My study guide from my ACE Sports Nutrition for Fitness Professionals certification

3. CARBOHYDRATES (CHO) – 4 CAL/GRAM
Simple Carbohydrates
 Monosaccharides
 Disaccharides
Complex Carbohydrates
 Oligosaccharides
 Polysaccharides

4. SIMPLE CARBOHYDRATES
Monosaccharides
• Glucose
• Predominate form in nature; basic building block of other carbs
• Fructose
• Sweetest; found in fruit
• Galactose
• Often bound with glucose to form lactose (in milk)
• Bound by glycosidic bonds to form more complex molecules
• Body uses glucose; so convert fructose and galactose

5. DISACCHARIDES
Lactose
• Glucose + Galactose
• Dairy (milk, yogurt, ice cream)
Sucrose
• Glucose + Fructose
• Table sugar
Maltose
• Glucose + Glucose
• Malt sugar
Honey is a natural form of sucrose that
is made from plant nectar and
harvested by honeybees, which
secrete an enzyme that hydrolyzes
sucrose to form glucose and
fructose.

6. Oligosaccharides and
Polysaccharides
Oligosaccharides
• Chain of 3 – 10 simple sugars
• Fructooligosaccharides
• Found in fruits/veggies
• Commercially produced as low-cal sweetener
• Mostly indigestible
• Help relieve constipation, improve TG levels,
decrease foul-smelling stool
Polysaccharides
• Hundreds of monosaccharides bound together
• Starch
• Produced by grains and veggies
• Amylose
• Small linear molecule of tightly packed
glucose molecules
• Mostly resistant to digestion
• Amylopectin
• Larger, highly branched chain of glucose
molecules that is easily digested
• Cellulose
• Low viscosity starch made of long chains of
glucose; structural component of the cell wall
in plants that is indigestible to humans
• Fiber
• Largely indigestible 2/2 lack of enzymes to disrupt
glycosidic bonds
• Some fiber Is fermented in large intestine for
energy to flora
• 1.5 – 2.5 cal/gm
• Glycogen
• Polysaccharide that is a highly branched chain of
glucose molecules
• Chief carb storage material in animals formed and
stored in liver and muscle
COMPLEX CARBOHYDRATES

7. CARBOHYDRATE DIGESTION

9. CARBOHYDRATE METABOLISM
• Glucose  C02 + H20 + ATP
• Liver: 90 gm glycogen
• Muscle: 150+ gm glycogen
• Excess carbs  adipose tissue

10. HORMONE REGULATION
Insulin
• Postprandial rise in BG
• Aids in cellular glucose uptake
• Promotes conversion of carbs into fat for LT storage
• When sugar is abundant and glycogen stores maximized
Glucagon
• Low BG levels
• Increase BG levels
• As glycogen levels decrease, glucagon metabolizes fat from storage for fuel
to help conserve glycogen and maintain BG levels

11. GENERAL CARBOHYDRATE RECOMMENDATIONS
• Acceptable Macronutrient Distribution Ranges (AMDR)
• Range assoc. with reduced risk for chronic dz while still providing adequate intake
of nutrients (ie vit/min)
• For carbs: 45% to 65% of total cal intake
• Recommended Dietary Allowances (RDA)
• Amount of nutrient known to be adequate to meet the nutritional needs of nearly
all healthy persons
• For carbs: 130 gm/day
• Min based on brain needs (so need more for body reqs)
• Academy of Nutrition and Dietetics/ACSM
• Carb needs for athletes: 6-10 g/kg (2.7 to 4.5 g/lb) of body wt daily
• Depends of total daily energy expenditure, types of exercises performed, gender,
environmental conditions to maintain BG levels during exercise and to replace
muscle glycogen

13. GLYCEMIC INDEX
• Ranks carbs based on their BG response; based on reference amt (50 gm)
• High GI
• Enter bloodstream rapidly  large BG spike  insulin spike  muscle
glucose uptake and fat deposition in adipose tissue
• From 2 – 4 hrs postprandial, residual effects of insulin spike can lead to
hypoglycemia
• Low GI
• Digested slowly  small BG increase  small insulin boost

