Nutrition Test 2

Roles of parents and children in the development of healthy eating habits

-Parents need to promote nutritious choices and healthful habits while nurturing that child's self esteem and well being
-offer raw, undercooked veggies
-smooth foods should have no lumps (mashed potatoes)
-make meal times fun
-let children decide to try new foods themselves and do NOT force
-play first then eat
-allow children to help plan and prepare the family's meals
-teach children how to snack
-teach children to brush and floss after meals

Calcium

Most abundant mineral in body
Role:
-bones and teeth
-acts in muscle contraction and relaxation, nerve functioning, blood clotting, BP, immune. defenses

Deficiency:
-stunted growth in children
-adult bone loss (osteoporosis)

Toxicity:
-constipation; increased risk of urinary stone formation and kidney dysfunction, interference with absorption of other minerals

Sources:
-milk, milk products, oysters, small fish, tofu, greens, legumes

Functions of water in the body's fluids

-carries nutrients and waste products throughout the body
-maintains the structure of large molecules such as proteins and glycogen
-participates in metabolic reactions
-serves as the solvent for minerals, vitamins, amino acids, glucose, and many other small molecules so that they can participate in metabolic activities
-maintains blood volume
-aids in the regulation of normal body temperature, as the evaporation of sweat from the skin removes excess heat from the body
-acts as lubricant and cushion around joints and inside the eyes, spinal cord, and amniotic sac around the fetus in the womb

Water intake processes

-Thirst and satiety govern water intake
-When blood becomes too concentrated, HYPOTHALAMUS initiates drinking behavior
-Dehydration can be a threat to older adults because thirst sensation can diminish
-Water intoxication can hyponatremia

Water excretion processes

-Regulated by the brain and the kidneys
-HYPOTHALAMUS monitor blood salts and stimulates the pituitary gland to release ADH when salts are too concentrated or blood volume or BP is too low
-ADH causes kidneys to reabsorb water rather than excrete it (more water you need, the less you excrete)
-too much water lost from body, blood volume and BP too low so kidneys release RENIN for low BP
-ALDOSTERONE causes kidneys to retain water, so less is excreted
-more water a person drinks, more diluted the urine
-equates to about 2 1/2 liters a day

Dehydration

-thirst
-weakness
-exhaustion
-delirium
-dry mouth
-concentrated urine

Water intoxication

-confusion
-convulsion
-coma
-hyponatremia
-even death

Fluid and Electrolyte Balance

-Electrolytes: a salt that dissociates in water
-The movement of salts determines where the fluids flow because water follows salt
-Osmosis
-By maintain specific amounts of Na outside the cell and K inside the cell, cells can regulate exact amounts of water inside and outside their boundaries
-Kidneys regulate body's sodium
-Intestinal tract absorbs sodium and puts it in the blood; kidneys excrete unneeded amounts

Acid-Base Balance

-Help regulate the acidity of its fluids
-Electrolyte mixtures in body fluids help protect the body against changes in acidity by acting as BUFFERS
-Lungs, kidneys, skin, GI tract provide other defenses
-Kidneys play major role in maintaining acid-base balance
-Disorder of kidneys impair acid-base balance and fluid and electrolyte balance

Bioavailability of Minerals

-The fraction of the ingested nutrient that is absorbed and utilized for normal physiological functions
-Factors that influence it include: GI tract from inflammations or gastric acid, systemic factors like pregnancy and age, deficiencies of nutrients or changes in physiological state

Major minerals vs Trace minerals

Major: needed in larger amounts
-Sodium, Chloride, Potassium, Calcium, Phosphorus, Magnesium, Sulfate

Trace: needed in smaller amounts
-Iron, Zinc, Selenium, Iodine, Copper, Manganese, Fluoride, Chromium

Shortfall nutrients

calcium, potassium, magnesium, iron

Overconsumed mineral

sodium

Sodium

Primary regulator of the ECF volume
Role:
-with chloride and potassium, maintains cells' normal fluid balance and acid-base balance in the body
-critical to nerve impulse transmission and muscle contraction

Deficiency:
-muscle cramps, mental apathy, loss of appetite

Toxicity:
-hypertension

Sources:
-salt, soy sauce, processed foods

Chloride

In the stomach as part of hydrochloric acid and in NaCl
Major negative ion of the ECF
Role:
-part of the hydrochloric acid found in the stomach and necessary for proper digestion

Deficiency:
-does not occur in normal circumstances

Toxicity:
-normally harmless, can cause vomiting

Sources:
-salt, soy sauce; moderate amounts in whole, unprocessed foods; large amounts in processed foods

