Nutrition Exam 3

Describe the general characteristics of vitamins

Vitamins are essential nutrients in small amounts, provide no Kcals, and are classified based on solubility

Fat soluble vitamins

Vitamin A, D, E, K

Water soluble vitamins

B-vitamins: thiamin, riboflavin, niacin, B-6, pantothenic acid, folate, biotin, B-12,

Vitamin C

Why are vitamins important for health

bone health, energy metabolism, blood clotting, growth & development, RBC formation, immune function, antioxidant defense, amino acid metabolism

How do antioxidants work?

Protect cells by giving up electrons to free radicals (substance with unpaired electron)

Vitamins that act as antioxidants

Vitamin C, E, A

Vitamin Bioavailability

amount of a vitamin that is actually available for use by the body

What factors influence bioavailability of vitamins

GI transit time: diarrhea, bariatric surgery
health conditions: gall-bladder, pancreas
Source of vitamin: natural food source or synthetic food source
Food processing

Food preparation techniques

Boiling: this can take out the water soluble vitamins if boiled in too much water
Steaming, microwaving, and stir-frying are best

General characteristics of fat-soluble vitamins

occur together with fat in foods, require fat for absorption, concentrated and stored in tissues

Main forms of vitamins A, D, E, K

A: retinoids
D: Calciferol, D2 (plants), D3 (animals)
E: Alpha-tocopherol, gamma- tocopherol
K: Phylloquinone, menaquinone, menadione

Key functions of Vitamins A, D, E, K

A: vision, reproduction, cellular growth, immune system
D: Bone health, calcium/phosphorus absorption, mineralization, immune system
E: antioxidant against chronic disease
K: production of active blood-clotting factors

Three food sources for vitamins A, D, E, K

A: beef liver, sweet potato, pumpkin
D: Salmon, milk (fortified), eggs
E: Almond-milk, sunflower seeds, peanut butter
K: Kale, spinach, broccoli

Deficiency of vitamin A, D, E, K

A: night blindness, dry eye, poor growth, frequent infections
D: Rickets, osteomalacia
E: nerve damage, blindness
K: excessive bleeding

Toxicity of vitamins A, D, E, K

A: liver damage, headache, nausea, vomiting, hair loss, carotenemia
D: Calcium deposits in soft tissue, poor growth
E: blood clotting, hemorrhage
K: Unknown

What are key contributing factors that increase an individuals risk for obesity?

Chronic inflammatory/oxidation, cardiovascular disease, diabetes, arthritis, kidney disease, gout, cancer, weakened immunity

How have overweight and obesity rates changed in the US between 1988 and 2025?

Rates of obesity have continued to rise

Specific health problems associated with obesity

Hypertension, type 2 diabetes, gout, cardiovascular disease

Calculate a persons BMI

Kg/(m)2=BMI. 1kg= 2.2lbs. 1in= 0.0254 m

BMI underweight, overweight, normal weight

Underweight: less than 18.5
Normal weight: 18.5-25
Overweight: 25-30
Obesity: 30+

Major limitations of using only BMI to evaluate a person’s health

doesn’t account for body composition (fat vs muscle)

Two ways that body fat can be measured

DXA, skin fold test

What can waist circumference tell you about a person’s health?

Quick and easy measure to assess abdominal fat and potential health risks.

Factors that contribute to an increase or decrease in accumulation of body fat?

Dietary intake, physical activity levels, hormonal changes, and genetics.

What are the four components of energy output?

Basal metabolism, physical activities, thermic effect of food, non-exercise activity

What does BMR tell you?

minimum Kcals body uses for vital activities when at complete rest

Factors that increase and decrease BMR

increase: growth, exercise, stress, stimulant drugs
decrease: very low-cal diets, insufficient thyroid hormone, aging, less body surface area

Factors that influence how much energy a person burns during physical activity

type of activity, duration, intensity, individual

Thermic effect of food and how it contributes to a person’s energy output

small amount of energy required to digest, absorb, metabolize nutrients, 5-10% total energy output

What is NEAT

non-exercise activity thermogenesis, involuntary skeletal muscle activity (fidgeting, shivering, posture)

Describe set-point theory

body’s fat content and body weight is genetically pre-determined

A person who has obesity is more likely to have more or less active “thrifty genes”

more active "thrifty genes," which promote energy storage and increased fat retention.

Hunger

physiological need for food that drives eating behavior.

Appetite

desire to eat appealing food

Ghrelin and leptin influence of food intake

Ghrelin increases food intake
Leptin decreases food intake

What dietary and behavioral recommendations do you have for a person voluntarily trying to lose weight

dietary: mindful eating, portion control, emphasizes fruits & vegetables, self monitoring, sustainable, intermittent fasting
behavioral: physical activity, stress management, sleep

Describe characteristics of mindful eating

Taking a break and eating meals at a table, preparing meals at home, using all senses to savor food, sharing meals with people

How do weight-loss medications work?

reduce hunger, change metabolism, reduce fat absorption

What is the basic premise behind bariatric surgery

Reduce size of stomach to treat obesity

Why can it be so effective in rapid weight loss?

Because the stomach shrinks

What are the potential benefits of bariatric surgery

Losing weight and improving obesity-related health conditions, such as diabetes and hypertension.