14. GLYCEMIC LOAD
• Accounts for portion size
• Glycemic Load (GL) = GI x grams of carbs ÷ 100
• A food can have high GI but a low GL
• i.e. carrots have high GI, but 50 gm carrots = 4 cups, but since serving size is
½ cup, then GL is low
• Carb foods that are also mod to high in fat or protein, fiber, and other nutrients
and that are min processed may have a high GI and low GL
• Benefits of Low GI foods
• Weight control
• Decreased risk of diabetes and CVD
• Usu more nutrient dense
• i.e. 16 oz soda has same amt of carbs as 2 med-size apples

15. Functional Fiber
• Nondigestible carbs
isolated from food or
added to food products,
with potentially beneficial
health effects
• Improved GI sxs, wt loss, dec
cholesterol, colon ca prevention
• Food labels:
• Isolated nondigestible plant carbs
• Resistant starch, pectin, gum
• Animal carbs
• Chitin, chitosan
• Commercially produced carbs
• Resistant starch, polydextrose,
inulin, indigestible dextrin
Dietary Fiber
• Nondigestible carbs and
lignins that are obtained
naturally from plant foods
• High viscosity (soluble) fiber
• A type of fiber that forms gel in water;
may help prevent CVD and stroke by
binding bile and cholesterol, diabetes
by slowing glucose absorption, and
constipation by holding moisture in
stools; includes gums, pectin, psyllium
seeds
• Low viscosity (insoluble) fiber:
• Fiber that does not bind with water
and adds bulk to the diet (includes
cellulose, hemicellulose, and lignins
found in wheat bran, veggies, and
whole grain breads and cereals);
important for proper bowel bowel
function and reducing sxs of
constipation
FIBER = FUNCTIONAL FIBER + DIETARY FIBER

16. Large biological molecules, or
macromolecules, consisting of
one or more long chains of
amino acid residues. Proteins
perform a vast array of
functions within living
organisms, including catalyzing
metabolic reactions, replicating
DNA, responding to stimuli,
and transporting molecules
from one location to another.
Proteins differ from one
another primarily in their
sequence of amino acids,
which is dictated by the
nucleotide sequence of their
genes, and which usually
results in folding of the protein
into a specific three-
dimensional structure that
determines its activity.
PROTEIN

17. Complete protein
• A food item that
contains all essential
AAs
• Generally animal
products
• Also plant-based soy, quinoa,
chia seeds, buckwheat, hemp,
flax seeds
Incomplete
protein
• A food item that does
not contain all essential
AAs
• Generally plant
products
PROTEIN QUALITY

18. WHEY PROTEIN

19. PROTEIN DIGESTION AND ABSORPTION
Denaturation- the process of unfolding a protein by destroying its quaternary,
tertiary, and secondary nature

20. AS WITHIN, SO WITHOUT

21. PROTEIN SYNTHESIS

23. 1) Stomach- HCL acidifies
stomach, triggering activation
of pepsin
2) Pancreas- secretes
proteolytic enzymes into
small intestines
3) Small intestines- trypsin
further breaks proteins down
into di- and tripepides 
cleaved into single AAs 
blood  liver
4) Liver- regulates distribution
of AAs throughout body

24. MUSCLE PROTEIN CATABOLISM
Glucose-Alanine Cycle

25. PROTEIN RECOMMENDATIONS
• RDA = 0.8 g/kg/day
• Academy of Nutrition and Dietetics, Dietitians of Canada, ACSM
• Endurance athletes = 1.2 – 1.4 g/kg (0.5 to 0.6 g/lb) daily
• Strength-training = 1.6 – 1.7 g/kg (0.7 to 0.8 g/lb) daily
• IOM = “no compelling scientific evidence to support active individuals
increasing their daily protein intake above the RDA of 0.8 g/kg)
• AMDR = 10 – 35% daily caloric intake

26. PROTEIN AND ATHLETICISM
• Carb:Protein = 3:1
• Encourages + nitrogen balance  muscle synthesis, hydration, energy
• 6 – 20 gm protein and 30 – 40 gm carbs post-workout (w/in 3 hrs)
• As little as 5 – 10 gm protein immediately post-exercise can promote optimal muscle repair
• BCAAs
• Combats fatigue when consumed during workout
• Leucine 45 mg/kg/day; Isoleucine 22.5 mg/kg/day; Valine 22.5 mg/kg/day (2:1:1)
• Vegetarians
• Should consume 10% more grams of protein daily than recs
• Plant proteins not as readily digestible
• Need complimentary protein-rich plant foods

27. FAT FARM
• 1 gm fat = 9 calories
• Lipids
• Fat or fat-like substance used in body or bloodstream; includes fats, oils,
waxes, sterols, TGs, all of which are insoluble in water

