Nutrition Final Exam Notes Chapter 1: Foundations of Nutrition - The Recommended Dietary Allowance or RDA is defined as the average

daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (approximately 98 percent) healthy individuals; AI stands for adequate intake. The AI is a recommended intake value based on observed or experimentally determined estimates of nutrient intake by a group of healthy people that are assumed to be adequate. An AI is established when an RDA cannot be determined; UL stands for tolerable upper intake level. The UL is the highest level of daily intake of a specific nutrient likely to pose no risk of adverse health effects in almost all individuals of a specified age. - Taste, habit, culture food taboos, social environment, availability, convenience, cost, emotions, religious beliefs, political/environmental beliefs, self-image, health benefits - Carbohydrates, proteins, fats, vitamins, minerals, water o Macronutrients constitute the majority of an individual s diet. Macronutrients include carbohydrates, proteins, fats, macro minerals, and water. Carbohydrates, proteins, and fats are interchangeable as sources of energy, with fats yielding 9 calories per gram, and protein and carbohydrates each yielding 4 calories per gram. Micronutrients are vitamins and trace minerals. Vitamins and trace minerals are labeled as micronutrients because the body only requires them in very small amounts. o Organic-carbs, fats, proteins, vitamins (organic nutrients contain carbon); Inorganic-minerals, water o Carbs 4 kcal/g, fat 9 kcal/g, protein 4 kcal/g, alcohol 7 kcal/g - Not everyone who gives out nutrition info or sells diet-related products is trustworthy; Nutrition on TV; Nutrition in the News; Nutrition on the net Red Flags of Nutritional Quackery o Satisfaction guaranteed o Quick and easy fixes o Natural o One product does all o Time tested (i.e. not research tested) o Paranoid accusations (secret knowledge) o Personal testimonials (check credentials) o Meaningless medical jargon o Free trials that you need to give credit card info

Chapter 2: Diet Planning - adequacy, balance, kilocalorie control, nutrient density, moderation, variety - Nutrient dense foods have a high nutrient to calorie ratio meaning they are rich in nutrients when compared to their calorie content; Energy-dense foods are those that are high in sugar, salt, and fats with little to no vitamin, mineral, or fiber content for the volume - 2005 dietary guidelines

o Adequate nutrients within energy needs  Consume foods from all food groups and limit foods that can be detrimental to health.  Consume a balanced diet. o Weight management  Maintain a healthy body weight.  Prevention of weight gain o Physical activity  Increase energy expenditure and decrease sedentary activities.  Include cardiovascular conditioning, stretching, and resistance exercises. o Food groups to encourage  Choose a variety of fruits, vegetables, milk and milk products, and whole grains. o Fats  Limit saturated fat, dietary cholesterol, and trans fats.  Choose monounsaturated and polyunsaturated fat sources.  Choose lean, low-fat, or fat-free foods. MyPyramid o Grains, fruit, vegetables, oils, dairy, meat and beans, fats and sugars o Discretionary kcals- solid fats and sugars  Extra free calories to use after you get all the nutrients you need from nutrient dense foods  Varies based on total kcal requirement Structure-Function Claims claims not about any diseases ( builds strong bones , etc.) very similar to health claims no regulation by FDA; health claims- unqualified health statements like calcium and reduced risk of osteoporosis

Chapter 4: Carbohydrates - Simple carbohydrates are quick energy sources, but they do not usually supply any other nutrients or fiber; Complex carbohydrates often supply energy and other nutrients and fiber that the body needs. They are a better choice. - Diasaccharides (= two ) o Maltose (beer, malted milk like from the 50s)  Glucose + Glucose  Also called malt sugar o Sucrose (most foods with sugar)  Glucose + Fructose (50% of each)  Also called table sugar o Lactose (milk and dairy products)  Glucose + Galactose  Also called milk sugar - Glycogen (role in body) o Glycogen is the molecule that functions as the secondary long-term energy storage in animal cells

