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Describe the general characteristics of vitamins
-organic nutrient -do not provide energy (kcal) -essential for life
List the fat-soluble vitamins
vitamin A,D,E,K
list the water soluble vitamins
vitamins B and C
What are some of the reasons why vitamins are important to health?
-bone health -energy metabolism -blood clotting -growth and development -RBC formation -immune function -antioxidant defense -amino acid metabolism
What is a free radical and how do antioxidants work (simplistically)?
-substance with unpaired electrons -protect cells by giving up electrons to free radicals
What nutrients act as antioxidants?
vitamins C,E,A
Define vitamin bioavailability
Amount of vitamin that is actually available for use by the body
What are factors that influence the bioavailability of vitamins?
-GI transit time -health conditions affecting fat absorption -food processing and preparation -source of the vitamin
Contrast the effects of different food preparation techniques on vitamins - do you recommend boiling, steaming, microwaving, stir-frying vegetables?
-steaming do not come in contact with the water -boiling lose some of the vitamins -sauté oil can optimize bioavailability -microwaving no water, cooks for short amount of time -recommend steaming, sauté, and microwaving
What are the general characteristics of fat-soluble vitamins?
-often occur together with fat in foods -require fat (and bile) for absorption -concentrated and stored in tissues
vitamin A (1.) the main forms of the vitamin (2.) key functions of that vitamin (3.) at least three good food sources of that vitamin (4.) what happens with a deficiency of that vitamin (5.) what happens with a toxicity of that vitamin.
1.retinoids, beta carotene (preformed vitamin A) 2.vision, reproduction, cellular growth, immune system 3.eggs, fish, yellow/orange pigment foods, milk 4.night blinds, dry eye, poor growth, frequent infections 5.liver damage, carotenemia (yellowing of skin)
Vitamin D (1.) the main forms of the vitamin (2.) key functions of that vitamin (3.) at least three good food sources of that vitamin (4.) what happens with a deficiency of that vitamin (5.) what happens with a toxicity of that vitamin.
1.calciferol, ergocalciferol (D2 plant), cholecalciferol (D3 animal), 7-dehydrocholesterol (sun converts into D3) 2.bone health, immune system, reduce risk of chronic disease 3.fish, dairy products, egg yolks 4.rickets, osteomalacia 5.calcium deposits in soft tissues, poor growth
Vitamin E (1.) the main forms of the vitamin (2.) key functions of that vitamin (3.) at least three good food sources of that vitamin (4.) what happens with a deficiency of that vitamin (5.) what happens with a toxicity of that vitamin.
1.alpha tocopherol, gamma tocopherol 2.antoxidant 3.nuts, sunflower oils, soybeans 4.not common 5.not from foods, interfere with vitamin K in blood clotting, hemorrhage
Vitamin K (1.) the main forms of the vitamin (2.) key functions of that vitamin (3.) at least three good food sources of that vitamin (4.) what happens with a deficiency of that vitamin (5.) what happens with a toxicity of that vitamin.
1.phylloquinone(most active form), menaquinone, menadione, dark leafy greens 2.production of active blood clotting, necessary to make fibrin 3.green leafy vegetables, fish, liver, eggs 4.excessive bleeding, newborns given vitamin K shots 5.unknown, people on warfarin (blood thinner) should monitor vitamin K
What are the general characteristics of water-soluble vitamins?
-B vitamins timpani, riboflavin, niacin, vitamin B-6, pantothenic acid, folate, biotin, vitamin B12 -Vitamin C
All B-vitamins serve what common role?
serve as coenzymes in energy metabolism
Which vitamin(s) is deficient in the following conditions - scurvy, beriberi, pellagra, neural tube defects, megaloblastic anemia, pernicious anemia, nerve damage leading to paralysis?
-thiamin/beriberi -niacin/pellagra -folate/megaloblastic anemia, neural tube defects -vitamin B12/pernicious anemia, pernicious anemia, nerve damage leading to paralysis -vitamin C/scurvy
What are the classic signs of ariboflavinosis?
-glossitis, inflammation of the tongue -chilosis, red dry cracks on lips -skin rash, confusion/headaches
Why would someone be taking high doses of niacin and what are potential toxicity concerns?
-4 Ds, dermatitis, diarrhea, dementia, death -megadoses used to treat high cholesterol. not from foods
What are two key functions of folate?
DNA synthesis and homocysteine metabolism
Describe why more healthcare facilities are testing for blood homocysteine levels.
high levels in the blood are risk for heart disease, cancer, dementia, etc.
List at least three food sources of folate.
-asparagus and papaya -cereal grain enriched in folate acid
How much folate should women of childbearing potential consume?
