Special Topics- EXPH 4189

Public health focus

Iodine deficiency

Water fluoride

Promote Breastfeedin

Lead

Iodine deficiency-

1. What's it from

2. What's it needed for/what happens without

3. How has the US combatted it

1. happens when soil is iodine poor

2. needed for thyroid function

results in goiter

results in low mental capacity worldwide

3. added to salt to combat deficiency

Water fluoridation

to prevent cavities

some people don't consume fluoride water though because they think it's harmful

Promoting Breastfeeding

Breastmilk is best diet for child

Though you can take formula, it probably doesn't have enough nutrients

Lead

toxin in water

we don't want lead! especially in young children because it hinders development

Life cycle nutrition- pregnancy (what changes for the mother?)

maternal weight gain of 25-35 lb is normal

need more protein 1.1 g/kg

higher RDA for folate & iron

Pica

What's pica?

craving for non food items

life cycle nutrition- breastfeeding

positive when possible

What does WHO recommend for breast feeding? What % achieves this?

exclusively breastfeed for first 6 months

<40% achieve world-wide

Is the US breastfeeding rate any different that than worldwide?

No- 25% or less don't breastfeed, and ~50% get to the 6 month mark

lactation consultant

A breast-feeding specialist who shows helps mom's breastfeed

Maternal protein RDA during breastfeeding

1.3 g/kg

Greater than during pregnancy

Breastfeeding effect on ovulation

decreases it

becomes a natural form of birth control

Breastmilk provides what

Prebiotics, immune & growth-stimulating factors

Prebiotics are things that only ______ can digest

microbiota

How can the breastmilk contents be impacted?

mother's health and diet

Leptin

A hormone produced by fat cells that acts as a satiety factor in regulating appetite.

What kind of hormone is leptin

protein hormone

Does baby formula have leptin in it? Why might this cause an issue?

No- babies with formula have higher risk of obesity later in life since leptin has been found to potentially prevent obesity in children

What's in baby formula?

Magnesium, calcium lots of other nutrients

Source of DHA

40% of calories in breastmilk comes from ________

lactose

Why is it notable that 40% of the calories from breastmilk come from lactose?

it's very sweet

high in energy

easy to digest

Infant growth

rapid grwoth

highest nutrition needs

1.5 g/kg BW for protein

Why do infants need such a high amount of protein?

They are in an anabolic state

Colostrum

Name you give breast milk over the first couple days women produces it

Not same color or consistency as real breastmilk (Yellower and stickier)

More antibodies & protein content

Breastmilk is high in what two things for energy?

Lactose and fat

Is breastmilk high in protein?

No really- only about 10% is protein

Why is it good for an infant to be chubby?

Because this means they have enough fat and fuel to grow

Infants and vitamin K

Receive vitamin K injection at birth

For blood clotting- without there's a risk of hemorrhage

When might an infant need a B12 supplement?

If the mother is vegan

Failure to thrive

If baby falls on growth chart = risk of failure to thrive

Looking at body size of baby (percentile of height/weight)

What did the egg study tell us about infant development?

Reduced failure to thrive by 70%

BUT the egg diet was restricting calories from another place/source

Children protein needs

1.0 g/kg

Elderly- diet and concerns

concern if their diet is inadequate

commonly due to eating less food, less access to food, lack of vigor/outdoor exercise

What two vitamins are the elderly typically deficient in and why?

Vitamin D- not going outside or eating fortified things

Vitamin B12- produce less intrinsic factor allowing you to absorb this, less teeth so hard to chew

Are Americans getting most of their calories from animals or plants? How much? What does this tell us?

Animals- 700 kcals

Plants- rest of kcals in 2400 kcal diet

Tell us Americans are primarily planted based when it comes to energy

What percentage of the US adult population self-identifies as vegetarian/vegan?

