Nutr Unit 4

Dietary Supplement Health and Education Act

Which piece of legislation regulates dietary supplements?
-it expanded the formal definition of dietary supplements
- modified FDA's role in regulating dietary supplements

Food and Drug Administration and the Federal Trade Commission

the two federal agencies involved in regulating supplements and supplement claims and labeling

Food and Drug Administration

regulates dietary supplements differently than conventional foods and drugs
manufacturer must ensure supplement safety before placing on market
adverse events reported to FDA or manufacturer
FDA tracks adverse events and may prohibit sale of supplements via: Post-market surveillance

The Federal Trade Commission

monitoring accuracy of advertising and labeling of supplements

NONE

which federal agency regulates product quality of supplements?

Risk of dietary Supplements

Quality may be poor
Efficacy and safety not guaranteed
Harmful interactions with some drugs
Possibility of contamination and/or adulteration

Beneficial Dietary Supplements

Omega-3s acids and fish oils
Glucosamine Chondroitin
Creatine
Caffeine

Who uses Dietary supplements

Women- they are at greatest risk for iron deficiencies and prenatal care
Adults age 60 or older- metabolism slows down and so needs help acquiring certain nutrients in digestive system and in blood
Caucasians
those with higher education level- socioeconomic status plays a role because you have the extra resources to spend on vitamins and etc.
Athletes
College Students

Steps in decision making about dietary supplements

1. Evaluate your diet
2. Check with you health care practitioner
3. Ask yourself, does it sound too good to be true?
4. Lean to recognize a fraudulent claim
5. Be skeptical

Fitness

ability to perform moderate to vigorous levels of physical activity without fatigue throughout lifeC

Components of Fitness

Cardiorespiratory endurance
Muscular Strength
Muscular endurance
Flexibility/Stretching's

Optimal Cardiovascular health

participate in moderate intensity excersie 3-5 days per week

Heart Rate Range for moderate intensity exercise

(220-age)X0.55 and (220-age)X0.7

Heart Rate range for high intensity exercise

(220-age)X0.7 and (220-age)X0.85

Muscular Strength

how much can you lift of something?

Muscular endurance

how long can you lift something for? how long can you hold the weight for

Strength Training to achieve maximum benefits

8-12 repetitions
8-10 different exercises
more than 2 non consecutive days per week

Flexibility

how much can you move without pain?

Cardiorespiratory endurance

how long can you maintain excerise for? like how long can you do it?

Static Stretching

non-movement stretching, holding positions

Dynamic Stretching

there is movement in the stretches

Benefits of exercise and physical activity

-helps prevent chronic disease
-improves quality of sleep
-helps with body weight management
-maintenance of muscle mass

Chronic Disease and exercise

increase HDL, good cholesterol
decreases resting heart rate
decreases blood pressure

body weight management and exercise

-exercise assist with weight management by regulating hunger
>increases metabolic rate
>muscle mass maintenance requires more calories than fat
-in older adults, exercise also important for maintaining strength, improving balance and recovery from illness

Energy systems used by the body

Immediate energy system
anaerobic metabolism
aerobic metabolism

Immediate energy system

ATP- creatine phosphate (ATP-CP) system
uses ATP stored in muscle
used during first 10 seconds of exercise
quick energy bursts

Anaerobic metabolism

no oxygen is used
glycolysis
used during first 2-3 minutes of activity
breakdown of glucose to pyruvate in muscle
> pyruvate goes to lactic acid
much of the lactic acid is transported to liver
> 2 lactic acid molecules to glucose
cori cycle is involved hereC

Cori Cycle

process of transporting lactic acid from muscle to liver and retunr of glucose to muscle

Aerobic metabolism

oxygen is used
meets prolonged demands of sustained activity
> 2 minutes to several hours
>carbohydrate, fat amino acids are continuously oxidized to provide ATP
during rest, body derives most ATP from oxidation of fatty acids and glucose
during physical activity, body adjusts fuel mixtures
> muscles always use combination of fuel sources

Female Athlete Triad

describes 3 interrelated health problems associated with prolonged caloric restriction
eating disorder
-anorexia
-bulimia
-disordered eating
amenorrhea
-delayed menarche
-absence of menstrual cycle
osteoporosis
-increases risk of stress fractures
-low bone density

Recommendation for fluid intake for athletes

5-12 ozs, every 5-20 minutes under normal conditions
fluids with sodium are needed for exercises > 2 hours and in hot conditions

Recommendation for protein intake for athletes

AMDR: 15-20% of total calories for athletes,
1.Both strength and endurance athletes have higher protein needs than sedentary person
2.Strength athlete needs more protein for muscle repair and growth
3.Endurance athlete needs more protein for muscle repair and muscle growth and energy needs

Recommendation for Carbohydrate intake for athletes

Daily carbohydrate needs depend on frequency, intensity, and duration of exercise
Low to moderate intensity cardiorespiratory activity
> 1 hr in duration
4-5 grams of carbs per kg of body weight
Endurance activities of higher intensity
7-8 grams of carbs per kg of body weight
High intensity daily training
8-10 grams of carbs per kg of body weight