Potential drawbacks with bariatric surgery

Major surgery, intestinal blockage & bleeding, wound infections, dumping syndrome, nutrient deficiencies, psychological concerns

What is weight bias in healthcare

Weight bias in healthcare refers to negative attitudes or beliefs about individuals based on their body weight

How does weight bias impact quality of care

Overweight people don’t want to seek health-care, engage in unhealthy eating, avoid physical activity, experience depression

How can a healthcare provider best support their patients as it relates to body weight and composition

Use first person language, be empathetic, focus on behavioral & health outcomes rather than weight

Disordered eating

chaotic and abnormal food related practices, skipping meals, limiting food choices, following FAD diets, eating excessive amounts, tempory-stress

Eating disorder

Psychological disturbances that lead to certain physiological changes & health complications

3 major types of eating disorders

anorexia nervosa, bulimia nervosa, binge-eating disorder

Key risk factors for disordered eating

being female, being an adolescent, having a history of frequent dieting, being bullied, relative with an eating disorder

General characteristics of anorexia nervosa

severe psychological disturbance, self-imposed starvation

3 signs and symptoms of AN

distorted body image, low self-esteem, extremely structured eating, extreme thinness, mild anemia, brittle hair/nails

General characteristics of bulimia nervosa (BN)

repeated episodes of binge-eating followed by unhealthy behaviors to prevent weight gain

3 signs and symptoms of BN

Chronic sore throat, swollen salivary glands, heartburn, dehydration

General characteristics of binge eating disorder

recurrent episodes of binge-eating not followed by purging behaviors, individual is often “normal” weight or overweight

Diabulimia

a person with type 1 diabetes restricts insulin intake

Orthorexia

Extreme obsession with eating healthy foods

Night eating

binges take place after evening meal and person awakes from sleep

Muscle dysmorphia

unhealthy preoccupation with the body being too small or not muscular enough

3 components of the female/male athlete triad

low energy availability, low testosterone/menstral disturbances, reduced bone density

Describe treatment options for eating disorders

multi-disciplinary effort, counselors, dietitians, physicians, nurses
out patient & in patient treatments, innovative therapies, cognitive behavioral therapy

Alternative treatments in addition to other treatments to help with eating disorders

Acupuncture, photo-therapy, relaxation therapy, biofeedback, meditation, equine therapy

Where would you refer a UK student who may have an eating disorder

I would refer them to the student services center to meet with a full-time dietician that works on campus to help students fight their eating disorders.

What are general characteristics of water-soluble vitamins?

washing & cooking with water can result in losses, body exerts & absorbs easily, tissues actively enhance in & out vitamins, foods do not deliver toxic doses but supplements do

All B-vitamins serve what common role

serve as coenzymes in energy metabolism

Which vitamins cause the deficiency of scurvy, beriberi, pellagra, neural tube defects, megaloblastic anemia, pernicious anemia, nerve damage?

Scurvy: Vitamin C
Beriberi: Thiamin
Pellagra: Niacin Neural tube defects:

Folate Megaloblastic anemia: Vitamin B12, folate

Pernicious anemia: Vitamin B12

Nerve damage: Vitamin B6

What are the classic signs of ariboflavinosis

Glossitis, cheilosis, skin rash, confusion, headaches

Why would someone be taking high doses of niacin and what are the potential toxicity concerns?

used to treat high cholesterol, side effects: flushing of skin, GI upset

What are two key functions of folate?

DNA synthesis, homocysteine metabolism

List at least 3 food sources of folate

papaya, broccoli, asparagus, white rice

How much folate should women of childbearing potential consume?

400ug/day

When does the neural tube close during pregnancy

first trimester

Two concerns with excessive intake of folate

may stimulate cancer cell growth, “masks” vitamin B12 deficiency

How is vitamin B12 important

Needed for cellular processes like folate metabolism, maintenance of myelin sheaths, homocysteine metabolism

Vitamin B12 is only found in…

animal foods

What substance is required for B12 absorption and digestion? Where is it secreted? What happens to levels as you age?

Intrinsic factor is required for B12 absorption and digestion. It is secreted by stomach cells and levels decrease as you age.

3 populations at risk for a B12 deficiency

Older adults, vegan diet, megaloblastic anemia individuals

How long does it generally take for paralysis to develop as a result of a B12 deficiency

5-10 years

Key functions of vitamin C to health

connective tissue synthesis, antioxidant, immune system, synthesis of neurotransmitters, enhances iron absorption in GIT

3 food sources of vitamin C

oranges, limes, red peppers

Two signs of scurvy

bleeding gums, pinpoint hemorrhaging

UL of vitamin C

2,000mg/day

6 dietary classes of dietary supplements

vitamins, minerals, herbs, amino acids, biobatgnicals, metabolocytes

What vitamin would you recommend to be consumed at the same times as iron?

vitamin c, orange juice

General characteristics of minerals

inorganic nutrients, needed in small amounts, classify as a major, trace or possible essential

Major mineral

needed in large amounts >100mg/day

What mineral is found in the highest concentration in the body?

Calcium

Important functions of calcium

Used for bones, teeth, muscle contraction, blood clot formation, nerve transmission

3 food sources for calcium

cows milk, cheese, yogurt

3 factors that influence calcium absorption and bioavailability

vitamin D (calcitriol), stomach acid, lactose (infants only)

What happens in calcium intake is insufficient

Insufficient calcium intake can lead to weakened bones, an increased risk of osteoporosis, and impaired muscle function.

How does the body respond when blood calcium levels that are low and high

When blood calcium levels are low, the parathyroid hormone is released to increase calcium reabsorption from bones and renal absorption. When levels are high, calcitonin is released to inhibit bone resorption and promote calcium excretion.

When is your peak bone mass achieved for most people

20-30 years

4 key modifiable risk factors for osteoporosis

lower fiber intake, lower phosphorus intake, eat more dairy foods with vitamin D, lift more weights

Why do healthcare workers check homocysteine levels

higher levels lead to risk for heart disease. They look at B12 ad folate levels