Summer 2013 Midterm Review

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Summer 2013 Midterm Review

  1. 1. Nutrition HO-15 Midterm Review We’ll begin the review at 9:00 AM
  2. 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. 3. Nutrients Water Carbohydrates Fat Protein Vitamins Minerals
  4. 4. Nutrients - Organic Water Carbohydrates Fat Protein Vitamins Minerals
  5. 5. Nutrients – Energy Yielding Water Carbohydrates - 4 calories/g Fat – 9 calories/g Protein - 4 calories/g Vitamins Minerals
  6. 6. Nutrients – Energy Yielding
  7. 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. 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. 9. Research Case Study Laboratory Double blinded study Placebo controlled Interventional Epidemiologic
  10. 10. Research – Gold Standard Randomized Double Blinded Placebo Controlled interventional Trial
  11. 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. 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. 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. 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. 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. 16. Macronutrients Percent of Total Calories Carbohydrates 45-65% Fat 20-35% Protein 10-35% (10-15%)
  17. 17. Macronutrients Example: Carbohydrates 45% Fat 30% Protein 25% TOTAL 100%
  18. 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. 19. Importance of Exercise
  20. 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. 21. Benefits of Exercise more restful sleep improved bone density lower risks of chronic disease higher quality of life
  22. 22. Mouth Stomach Liver Gallbladder Pancreas Small Intestine Colon
  23. 23. Mouth - chews, mixes food with saliva Stomach - Liver - Gallbladder - Pancreas - Small Intestine- Colon -
  24. 24. Mouth - chews, mixes food with saliva Stomach - mixes & churns food into a chyme. Denatures (uncoils) protein Liver - Gallbladder - Pancreas - Small Intestine- Colon -
  25. 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. 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. 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. 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. 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. 30. Storage Organs – when we eat too much CHO Where? Where? Fat Where? Protein Where?
  31. 31. Storage Organs – when we eat too much CHO Glycogen Fat Fat Where? Protein Where?
  32. 32. Storage Organs – when we eat too much CHO Glycogen Fat Fat Fat Protein Where?
  33. 33. Storage Organs – when we eat too much CHO Glycogen Fat Fat Fat Protein Fat N o t
  34. 34. Carbohydrates • Simple or Complex?
  35. 35. Carbohydrates • Simple or Complex? Simple!
  36. 36. Simple Carbohydrates Monosaccharides Disaccharides
  37. 37. Complex Carbohydrates fiber glycogen Starch Fiber Glycogen
  38. 38. Fiber
  39. 39. Which part of the wheat kernel Has fiber?
  40. 40. Which part of the wheat kernel has fiber? Bran Which part of the wheat kernel has starch?
  41. 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. 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. 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. 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. 45. Diabetes (Type I & II) Onset? • Type 1 • Type 2
  46. 46. Diabetes (Type I & II) Onset? • Type 1-typically childhood • Type 2-typically adulthood
  47. 47. Diabetes (Type I & II) Cause? • Type 1 • Type 2
  48. 48. Diabetes (Type I & II) Cause? • Type 1 - autoimmune disease • insulin secreting cells impaired • Type 2 - acquired • insulin resistance, obesity, genetics, diet
  49. 49. Diabetes (Type I & II) Insulin Secretion? • Type 1 • Type 2
  50. 50. Diabetes (Type I & II) Insulin Secretion? • Type 1 - no natural insulin • Type 2 - enough or too much insulin
  51. 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. 52. Fats
  53. 53. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat
  54. 54. Percent of Calories from Fat • Hamburger – 500 calories – 25 g saturated fat 25 g X 9 calories/g = 225 calories
  55. 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. 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. 57. LDL and HDL What is LDL? What is HDL?
  58. 58. LDL and HDL What is LDL? • Low density lipoprotein What is HDL? • High density lipoprotein NOT ACTUALLY CHOLESTEROL
  59. 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. 60. LDL and HDL How do you lower LDL? How do you increase HDL?
  61. 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. 62. Trans Fats
  63. 63. Essential Fatty Acids EFAs are which type of fatty acid? Saturated fatty acid? Monounsaturated fatty acid? Polyunsaturated fatty acid?
  64. 64. Essential Fatty Acids EFAs are which type of fatty acid? Saturated fatty acid? Monounsaturated fatty acid? Polyunsaturated fatty acid
  65. 65. Structure of Proteins Peptide Bond
  66. 66. Structure of Proteins
  67. 67. Roles of Proteins Enzymes Structural Hormones Precursors (neurotransmitters/vitamins) Antibodies Fluid Balance Buffers Blood Clotting Provide Energy
  68. 68. Protein digestibility Which types of proteins are best absorbed by the body?
  69. 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. 70. Complementary Proteins Amino acids from one protein source complement the amino acids from another protein source to form a complete protein.
  71. 71. Wasting • When the amine group has been removed, it means the amino acid has been wasted
  72. 72. Protein Energy Malnutrition
  73. 73. Protein Energy Malnutrition Marasmus Chronic protein and energy deficiency Severe wasting Matchstick arms
  74. 74. Protein Energy Malnutrition
  75. 75. Protein Energy Malnutrition Kwashiorkor Protein malnutrition Acute onset (1-3 yr) Edema (legs/belly) Fatty liver