400 ug/day
When does the neural tube close during pregnancy?
within 6-8 weeks of pregnancy
What are two concerns with excessive intake of folate?
too much may stimulate cancer cell growth and masks vitamin B12 deficiency
How is vitamin B12 important?
part of coenzymes needed for folate metabolism, homocysteine metabolism, and maintenance of myelin sheaths
Vitamin B12 is only found in ___ foods.
animal
What substance is required for B12 digestion and absorption? Where is it secreted?
intrinsic factor, secreted in stomach
What happens to B12 levels as you age?
as you get older the body makes less intrinsic factor. more likely to have a B12 deficiency
List three populations at an increased risk for a B12 deficiency and explain WHY each is at increased risk.
-vegans -elderly -people with gastritis, could result of viral/bacterial infection or GI disorder
How long does it generally take for paralysis to develop as a result of a B12 deficiency?
results in 5-10 years
Identify key functions of vitamin C to health
-connective tissue synthesis -antioxidant -immune system -synthesis of neurotransmitters -enhances iron absorption in GIT
List at least three food sources of vitamin C.
-fresh fruits and vegetables -green leafy vegetables -red bell peppers
What are two classic signs of scurvy?
-poor wound healing -pinpoint hemorrhages -bleeding gums -bruises -depression
What is the UL for vitamin C?
2000 mg/day (2g/day)
Would you recommend vitamin C for someone to fight the common cold? Why or why not? And, if yes, how much would you recommend?
yes, because shortens cold by one day, decreases severity of symptoms by 25%
List the six classes of dietary supplements
vitamin, mineral, herb, botanical, amino acid, metabolite
How are supplements regulated (or not)?
-DSHEA requires labeling and honesty on product -FDA does not test or evaluate safety
When is the best time to take a multivitamin/multimineral?
take with food, full stomach retains pill and dissolves it with its churning action
What food/beverage would you recommend be consumed at the same time as an iron supplement to maximize absorption?
vitamin C, OJ, citrus fruits
What are the general characteristics of minerals?
inorganic nutrients
needed in small amounts
classify as major. trace, or possible essential
What is the definition of a major mineral?
stored predominately in bones. calcium and phosphorus
Which mineral is found in the highest concentration on the human body?
calcium
Describe the most important functions of calcium.
-bone and teeth (mineralization of bone and teeth) -muscle contraction -blood clot formation -nerve transmission
List at least three good food sources of calcium.
-cows milk, whole grain cereal, green leafy foods, dairy foods
What are three factors that influence calcium absorption and bioavailability?
-stomach acid secretion -drinking on cup of milk -high fiber/phosphorus intake
What happens if calcium intake is insufficient?
-vitamin D deficiency -reduced stomach acid secretion -chronic diarrhea -fat malabsorption
Describe how the body responds when blood calcium levels are low
The hormone PTH (parathyroid hormone) is secreted from parathyroid glands
PTH then stimulates vitamin D activity
Increases activity of osteoclast cells (cells that break down bone)
Increase calcium retention in the kidneys (so not as much is secreted in the urine)
Increases calcium absorption in the small intestine Ultimately through those 4 actions blood calcium levels should RISE
Describe how the body responds when blood calcium levels are high
The hormone calcitonin is secreted from the thyroid gland
Inhibits vitamin D activity
Increases osteoblast activity (bone forming cells)
Decreases calcium retention in the kidneys (excrete more in the urine)
Decreases calcium absorption in the small intestine Ultimately through those 4 actions blood calcium levels FALL
When is peak bone mass achieved for most people?
around age 30
List four key modifiable risk factors for osteoporosis.
-following diets that contain inadequate amounts of calcium and vitamin D -using medications such as steroids or some type of anticonvulsants -being physically inactive -smoking cigarettes -consuming excessive alcohol
What recommendations do you have for a person at risk for osteoporosis?
Proper diet and regular exercise
Exposing skin to sunlight to form vitamin D
Exercise Training (weight-bearing activities)
Describe the actions of ADH and renin/angiotensin/aldosterone.
-ADH, secreted from pituitary glands in response to dehydration, stimulates kidneys to conserve water -renin/angiotensin/aldosterone, in response to low blood volume and falling BP, stimulates kidneys to conserve water and sodium/electrolytes
How have overweight and obesity rates changed in the US between 1988 and 2019?
-overweight has not changed that much over the last 20 years -obesity drastically changed. 1990s 23% to 34%. extreme obesity 30% to 64%
List specific health problems associated with obesity.
-pulmonary disease -gallbladder disease -fatty liver disease -male and female gynecologic abnormalities -osteoarthritis (knees) -certain types of cancer (hormonal) -gout (toes/feet) -pancreatitis -coronary heart disease -cataracts -stroke -hypertension
Be able to calculate a person's BMI
BMI = weight (kg)/height (m)^2 * 703
identify if that person is underweight, normal, overweight, or obese class I, II, III.
What are major limitations of using only BMI to evaluate a person's health?