Fiber Soluble fiber (also called viscous fiber)  Can be digested by bacteria in GI tract  Help to lower blood cholesterol  Fruit & vegetables, oats o Insoluble fiber (nonviscous)  Passes completely through GI tract  Promotes GI tract health  Whole grains & vegetables Carb digestion o Begins in mouth with amylase (= starch + enzyme ) o In stomach, fiber contributes to feeling of fullness (satiety) o Small intestine: Enzymes break sugars down into monosaccharides  Maltase, Sucrase, Lactase  Absorption o Colon: fibers attract water, some digested by bacteria Insulin/Glucagon (& their effect on blood sugar level) o Insulin's job in the body is to keep the level of sugar in the bloodstream in a healthy range to provide energy to your body and brain o Glucagon has a major role in maintaining normal concentrations of glucose in blood, and is often described as having the opposite effect of insulin. That is, glucagon has the effect of increasing blood glucose levels Difference between Type 1 & Type 2 Diabetes o Type I no insulin produced  Most commonly appears in children, but can appear unannounced at any time in life  Must get insulin shots several times per day o Type II cells no longer recognize insulin that is produced  Adult onset, often consequence of obesity  No insulin shots; controlled through diet and weight loss Lactose Intolerance o Symptoms: bloating, diarrhea, abdominal discomfort o Body stops producing lactase enzyme o Lowest prevalence in Northern Europeans; highest in SE Asians, Native Americans o Can be cured by slowly increasing lactose consumption, start with cup of milk per day o Lactose-free milk has been treated with lactase enzyme already Starvation/What does the body do when there s not enough carbohydrate? o Goes into a state of ketosis (our liver converts fat to fatty acids and ketone bodies which can be used for energy) o

Chapter 5: Lipids - Triglycerides (fats and oils) o Have more carbon and hydrogen than carbohydrates (why it s 9 kcal/g) o Composed of 1 glycerol molecule & 3 Fatty acids

o Glycerol o 3 Carbon alcohol ( ol = alcohol) o Backbone for triglycerides Essential Fatty Acids o Omega3- linolenic acid, EPA, DHA o Omega6- linoleic acid o Omega3 foods  Cold-water fish (salmon, tuna), flaxseed oil, vegetable oil  Not in tropical fish (e.g. Tilapia) o Omega6 foods  Most vegetable oils, most meats and fishes Unsaturated vs. Saturated vs. Trans fats o How do they differ?  Unsaturated y Monounsaturated fats and polyunsaturated fats are two types of unsaturated fatty acids. They are derived from vegetables and plants. o Monounsaturated fats are liquid at room temperature but begin to solidify at cold temperatures. This type of fat is preferable to other types of fat and can be found in olives, olive oil, nuts, peanut oil, canola oil and avocados. Some studies have shown that these kinds of fats can actually lower LDL (bad) cholesterol and maintain HDL (good) cholesterol. o Polyunsaturated fats are also liquid at room temperature. These are found in safflower, sesame, corn, cottonseed and soybean oils. This type of fat has also been shown to reduce levels of LDL cholesterol, but too much can also lower your HDL cholesterol  Saturated y These fats are derived from animal products such as meat, dairy and eggs. But they are also found in some plant-based sources such as coconut, palm and palm kernel oils. These fats are solid at room temperature. Saturated fats clog our arteries and directly raise total and LDL (bad) cholesterol levels.  Trans y Trans fats are actually unsaturated fats, but they can raise total and LDL (bad) cholesterol levels while also lowering HDL (good) cholesterol levels. Trans fats are used to extend the shelf life of processed foods, typically cookies, cakes, fries and donuts. Any item that contains hydrogenated oil or partially hydrogenated oil likely contains trans fats. Hydrogenation is the chemical process that changes liquid oils into solid fats. o Health effects

Excesses of saturated fat, trans fat, and dietary cholesterol implicated in future heart attack/stroke risk

o Foods  Saturated y Coconut oil, butter, palm oil,  Unsaturated y Vegetable oils Blood lipid levels (normal cholesterol, HDL, LDL levels) o How to control  Weight control  Replace saturated fats with unsaturated fats  Eating soluble fiber (fruit, veg, oatmeal)  Phytochemicals (fruits and vegetables)  Moderate alcohol consumption  Physical activity  More frequent, smaller meals  Genetics  Drugs (statins, niacin <- don t use supplements) o Health effects  Excesses of saturated fat, trans fat, and dietary cholesterol implicated in future heart attack/stroke risk Cholesterol o Food sources  found exclusively in foods of animal origin such as dairy products, eggs, beef, pork, lamb, poultry and fish