DSM-V

serves as a reference for diagnosing eating disorders

Anorexia Nervosa

Refusal to maintain body weight at or above a minimally normal weight for age and height
intense fear of gaining weight or becoming fat
-generally underweight individuals
poor body image
amenorrhea may occur

Bulimia Nervosa

Eating large quantities of food in short period of time and then followed by inappropriate weight compensatory behavior
Binging, feelings of loss of control
Binging is followed by inappropriate weight compensatory behavior: Purging, laxative use, dieting, excessive exercise
individuals is generally of normal weight

Binge eating disorder

recurrent episodes of binge eating
lack of compensatory behaviors to control weight
often goes unreported, may be higher among obese individuals

restricting anorexia nervosa

individuals restrict what they eat

Bing-eating or purging anorexia nervosa

individuals binge eat and then they purge their diet

Purging bulimia

by means of laxatives, diuretics, or vomiting

nonpurging bulimia

excessive exercise or dieting

Other specified feeding or eating disorder (OSFED)

disordered eating patterns and behaviors that do not meet specific criteria for other eating disorder diagnosis
associated with - reduced ability to engage in social interactions and -inability to perform work at expected level

Atypical anorexia nervosa

anorexia nervosa but weight is at or above the normal range

Bulimia nervosa of low frequency and/or limited duration

Frequency: < 1 episode per week
Duration:

Binge eating disorder of low frequency and/or limited duration

Frequency: < 1 episode per week
Duration:

Purging Disorder

Recurrent purging to influence weight or shape in the absence of binging

Night Eating syndrome

recurrent episodes of night eating
eating after waking from sleep or excessive food intake after evening meal

Unspecified feeding or eating disorders

eating disorders that do not meet specific criteria for eating disorders
results in clinically significant distress or impaired and occupational engagement

Risk factors for disordered eating behavior

Dieting, Cultural pressure, body dissatisfaction, teasing, poor self-esteem, puberty, family, athletics

Orthorexia

Fixation on righteous eating
Unhealthy obsession with eating only foods considered pure and of high quality

Body dysmorphia disorder

psychological condition of an altered impression of one's body
preoccupied with the thought that appearance is unattractive or deformed

Muscle dysmorphia

type of BDD im which individuals focus on their muscularity and believe they are never muscular enoughb

body image

how individuals picture their body or how they feel about how they look

Body dissatisfaction

poor body image
risk factor for developing disordered eating behavior

Anabolic-androgenic steroids

manufactured hormones related to natural male sex hormones
developed in the 1930s for medial purposes
illegal to possess without a prescription
banned in most competitive sports

societal influences and eating disorders

society places a portrayal of what a man or woman should look like, and this can be seen in the media and in advertising. so this creates an unrealistic standard for people to achieve or maintain

Family characteristics and increased risk of developing eating disorders

1. Not accepting individuality
2. Overprotectiveness
3. Inflexibility in rules
4. Inadequate boundaries
5. Inability to effectively communicate or express feelings
6. Genetic link may also exist

Health complications of eating disorders

can range from mild to severe
heart failure
kidney failure
multiple organ failure
illness such as pneumonia- related to poor immune response
5-20% of anorexia nervosa patients die

Multidisciplinary treatment for eating disorders

1. Individual therapy
2. Group therapy
3. Family therapy
4. Complementary therapies
5. Cognitive/behavioral therapy
6. Nutrition counseling with registered dietitian
7. Essentially there is a lot of therapies that an individual with an eating disorder should be in so that they properly overcome the eating disorder. It is a team approach in solving a eating disorder

arginine

supplement that can lower blood pressure by relaxing blood vessels by nitric oxide

protein content in milk

20%- whey
80%- casein

Independent agencies that aid in ensuring supplement quality.

U.S. Pharmacopeia
ConsumerLab.com
NSF international

similar

recommendations for athletes and non-athletes are ________

Glycolysis

the metabolic pathway in cellular respiration that does not require oxygen

carbohydrates

what is the preferred fuel source during higher intensity exercise?

aerobic metabolism

during low to moderate intensity exercise, the body primarily utilizes

Energy Recommendation for Pregnancy

1. No need to increase during the first trimester
2. After the first trimester you should increase your calories by 200-300 calories a day from pre-pregnant needs
3. Best indicators that energy needs are being meet
-hunger
-progression of weight gain

Protein Recommendations for Pregnancy

1.Protein is important for building body tissues
2.Should increase by ~25 grams a day
3.The same sources of proteins but certain (predatory)fishes should be avoided (king mackerel, tilefish, swordfish)
4.Vegetations should pay close attention to protein intake

Carbohydrates Recommendation for Pregnancy

1. Primary source of energy
2. Should consume 175 grams or more a day
3. Fiber- help prevents constipation and hemorrhoids
4. Decrease intake of simple sugars or empty calories in order to meet the increased nutrient needs

Fat Recommendation for Pregnancy

1. TOTAL FAT INTAKE DOES NOT CHANGE
2. Essential fatty intake should increase
-Linoleic and alpha-linolenic acids
-Focus on polyunsaturated fats
3. 3rd trimester fat is stored for the newborn to use.