-does NOT account for body composition -muscle weighs more than fat
subcutaneous fat
-layer underneath -women have more in hips, butt, abdominal cavity
visceral fat
-fat embedded within abdominal cavities and vital organs -more derimental
Which fat is more dangerous from a health standpoint?
visceral = DANGER
List two ways that body fat can be measured.
-underwater weighing -air displacement
What are healthy body fat percentages for males and females?
-men 13-21% -women 23-31%
What can waist circumference tell you about a person's health?
-assesses android obesity -greatest contributor to risk for chronic disease -looks at visceral fat
Are males more likely to have an "apple" or "pear shape?"
apple shape
Are females more likely to have an "apple" or "pear shape?"
pear shape
Remember that if energy in is equal to energy out
a person should maintain their current body weight
What are the four components of energy output?
-basal metabolic rate (BMR) -physical activity -thermic effect of food -non exercise activity thermogenesis (NEAT)
What factors influence how much energy a person burns during physical activity?
type of activity, duration, intensity, weight of person
What is the thermic effect of food and how significantly does it contribute to a person's energy output?
-small amount of energy required to digest, absorb, and metabolize nutrients -5-10% of total energy output -higher percentage=burning more calories as heat
What is NEAT?
Nonexercise activity thermogenesis, is the energy expended during spontaneous physical activity that is not active muscular contraction characteristic of exercise.
What are examples of internal, individual, community, local, and global factors that influence a person's body weight?
-genetic factors -psychological factors -access to food -caloric intake -stress levels
Describe the set-point theory.
bodys fat content and body weight in genetically pre determined
A person who is obese is more likely to have more or less active "thrifty genes?"
more active
Contrast hunger and appetite.
-hunger is the psychological need to eat -appetite is the desire to eat appealing food
Briefly describe how ghrelin and leptin influence food intake.
-grehlin stimulated/released from the stomach, stimulates hunger, appetites, and food intake -leptin secreted from adipose tissue, tells the brain you are satiated
What dietary recommendations do you have for a person voluntarily trying to lose weight?
portion and calorie control, emphasize fruits and vegetables, self monitoring
What behavioral recommendations do you have for a person voluntarily trying to lose weight?
physical activity, stress management, sleep
How do weight-loss medications work?
-from a neural standpoint, reduces a persons appetite -inhibit fat absorption
what is disordered eating
chaotic and abnormal food related practices
what is an eating disorder
physiological disturbances that lead to certain physiological changes and serious health complications
What are the three major types of eating disorders?
-anorexia nervosa -bulimia nervosa -binge eating disorder
List the risk factors for eating disorders
-female -adolescent -history of frequent dieting -first-degree relative with an ED -"ideal" body shape important -poor self-image and low self-esteem -perfectionist -dysfunctional family -occupation or sport that emphasizes lean body
Describe the general characteristics of anorexia nervosa (AN).
-self imposed starvation -caloric intake well below BMR -lose significant amount of weight quickly and nutrient deficient -100-200kcal
What are three signs or symptoms of AN?
low self esteem, distorted body image, extreme thinness
Describe the general characteristics of bulimia nervosa (BN).
-repeated episodes of binge eating, followed by unhealthy behaviors to prevent weight gain -5,000-10,000kcals -done in private/later in the day
What are three signs or symptoms of BN?
-swollen salivary glands -intestinal distress and irritation -severe dehydration
Describe the general characteristics of binge eating disorder (BED).
-Recurrent episodes of binge eating, NOT followed by purging behaviors -Individual often normal weight or overweight
What are three signs a person may have BED?
Eating unusually large amounts of food in a short period of time
Eating until uncomfortably full
Eating when not hungry
Eating fast during binge episodes
Eating alone or in secret to avoid embarrassment
Feeling ashamed about eating
Dieting frequently, possibly without weight loss
describe diabulimia
-Person with diabetes (particularly type 1), restricts insulin in an effort to lose weight -Blood glucose levels go up, and body weight goes down
describe orthorexia
-Extreme obsession with eating healthy foods -Fear of eating unhealthy food
describe night eating syndrome
-Binge takes place after the evening meal and when person awakes from sleep during the night -50% kcals during binge
describe muscle dysmorphia
-Unhealthy preoccupation with the bod being too small or not muscular enough -Exercise obsessively -More common in males than females -Prevalence on the rise
What are the three components to the female athlete triad?
-Low energy availability -Menstrual disturbances (menuria) -Reduced bone mineral density
Describe treatment options for eating disorders.
-Multidisciplinary effort -Out patient and in patient treatment options -Innovative therapies, Cognitive behavioral therapy (CBT) -Alternative therapies for eating disorder
What are examples of alternative therapies that may be beneficial as complementary treatment with eating disorders?
Acupuncture
Phototherapy
Equine Therapy
Meditation
Biofeedback
Relaxation Therapy
Where would you refer a UK student who may have an eating disorder?
Counseling center
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