Potassium

Positive ion inside the cells
Role:
-Facilitates in making protein
-maintenance of fluid and electrolyte balance
-support cell integrity
-transmission of nerve impulses
-contracting muscles including the heart

Deficiency:
-from diabetic acidosis, dehydration, prolonged vomiting or diarrhea
-Moderate: elevated BP, increased salt sensitivity, increased risk of kidney tones and increased bone turnover
-Severe: cardiac arrhythmias, muscle weakness, glucose intolerance

Toxicity:
-muscular weakness, triggers vomiting; if given in vain, can stop heart

Sources:
-Whole foods, meats, milk, fruits, veggies, grains, legumes

Phosphorus

2nd most abundant mineral in body
Found in all body tissues
Role:
-mineralization of bones and teeth
-important in cells' genetic material, in cell membranes as phospholipids, in energy transfer and in buffering systems

Deficiency:
-unknowm

Toxicity:
-calcification of nonskeletal tissues, particularly the kidneys

Sources:
-animal sources

Magnesium

Barely qualifies as a major mineral
Role:
-bone mineralization
-building of protein, enzyme action
-normal muscular contraction and transmission of nerve impulses

Deficiency:
-low blood calcium, muscle cramps, confusion, seizures, bizarre movements, hallucinations, and difficulty swallowing; growth failure in children

Toxicity:
-from nonfood sources only
-diarrhea, nausea, abdominal cramps, acid-base imbalance, potassium depletion

Sources:
-nuts, legumes, whole grains, dark green veggies, seafoods, chocolate, cocoa

Sulfate

Role:
-component of certain amino acids
-part of vitamins biotin and thiamin and the hormone insulin
-stabilizes protein shape by forming sulfur-sulfur bridges

Deficiency:
-none known
-protein deficiency would occur first

Toxicity:
-only if sulfur amino acids were eaten in excess
-depresses growth

Sources:
-all protein containing foods

Iron

Every living cell contains iron
Most of iron in the body is a component of the proteins hemoglobin and myoglobin
Role:
-part of the protein hemoglobin, which carries oxygen in the blood
-part of the protein myoglobin in musicales to make oxygen available for muscle contraction
-needed for the utilization of energy

Deficiency:
-anemia: weakness, headaches, pallor, reduced work productivity, inability to concentrate, impaired cognitive function in children, lowered cold tolerance

Toxicity:
-iron overload: infections, liver injury, possible increased risk of heart attack, acidosis, bloody stools, shock

Sources:
-red meat, fish, poultry, shellfish, eggs, legumes, dried fruits

Zinc

Necessary for that activation of 300 different enzymes
Role:
-part of insulin and many enzymes
-involved in making genetic material and proteins
-immune reactions, transport vit A, taste perception, would healing, making of sperm, normal fetal development

Deficiency:
-growth retardation, delayed sexual maturation, impaired immune function, loss of tase, poor wound healing, eye and skin lesions

Toxicity:
-loss of appetite, impaired immunity, low HDL, nausea, vomiting, diarrhea, headaches, copper and iron deficiencies

Sources:
-protein containing food, meats, grains, veggies, grains

Selenium

Functions as an antioxidant nutrient
Role:
-assists a group of enzymes that break down reactive chemicals that harm cells

Deficiency:
-predisposition to hear disease characterized by cardiac tissue becoming fibrous

Toxicity:
-nausea, abdominal pain, nail and hair changes, nerve damage

Sources:
-seafoods, organ meats, whole grains and veggies

Iodine

Traces of iodine are indispensible to life
Role:
-component of two thyroid hormones to help regulate growth, development and metabolic rate

Deficiency:
-goiter, cretinism

Toxicity:
-depressed thyroid activity; goiter like thyroid enlargement

Sources:
-iodized salt, seafood, bread, plants

Copper

Body contains about 100 mg
Role:
-needed for absorption and use of iron in the formation of hemoglobin
-part of several enzymes

Deficiency:
-anemia, bone abnormalities

Toxicity:
-vomiting, diarrhea, liver damage

Sources:
-organ meats, seafood, nuts, seeds, whole grains, drinking water

Manganese

Human body contains 20 mg
Role:
-facilitator with enzymes of many cell process
-bone formation

Deficiency:
-rare

Toxicity:
-nervous system disorders

Sources:
-nuts, whole grains, leafy veggies, tea

Fluoride

Prevention of dental caries
Role:
-element involved in the formation of bones and teeth
-helps to make teeth resistant to decay

Deficiency:
-susceptibility to tooth decay

Toxicity:
-fluorosis(pitting and discoloration of teeth), skeletal fluorosis(weak, malformed bones)