3-5%

Vegan/Vegetarian- nutrient concerns

Limited, so increased risk

need adequate calories

Vegan/Vegetarian nutrient concerns- fortified foods

Deficient if you aren't adding in fortified things that get you to adequate levels

Vegan/Vegetarian nutrient concerns- Omega 3's

Can seek out in nuts, but these are trying to become EPA and DHA in body

Vegan/Vegetarian nutrient concerns- Vitamin B12 & D

B12- comes from animals, so need to supplement

D- in fortified dairy products

Vegan/Vegetarian nutrient concerns- Iron

vegetable sources of iron are less available to the body, so we absorb less

Vegan/Vegetarian nutrient concerns- higher phytates, lectins, oxalates, tannins

Bind to minerals and prevent absorption (less absorption)

How can you get lower levels of phytate?

Eat sourdough bread instead of normal bread because it's fermented, so it has lower phytate levels

How can you get lower levels of lectin?

Soak dry beans, let them sprout, then cook them

Vegan/Vegetarian nutrient concerns- protein

complete protein sources come from animals

vegans/vegetarians consume many incomplete

CAN have complementary though (two incomplete = complete)

Daily food guidelines for vegetarian/vegans

Grains- more needed

Legumes

Nuts/seeds- 3 servings

Fruits/veg- more than normal

Dairy- if vegetarian, good source of calcium and could get vitamin D if fortified

Health benefits from vegetarian/vegans

Have been found to be healthier than carnivores (better metrics)

Reasons vegan/vegetarians might be healthier

Low calorie

Nutrient density

Low fat

Low added sugar

Higher fiber

High phytochemical

So overall, if we compare vegetarians to omnivores, what can we say about health benefits?

Compares omnivores with vegetarians who are eating the SAME amount of VEGGIES..they have SIMILAR all cause mortality

Vegetarian diet is providing health benefits because of fruits/veggies but omnivore could have same benefits from eating the same amounts

Game Changer Documentary

Athletes that went plant based

Very motivational

Suggest we should think carefully about how to get proper nutrients from a vegetarian diet

What the Health Documentary

poor diets leading to poor health

very fear invoking

Chronic diseases are _______ related diseases

diet

Forks over Knives Documentary

Bringing in statistics

Poor health is leading to disease

People might just be lacking the proper plant protein in their diet, maybe animal products aren't the issue

Fat, Sick, and Nearly Dead Documentary

Promoting fat loss through a green juice

Implications- GI issues from influx of fiber/phytochemical

How is health related to productivity?

Poor health = bad for productivity

Probiotics

bacteria cultured in the product

"critters"

examples of probiotics

yogurt

sauerkraut

kombucha

Prebiotics

Things the "critters" (or gut bacteria) digest

You cannot digest prebiotics

Chicory root

Prebiotic

Contains high levels of inulin

Oligosaccharide you can't digest

FODMAPS and gut microbiota

FODMAPS are creating GI problems because their contents are giving food to the microbiota

Introducing microbiota to things like a lot of fiber from fruits/veggies

Eating & gut microbiota

What you eat impacts the gut microbiota

We have hundreds of species living in our gut

Where does the gut microbiota primarily live?

Large intestine

What can disrupt and radically change the gut microbiota?

Antibiotics

What have some suggest about the appendix's role in your microbiome?

It creates a reservoir for the gut microbiota, so without it you might be at risk

How does the microbiota influence childhood obesity?

If infant is given antibiotics, could be disrupting the gut and metabolism relationship leading to obesity

What else does the microbiota influence in relation to health?

Mental/metabolic health

Immunity and inflammation

How does the microbiota influence undernutrition?

Gordan lab at Wash U found that a specific probiotic that increased children's weight gain for kids at risk of low weight

Suggests that we MAY be able to target health issues by giving certain probiotics

How does the microbiota influence depressive symptoms?

Reduced symptoms of depression in people that got the active probiotic

What does the study in reduction of depressive symptoms suggest in regards to the gut microbiota?

When you manipulate things in the gut, it manipulates your mood

Gut microbiota is feeding info from the gut thru the vagus nerve to the brain

What does the twin mice study in the Gordan Lab at Wash U tell us about gut microbiota?

