FINAL REVIEW
Intro to Nutrition

73 questions, 200 points
Multiple choice true / false & matching
2.75 hours to take the e...
Essential
A

necessary nutrient that can be
obtained only from the diet
Vitamins

Minerals

Water

Carbohydrates

Lipids
...
Nutrient Density
A

high proportion of micronutrients
and fiber with a low proportion of
calories, saturated fat and suga...
Energy Yielding Nutrients
Protein
Fat
Carbohydrate
Energy Yielding Nutrients
Protein
4 cal/g
Fat
9 cal/g
Carbohydrate
4 cal/g
Leading Causes of Death

diabetes

heart
disease

cancer

stroke
Whole Foods
whole
fruits, vegetables, grains, grass
fed meats, eggs

Refined
carbohydrates, processed
oils, packaged produ...
DRI
FAT: 20-35% total calories
• SATURATED FAT: < 10% of total calories
• AHA < 7%
• TRANS FAT: as low as possible (<1%)
•...
RDA and EER
Phytochemicals
Biologically active substance in plants

Non-nutrient

May protect against chronic disease

Anti-oxidants
•...
Fruit vs Vegetable

Fruit

Vegetable

• entire plants with seeds

• seeds, stems, flower, leaves, stem, root
Digestion and Absorption
• Mouth

• Stomach
• Intestines

• Liver
• Gallbladder

• Colon
Digestion & Absorption
Digestion:
Breakdown of
nutrients

Absorption:
passage of
nutrients from the
digestive tract to
the...
Storage Organs – when we eat too
much

CHO
Fat

Fat

Protein
N
o
t

Glycogen

Fat

Fat
Carbohydrate Recommendations

Carbohydrates

Added sugar

45-65%

< 5%

Fiber

Women: 25
grams

Men: 38 grams
Simple Carbohydrates

monosaccharides

disaccharides
Carbohydrates
Simple Carbohydrates

Complex Carbohydrates

fiber

glycogen
Blood Sugar
Blood sugar :
results in insulin
secretion by the
pancreas
Blood sugar :
results in glucagon
secretion by th...
Wheat Kernel
A: Husk - removed
B: Bran - most of fiber
C: Endosperm - starch

D: Germ - nutrients/
protein
What happens du...
Diabetes


Type I Diabetes






Autoimmune disease
Cells of the pancreas do not secrete insulin
Typical onset is chi...
LIPIDS

Lipids

Triglycerides (TG)

≈95% of all lipids in
foods and the human
body

Phospholipids

For example, lecithin

...
Fatty Acids
Essential Fatty
Acids
• Omega - 6
• Omega - 3

* Most Americans consume more omega-6 FAs than omega-3 FAs
Lipoproteins
LDL
Transport cholesterol
and other lipids to body
tissues
HDL
Carry cholesterol from
body cells to the liver...
Trans Fatty Acids

Trans fats are a byproduct of hydrogenation
Proteins
1.
2.
3.
4.
5.

Genes determine
the sequence
String of amino
acids
Peptide bond
Not a straight
chain
Shape determ...
Proteins
 Multiple

functions - we don’t want to
use proteins for energy
 Antibodies
 Enzymes
 Connective

Tissue (mus...
Wasting
• When the amine group has been removed, it
means the amino acid has been wasted
Vegetarian/Vegan Diet
• A healthy vegetarian diet is associated with a
lower risk of chronic disease
• Both a vegetarian d...
Vitamins
Water Soluble Vitamins






Dissolve in water
Easily absorbed and transported
Not stored extensively
Rarely ...
Vitamin A
Vision
2. Growth and maintenance
1. Needed by the body linings and skin
2. For growth of bones and teeth
3. Immu...
Beta - carotene
1.

2.
3.
4.
5.

