E1 Nutrition

nutrient

substance obtained from food used by the body

• Micro and macro

Essential Nutrients:

nutrients that must be obtained from food

Nutrient Dense:

a food’s nutrients relative to its calories

Calorie:

unit used to measure the energy value of food

six classes of nutrients

carbohydrates

proteins

fats/lipids

minerals

vitamins

water

how much energy in carb/protein/lipid

carb: 4 cal/g

protein: 4 cal/g

lipid: 9 cal/g

features of a nutritious diet

variety, moderation, calorie control, balance, adequacy

calorie control

consume enough to meet personal energy needs based on metabolic rate and physical activity

macronutrients

• provide us calories, measured in grams

  • Carbs, fats, proteins

  • Carb and protein have same cal/g

nutrient experts

registered dietitians

registered dietetic technicians

certified diabetes educators

public health nutritionists

integrative and functional medicine practicioners

nutritional counseling vs medical nutrition therapy

counsel anyoen can do, not certified

mnt = certified, dr refereral

diet (in diet culture)

intentional restriction

which nutrient classes are organic (chem def)

carb, fat, protein, vitamins

energy yielding nutrients

fats, proteins, carbs

micronutrients

vitamins and minerals, only a littke bit needed by body

foodways

culture’s habits, customs, beliefs, prefs for food

What type of research studies use population-based information from the National Health and Nutrition Examination Surveys (NHANES) to determine correlations between dietary practices and health?

epidemiological studies

Which of the following is the second-most important factor that influences food choices made by U.S. consumers?

m

price

In terms of the process of change, how many stages of behavior modification are typically described by psychologists

6

What type of research studies are performed under tightly controlled conditions and are used to determine mechanisms of cause and effects?

lab studies

malnutrition

deficiencies, imbalances, and excesses of nutrients, alone or in combination, any of which can take a toll on health over time.

leading causes of death linked with diet and alcohol.

Heart disease, cancer, stroke, and diabetes

Which macronutrient can yield energy and provide materials that form structures and working parts of body tissues?

protein

Which foods should form the basis of a nutritious diet

Whole foods that include grains, meats, vegetables, fruits, and milk

number-one factor driving people’s food choices.

taste

nutrient dense food..

provides needed nutrients with relatively few calories.

what is basal metabolic rate based on

age, height, growth stage, body composition, illness/restriction

factors that impact weight

meds, hormones, genetics, sleep

ineffective metabolism resets

restricting calories, supplements alone, green tea/ACV/cayenne pepper, anything not sustainable for the person

evidence based ways to reset metabolism

not restricting energy/focusing on balancing blood sugar, building muscle mass, increasing sleep, stress reduction

what is needed to balance blood sugar

protein, healthy, fat, fiber

why don’t diets work

90-95% of people gain weight back, avg american tries 4 fad diets/yr, progression to disordered eating and eating disorders, thoughts related to food and/or our bodies

diet backlash

cravings, shorter diet, binges, decreased trust, feel undeserving, last supper syndrome, social withdrawal, impaired metabolism, caffeine overuse, eating disorders

ways to assess dietary intake

24 hour recall/multiple pass method, food diary/record, food frequency questionnaire

nutrition research limitations

underreporting is common, difficulty in retaining/recruiting participants, reductionist approach focus on single nutrient, variety of inconsistent recs

Dietary Reference Intakes

reference values used to plan and assess nutrient intakes

• estimated average requirement

• recommended dietary allowance

• acceptable macronutrient distribution ranges (amdr)

