HUNT 141

double burden

over and underweight, we have people worldwide that are undernourished but also people that are overweight/obese

triple burden

undernutrition, macronutrient deficiencies, overweight/obesity

global burden of disease (GBD)

information/data on human health, mental health, diet

nutrition

act of process of nourishing/being nourished, process of providing/obtaining food necessary for health and growth

nutrients

water, carbs, lipids, proteins, vitamins, minerals. molecules found in food/beverages needed by the body for energy, growth, development

micronutrients

vitamins/minerals (mg)

macronutrients

carbs, lipids, proteins (g)

non-communicable disease (NCD)

chronic diseases, take a long time to develop and can’t spread between people (heart disease, cancer, diabetes)

CMNN

communicable, maternal, neonatal, nutritional disease (chicken pox, covid, flu)

number of risk factors for early death dietary

3/15 in 2015

burden of proof

strength of relationship between risk + outcome, strength of evidence for risk-outcome relationship (measured 1-5, 5 is strong association 1 is possibly none)

NZ guidelines

eating/activity guidelines combined, updated 2020, multidisciplinary factors, moving away from bodyweight. variety of nutritious foods every day, choose/prepare foods with, make plain water first choice, keep alcohol intake low, make good choices

gross energy

total chemical energy of a food, determined by combustion of a food sample in a bomb colorimeter (heat of combustion = gross energy of a food)

atwater factors

used to calculate metabolizable energy when you know the amount of a macronutrient eaten (kJ or calories) (carbs and protein 17, fat 37, alcohol 29 kJ/g)

to calculate total energy (TE) from a macronutrient

macronutrient g x Atwater factor kJ/g = total energy kJ

to calculate % TE from a macronutrient

(g macronutrient x Atwater factor) x 100% / total daily energy kJ

AMDR protein

15-25%, ANS 17%

AMDR carbs

45-65%, ANS 49%

AMDR fat

20-35%, 34%

EER

estimated energy/average requirement, average dietary intake predicted to maintain energy balance in a healthy adult of defined age, gender, weight, height, and level of physical activity, pregnancy, lactation status, meets needs of about ½ of the population

RDI

recommended dietary intake, average daily dietary intake level sufficient to meet nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage/gender group, EAR + 2 standard deviations

AI

adequate intake, average daily nutrient intake level based on observed or experimentally-determined approximations or estimates of nutrient intake by a group of health people that are assumed to be adequate, use when RDI can’t be determiend

UL

upper limit of intake

NRV

nutrient reference value for long term health

EAR/RDI

either EAR/RDI or AI, not both

digestion

breaking down foods, peristalsis, macronutrients broken down, micronutrients released/absorbed

mouth

breaks down food into smaller pieces, amylase and lipase

amylase

breaks down carbs

lipase

breaks down fats

stomach

protein starts to become digested, fat/lipid digestion stops

small intestine

majority of digestion/absorption occurs here, secretions break down specific things

bariatric surgery

decrease capacity of stomach, influence absorption of nutrients, immediate effect on type 2 diabetes

large intenstine

reabsorption of water/minerals, gut microbiome

celiac disease

flattens villi in large intestines, hinders absorption of vitamins/causes deficiencies, 1 out of 100 adults

gut microbiome

probiotics (yogurt, miso, kimchi, tempeh)/prebiotics (apple, artichoke, banana), research is weak

carbohydrates

starches, sugars, dietary fibre, glycogen (negligible in foods)

monosaccharides

single sugars (glucose essential energy source, fructose sweetest, galactose rarely occurs naturally as single sugar)

disaccharide

2 monosaccharides (maltose, sucrose, lactose)

maltose

2 glucose produced during seed germination/fermentation

sucrose

glucose + fructose, refined from sugar cane/sugar beets

lactose

glucose + galactose found in milk

oligosaccharides, polysaccharides

few or many glucose units bound/linked

starch

storage form of glucose in plants, found in grains/tubers/legumes

glycogen

multi-branched polysaccharide of glucose, main storage form of glucose in the body, provides glucose during fasting state to body/CNS

dietary fibre

only found in plants, any part of plant that doesn’t get digested in the small intestine broken down by gut bacteria in large intestine (fermentation), laxation/reduction in blood cholesterol/modulation of blood glucose

non-starch polysaccharide (NSP)

resistant starch, resistant to being broken down in small intestine, passes to large intestine to become dietary fibre

Burkitt’s hypothesis

high-fibre diets = less disease

AI for fibre

25 g/day for females, 30 g/day for males

SDT for fibre

28 g/day for females, 38 g/day for males to reduce risk of disease long-term

NZ fibre

ANS says average NZ adults don’t meet AI for fibre, long way away from SDT

free sugars

mono/disaccharides added to foods/beverages by the manufacturer/consumer + naturally present sugars in honey, syrups, fruit juices

intrinsic sugars

naturally occurring found in whole/unprocessed foods

added sugars

extracted/concentrated/refined from sources such as sugar cane, fruit, coconut, sugar beet, or corn, natural but not healthy?