Sources:
-drinking water, tea, seafood

Chromium

Participates in carb and lipid metabolism
Role:
-enhances insulin action
-may improve glucose tolerance

Deficiency:
-diabetes like condition marked by an inability to use glucose normally

Toxicity:
-none

Sources:
-meats, whole grains

Populations at risk for mineral deficiencies

-illness
-alcohol or drug addiction
-conditions that limit food intake
-vegetarians and vegans
-older adults
-people who are lactose intolerant

Vitamin mineral supplements

Appropriate uses: to correct deficiencies or to reduce risks of disease

Advantages: it can correct deficiencies and reduce risk of disease

Disadvantages:
-risk of toxicity
-some sold are contaminated with pharmaceutical drugs
-taken in a concentrated form can interfere with other absorption of minerals from food

Regulation and marketing of dietary supplements

-if USP symbol is on label, that manufacturer has voluntarily paid an independent laboratory to test the product and affirm that it contains the ingredients available for absorption
-have labeling requirements
-supplement facts
-may make health claims supported by significant scientific agreement
-make make structural/function claims
-may claim to diagnose, treat, cure, or relieve common complaints
-no FDA approval needed before a manufacturer puts a supplement on store shelves
-do not list contact info on labels

Identify the need for appropriate nutrients prior to and during pregnancy

-Full nutrient stores before pregnancy are essential to conception and healthy infant development during pregnancy
-Within early weeks of pregnancy, significant developmental changes occur that depend on the woman's nutrient stores

Potential effects of low birthweight on the infant

-Infant birthweight correlates with prepregnancy weight and weight gain during the pregnancy
-Has high risk of have a low-weight infant
-Low-weight infants are more likely to contract diseases and are 40x more likely to die in the first month of life
-Can make obesity and chronic diseases like hypertension and heart disease more likely to occur later in life
-Can cause the infant to have lower adult IQ, short stature, and educational disadvantages

Nutrient deficiencies during critical periods of development

-nutrients and other environmental factors must be supplied ON TIME of the organ development to reach full potential
-if it is limited, recovery is impossible
-seen in defects of the nervous system of the embryo, child's poor dental health, and in the adolescent's and adult's vulnerability to infections and higher risks of diabetes, hypertension, stroke or heart disease
-effects of malnutrition during critical periods is irreversible

Energy and nutrient needs for non-pregnant, pregnant, and lactating women

Non-pregnant
-need less energy
-need calcium

Pregnant
-need more energy
- 25 more grams of protein
-450 more kcal per day
-175 grams or more per day of carbs
-need large amounts of folate, choline and B12
-calcium and vit D

Lactating
-need more energy
-need more protein
-need lots of Vitamin A, C and iodine

Ways to supplement the diets of pregnant women

-Iron supplements
-Daily mutivitamin mineral supplements
-Prenatal supplements
-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): provides vouchers to low-income pregnant and lactating women and their children
-Supplemental Nutrition Assistance Program (SNAP): provides debit card that can help stretch the low-income pregnant woman's grocery dollars

Appropriate weight gain during pregnancy

3.5 pounds the first trimester, and 1 pound each week after

Underweight: 28-40 lb
Healthy weight: 25-35 lb (twins: 37-54 lb)
Overweight: 15-25 lb (twins: 31-50 lb)
Obese: 11-20 lb (twins: 25-42 lb)

Nutritional needs and weight gain of pregnant adolescents

-need vit. B12 and D and iron, calcium and folate
-less likely to receive early prenatal care
-more likely to smoke during pregnancy
-in a healthy weight, encouraged to gain 35 lb

Reasons for cravings and aversions during pregnancy

-due to hormone induced changes in taste and sensitivities to smells
-quickly disappear after birth

Pica: nonfood cravings due to iron deficiency

Physiologic changes of pregnancy to common conditions

Nausea
-on waking, arise slowly
-eat dry toast or crackers
-chew gum or suck on hard candies
-avoid foods with offensive odors

Constipation
-eat foods high in fiber
-exercise daily
-drink 8 glasses of liquid a day
-use laxatives as prescribed

Heartburn
-relax and eat slowly
-chew food thoroughly
-eat small, frequent meals
-drink liquids between meals
-avoid spicy, greasy foods
-wait before exercising or laying down

Strategies to avoid negative outcomes associated with environmental contaminants, food-borne illness, and alcohol during pregnancy

Environmental contaminants
-consume food and beverages free of contamination
-dietary calcium
-avoid shark, swordfish, king mackerel and tilefish

Food-borne illness
-use only pasteurized juices and dairy products
-do not eat hot dogs or lunch meat
-thoroughly cook meat, poultry, eggs and seafood
-do not eat smoked food