Chapter 6: Protein - Protein Quality o Complete vs. Incomplete  In general, animal proteins (meat, fish, poultry, milk, cheese, and eggs) are considered good sources of complete proteins. Complete proteins contain ample amounts of all essential amino acids.  On the other hand, vegetable proteins (grains, legumes, nuts, seeds, and other vegetables) are incomplete proteins because they are missing, or do not have enough of, one or more of the essential amino acids. o Complementary proteins  Combining plant foods that together contain all the essential amino acids - Essential vs. Non-essential o Amino acids are categorized as essential and nonessential. Of the twenty amino acids that have been identified, nine are considered essential amino acids those that are not manufactured by the body, these must come from

dietary intake. The body can manufacture the non-essential amino acids from the by-products of carbohydrate metabolism. PEM (protein-energy malnutrition) o Kwarshiorkor  Protein deprivation; child gets enough kcalories o Marasmus  Protein and energy deprivation Protein Digestion o Proteases are enzymes in digestive system which break down denatured proteins to amino acids o Amino acids absorbed in small intestine o Digestive system handles whole proteins better than individual amino acids Denaturation of proteins o Proteins can only perform their functions when in the right shape o Denatured proteins have lost their shape, and thus, their function  Heat (ex. Cooking egg whites)  Acid (ex. Making cheese from milk) o This is usually irreversible o 1st step in breakdown of food protein Functions of proteins (many essential body proteins) o Growth and maintenance o Enzymes o Hormones o Fluid balance o Acid-base balance o Nutrient transportation o Antibodies o Energy Nitrogen balance (positive vs. negative) o In healthy adults, protein synthesis usually equals protein breakdown.  Zero nitrogen balance o People who are building more protein than breaking down are in positive nitrogen balance. o People who are breaking down more than building are in negative nitrogen balance Health effects of high protein intake o High-protein diet (especially animal-protein diet) may contribute to heart disease  Increases blood level of homocysteine, an amino acid correlated with heart disease risk.  Coffee, cigarettes, alcohol abuse also increase homocysteine; B vitamins may decrease  Unsure whether homocysteine is a cause or effect of heart disease o High animal-protein consumption can lead to cancer (colon, breast, kidney, pancreas, prostate)

o High intake of protein (all sources) promotes calcium excretion, thus promotes osteoporosis  Inadequate protein may also promote osteoporosis o High protein intake (and low water intake) can lead to kidney stones

Chapter 7: Metabolism/Alcohol - Anabolic vs. Catabolic Reactions o Anabolic  Reactions in which small molecules are put together to build larger ones  Require energy o Catabolic  Reactions in which large molecules are broken down to smaller ones  Release energy - Glycolysis o Breakdown of glucose to 2 pyruvate molecules  Produces 2 ATP directly  Converts NAD into high-energy form NADH  If there s oxygen, NADH will make lots of ATP o Glycolysis is anaerobic no oxygen required - Ketosis/Starvation o Fuel use during starvation? What gets broken down?  Early in a fast, glucose can be made from glycogen and protein  as the fast continues, the body uses ketone bodies to fuel the brain  it combines acetyl CoA fragments derived from fatty acids and forms ketone bodies  RBC continue to use small amount of glucose produced from glycerol Chapter 8: Energy Balance/Body Composition - Satiation vs. Satiety o Satiation: fullness, satisfaction with what you ve ate; ready to stop eating  Protein, complex carbs, water increase satiation in meal  Fat lowest satiating nutrient o Satiety: how long until you feel ready to eat again  Fiber keeps you feeling full for longer  Simple sugars decrease satiety - Appetite vs. Hunger o Hunger: need to eat o Appetite: sensory appeal of food or thinking about food - Basal Metabolic Rate o Energy required to keep you alive; heart, brain, lungs, digestive system, etc. - BMI o Way to compare weights for people with different heights o ONLY includes height & weight

