • 36. Simple Carbohydrates Monosaccharides Disaccharides
  • 37. Complex Carbohydrates fiber glycogen Starch Fiber Glycogen
  • 38. Fiber
  • 39. Which part of the wheat kernel Has fiber?
  • 40. Which part of the wheat kernel has fiber? Bran Which part of the wheat kernel has starch?
  • 41. Which part of the wheat kernel has fiber? Bran Which part of the wheat kernel has starch? Endosperm Which part of the wheat kernel has nutrients & protein?
  • 42. Which part of the wheat kernel has fiber? Bran Which part of the wheat kernel has starch? Endosperm Which part of the wheat kernel has nutrients & protein? Germ Which part of the wheat kernel is not edible?
  • 43. Which part of the wheat kernel has fiber? Bran Which part of the wheat kernel has starch? Endosperm Which part of the wheat kernel has nutrients & protein? Germ Which part of the wheat kernel is not edible? Husk
  • 44. List the appropriate sequence of events which happen after you eat a plain white bagel: I. Starch starts to breakdown into maltose in the mouth II. Maltose breaks down into glucose in the small intestines III. Glucose is absorbed from the small intestines into the bloodstream IV. The pancreas secretes insulin in response to high blood glucose V. Insulin transports glucose from the bloodstream into cells VI. Blood glucose decreases
  • 45. Diabetes (Type I & II) Onset? • Type 1 • Type 2
  • 46. Diabetes (Type I & II) Onset? • Type 1-typically childhood • Type 2-typically adulthood
  • 47. Diabetes (Type I & II) Cause? • Type 1 • Type 2
  • 48. Diabetes (Type I & II) Cause? • Type 1 - autoimmune disease • insulin secreting cells impaired • Type 2 - acquired • insulin resistance, obesity, genetics, diet
  • 49. Diabetes (Type I & II) Insulin Secretion? • Type 1 • Type 2
  • 50. Diabetes (Type I & II) Insulin Secretion? • Type 1 - no natural insulin • Type 2 - enough or too much insulin
  • 51. Lipids P LIPIDS Triglycerides (TG) ≈95% of all lipids in foods and the human body Phospholipids For example, lecithin Sterols For example, cholesterol
  • 52. Fats
  • 53. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat
  • 54. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat 25 g X 9 calories/g = 225 calories
  • 55. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat 25 g X 9 calories/g = 225 sf calories 225 sf calories / 500 calories = .45 = 45%
  • 56. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat 25 g X 9 calories/g = 225 calories 225 calories / 500 calories = .45 = 45% 45% of the calories in the burger are from saturated fat
  • 57. LDL and HDL What is LDL? What is HDL?
  • 58. LDL and HDL What is LDL? • Low density lipoprotein What is HDL? • High density lipoprotein NOT ACTUALLY CHOLESTEROL
  • 59. LDL and HDL What is LDL? • Low density lipoprotein • Transports cholesterol to tissues • “bad” cholesterol What is HDL? • High density lipoprotein • Scavenges cholesterol • “good” cholesterol
  • 60. LDL and HDL How do you lower LDL? How do you increase HDL?
  • 61. LDL and HDL • Lower your intake of saturated fat and trans fat How do you lower LDL? • Exercise How do you increase HDL?
  • 62. Trans Fats
  • 63. Essential Fatty Acids EFAs are which type of fatty acid? Saturated fatty acid? Monounsaturated fatty acid? Polyunsaturated fatty acid?
  • 64. Essential Fatty Acids EFAs are which type of fatty acid? Saturated fatty acid? Monounsaturated fatty acid? Polyunsaturated fatty acid
  • 65. Structure of Proteins Peptide Bond
  • 66. Structure of Proteins
  • 67. Roles of Proteins Enzymes Structural Hormones Precursors (neurotransmitters/vitamins) Antibodies Fluid Balance Buffers Blood Clotting Provide Energy
  • 68. Protein digestibility Which types of proteins are best absorbed by the body?
  • 69. Protein digestibility Which types of proteins are best absorbed by the body? • Animal sources: ≈ 90+% • Legumes: ≈ 80%-90% • Grains: ≈ 70%-90% • Moist heat increases digestibility • Dry heat decreases digestibility Digestion and absorption
  • 70. Complementary Proteins Amino acids from one protein source complement the amino acids from another protein source to form a complete protein.