28. CHOLESTEROL AND STEROIDS
• Cholesterol- fat-like, waxy substance produced in liver
and found in cell membrane of all animal tissues 
cell structure and integrity
• Adrenals  glucocorticoid (cortisol) and
mineralocorticoids (aldosterone)
• Testes, ovaries  androgens and estrogens
• Liver  bile acids
• Skin  cholesterol becomes cholecalciferol with
sun exposure, then converted to calcitriol (active Vit
D)
Susceptible to oxidation, distributing
cholesterol to inner lining of arteries,
leading to atherosclerosis

29. FATTY ACIDS AND TRIGLYCERIDES
• Adipose tissue is an endocrine organ!!!
• Leptin- a hormone produced by
adipose tissue that suppresses the
appetite and increases energy
expenditure; levels increase with
increased fat storage
• Resistin- hormone secreted by
adipose tissue that decreases cell
sensitivity to insulin
• TNF-alpha- helps regulate fat
metabolism and contributes to acute
inflammatory rxns

30. FAT DIGESTION AND ABSORPTION
1. Lingual lipase- enzyme released from mouth that begins breakdown of
short- and medium-chain FAs
2. Gastric lipase – further digestion of fat
3. CCK – triggered by fat in small intestine; stimulates release of GIP (gastric
inhibitory peptide)  decreases gut movement and slows digestion

31. • Adipose Tissue Growth:
• Hyperplasia- abnl increase in # of
cells
• Hypertrophy- abnl increase in size
of current cells
• Two Types of Fat Cells:
• White Fat- store fat and provide
thermal insulation
• Brown Fat- help to generate body
heat; present in newborns; iron-
containing mitochondria
FAT METABOLISM AND STORAGE

32. GENERAL FAT RECOMMENDATIONS
• DRIs set AMDR of fat as 20% to 35% of total calories from fat
• AI of linolenic acid (omega-3) is 1.6 and 1.1 gm/day for men and women
• AI of linoleic acid (omega-6) is 17 and 12 gm/day for men and women
• 2010 Dietary Guidelines for Americans:
• Fewer than 10% of calories from saturated fat
• Less than 300 mg/day cholesterol
• Consume more mono/polyunsaturated fats
• Consume less saturated and trans fats
• Avoid solid fats and added sugars

33. FAT AND HEALTH
• Replace saturated fat with polyunsaturated fat whenever possible, or
otherwise with monounsaturated fat. Polyunsaturated fats lower LDL
cholesterol and improve HDL:total cholesterol ratio, often by increasing the
HDL component. Monounsaturated fats have a more neutral effect.
• Choose healthful fats over “low fat” foods that contain refined carbs, as these
foods decrease HDL cholesterol, increase TGs, and overall worsen the
atherogenic dyslipidemia assoc w/ obesity and insulin resistance.
• Consume omega-3 FAs in the diet at least 2x/week
• Avoid trans fats, as they decrease HDL cholesterol and increase total
cholesterol.
• Total fat intake and ratio of omega 3:6 FAs are not predictors of heart health.
• Exercise regularly to decrease LDL levels and prevent redux in HDL assoc w/
a diet higher than recommended in total fat and saturated FAs.

34. FAT- WHAT TO TELL CLIENTS
• Use liquid vegetable oils whenever possible
• When solid fats are necessary, keep trans fats to a min.
• Balance calories by limiting refined carbs and not through avoidance of the
healthy polyunsaturated and monounsaturated fats.
• Limit saturated fats to less than 10% of total fat intake.
• Dietary fats are never purely one type, but a combo.
• Promote fruits, veggies, and whole-grain as ideal sources of carbs rather than
refined or processed carbs
• Dietary patterns are more important than single dietary components. A
healthful eating plan includes fruits, veggies, unprocessed whole grains, fish,
lean meat, low0fat dairy, and vegetable oils.
• Calorie balance should emphasize quality of food selection.