Precursor to Vitamin A
Not toxic from foods
Supplements are not recommended
Can turn the ...
Other Fat Soluble Vitamins
Vitamin D
Vitamin E
Vitamin K
Other Fat Soluble Vitamins
Vitamin D
Regulate blood calcium

Vitamin E
Antioxidant / works with Selenium

Vitamin K
Forms ...
Other Fat Soluble Vitamins
Vitamin D - deficiency
Vitamin E - deficiency
Vitamin K - deficiency
Other Fat Soluble Vitamins
Vitamin D - deficiency
Rickets

Vitamin E - deficiency
Erythrocyte hemolysis in premature infan...
Vitamin K
K1: Synthesis of blood clotting proteins

K2: Synthesis of bone proteins
The Gatekeeper and the Traffic Cop

Vitamin D:
Gatekeeper

Vitamin K:
Traffic Cop
Other Fat Soluble Vitamins
Vitamin D - SEVERE deficiency
Rickets

Low levels of Vitamin D associated with


Osteoporosis
...
Water Soluble Vitamins
Vitamin C
 Important

in the formation of collagen

 Deficiency

results in scurvy

 Anti-oxidan...
Water Soluble Vitamins
B - vitamins
 Coenzymes
 Energy

metabolism
 Act in conjunction with one another

VITAMINS don’t...
Water Soluble Vitamins
B - vitamins
 Thiamin
 Deficiency

results in Beriberi

 Niacin
 Deficiency

results in Pellagr...
Neural Tube Defects
Spina bifida

Folate
Neural Tube Defects
almost 25% drop
in the national
incidence of neural
tube defects

All enriched grain
products are fort...
Pernicious Anemia
A

result of Vitamin B12 deficiency
 A lack of intrinsic factor will decrease
absorption
 Main

cause...
Food Preparation & Storage
Vitamin C&E can be oxidized
• Close lids tightly
• Eat soon after chopping
Vitamin C & Bs, mine...
Supplements
 Not

regulated by the FDA

 Healthy

individuals do not need
supplements

 Best

source of vitamins & mine...
Sodium and Potassium

–Sodium and potassium are important in
fluid and electrolyte balance
–Most of excess sodium is from
...
Iron
Iron absorption
•Heme (23%)

Iron

•Non- heme (2-20%) heme
Increase absorption (non-heme)
•Vitamin C
•MFP

Inhibit ab...
Iron Deficiency
• Iron deficiency can lead to anemia
• Women in their childbearing years
are most at risk
Calcium - Osteoporosis
• Loss of bone mineral density
• Not achieving peak bone mass increases
the risk of developing oste...
Iodine
• Part of thyroxine
• helps to regulate metabolism

•Deficiency can result in goiter
Selenium
Selenium
Vitamin
E

Vitamin
C

antioxidants
Overweight & Obese
• 65% of Americans are
overweight
•30% of Americans are
obese
Central Obesity
• Visceral Fat
• more active
• contributes more to
blood lipids than
subcutaneous fat
• Apple shape

• Hig...
BMI: Body Mass Index

Risk for heart disease, hypertension, diabetes, stroke

Determine risk: BMI, Waist, Disease Profile,...
Hunger & Satiety
 Hunger:

physiologic need for food/

energy
 Appetite: psychological desire for
food
 Satiety: feelin...
Calorie

Unit of food energy
Energy Expenditure
Energy In:
Food + beverages

Energy Out:
Physical Activity

BMR

TEF
Risk Factors and Disease

Association

causation

Risk Factors for Heart Disease
 High

LDL/Low HDL
 Atherogenic Diet
 ...
Heart Disease & Smoking

Smoking is a powerful risk
factor for heart disease
 Direct damage to the heart
 Increases bloo...
Atherosclerosis
Damage to
artery wall

• Smoking
• Aging
• Hyperlipidemia

Fatty streak

• Body responds
• Inflammation
• ...
Atherogenic Diet
Contributing factor for Heart Disease
1. High in saturated fats
2. High in trans fats
3. Low in fruits an...
Hypertension
Elevated Blood Pressure
 Ideal

resting blood pressure is 120/80
 Can’t feel when BP is too high
 Increase...
Cancer Development

smok
e

Carcinogen

.

.

Promoters

DNA
Damage

.

.

Metastasis

Cells
multiply
Exposed to carcinogens daily
Not all carcinogens cause
damage
Anti-oxidants quench free
radicals
Body can repair cell dama...
Infant Birthweight
Infant birthweight is the most potent
single indicator of an infant’s future
health

Sign that the moth...
Iron
 During
 the

pregnancy

body avidly conserves iron

 Iron

 The

absorption increases

developing fetus still dr...
Breast Milk

Infant Stores

Supplements?