Alcohol
-don't drink alcohol while pregnant

Advantages of breastfeeding for mothers and infants

Mothers
-contracts the uterus
-delays the return of regular ovulation
-conserves iron stores
-may protect against breast and ovarian cancer and reduce risk of type 2 diabetes

Infant
-provide appropriate composition and balance of nutrients with high bioavailability
-provides hormones that promote physiological development
-improves cognitive development
-protects against infections and illnesses
-may protect against chronic diseases
-protects against food allergies
-supports healthy weight
-reduces risk of SIDS

Growth rate of infants

-grows faster in the first year than ever again
-growth reflects nutritional well-being
-birthweight doubles by 5 months and triples by 1 year (20-25 lbs)
-length increases about 10 in from birth to 1 year

Nutrient needs of infants

-have rapid growth and high BMR so lots of nutrients needed
-Vitamin A, D, and calcium
-Iodine
-100 cal / kg
-WATER

Breast milk

-more easily and completely digested than formula
-Carb: oligosaccharides to help prevent infection and lactose to enhance calcium absorption
-less protein than cows milk: puts less strain on infants kidneys
-Protein: alpha-lactalbumin which is easily digested and absorbed
-Lipids: provide main source of energy (linoleum acid and linolenic acid, arachidonic acid and docosahexaenoic acid)
-Vitamins and minerals: calcium in adequate amounts and a low amount of vit D
-immunological protection: antiviral agents, anti-inflammatory agents, antibacterial agents and infection inhibitors
-Colostrum and antibodies

Infant formula

-no protective antibodies
-has a bit more protein and carbs than breastmilk
-a bit less fat than breastmilk

Cow's milk

-way more protein than breastmilk
-not appropriate during the first year
-poor source of iron
-higher in calcium and lower in vit C than breastmilk or iron fortified formula

Dietary supplements for Infants

-Vit D
-Iron
-Fluoride (after 6 months)
-Vit K at birth to prevent uncontrolled bleeding

Guidelines for feeding an infant

Can introduce complementary foods between 4-6 months of age
-main purpose: to introduce solid foods to provide needed nutrients that are no longer supplied by breast milk adequately
-based on infants nutrient needs, physical redness to handle different forms of food and the need to detect and control allergic reactions
-nutrients needed earliest are iron and zinc, then vit C

Foods to include:
-4-6 months: iron-fortified cereal, pureed meats, legumes, veggies and fruits
-6-8 months: textured veggies and fruits, unsweetened fruit juices from cup
-8-10 months: breads and cereals from table, yogurt, soft, cooked veggies and fruit from table, finely cut meats, fish, casseroles, cheese, eggs and mashed legumes
-10-12 months: variety, gradually increase portion sizes

Energy and nutrient needs in childhood

-appetites diminish after age 1 and growth slows
-supply nutritious foods at regular intervals
-total energy needs increase with age but energy/kg decreases
-active children need more energy
-vegan children have trouble meeting energy needs
-Carb recommendation: same as adult after 1 year
-Fiber: same as adult unless low energy intake
-Fat: 30/40% of energy for 1-3 yo and 25/25% for 4-18 yo
-Protein: increase with age
- 7-10 mg of iron daily
- Vit D

Effects of hunger on children's behavior and health

Short term hunger:
-impairs child's ability to pay attention and be productive
-irritable, apathetic and uninterested in environment

Long term hunger:
-impairs growth and immune defenses

Iron deficiency

Causes:
-not enough iron in the blood
-lead poisoning
Symptoms:
-impairs learning ability and attention span
-perform poorly on tests and are disruptive in classroom
Treatment:
-iron supplements

Lead toxicity

Symptoms:
-malnourished
-eat dirt or chips of old paint
-anemia
-diarrhea
-irrability
-fatigue
-may develop learning disabilities and behavior problems
-severe: irreversible nerve damage, paralysis, mental retardation, death

Prevention methods:
-reductions in leaded gasolines, lead-based solder and other products
-clean surfaces regularly
-prevent children form eating dirt or old painted objects and make sure they wash hands before eating
-feed children balanced diets with iron and calcium
-dont use lead contaminated water

Food allergies

-always involve antibodies; may or may not have symptoms
-NIAID (National Institute of Allergy and Infectious Diseases): developed guidelines and management of food allergy
-skin rash, respiratory difficulties, vomiting, diarrhea, anaphylactic shock
-allergic reactions may be immediate or delayed
-anaphylactic shock: most often caused by peanuts, tree nuts, milk, eggs, wheat, shellfish, soybeans or fish
-food intolerances: not allergies due to the reactions involve symptoms but no antibodies