• estimated energy requirement (eer)

dietary reference intakes agency

institute of medicine

dietary guidelines for americans (DGA) agency

dept of health and human services

USDA

DGA main themes

maintaining a healthy weight

food/components to be reduced

food/ nutrients to be consumed

building healthy eating patterns

food label nutrition facts panel agency

FDA

USDA

T/F: daily values are not nutrient intake goals for individuals

T

food packaging claims agency/ nutrition facts panel

FDA

USDA

MyPlate agency

USDA

diet culture

 system of beliefs, 4 tenets

• Worships thinness, equates it with moral virtue

• Promotes weight loss as means to higher status

• Extreme dichotomy

• Oppresses ppl that don’t meet the thin ideal (POC too)

alt measures of metabolic health

cholesterol/triglycerides/blood lipid levels, A1C fasting insulin, liver enzymes, waist circumference

visceral vs subcutaneous fat

v: around midsection, more metabolically active

s: under skin

when should someone’s dietary intake be assessed

pregnancy, unexplained weight loss/gain, chronic illness, surgery, change in eating patterns, change in food environment, old age, intense periods of growth (adolescence, pregnancy)

24 hr recall

5-6 step process (go through it several times for forgotten foods)

done unannounced, have to be trained (registered dietitians, research assistants)

pick a typical day like a weekday

issues= memory, not being able to quantify, not knowing portion sizes, bias

used to assess dietary intake

food diary/record

easy and common tool for assesing dietary intake

either 2 weekdays and weekday or a full week

issues: bias, forgetting foods

food frequency questionnaire

mostly used for research, as not very useful for idividual use,

either have broad categories or specific foods tailored to study population, respondent answers how often they eat that food/category

MOST VALID AND REPORTED ON AT A POPULATION STUDY POPULATION LEVEL

issues: portion size, assumes consistent diet, recall bias, forgetting

What is considered the gold standard for nutrition research and why?

intervention study bc they actually change something about a person’s diet, physical activity, access, movement. we get more info about relationships and outcomes between what is being studied

case study

small, used to generate hypotheses, likely not applicable to populations as a whole

intervention study

type of epidemiological study

epidemiological studies

observational population studies

secondary data analysis

• look at relationship/correlation b/w variables

• ex) certain supply of nutrient, then country is less likely to have whatever

laboratory study

makes up a lot of nutrition research (petri dishes, animals), good for biological mechanisms

intervention study

changes something

very expensive

gold standard for nutrition research

uses control

randomized control trial

nhanes

under the CDC/NCHS, our National Nutrition Monitoring System

National Health and Nutrition Examination Survey

main nutritional data set in US, done electronically

lot of studies based on this data

what does reductionist mean in this context

thinking that you should only eat a certain thing in order to get a certain nutrient

DRI

big umbrella category for very specific values based on amount of data available

exist for micronutrients, vitamins and minerals

intakes are optimums, not minimums

AMDR (acceptable macronutrient distribution ranges)

the % of energy that should come from carbs, fats and proteins

dietary guidelines for americans (DGA)

report w guidelines published every 5 years

joint project b/w Department of Health and Human Services (DHHS) and USDA

target audience NOT individuals, rather it is policymakers, program people, practitioners

committee creates it based on evidence based guidelines

highly influenced by policy/congress

nutrition facts panel agency

FDA (USDA also lowkey)

what is the intent of food labels

to inform consumer of what’s in the product and to use for comparison, NOT individual nutrition advice for individuals, based on 2k calorie diet

3 categories of claims manufacturers put on package

nutrient claims (describes nutrient level, “free/high/low”, based on content of food product)

health claims

structure function claims

nutrient claims

describes nutrient level, “free/high/low”, based on content of food product

health claims

based on standard definition w 2 components

FDA has pre approved list of claims

1) has to specifically mention the substance (food, food component, ingredient)

2) specifically mentions disease or health related condition

ex) “oatmeal helps reduce cholesterol”

doesn’t actually mean the specific product does it

structure function claim

does not require FDA approval

often seen in supplements

“supports immunity and digestive health”

vague

MyPlate

USDA

audience: individuals and professionals

# and serving sizes of dif foods

can personalize

personalized data comes from DRI

internalized fat bias

• Only by larger ppl

• Fat bias by medical practitioners

• Anywhere w seats (movie theater, plane)