Iron

At 4-6 months, an
exclusively breast
fed infant is at risk
of iron deficie...
Nutritional Deficiency in Pregnancy
Nutritional deprivation of the mother will reduce
the quantity, not the quality, of he...
Calcium Absorption

Doubles

During Pregnancy
Carbohydrate

Lipids

Protein

Lactose

Main
energy
source

Easily
digested

Easy to
digest

EFAs

Lactoferrin
- iron

Enh...
Vitamins

Minerals

Vitamin C
High

Ca highly
absorbable

Vitamin D
Low

Low in
sodium

High in zinc
and iron
Protein
Mineral
s

Carbs

Toddler
Nutrient
Needs
Vitamin
s

Fiber

Fatty
acids
Food
Allergy

Food
Intolerance

Food
Aversion

Recognized
as foreign

Not an
allergy

Intense
dislike

Immune
response

Un...
Too Little

Too much
Protein
• Recommendation stays the same
Fiber
• Same: adequate amounts are important!
Fat
• AHA diet

Vitamin A
• Recommen...
Physical Activity

Physical Activity in Elderly
Allows for consumption
of more nutrients
Decreases mental
losses

Increase...
48 million cases of foodborne illness
3,000 deaths annually
E Coli
• Not all E coli are dangerous
• Lives in our intestine...
Food Safety
Bacteria grow at 40 - 140 degrees
Wash dishes with warm soapy water and rinse at 140 degrees, air
dry or with ...
Preserving Foods
Freezing
• At 0 degrees minimal nutrient losses

Canning
• Some nutrient losses
• Protects from most micr...
itromax Flavors

Natural and Artificial Flavors
Pesticides

Control
insects, weeds, diseases
4.5 billion lbs of
pesticides/year
Linked with birth
defects, tumors in
anima...
Pros

Cons

Minimize
pesticide
exposure

25% of organics
have pesticides

Limits pesticide
resistance

High cost

Benefits...
GMO
Pros

GMO
Cons
THE END
Final exam review fall 2013
Final exam review fall 2013
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Final exam review fall 2013