Central vs. peripheral obesity (health effects, how to measure) o Central obesity  Intra-abdominal fat (or visceral fat)  Apple shape (associated with males)  Higher disease risk o Peripheral obesity  Fat storage just under the skin (subcutaneous fat)  Pear shape (associated with females)  Lower disease risk Eating disorders o Female athlete triad  Disordered eating habits can develop from: y Desire to improve performance y Enhance aesthetic appeal of their performance y Meet unsuitable weight standards o Anorexia vs. Bulimia  Anorexia y Characteristics of Anorexia Nervosa o Self-starvation o Physical consequences are major and life threatening. y Treatment is multidisciplinary o Food and weight o Relationships with self and others  Bulimia y Characteristics of Bulimia Nervosa o Binge eating o Purging behaviors y Treatment of Bulimia Nervosa o Weight maintenance o Regular exercise o Counseling

Chapter 9: Obesity - Fat cells o During growth fat cells increase in number o When energy intake exceeds expenditure fat cells increase in size o When fat cells have enlarged and energy intake continues to exceed energy expenditure fat cells increase in number again o With fat loss the size of the fat cell shrinks but not the number - Set point theory o Human body tends to maintain a certain weight o Hormones adjust metabolic processes to maintain weight as much as possible - Leptin vs. Ghrelin

o Leptin  Increases energy expenditure, decreases appetite  Less of this in obese people  More research needed o Ghrelin  Opposite effect of leptin  Increases appetite  Decreases energy expenditure White vs. Brown Fat o White fat  Most common in your body  Fat storage  Very low metabolic rate o Brown fat  Produces heat to raise body temperature  White fat can change to brown fat, but not common  Most metabolically active cells  Energy from fat breakdown used to generate heat, not make ATP Weight loss strategies o Drugs  Sibutramine (appetite suppressor)  Orilstat (blocks fat absorption) o Surgery o Diet o Exercise

Chapter 10: Water-soluble Vitamins - Water- & fat-soluble vitamins o Water-soluble vitamins  Absorbed directly into blood  Travel freely in body  Not stored, excess removed by kidneys  Easier to get deficiency  Toxicity only from supplements o Fat-soluble vitamins  Absorbed into lymph, then travel to blood  Need proteins to carry them  Stored in fat cells  Deficiency takes longer to develop  Toxicity likely from supplements, possible from food sources o Which ones are in which group?  Water y B vitamins o Thiamin (B1) o Riboflavin (B2)

y  Fat y

o Niacin (B3) o Pantothenic Acid (B5) o B6 o Biotin (B7) o Folate (B9) o B12 Vitamin C Vitamin A o Beta-carotene o Lycopene Vitamin E Vitamin D Vitamin K

y y y -

Vitamin C o Functions  Neutralize free radicals  Helps to form collagen y Bones y Wound healing y Tendons y Skin y Many other functions  Histamine blocker (immune system) o Food Sources  Citrus fruit (lemons, limes, grapefruit, orange)  Broccoli  Strawberries  Bell pepper (!)  Kiwi  Brussles Sprouts  Other fruits & vegetables o Deficiency Symptoms  Bleeding gums, pinpoint hemmorages, rough skin o RDA for adults  75 mg (women), 90 mg (men), +35 (smokers) Antioxidants & Free Radicals o Antioxidant nutrients  Vitamins A, C, E o What are free radicals? What do they do?  Molecules with unpaired electrons  Unstable, highly reactive  Chain reactions that produce more free radicals  Attack & destroy cell components  Cause cell death, lead to diseases, aging

y Cancer, arthritis, cataracts, diabetes, heart disease Oxidative stress

Chapter 12: Water & Major Minerals - Normal blood pH range o 7.35-7.45 - Acid-base balance o What is a buffer?  Carbon dioxide (from lungs, metabolism) is used to make the buffer. Water + carbon dioxide makes carbonic acid. Carbonic acid can then break up into bicarbonate and a proton (acid). This creates a buffer. - Sodium o Food Sources  Table salt, condiments, processed foods o Relationship with hypertension  Sodium toxicity results in hypertension - Calcium o Calcium & Osteoporosis  Too low calcium intake leads directly to osteoporosis, increased fractures in adulthood o Control of blood calcium  Blood calcium regulated at expense of bone calcium o Calcium & High-protein diets  The high intake of protein leaches calcium from the bones, which leads to osteoporosis