36. VITAMINS
Organic substances obtained from plant and animal foods that are essential in
small quantities for normal growth and activity of the body.
• Exceptions for the food source rule:
• Vitamin K and biotin produced by normal intestinal flora
• Vitamin D self-produced via sun exposure
• Niacin synthesized from tryptophan
• Vitamin A synthesized from beta-carotene
The reference values
1. Recommended Dietary Allowances (RDAs)- the daily dietary intake of a nutrient known to meet the nutritional
needs of 97% of healthy persons in age- and gender-specific groups. The Food and Nutrition Board, an entity of
the Institute of Medicine, establishes RDAs.
2. Estimated average requirement (EAR)- an amount of nutrient known to be adequate to meet nutritional needs
in 50% of an age- and gender-specific group.
3. Tolerable upper intake level (UL)- the maximum intake that is unlikely to pose risk of adverse health effects to
almost all individuals in an age- and gender-specific group.

39. THIAMIN- VITAMIN B1 • Essential for carb metabolism and plays role in nerve
fxn

40. RIBOFLAVIN- VITAMIN B2

41. NIACIN- VITAMIN B3
• Cofactor for over 200 enzymes involved in carb, AA, and FA metabolism
• Lean meats, poultry, fish, peanuts, and yeast
• Muscular weakness, anorexia, indigestion, and skin abnormalities are early
sxs of niacin def.  can lead to pellagra (see below)

42. PYRIDOXINE- VITAMIN B6
Plays improtant role in protein metabolism, RBC production,
glycogenolysis, conversion of tryptophan to niacin, neurotransmitter
formation, and immune system fxn.
Deficiency leads to decrease dneurological and dermatological fxn
weakend immunity

43. FOLATE
• DNA production
• Red and white blood cell formation
• Neurotransmitter formation
• AA metabolism
• Deficiency leads to megaloblastic anemia, skin lesions, poor growth
• Excess folate can mask Vitamin B12 deficiency

44. COBALAMIN- VITAMIN B12
Rich sources: clams, oysters, milk, eggs, cheese, muscle meats, fish, liver,
kidney
Deficiency- megaloblastic anemia and neuro dysfxn- demyelination 
parasthesias, burning feet, stiffness and generalized LE weakness

45. BIOTIN- VITAMIN B7
• The ultimate “helper vitamin”
• Typically bound to protein, carries and carboxyl group (-COOH)
• Plays important role in fxns of pantothenic acid, folic acid, vit B12
• Deficiency uncommon

46. PANTOTHENIC ACID- VITAMIN B5
Present in all plant and animal tissues
Forms integral component of coenzyme A and acyl-carrier protein
essential for metabolism of fatty acids, amino acids, and carbs, and as
well as for normal protein fxn
essential for synthesis of acetylcholine
Involved in the production of steroid hormones, Vit D, Vit A, and cholesterol

47. VITAMIN C
• Plays a role as an antioxidant
• Necessary to make collagen
• Deficiency leads to scurvy
• Causes dark purplish skin lesions and spongy/bleeding gums
• Improves iron absorption, promotes resistance to infection, and helps with steroid,
neurotransmitter, and hormone production
• Sxs of deficiency: impaired wound healing, swelling, bleeding, and weakness in bones,
cartilage, teeth, and connective tissues

48. VITAMIN A
• Vision, growth, development
• Development and maintenance of epithelial tissue (including bones/teeth)
• Immune fxn
• Reproduction

49. VITAMIN D
Vitamin D3
(cholecalciferol) from sun,
animals, supps
Vitamin D2 (ergocalciferol)
from plants and supps
CALCITRIO
L
Responsible for vitamin D’s
biological effects

51. VITAMIN E
Protects against conditions related to oxidative stress: aging, air pollution,
arthritis, cancer, CVD, cataracts, diabetes, infection

52. VITAMIN K

53. MINERALS!!!

54. MORE MINERALS!!!

55. MACROMINERALS
Major Elements
• Body requires 100+ mg daily
• Calcium
• Phosphorous
• Magnesium
• Sulfur
• Sodium
• Chloride
• Potassium

56. MICROMINERALS
Trace Elements
• Body requires <20 mg daily
• Iron
• Iodine
• Selenium
• Zinc
• Copper
• Chromium
• Other minerals w/o established DRI

57. CALCIUM
Calcium is the most abundant mineral in the body and serves various functions, including mineralization of
the bones and teeth, muscle contraction, blood clotting, blood-pressure control, immunity, and possibly
colon-cancer prevention.