  • 71. Wasting • When the amine group has been removed, it means the amino acid has been wasted
  • 72. Protein Energy Malnutrition
  • 73. Protein Energy Malnutrition Marasmus Chronic protein and energy deficiency Severe wasting Matchstick arms
  • 74. Protein Energy Malnutrition
  • 75. Protein Energy Malnutrition Kwashiorkor Protein malnutrition Acute onset (1-3 yr) Edema (legs/belly) Fatty liver
  • 76. DRI Protein • DRI protein: example – 130 lb sedentary 35 yr female – 130 lb X 1kg/2.2 lb = 59 kg
  • 77. DRI Protein • DRI protein: example – 130 lb sedentary 35 yr female – 130 lb X 1kg/2.2 lb = 59 kg – 59kg X 0.8g/kg = 47g protein/day
  • 78. DRI Protein • DRI protein: example – 130 lb sedentary 35 yr female – 130 lb X 1kg/2.2 lb = 59 kg – 59kg X 0.8g/kg = 47g protein/day – 47g X 4 cal/g = 188 calories – 188 cal/1800 calories = 10 % total calories
  • 79. DRI Protein • DRI protein: example – 130 lb sedentary 35 yr female – 130 lb X 1kg/2.2 lb = 59 kg – 59kg X 0.8g/kg = 47g protein/day – 47g X 4 cal/g = 188 calories – 188 cal/1800 calories = 10 % total calories – 10-15% of total calories from protein-most Americans – 10-35% of total calories
  • 80. Vitamins • Dissolve in water • Easily absorbed and transported • Not stored in significant quantities • Rarely toxic from food sources Water Soluble – Vitamin C & B • Do not dissolve in water • Need fat to be absorbed • Stored extensively • Can reach toxic levels Fat Soluble – Vitamin A, D, E & K
  • 81. What are the main functions of Vitamin A?
  • 82. What are the main functions of Vitamin A? Vision • body linings and skin • For growth of bones and teeth Growth and maintenance Immune defenses
  • 83. • What happens in Vitamin A deficiency?
  • 84. • What happens in Vitamin A deficiency? night blindness Keratinization
  • 85. Can toxicity develop from Vitamin A? Beta-carotene?
  • 86. Vitamin A? YES •From supplements or fortified foods Beta-carotene? NO Can toxicity develop from Vitamin A?
  • 87. What are the roles of Vitamin D in the body?
  • 88. What are the roles of Vitamin D in the body? Regulation of blood calcium Regulation of phosphorus Raises blood calcium levels
  • 89. What happens in Vitamin D deficiency? Vitamin D Deficiency
  • 90. RICKETS Most people are not receiving ENOUGH vitamin D because of the lack of sun exposure Vitamin D Deficiency
  • 91. What are the best sources of Vitamin D?
  • 92. What are the best sources of Vitamin D? Sunshine! Fortified milk Mushrooms
  • 93. What is the main function of Vitamin E?
  • 94. What is the main function of Vitamin E? Antioxidant: • quenches free radicals • protects cellular structures from oxidative damage
  • 95. What is the main function of Vitamin K?
  • 96. What is the main function of Vitamin K? Synthesis of blood clotting proteins • Interferes with function of blood thinners Synthesis of bone proteins • Adequate intake may reduce risk of hip fracture
  • 97. Vitamin K Vitamin K is synthesized by bacteria in the intestines Vitamin K is given at birth because the intestines are sterile.
  • 98. What are the roles of Vitamin C in the body?
  • 99. What are the roles of Vitamin C in the body? Maintenance of connective tissues • Formation of collagen Cofactor in the production of carnitine Antioxidant Restores Vitamin E to it’s active form Supports the immune system Boosts Iron absorption
  • 100. What condition develops in Vitamin C deficiency?
  • 101. Scurvy Vitamin C Deficiency
  • 102. Vitamin C Does not prevent colds Vitamin C reduces histamine
  • 103. What is the main function of the B vitamins?
  • 104. What is the main function of the B vitamins? Part of coenzymes Energy metabolism New cell synthesis
  • 105. Thiamin deficiency results in what condition?
  • 106. Thiamin deficiency results in what condition? Beriberi (affects nerves) Loss of sensation in hands and feet muscular weakness advancing paralysis
  • 107. What condition develops in Niacin deficiency?