  1. 1. FINAL REVIEW Intro to Nutrition 73 questions, 200 points Multiple choice true / false & matching 2.75 hours to take the exam
  2. 2. Essential A necessary nutrient that can be obtained only from the diet Vitamins Minerals Water Carbohydrates Lipids Protein
  3. 3. Nutrient Density A high proportion of micronutrients and fiber with a low proportion of calories, saturated fat and sugar
  4. 4. Energy Yielding Nutrients Protein Fat Carbohydrate
  5. 5. Energy Yielding Nutrients Protein 4 cal/g Fat 9 cal/g Carbohydrate 4 cal/g
  6. 6. Leading Causes of Death diabetes heart disease cancer stroke
  7. 7. Whole Foods whole fruits, vegetables, grains, grass fed meats, eggs Refined carbohydrates, processed oils, packaged products
  8. 8. DRI FAT: 20-35% total calories • SATURATED FAT: < 10% of total calories • AHA < 7% • TRANS FAT: as low as possible (<1%) • CHOLESTEROL: < 300mg CARBOHYDRATE: 45-65% of total calories • ADDED SUGAR: < 5% of total calories PROTEIN: 10-15% upper limit 35% • or 0.8g/kg
  9. 9. RDA and EER
  10. 10. Phytochemicals Biologically active substance in plants Non-nutrient May protect against chronic disease Anti-oxidants • Example: Soy, chocolate, flaxseed, tomatoes, garlic, wine, tea
  11. 11. Fruit vs Vegetable Fruit Vegetable • entire plants with seeds • seeds, stems, flower, leaves, stem, root
  12. 12. Digestion and Absorption • Mouth • Stomach • Intestines • Liver • Gallbladder • Colon
  13. 13. Digestion & Absorption Digestion: Breakdown of nutrients Absorption: passage of nutrients from the digestive tract to the bloodstream
  14. 14. Storage Organs – when we eat too much CHO Fat Fat Protein N o t Glycogen Fat Fat
  15. 15. Carbohydrate Recommendations Carbohydrates Added sugar 45-65% < 5% Fiber Women: 25 grams Men: 38 grams
  16. 16. Simple Carbohydrates monosaccharides disaccharides
  17. 17. Carbohydrates Simple Carbohydrates Complex Carbohydrates fiber glycogen
  18. 18. Blood Sugar Blood sugar : results in insulin secretion by the pancreas Blood sugar : results in glucagon secretion by the pancreas
  19. 19. Wheat Kernel A: Husk - removed B: Bran - most of fiber C: Endosperm - starch D: Germ - nutrients/ protein What happens during refining?
  20. 20. Diabetes  Type I Diabetes     Autoimmune disease Cells of the pancreas do not secrete insulin Typical onset is childhood Type II Diabetes  Insulin resistance  Pancreas secretes enough or too much insulin  Typically adult-onset, now seen in children
  21. 21. LIPIDS Lipids Triglycerides (TG) ≈95% of all lipids in foods and the human body Phospholipids For example, lecithin Sterols For example, cholesterol P
  22. 22. Fatty Acids Essential Fatty Acids • Omega - 6 • Omega - 3 * Most Americans consume more omega-6 FAs than omega-3 FAs
  23. 23. Lipoproteins LDL Transport cholesterol and other lipids to body tissues HDL Carry cholesterol from body cells to the liver for disposal (scavenges cholesterol)
  24. 24. Trans Fatty Acids Trans fats are a byproduct of hydrogenation
  25. 25. Proteins 1. 2. 3. 4. 5. Genes determine the sequence String of amino acids Peptide bond Not a straight chain Shape determines function.
  26. 26. Proteins  Multiple functions - we don’t want to use proteins for energy  Antibodies  Enzymes  Connective Tissue (muscle, ligament, etc)  Hormones  Acid Base Balance  Buffers
  27. 27. Wasting • When the amine group has been removed, it means the amino acid has been wasted
  28. 28. Vegetarian/Vegan Diet • A healthy vegetarian diet is associated with a lower risk of chronic disease • Both a vegetarian diet and a meat eater’s diet should include a wide variety of fruits and vegetables and whole grains • A vegan diet needs to be supplemented with Vitamin B12 • Mutual supplementation is the combining of plant foods to form complete proteins
  29. 29. Vitamins Water Soluble Vitamins     Dissolve in water Easily absorbed and transported Not stored extensively Rarely toxic from food Fat soluble Vitamins     Does not dissolve in water Needs fat to be absorbed Stored in the body Can be toxic from food sources
  30. 30. Vitamin A Vision 2. Growth and maintenance 1. Needed by the body linings and skin 2. For growth of bones and teeth 3. Immune defenses 1. Can be toxic from food (Vitamin A potentially the most toxic)
  31. 31. Beta - carotene 1. 2. 3. 4. 5. Precursor to Vitamin A Not toxic from foods Supplements are not recommended Can turn the skin orange Plant source
  32. 32. Other Fat Soluble Vitamins Vitamin D Vitamin E Vitamin K