  76. 76. DRI Protein • DRI protein: example – 130 lb sedentary 35 yr female – 130 lb X 1kg/2.2 lb = 59 kg
  77. 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. 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. 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. 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. 81. What are the main functions of Vitamin A?
  82. 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. 83. • What happens in Vitamin A deficiency?
  84. 84. • What happens in Vitamin A deficiency? night blindness Keratinization
  85. 85. Can toxicity develop from Vitamin A? Beta-carotene?
  86. 86. Vitamin A? YES •From supplements or fortified foods Beta-carotene? NO Can toxicity develop from Vitamin A?
  87. 87. What are the roles of Vitamin D in the body?
  88. 88. What are the roles of Vitamin D in the body? Regulation of blood calcium Regulation of phosphorus Raises blood calcium levels
  89. 89. What happens in Vitamin D deficiency? Vitamin D Deficiency
  90. 90. RICKETS Most people are not receiving ENOUGH vitamin D because of the lack of sun exposure Vitamin D Deficiency
  91. 91. What are the best sources of Vitamin D?
  92. 92. What are the best sources of Vitamin D? Sunshine! Fortified milk Mushrooms
  93. 93. What is the main function of Vitamin E?
  94. 94. What is the main function of Vitamin E? Antioxidant: • quenches free radicals • protects cellular structures from oxidative damage
  95. 95. What is the main function of Vitamin K?
  96. 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. 97. Vitamin K Vitamin K is synthesized by bacteria in the intestines Vitamin K is given at birth because the intestines are sterile.
  98. 98. What are the roles of Vitamin C in the body?
  99. 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. 100. What condition develops in Vitamin C deficiency?
  101. 101. Scurvy Vitamin C Deficiency
  102. 102. Vitamin C Does not prevent colds Vitamin C reduces histamine
  103. 103. What is the main function of the B vitamins?
  104. 104. What is the main function of the B vitamins? Part of coenzymes Energy metabolism New cell synthesis
  105. 105. Thiamin deficiency results in what condition?
  106. 106. Thiamin deficiency results in what condition? Beriberi (affects nerves) Loss of sensation in hands and feet muscular weakness advancing paralysis
  107. 107. What condition develops in Niacin deficiency?
  108. 108. What condition develops in Niacin deficiency? Pellagra Diarrhea Dermatitis Dementia Death
  109. 109. Source of Niacin Tryptophan can be converted to niacin Tryptophan is in most proteins
  110. 110. What condition results from folate deficiency in pregnancy? Folate Deficiency
  111. 111. Neural tube defects Fortification of food is important - Most women don’t know they are pregnant for weeks Folate Deficiency
  112. 112. What condition results from Vitamin B12 deficiency?
  113. 113. What condition results from Vitamin B12 deficiency? • Pernicious Anemia Is Pernicious Anemia more likely to develop from lack of intake or malabsorption?
  114. 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. 115. Who is at risk for Pernicious anemia?
  116. 116. Who is at risk for Pernicious anemia? Vitamin B12 is only found in animal sources Elderly - most at risk Strict Vegetarians
  117. 117. Can Vitamin B6 can be toxic from supplements?
  118. 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. 119. Calcium What other function does calcium have besides formation and maintenance of bone structure?
  120. 120. Most abundant mineral in the body Calcium Nerve transmission Transport of ions Blood pressure Blood clotting Muscle contraction
  121. 121. Which mineral assists with muscle relaxation?
  122. 122. Which mineral assists with muscle relaxation? Magnesium
  123. 123. Which mineral is part of RNA and DNA?
  124. 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. 125. What is the main extracellular cation? What is the main intracellular cation?
  126. 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. 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. 128. Potassium fluid and electrolyte balance cell integrity • Diets high in potassium help decrease the risk of hypertension heartbeat
  129. 129. Which mineral is needed for some proteins to assume their functional shape? •makes the proteins strong through certain bonds
  130. 130. Which mineral is needed for some proteins to assume their functional shape? •makes the proteins strong through certain bonds Sulfate
  131. 131. Which mineral is a component of thyroxine?
  132. 132. Which mineral is a component of thyroxine? •Iodine •Thyroxine regulates what?
  133. 133. Which mineral is a component of thyroxine? •Iodine •Thyroxine regulates what? •metabolism
  134. 134. Iodine deficiency can cause? Iodine Deficiency
  135. 135. Iodine deficiency can cause? Iodine Deficiency Goiter • irreversible mental and physical retardation Iodine deficiency can cause cretinism
  136. 136. What two forms are iron absorbed in? What is the absorption rate? Iron Absorption
  137. 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. 138. Increasing iron absorption • Found in Meat, Fish, Poultry MFP factor Vitamin C
  139. 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. 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. 141. Zinc Important in: wound healing immune function
  142. 142. Fluoride Deficiency dental carries Toxicity Fluorosis
  143. 143. Works with insulin to regulate blood glucose Chromium
  144. 144. Which mineral is an antioxidant?
  145. 145. Selenium A mineral which is an antioxidant Note: Vitamin C & E are also antioxidants
  146. 146. THE END

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