  • 108. What condition develops in Niacin deficiency? Pellagra Diarrhea Dermatitis Dementia Death
  • 109. Source of Niacin Tryptophan can be converted to niacin Tryptophan is in most proteins
  • 110. What condition results from folate deficiency in pregnancy? Folate Deficiency
  • 111. Neural tube defects Fortification of food is important - Most women don’t know they are pregnant for weeks Folate Deficiency
  • 112. What condition results from Vitamin B12 deficiency?
  • 113. What condition results from Vitamin B12 deficiency? • Pernicious Anemia Is Pernicious Anemia more likely to develop from lack of intake or malabsorption?
  • 114. What condition results from Vitamin B12 deficiency? • Pernicious Anemia Is Pernicious Anemia more likely to develop from lack of intake or malabsorption? • Malabsorption •Absorption of Vitamin B12 requires intrinsic factor (IF)
  • 115. Who is at risk for Pernicious anemia?
  • 116. Who is at risk for Pernicious anemia? Vitamin B12 is only found in animal sources Elderly - most at risk Strict Vegetarians
  • 117. Can Vitamin B6 can be toxic from supplements?
  • 118. Can Vitamin B6 can be toxic from supplements? Yes! A single B6 supplement can deliver 2 grams of the vitamin, the equivalent of • 3,000 bananas • 3,800 chicken breasts Toxicity UL: O.1 gram • * numb hands and feet
  • 119. Calcium What other function does calcium have besides formation and maintenance of bone structure?
  • 120. Most abundant mineral in the body Calcium Nerve transmission Transport of ions Blood pressure Blood clotting Muscle contraction
  • 121. Which mineral assists with muscle relaxation?
  • 122. Which mineral assists with muscle relaxation? Magnesium
  • 123. Which mineral is part of RNA and DNA?
  • 124. Which mineral is part of RNA and DNA? Phosphorus P Part of phospholipids Buffer • A T P • adenosine tri phosphate Release of energy
  • 125. What is the main extracellular cation? What is the main intracellular cation?
  • 126. What is the main extracellular cation? What is the main intracellular cation? Note: Chloride is an anion - intake is as NaCl (table salt)
  • 127. •Most people get too much much sodium •Usually from processed foods and fast food •Excess sodium does not cause hypertension - but increases risk Sodium
  • 128. Potassium fluid and electrolyte balance cell integrity • Diets high in potassium help decrease the risk of hypertension heartbeat
  • 129. Which mineral is needed for some proteins to assume their functional shape? •makes the proteins strong through certain bonds
  • 130. Which mineral is needed for some proteins to assume their functional shape? •makes the proteins strong through certain bonds Sulfate
  • 131. Which mineral is a component of thyroxine?
  • 132. Which mineral is a component of thyroxine? •Iodine •Thyroxine regulates what?
  • 133. Which mineral is a component of thyroxine? •Iodine •Thyroxine regulates what? •metabolism
  • 134. Iodine deficiency can cause? Iodine Deficiency
  • 135. Iodine deficiency can cause? Iodine Deficiency Goiter • irreversible mental and physical retardation Iodine deficiency can cause cretinism
  • 136. What two forms are iron absorbed in? What is the absorption rate? Iron Absorption
  • 137. Iron heme •Heme (~23%) • Animal sources • Non- heme (2-20%) • Plant and animal sources What two forms are iron absorbed in? What is the absorption rate? Iron Absorption
  • 138. Increasing iron absorption • Found in Meat, Fish, Poultry MFP factor Vitamin C
  • 139. Iron Inhibitors • Found in tea and coffee Tannins • Milk Calcium and phosphorus • Found in the fiber of legumes and whole- grain cereals, breads Phytates
  • 140. Iron in Meals Roast beef sandwich on whole grain bread Scrambled eggs with a cup of coffee Spinach salad with a glass of orange juice Iron fortified whole grain cereal with low fat milk
  • 141. Zinc Important in: wound healing immune function
  • 142. Fluoride Deficiency dental carries Toxicity Fluorosis
  • 143. Works with insulin to regulate blood glucose Chromium
  • 144. Which mineral is an antioxidant?
  • 145. Selenium A mineral which is an antioxidant Note: Vitamin C & E are also antioxidants
  • 146. THE END