58. CALCIUM SUPPLEMENTATION
• No more than 500 mg of calcium should be taken at a time because this is
the maximum amount the body can absorb at once. Calcium carbonate
should be taken with food to help with absorption; calcium citrate can be
taken with or without food
• High calcium intake can interfere with absorption of iron, zinc, manganese
and can lead to constipation and nephrolithiasis

59. PHOSPHORUS
Along with calcium, phosphorus plays a key role in mineralization of bones and
teeth. Phosphorus helps filter out waste in the kidneys and contributes to
energy production in the body by participating in the breakdown of carbs,
proteins, and fats. Phosphorus is needed for the growth, maintenance, and
repair of all tissues and cells, and for the production of DNA and RNA.
Phosphorus is also needed to balance and metabolize other vitamins and
minerals including vitamin D, calcium, iodine, magnesium, and zinc. Too much
phosphorus intake interferes with calcium absorption and may lead to
decreased bone mass and density.

60. MAGNESIUM
• Important for bone mineralization, protein production, muscle contraction,
nerve conduction, enzyme function, healthy teeth
• Food sources: nuts, legumes, whole grains, dark leafy green veggies, milk
• High intakes of calcium, protein, vitamin D, and EtOH increase body’s
magnesium requirements
• Depletion can occur as a result of aging, IDDM, hypermagnesuric diuretics
• Can contribute to many chronic illnesses and is assoc w/ heart arrythmias
and MI
• Magnesium toxicity (very rare) may prevent bone calcification

61. SULFUR
• Important component of many important body compounds
• Cysteine and methionine
• Thiamin, biotin, panothenic acid
• Heparin
• Food sources: meat, poultry, fish, eggs, dried beans, broccoli, cauliflower

62. IRON
• Regulates cell growth and differentiation
• Production of hemoglobin and myoglobin
• Fe stored in the body as ferritin for future use
• Liver, spleen, bone marrow
• Fe released from breakdown of RBCs transferred to working cells via
transferrin

63. IRON HOMEOSTASIS
• Heme iron: from animal sources; 10 -
35% bioavailability
• Nonheme elemental iron: from plant
sources; 2 - 10% bioavailability
• Increase Fe absorption via vitamin C
• Decrease Fe absorption via coffee/tea;
excess Zn, Mg, Ca; high phytic acid
(fiber)

64. SPORTS ANEMIA (PSEUDOANEMIA)
• Athletes experience small amounts of exercise-induced blood loss
• Urine, GI bleeding, high sweat rates, mechanical trauma
• Leads to increased RBC destruction and loss of Fe
• Hg low; Fe normal
• 2/2 increased plasma volume in response to physical training
• Total Hg unchanged
• Hg concentration decreased
• Total Hg divided by total volume

65. IODINE
• Stored in thyroid gland
• Essential for normal growth
• Food sources: seafood and iodized salt

67. SELENIUM
• Antioxidant
• Deficiency: heart dz, hypothyroidism, weakened immune system
• Excess: (selonosis) GI distress, alopecia, white blotchy nails, garlic
breath, fatigue, irritability, nerve damage

68. ZINC
• Found in almost every cell; 2nd most abundant trace element after iron
• Stimulates activity of enzymes, supports a healthy immune system, assists in
wound healing, strengthens the senses (esp taste and smell), supports normal
growth and development, and helps with DNA synthesis
• Food sources: meat, fish, poultry, dairy, seafood
• Deficiency: delayed wound healing, immune dysfunction
• Toxicity: decreased HDL, impaired copper absorption, altered Fe function

69. CHROMIUM
• Trace mineral that helps to increase the effectiveness of insulin and aids in
glucose metabolism
• Food sources: corn oil, clams, whole-grain cereals, brewer’s yeast
• Deficiency and toxicity are very rare

70. COPPER
• Helps make RBCs
• Keeps nerve cells and immune system
healthy
• Helps in formation of collagen and
cellular energy production
• Acts as an antioxidant by eliminating
free radicals
• Helps in the absorption of Fe
• Food sources: oysters, liver, organ
meats, dried legumes
• Deficiency rare: anemia, low body temp,
bone fractures, osteoporosis

71. ELECTROLYTES
Four Essential Roles
1. Water balance and distribution
2. Osmotic equilibrium
3. Acid-base balance
4. Intracellular/extracellular differentials
Sodium
Potassium
Chloride

72. MICRONUTRIENT DIGESTION, ABSORPTION, DISTRIBUTION

73. ATHLETES RISK LOSING…
• B vitamins
• Vitamin C
• Vitamin E
• Beta-carotene
• Calcium
• Vitamin D
• Selenium
• Iron
• Zinc
• Magnesium

74. B VITAMINS AND EXERCISE
Two essential roles:
• Supporting energy production
• Thiamin
• Riboflavin
• Niacin
• Pyridoxine (B6)
• Pantothenic acid
• Biotin
• Supporting formation of RBCs
• Folate
• Cobalamin (B12)

75. DRINK MORE H2O

77. DIETARY GUIDELINES
• Published q5yrs by USDA and Department of Health and Human Services
• Includes 23 recs for gen pop and 6 addl recs for special groups
• 4 categories
1. Balance calories to achieve and maintain a healthy weight
2. Foods and food components to reduce
3. Foods and nutrients to increase
4. Building healthy eating patterns.