Folate Recommendation for Pregnancy

1. Prepregnancy- 400 ug a day
2. Pregnancy- 600 ug a day
3. So a 50% increase

Inadquate folate leads to

Neural tube defects
1. Spina bifida
2. Anencephaly
3. Preterm delivery
4. Low birthweight baby
5. Slow fetal growth rate

Iron Recommendations during Pregnancy

1. Iron increases to 27 mg a day
2. Increased iron is needed for building red blood cells in fetus to carry oxygen to cells

Inadequate Iron leads to

Maternal iron-deficiency anemia associated with an increased risk with premature delivery, low birthweight, and low iron stores in the infant

Calcium Recommendation for Pregnancy

Increased 30mgs during the 3rd trimester
1. Absorption doubles in intestine
2. The kidneys increase resorption
3. Calcium turnover in bone increases
DOES NOT INCREASE DURING PRGNANCY
Needed for
1. Development of bones and teeth in the fetus
2. Maintain strength in the bones of the mother

Zinc Recommendation for Pregnancy

1. Requirements are increased by more than 30% during pregnancy
Needed for DNA and RNA synthesis

Inadequate Zinc Leads too

1. Birth defects
2. Poor cognitive development after birth
3. Premature delivery
4. Prolonged labor

Fluid Recommendation for Pregnancy

1. General fluid needs increased during pregnancy in order to support fetal circulation, amniotic fluid, and higher blood volume and also helps prevent constipation
2. 1-1.5 mL per calorie consumed
3. Increased fluid intake by 300 mL above non-pregnancy intake

Multi-vitamin supplementation needed for

Vegans, breast feeding women, follow restrictive diets, smoke cigarettes, abuse alcohol, are carrying twins or triplets

Iron Supplementation

this vitamins needs are difficult to meet via diet

Folic acid supplementation

this vitamin needs should begin 1 month before conception

calcium supplementation

this vitamin is recommended for vegans, women older than 25 and those avoiding milk products

Gestational Diabetes

-rise in blood glucose diagnosed during pregnancy
-usually controlled via diet and lifestyle
-complications associated with exposure to increased glucose
1. for infant
1. macrosomia- very large birth weight
2. for mother
2. increased risk for type 2 diabetes

edema

Fluid retention that results in swelling of hands, feet and ankles

Pica

compulsive eating of nonfood substances such as clay, chalk, or dirt, or paper

pre-eclampsia

1. High blood pressure and edema
2. Protein in the urine

Eclampsia

1. Manifestation of pre-eclampsia
2. Convulsions or seizures

Negative Impacts of Caffeine

1. Travels through placenta and effect fetal heart rate and breathing.
2. Consuming more than 2 cups of coffee daily may increase risk of miscarriage or low birthweight baby
3. Breast milk can also transfer to baby which leads to irritability in the baby
4. Avoid or limit caffeine to less than 300mg a day

Negative impacts of Alcohol

1. Should consume NONE
2. Can lead to Fetal Alcohol Syndrome

Fetal Alcohol Syndrome

condition condition in infant caused by maternal alcohol consumption
Characterized by growth retardation, facial abnormalities, and central nervous system (CNS) dysfunction

Negative Impacts for smoking

1. Increased risk for
-Miscarriages
-Preterm delivery
-Smaller birth weight
2. May impair blood flow to developing fetus which leads to decreased nutrient and O2 delivery

Listeria

1. Uncooked meats and vegetables and unpasteurized milk
2. Ready to eat foods (hot dogs and deli meats)
caused by listeria monocytogenes

Toxoplasma

1. Parasite found in undercooked meat
2. Cat litter
caused by toxoplasma gondii

Benefits of breastfeeding for mother

1. Lose weight faster
2. Build stronger bonds with their babies
3. Decreased risk of breast and ovarian cancer
4. Saves money by not buying formula

Benefits of Breastfeeding for Infant

Newborns are less likely to experience
1. Allergies and intolerances
2. Ear infections (otitis media)
3. Vomiting
4. Diarrhea
5. Pneumonia, wheezing, and other respiratory diseases
6. Meningitis
7. Sudden infant death syndrome (SIDS)
8. Possible reduced obesity

Colostrum

first milk produced after birth if of thinner consistency and is slightly yellowish in color
high in protein
contains maternal antibodies and serves as a laxative to clear meconium
frequent small meals in first few days coat baby's digestive tract and prevent invasion of foreign substances

Complementary foods

solids and liquids that join breast-feeding in normal progression towards adult eating patterns

Extrusion reflex

tongue-thrusting reflex

Bottle mouth Syndrome

infants or toddlers who go to bed with a bottle or sippy cup of milk or juice are at risk for developing.

Amenorrhea

the lack or absence or delayed of a menstrual cycle