  33. 33. Other Fat Soluble Vitamins Vitamin D Regulate blood calcium Vitamin E Antioxidant / works with Selenium Vitamin K Forms blood clotting and bone proteins * Given to infants a birth because they do not have vitamin K producing bacteria
  34. 34. Other Fat Soluble Vitamins Vitamin D - deficiency Vitamin E - deficiency Vitamin K - deficiency
  35. 35. Other Fat Soluble Vitamins Vitamin D - deficiency Rickets Vitamin E - deficiency Erythrocyte hemolysis in premature infants Vitamin K - deficiency Fractures and bleeding
  36. 36. Vitamin K K1: Synthesis of blood clotting proteins K2: Synthesis of bone proteins
  37. 37. The Gatekeeper and the Traffic Cop Vitamin D: Gatekeeper Vitamin K: Traffic Cop
  38. 38. Other Fat Soluble Vitamins Vitamin D - SEVERE deficiency Rickets Low levels of Vitamin D associated with  Osteoporosis  Autoimmune diseases (RA, type 1 DM)  Some cancers (colorectal, breast, prostate)  Hypertension (high blood pressure)
  39. 39. Water Soluble Vitamins Vitamin C  Important in the formation of collagen  Deficiency results in scurvy  Anti-oxidant  Boosts iron absorption  Supports the immune system  But has not been proven to prevent the common cold  Need is greater in smokers
  40. 40. Water Soluble Vitamins B - vitamins  Coenzymes  Energy metabolism  Act in conjunction with one another VITAMINS don’t provide energy!
  41. 41. Water Soluble Vitamins B - vitamins  Thiamin  Deficiency results in Beriberi  Niacin  Deficiency results in Pellagra  Toxicity - niacin flush  Tryptophan converts to niacin  Niacin is sometimes prescribed to manage blood lipids  Riboflavin  Destroyed by UV light - opaque cartons for milk
  42. 42. Neural Tube Defects Spina bifida Folate
  43. 43. Neural Tube Defects almost 25% drop in the national incidence of neural tube defects All enriched grain products are fortified with folic acid
  44. 44. Pernicious Anemia A result of Vitamin B12 deficiency  A lack of intrinsic factor will decrease absorption  Main cause  Elderly most at risk  Vegans are also at risk of B12 deficiency, but not as common  Vitamin B12 is only found in animal sources * B12 function to maintain nerve sheaths
  45. 45. Food Preparation & Storage Vitamin C&E can be oxidized • Close lids tightly • Eat soon after chopping Vitamin C & Bs, minerals leached • Avoiding boiling and soaking cut vegetables Vitamin C, folate & thiamin heat intolerant • Avoid cooking at too high of a temp and too long
  46. 46. Supplements  Not regulated by the FDA  Healthy individuals do not need supplements  Best source of vitamins & minerals is from food
  47. 47. Sodium and Potassium –Sodium and potassium are important in fluid and electrolyte balance –Most of excess sodium is from processed foods
  48. 48. Iron Iron absorption •Heme (23%) Iron •Non- heme (2-20%) heme Increase absorption (non-heme) •Vitamin C •MFP Inhibit absorption (non-heme) •Tannins, phytates •Calcium, phosphorus hemoglobin
  49. 49. Iron Deficiency • Iron deficiency can lead to anemia • Women in their childbearing years are most at risk
  50. 50. Calcium - Osteoporosis • Loss of bone mineral density • Not achieving peak bone mass increases the risk of developing osteoporosis • If you do not achieve peak bone mass - you cannot catch up later in life • Ca & Vit D intake, gender, genetics, physical activity contribute to risk
  51. 51. Iodine • Part of thyroxine • helps to regulate metabolism •Deficiency can result in goiter
  52. 52. Selenium Selenium Vitamin E Vitamin C antioxidants
  53. 53. Overweight & Obese • 65% of Americans are overweight •30% of Americans are obese
  54. 54. Central Obesity • Visceral Fat • more active • contributes more to blood lipids than subcutaneous fat • Apple shape • Higher risk of heart disease, diabetes and stroke
  55. 55. BMI: Body Mass Index Risk for heart disease, hypertension, diabetes, stroke Determine risk: BMI, Waist, Disease Profile, Activity Level Can be overweight and healthy!
  56. 56. Hunger & Satiety  Hunger: physiologic need for food/ energy  Appetite: psychological desire for food  Satiety: feeling of fullness Hunger is a greater drive than satiety Stretch receptors in the stomach send a signal to the brain  satiety
  57. 57. Calorie Unit of food energy
  58. 58. Energy Expenditure Energy In: Food + beverages Energy Out: Physical Activity BMR TEF
  59. 59. Risk Factors and Disease Association causation Risk Factors for Heart Disease  High LDL/Low HDL  Atherogenic Diet  Hypertension  Genetics  Male, increasing age