78. DASH (DIETARY APPROACHES TO STOP HYPERTENSION)

79. MEDITERRANEAN DIET

80. MYPLATE
1. Balance calorie intake with calories expended through physical activity.
2. Enjoy food, but make sure proportions are appropriate; eat slowly; minimize
distractions (i.e. television; smartphones)
3. Avoid oversized portions; utilize smaller plates, smaller serving sizes, mindful
eating
4. Eat more vegetables, whole grains, fat-free or low-fat dairy products (or dairy-free
alternatives) for adequate potassium, calcium, vitamin D, and fiber
5. Make half of your plate fruits and veggies; most Americans need 9 servings of
fruits and veggies daily (2013 average adult in U.S. eats fruit 1.1x/day and veggies
1.6x/day)
6. Switch to fat-free or low-fat (1%) milk or dairy alternative like almond/coconut milk
7. Make at least half of grains whole grains; ensures adequate fiber intake and
decreased intake of processed foods
8. Eat fewer foods high in solid (saturated/trans) fats, added sugars, and salt
9. Compare sodium in foods and choose lower sodium version
10. Drink water instead of sugary drinks to cut sugar and unnecessary calories

81. DIETARY REFERENCE INTAKES
• RDA is the sufficient average intake for most healthy individuals. RDA values
may vary based on age and gender.
• Estimated average requirement (EAR) is an adequate intake (AI) in 50% of an
age- and gender-specific group
• Tolerable upper intake level (UL), the maximum intake of a nutrient that is
unlikely to pose risk of adverse health effects to almost all individuals in an
age- and gender-specific group.
• AI is used when a RDA cannot be determined. AI is a recommended nutrient
intake level that is based on research and is sufficient for healthy individuals

82. FOOD LABELS
Clients should minimize intake
of the first three nutrients:
• Fat (esp sat and trans): clients on a
2,000 cal/day diet should aim for a
total per day of < 65 g total fat or <
20g saturated fat
• Cholesterol: goal of < 300 mg
• Sodium: goal of <2,300 mg

83. REDUCE EXPOSURE TO FOODBORNE ILLNESS
• Check produce for bruises and punctures, either may allow for contamination.
• Look for sell-by date for breads and baked goods, a use-by date on packaged
foods, an expiration date on yeast and baking powder, and a pack date on
canned and some packaged foods.
• Make sure packaged goods are not torn, and cans are not dented, cracked or
bulging to prevent contamination or botulism.
• Separate fish and poultry from other purchases by wrapping them separately
in plastic bags. Once home, prevent leakage and cross-contamination.
• When shopping, choose refrigerated and frozen foods last. Try to make sure
all perishable foods are refrigerated within one hour of purchase.

85. FOOD SAFETY
• Wash hands often with warm water and soap for at least 20 seconds
• Clean hands, food contact surfaces, and fruits and veggies; to prevent cross-
contamination, meat and poultry should not be washed or rinsed.
• Separate raw, cooked, and ready-to-eat foods while shopping, preparing, and
storing foods
• Cook foods to safe temp to kill microorganisms; pregnant women and ppl over
age 65 should eat deli meats only if reheated to steaming hot to reduce risk of
infxn
• Refrigerate perishable food within 1-2 hrs and defrost foods properly; eat
refrigerated leftovers within 3-4 days; “When in doubt, throw it out”
• Avoid raw (unpasteurized) milk (products), raw or partially cooked eggs,
raw/undercooked meat/poultry, raw fish, unpasteurized juice, and raw sprouts
• Esp infants, young children, pregnant women, older adults,
immunocompromised individuals