Chapter 13: Microminerals - Iron o RDA for Adults  8 mg (men, post-menopausal women),  18 mg (women who menstruate), x 1.8 (vegetarians) o Food sources  Meat, fish, poultry  Shellfish  Eggs  Legumes  Grains  Dark green veggies o Food factors that affect iron absorption  Enhancing y Meat, fish, poultry  Inhibiting

y Insoluble fiber, calcium, tea o Heme vs. Non-heme  Heme (10% daily intake) y Found in meat  Non-heme (90% daily intake) y Found in meat and plants Chapter 14: Diet & Disease - Risk factors for: o Cardiovascular disease  Increasing age, male gender, family history, high blood LDL cholesterol, low blood HDL cholesterol, high blood pressure, diabetes, obesity, physical inactivity, cigarette smoking o Type 2 diabetes  Obesity, heredity, aging o Cancer  Environmental factors: y UV radiation y Pollution y Smoking  Dietary factors: y Obesity y Physical activity y Additives and pesticides y Smoked, burned foods y Alcohol use y Red meat (colon cancer) y Acrylamide (fried starches French fries, potato chips) y High-fat diet y Omega-3 fats y Antioxidant nutrients y Fruit and vegetables (lower risk) y Fiber (lower risk for colon cancer) y Phytochemicals o Hypertension  Age increases with age  Genetics those with family history, African-Americans have higher risk  Obesity 60% of those with hypertension overweight  Salt sensitivity  Alcohol consumption - DASH diet

o The DASH diet provides more than the traditional low salt or low sodium diet to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy. Chapter 18: Sports Nutrition & Fitness - What is fitness? o 3 Components:  Cardiorespiratory Endurance  Muscle Strength  Flexibility o Requires minimum amount of activity or exercise o Not just for competing athletes physical activity 3rd strongest predictor of disease risk. - Health benefits of fitness? o Better sleep o Body composition o Bone density/osteoporosis o Enhanced immunity o Strengthened circulatory system o Low disease risk o Lower risk of depression o Strong self-image - 2005 recommendations for activity (not the new ones!) o 30 minutes per day on most days o 60 minutes for weight control - Developing fitness o Progressive overload principle  Start at an intensity level you are comfortable with  Increase Frequency  Increase Intensity  Increase Duration  Push yourself a bit more than you did the last time o Cardiorespiratory Endurance  Activity must elevate heart rate  Must be sustained for 20 minutes  Average resting pulse: 70 (50 for endurance athletes) - Diets for Athletes o High-carbohydrate  60-70% of kcals (about 8 g per kg body weight)  Avoid fiber-rich foods pre-activity o Adequate protein  1.2-1.6 g per kg body weight (higher in power athletes) o Ample fluid - Protein RDA for athletes o 1.2-1.6 g per kg body weight

Chapter 20: Hunger - Food insecurity: What is it? o uncertain access to sufficient food, concerned about being able to buy enough food, can t afford to eat balanced meals - Hunger in the U.S. & Hunger in the World o In the US  11% of households were food insecure in 2003  4% were food insecure with hunger in 2003  Who? y Income below poverty line (35% food insecurity) y Single mothers (32%) y African Americans, Hispanics (22%) y Inner-city residents (15%) y Southern U.S., Western U.S. (13%) y Rural residents (12%)  In the World y 850 million people hungry across the world y Complex causes y Complex solutions needed - What are the causes of hunger? o Short-term causes:  Natural disasters  War/genocide/refugee situations o Chronic causes:  Political instability/ failed states  Economic policy  Poverty  Access to education & health care  Gender issues  Environmental degradation