  60. 60. Heart Disease & Smoking Smoking is a powerful risk factor for heart disease  Direct damage to the heart  Increases blood pressure
  61. 61. Atherosclerosis Damage to artery wall • Smoking • Aging • Hyperlipidemia Fatty streak • Body responds • Inflammation • LDL oxidation Plaque • Smooth muscle • macrophages • Lipoproteins
  62. 62. Atherogenic Diet Contributing factor for Heart Disease 1. High in saturated fats 2. High in trans fats 3. Low in fruits and vegetables 4. Low in whole grains
  63. 63. Hypertension Elevated Blood Pressure  Ideal resting blood pressure is 120/80  Can’t feel when BP is too high  Increased volume  increases pressure  Narrow vessels  increase pressure Factors:  Atherosclerosis, kidneys, obesity, genetics DASH diet lowers BP more than decreasing sodium intake alone
  64. 64. Cancer Development smok e Carcinogen . . Promoters DNA Damage . . Metastasis Cells multiply
  65. 65. Exposed to carcinogens daily Not all carcinogens cause damage Anti-oxidants quench free radicals Body can repair cell damage Damage not repaired -> cell self-destructs
  66. 66. Infant Birthweight Infant birthweight is the most potent single indicator of an infant’s future health Sign that the mother had poor nutritional status
  67. 67. Iron  During  the pregnancy body avidly conserves iron  Iron  The absorption increases developing fetus still draws heavily on its mother’s iron store  The fetus wants a store of iron for the first 3-6 months of life  Supplementing with iron during pregnancy is recommended
  68. 68. Breast Milk Infant Stores Supplements? Iron At 4-6 months, an exclusively breast fed infant is at risk of iron deficiency.
  69. 69. Nutritional Deficiency in Pregnancy Nutritional deprivation of the mother will reduce the quantity, not the quality, of her milk Nutrients will be taken from the mother’s stores first Calcium will be taken from the maternal stores (bones) if she is not taking enough Calcium recommendations stay the same during pregnancy
  70. 70. Calcium Absorption Doubles During Pregnancy
  71. 71. Carbohydrate Lipids Protein Lactose Main energy source Easily digested Easy to digest EFAs Lactoferrin - iron Enhance Ca absorption
  72. 72. Vitamins Minerals Vitamin C High Ca highly absorbable Vitamin D Low Low in sodium High in zinc and iron
  73. 73. Protein Mineral s Carbs Toddler Nutrient Needs Vitamin s Fiber Fatty acids
  74. 74. Food Allergy Food Intolerance Food Aversion Recognized as foreign Not an allergy Intense dislike Immune response Unpleasant symptom Grow out
  75. 75. Too Little Too much
  76. 76. Protein • Recommendation stays the same Fiber • Same: adequate amounts are important! Fat • AHA diet Vitamin A • Recommendation decreases Vitamin D • Recommendation increases Water • Same: adequate hydration important! Iron • Recommendation decreases – iron status improves. Calcium • Recommendation increases – absorption decreases
  77. 77. Physical Activity Physical Activity in Elderly Allows for consumption of more nutrients Decreases mental losses Increases physical strength independence Gain independence
  78. 78. 48 million cases of foodborne illness 3,000 deaths annually E Coli • Not all E coli are dangerous • Lives in our intestines with about 500 other bacteria • Infections with 0157:H7 can be fatal • Bloody diarrhea, intestinal cramping, dehydration
  79. 79. Food Safety Bacteria grow at 40 - 140 degrees Wash dishes with warm soapy water and rinse at 140 degrees, air dry or with rinse with dilute bleach or use dishwasher Food should be put away or thrown away after 2 hours Wash hands with warm soapy water Rinse fruit and vegetables for 30 seconds Don’t wipe counters with same sponge you cleaned dishes with
  80. 80. Preserving Foods Freezing • At 0 degrees minimal nutrient losses Canning • Some nutrient losses • Protects from most microbial growth Drying • Commercial drying eliminates spoilage and helps prevent nutrient losses
  81. 81. itromax Flavors Natural and Artificial Flavors
  82. 82. Pesticides Control insects, weeds, diseases 4.5 billion lbs of pesticides/year Linked with birth defects, tumors in animals Effective?
  83. 83. Pros Cons Minimize pesticide exposure 25% of organics have pesticides Limits pesticide resistance High cost Benefits environment Not nutritional superior
  84. 84. GMO Pros GMO Cons
  85. 85. THE END

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