• Clothing shop

• Negative feelings as result of discrimination

Interpersonal Fat Bias

• Person on plane agitated that theyre next to a larger person

Institutional Fat Bias

• Dr thinks fat patient is going in w issues related to size/body weight

• Dr recommends weight loss no matter what

5 basic tastes

Sweet, salty, umami, bitter, sour

Digestion:

process by which food is broken down into smaller, more absorbable molecules that body can use for energy growth and repair

• Mechanical and chemical

• Sphincters prevent unneeded/uncalled for movement

Mechanical Digestion

• Starts with teeth chewing and breaking down

• Esophagus

  • Perisalsis is involuntary

  • Segmentation: right to left, breaks the pieces

GI Tract Functions:

• Break down complex molecules (digestion

• Absorb individual nutrients (absorption

• Secrete specialized cells (and other substances, enzymes for digestion

• Provide barrier to infection

• Is NOT metabolizing things, just breaks things down to be absorbed into OTHER systems

mech vs chem digestion

Mech: teeth , muscles, physical action, segmentation, peristalsis, chewing

Chem: needs chemical agent, saliva, digestive juices

where does digestion start

Carb chem digestion starts in mouth w saliva

Other digestion starts in stomach

stomach

 intrinsic factor

• Helps unlock vitamin b12

• Goes down w age

• has volume sensor, not calorie sensor

accessory organs

necessary but food does NOT pass through them

• Pancreas releases enzymes to help break down lipids and what not

• Also helps maintain homeostasis w glucose

• Carbs, it releases insulin to help bring down blood glucose

  • If it cant make insulin = type 1 diabetes

- Liver and Gallbladder

• Bile produced in liver, stored in gb

• Liver stores glucose as glycogen, if too much it will be converted to fat

• Bile breaks lipids

  • 70% cholesterol, binds to lipids to take it out

peristalsis

involuntary, contractions to move bulge of food down

segmentation

muscle movement back and forth like right and left to break apart pieces and mix w digestive juice

intestine

Microvilli increases small intestines surface area by 600%

• Trap nutrients for absorption into cells

First part of small intestine is where absorption starts to happen

Majority of absorption is in small intestine

• Most in first two parts

  • Pancreatic enzymes and bile enter the small intestine

absorption/digestion timeline

(mouth to end): 24 hours

• Mouth less than min

• Stomach 1-2 hours

• Intestine for hours

large intestine

expels nutrients not absorbed

• Synthesizes vitamin k

where absorption/digestion

Absorption = intestines

Digestion = mouth to anus

absorption

transport of food molecules

• Out of digestive tract into circulatory or lymphatic system

• Fats, water transported through passive

• Fructose uses facilitated

• Proteins, amino acids use active absorption

• Carbs and proteins go directly into circulatory system, to liver for chem rxns so that they can be used over body

• Fats and fats soluble vitamins go through lymphatic system first

• Microvilli traps nutrients

• Cardiovascular system: blood bessels, water soluble proteins, carbs, B vitamins, vitamin C

Caffeine and digestion

• Caffein increases cramping

• A stimulant

• Speeds up digestion process, harsher for some

Gut Health

• Online = structural integrity of gi tract or about microbiome

• Probiotics, prebiotics, fiber 

• Connected to mental health

  • Some probiotic like low dose ssri

probiotic

• Live bacteria in gut

  • Make up the microbiome

  • Many types

  • Lab research (petri dishes, animals)

  • Fermented foods

  • Kimchi, kombucha, sauerkraut, 

    • Key staples in other cultures, beneficial

  • Live and active cultures, unpasteurized

prebiotic

• Fibers

• 2 categories: oligosaccharides, (not on exam)

• More important that probiotic

• Feed the good bacteria

• Eat more plants = more fiber

• >30g of fiber/day

gut microbiome

all bacteria in gi tract

• Heavily researched rn and recent

• Diverse mix of many bacteria, more positive than harmful is good for our health

#1 thing to improve gut health

Eat more fiber (drink more water) =