86. JAMA NUTRITION POLICY
Policy strategies to help increase nutrition and PA habits on a population level, to hopefully reduce obesity rates and improve health
• Taxation: imposing higher taxes on calorie-dense and nutrient-poor foods might lower consumption of unhealthy foods and generate
revenue to subsidize healthful foods.
• Food prohibitions: removing harmful ingredients from the food supply eliminates their health risks
• Regulation of food marketing to children and adolescents: restricting food advertising during children’s programs, counter-advertising
to promote good nutrition and physical activity, limiting use of cartoon characters, and other regulations may help protect children who are
otherwise unable to critically evaluate advertisements
• School policies: many school districts already have removed vending machines, provided healthier menus, and offered more PA
opportunities for school children. Much worked remains ahead
• The “built’ environment: zoning laws to limit the number of fast-food restaurants, expand recreational facilities, and encourage healthier
lifestyles would increase the ability for people to live and play healthfully, esp in poor neighborhoods where access to parks and healthy
foods is severely limited
• Disclosure: restaurants and manufacturers could be required to disclose nutritional content and health warnings so that consumers make
more informed decisions
• Tort liability: lawsuits against companies such as fast-food giants for selling “unreasonably hazardous’ products might force companies to
offer healthier alternatives and provide accurate information
• Surveillance: similar to how health departments monitor ID, states could monitor chronic diseases like diabetes
• “Training” Communities:
• Consider individuals within the larger social, economic, and cultural context
• Form partnerships
• Influence larger political and policy debates

90. THE POTENTIAL FOR ACTI(O)N

91. ATP AND MUSCLE CONTRACTION

92. GLYCOGENOLYSIS AND GLYCOLYSIS

93. OXYGEN AND NUTRIENT DELIVERY
• Oxygen-carrying capacity: the body’s ability to obtain oxygen from the air
inhaled into the lungs and transported to the bloodstream; affected by 2 main
factors:
1. The ability to adequately ventilate the alveoli in the lungs
2. Hemoglobin concentration in the blood
• Oxygen delivery: the ability of the body to transport oxygen from the lungs to
the mitochondria of the working cells; the amount delivered is a function of
cardiac output

94. VO2 MAX
a measure of maximal oxygen uptake; liters of O2 consumed per kilogram of
bodyweight per minute; generally considered the best indicator of a person’s
cardiovascular fitness and aerobic endurance (the more O2 used during intense
performance, the more ATP is produced)

95. AEROBIC GLYCOLYSIS- TCA
2 ATP
8 NADH
2 FADH
6 CO2

96. AEROBIC GLYCOLYSIS- OXIDATIVE PHOSPHORYLATION
2 ATP
8
NADH
2
FADH
6 CO2

97. LYPOLYSIS AND FATTY ACID OXIDATION

98. ENERGY

99. DEAMINATION AND PROTEIN AS ENERGY

100. FOOD TO FUEL

101. LIPOGENESIS

102. OXYGEN CONSUMPTION AND EXERCISE

103. GLYCOGENESIS

105. GLUCOSE- FOOD TO FUEL
• 1-4 hrs for carbs to be digested, absorbed, and
stored as glycogen in liver or muscle
• Carbs can be ingested at 3 gm/min before causing
GI upset
• Portal circulation is rate-limiting step in carb food to
fuel time
• Max rate of carb absorption is 1.2 – 1.7 gm/min
• Glucose released from liver at max 1 gm/min
• Glucose uptake by muscle at max 1 g/min
• Glucose  ATP at ~ 1 g/min

106. CARBOHYDRATE DIVERSITY
• Consumption of carbs with 2-3 diff saccharides (ie glucose, fructose, and
sucrose) may increase carb absorption bc diff transport mechanisms from
small intestine to bloodstream are used
• Less competition for transporters
• Enhanced athletic performance
• Decrease GI upset during exercise

107. CARBOHYDRATE LOADING
Eating pattern that consists of increasing the amount of carbohydrates
consumed in the days leading up to an athletic endurance event to
maximize muscle and liver glycogen stores. Typically, activity levels are
decreased during this time as well
• Increased muscle and liver glycogen storage
• Improvement in athletic performance
• 7-day, 6-day, and 1-day protocols in two stages:
1. Glycogen depletion stage: moderate-to-high intensity exercise to deplete
glycogen stores, coupled with low-to-moderate carbohydrate intakes
(<55% of total kcal)
2. Glycogen loading stage: tapered exercise (low-intensity, short-duration),
coupled with high carbohydrate intakes (>70% of total kcal)
• Two methods: classical and modified