Microbiota is controlling the energy balance of metabolism

Mice were given microbiota from lean and obese twins- obese donor = obese mice, lean donor = lean mice

Once put into cages they ate each other's shit and the obese became lean again

So the obese mouse became lean again after eating the lean one's shit...what does this tell us?

Eating each other's shit

creates a more DIVERSE ecosystem inside of it

When someone is lean, they have a diverse microbiota (jungle)

Limited gut microbiota = chance for metabolic problems like obesity

What are cellulose gums? What did studies find about them?

Emulsifiers

Shown to induce weight gain and metabolic disorders

Also interferes with chemical signals in the body (LDL, HDL, glucose)

How do we handle this info regarding cellulose gums having negative effects?

Don't label foods as good or bad but instead...

eat a diversity of whole foods and recognizable foods

Companies marketing with new knowledge about gums

Promoting no added gums

But now have gellan gum instead of cellulose gums

Dietary quality connection to mental health

Dietary quality and nutrient deficiencies have been found to be related to psychological problems

This is a big switch because normally only if you have a heart attack/diabetes/IBS will you be given diet instructions

BUT this study suggests the connection between mental health and diet

Better quality diet = ________ mental health

better

Gut Fermentation Syndrome

Gut microbiota repopulated by yeast in home brewing of beer

Whenever they ate carbs, it was turned into alcohol in the gut and they absorbed it

Explain the story about the person who got auto-brewery syndrome and how they got rid of it

Had periodic drunkenness from alcohol levels going up after eating carbs

Prolonged ingestion of ANTIOBIOTICS was the fuel from this condition

Treatment was antifungals and low carb diet

Given a PROBIOTIC to inhibit fungi

Was able to recover

Ethanol

the type of alcohol in alcoholic beverages

Alcohol is considered...

psychoactive drug

nutrient

toxin

Absorption of alcohol

MAJORITY in the small intestine, but some in the stomach

If the GI tract is empty, then alcohol is absorbed _______

quicker

What is responsible for the metabolism of alcohol?

Liver

Is alcohol an ergogenic? Why?

No- required more O2 to release energy than carbs or fat

Also needs to depressive and euphoric symptoms

How many kcals are in a glass of wine vs. beer vs. shot?

ALL have the same amount- 100 kcals

How do the kcals for beer differ?

It has carb calories, so pushes it to over 100 kcal at about 150 kcal

Metabolism of alcohol

Alcohol--> Acetaldehyde--> Acetate

Steps to metabolize alcohol

H+ pulled off ethanol to get acetaldehyde

NAD grabs H+

H+ can accumulates in liver

Then more H+ are pulled off acetaldehyde

Get acetate

What happens if too much H+ accumulate in the liver?

They can turn into fatty acids and cause cirrohsis of the liver creating alcoholic liver disease

Acetaldehyde effects

acts like a toxin and is what makes you feel sick

A hangover is from what?

Not enough acetate being made

*is this right??*

If some has MORE acetaldehyde, when they drink alcohol what happens?

They feel really bad

Asian flush

Some with Asian ancestry are less likely to have the second ENZYME that converts ACETALDEHYDE to acetate.... so will develop a rash

Getting an accumulation of acetaldehyde

Will not feel good when ingesting alcohol

Positive effects of alcohol

A drink a day lowers all cause mortality

Negative effects of heavy/binge drinking

Judgement/motor skills

liver disease, cirrhosis, cancer

higher risk of poorer function system wide

alcoholism

Are women at a higher or lower risk of negative effects from alcohol?

Higher

Why are women at a higher risk for negative effects of alcohol?

Higher body fat which means LESS body water to DILUTE alcohol

Less ADH enzyme in the stomach (some absorption happens in stomach)

Fetal alcohol syndrome

physical and cognitive abnormalities in children caused by a pregnant woman's heavy drinking

Organic food lowered the risk of developing ________

cancer