WHO sugar recommendation

reduce free/added sugar intake to less than 10% of total energy intake

lactase persistance

still producing lactase, 1/3 of humans

lactose intolerance

bacteria take over to digest the lactose and produce CO2/methane (bloating, flatulance, constipation, osmotic shock diarrhea)

glycemic index

measures blood glucose after eating a food and a control such as white bread or pure glucose, not a big deal for most healthy people, high = breaks down quickly/releases blood sugar rapidly, doesn’t tell you how high blood sugar could go when actually eat the food

fat/fibre

decrease GI and slow absorption of glucose into the blood

glycemic load

gives more accurate picture of foods real-life impact on blood sugar by telling how quickly glucose enters blood stream/how much glucose per serving it can deliver

IBS

chronic gut condition, uncomfortable but usualy harmless, 5-10% of population and more common in women, more common <50 years, no obvious cause/abnormality

FODMAP

fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

colon cancer

risk factors include old age, being overweight, drinking alcohol, not exercising, Crohn’s disease for >10 years, family history, genetic conditions

risks of colon cancer

decrease with physical activity, fibre, dairy, calcium, increase with red meat, processed meat, alcohol, overweight, tall

protein

amino acids for muscle, gene expression, enzymes, antibodies, transport, hormones, structural support. humans need 20 different types of amino acids to make our proteins

indispensable amino acids

essential, n=9, body cannot make them

dispensable amino acids

non-essential, n=5

conditionally indispensable

n=6, sometimes indispensable

EAR/RDI protein

52/64 g/day for men, 37/46 g/day in women, 0.8 g/kg bodyweight AMDR is 15-25% of daily energy

protein quality

essential amino acids and digestibility

limiting amino acid

body cannot perform protein synthesis without enough of the amino acid, no limiting amino acids compared to what humans need/require because most animal proteins have everything we need, complementary proteins over a day for plant foods

protein metabolism

peptides broken down to amino acids, transported to liver, can be used to make proteins/amino acids/other compounds or used for energy, excess can be converted to adipose fat tissue

vegetarian

almost all research shows benefits of vegetarian/vegan diets such as lower risk of chronic disease, lower energy intake, lower bodyweight/BMI, more health-conscious, higher in fibre, lower in saturated fat

lipids

source of energy, component of cell membranes, hormones, prostaglandins, maintain body temp, cushion internal organs

triglycerides

glycerol + 3 fatty acids, most of fat/lipid in diet (90%), energy/fatty acid storage, structural component of lipoproteins

fatty acids

chains of carbon molecules with a methyl group at one end of the chain and a carboxyl group at the other end, always even # of carbons, length of chain determines fatty acid type, type of bond affects function

length of chain

short chain C2-6, medium chain C8-12, long chain >14, most in diet are C10-C22

saturated fat

saturated with hydrogen, no double bonds so solid at room temp

unsaturated

mono = 1 double bond, poly = 2+ double bonds

C18:1n-9

oleic acid, double bond located 9 carbons from the methyl end and 18 carbons

essential fatty acids

humans cannot make double bond with the first 6 carbons from the methyl end, so linoleic and linolenic acid should make up 1-3% of total energy, deficiency symptoms of stunted growth, reproductive failure, skin lesions/kidney/liver disorders, pretty much impossible to be deficient in

triglycerides

mix of fatty acids attached to the glycerol backbone

phospholipids

5-10% of dietary lipids, chemical structure for cell membranes, plasma lipoproteins, glycerol backbone + fatty acids (hydrophobic) + phosphate group (hydrophilic)

lipid digestion

form fat globules, bile acids emulsify, lipases from pancrease and intestine break down, goes from lymph system to become chylomicrons which contain dietary fats and eventually go to liver

lipoprotein

biochemical assembly whose primary purpose is to transport hydrophobic lipid/fat molecules in water/blood/fluid

VLDL

takes cholesterol from liver through blood to tissues, 10% total

LDL

deposits cholesterol in the heart, high levels are bad, 65% total

HDL

takes fats/lipids away from tissues such as heart, high levels are good (25% total)

cardiovascular disease

risk factors include age, sex, smoking, exercise, total and LDL cholesterol, BMI, diabetes, blood pressure

diets high in saturated fat

tend to increase LDL concentration in most people

cohort study

huge groups, recruit people but don’t tell them to change lifestyle, follow entire life, association

randomized control trial

recruit, split into 2 random groups so differences are due to the factor being changed, tell cause/effect without bias but costly, ethical issues, smaller, shorter

ketones

replace glucose as the main fuel for the brain in situations of glucose scarcity (requires <20-50g carbs per day, some carbs needed for the brain to function on glucose)

margarine

turns vegetable oil into spread  by hydrogenation (add back in hydrogens for less double bonds, cis bonds become trans bonds)

energy balance

energy in - energy out, 2-10% lost in feces/urine

calorimetry

measurement of energy expenditure, direct/indirect or doubly labelled water

doubly labelled water

best technique for measuring energy expenditure but very expensive, tracks elimination rates of stable isotopes of hydrogen and oxygen from body water,

energy out

resting, thermic effect, physical activity, growth (children, pregnancy, training)

BMR vs REE

BMR is stricter, hard to measure, energy expended to fulfill life-sustaining conditions, REE is energy expended at rest without strict conditions

thermic effect of food

10% of energy is thermic affect of food used by digestion

BMI

weight in kg / height², underweight <18.5, healthy <25, overweight <30, obese >30, helpful at population level but need to look at a variety of factors for individuals