Hyperactivity

-it is inattentive and impulsive behavior that is more frequent and severe than is typical of others of a similar age; ADHD
-potential causes include: desire for attention, lack of sleep, overstimulation, watching too much tv or playing too many computer games, too much caffeine from pop or chocolate, or lack of physical activity
-NOT caused by poor nutrition
-MAY reflect inconsistent care

factors of childhood obesity

Casual factors
-parental obesity
-diet
-physical activity: more sedentary, TV
-soft drinks

School breakfast and lunch programs

Breakfast
-majority of children who eat it are low income families
-contains: one serving of milk, one serving of fruit or veggie, and either one or two servings of whole grains or one of whole grains and one of meat

Lunch
-more than half of them are free or reduced
-designed to provide at least one third of the recommendation for energy, protein, vitamin C, A, iron and calcium
-must follow dietary guidelines for Americans

Reasons for adolescents' increased energy and nutrient needs

-growth speeds up
-hormones direct intensity and duration of growth spurt
-boys energy needs may be higher

Nutrients that are likely to be deficient in adolescents' diets and the potential reasons for these deficiencies

-Vit D: dark skinned, females, and overweight adolescents
-Iron: due to menstruation or growth spurts; not intaking enough iron
-Calcium: not enough in diet or too little physical activity

Nutrition and Longevity

Slows the aging process: due to healthy habits, physical activity, and restriction of kcals
-live longer
-fewer disabilities
-physical activity and long life go together
-increases mobility in later years
-preserves mental ability by increased blood flow to the brain
-reduce risk and injury of falls
-energy restriction prolongs life by reducing lipid oxidation and changing genes associated with aging
-energy restriction can prevent chronic diseases
-Nutrition alone can help prevent the following: obesity, hypertension, diabetes, cardiovascular diseases, deficiency diseases, cancer, digestive tract disorders, dental caries, and osteoporosis

Nutrition and Cataracts

-oxidative stress appears to play role in development; but supplements of antioxidant nutrients do not seem to prevent or slow the progression
-healthy diet of fruits and veggies rich in these antioxidants (vit C, E, and carotenoids) seem to slow progression or risk of developing cataracts
-people who follow the dietary guidelines for Americans are reported to have fewer cataracts
-obesity plays a role in cataract development

Nutrition and Arthritis

-obesity is common in adults with arthritis
-weight loss helps relieve joints of stress, as well as pain in the hands
-aerobic activity and weight bearing activities help improve it and relieve pain
-drugs and supplements to treat the arthritis can impose nutrition risks
-rheumatoid arthritis link diet through the immune system
-omega 3 fatty acids can help prevent rheumatoid arthritis and reduce going tenderness and improve mobility

Nutrition and Dementia

-nutrient deficiencies can contribute to memory loss and cognition
-the ability of neurons to synthesize specific neurotransmitters depends on the availability of the precursor nutrients obtained from the diet
-Alzheimer's disease: free radicals and oxidative stress involved; antioxidant nutrients can limit free radical damage and delay/prevent Alzheimer's
-overweight and obesity associated with dementia

Why Energy Needs Decline with Age

-people usually reduce their physical activity with age
-basal metabolic rate declines and lean body mass and thyroid hormones diminish

Physiological Changes Associated with Aging that Affect Nutrient Intake and Utilization

-lean body mass and thyroid hormones diminish
-Sarcopenia: loss of muscle mass
-physical activity increases energy expenditure and enhances bone density and supports body functions
-protein: helps prevent losing muscle tissue, bone tissue and other lean body mass
-carbs and fiber: needed to protect body from using protein as energy, fiber alleviates constipation, ward off chronic diseases
-fat: too little can lead to nutrient deficiencies and weight loss
-water: older people do not feel as thirsty and total body water decreases as people age

Reasons why Older Adults are at risk of Dehydration

-those who have lost bladder control may be afraid to drink too much water
-older people do not feel as thirsty
-total body water decreases as people age so mild stressors like fever or hot weather can cause rapid dehydration

Nutrients that are Likely to be Deficient in Older Persons' Diets

Vit D
-older adults drink little or no milk
-limited exposure to sunlight
-aging reduces skins capacity to make bit D and kidneys' ability to convert it to active form
Vit B12
-older adults lose the ability to produce enough roach acid to make the protein bound form of vit B12 available for absorption
Folate
-fall short of recommendations for intake
Iron
-blood loss from diseases
-poor iron absorption due to reduced secretion of stomach acid and antacid use
Zinc
-medications can impair zinc absorption or enhance its excretion leading to deficiency
Calcium
-intakes are below recommendation

Services Provided by Food Assistance Programs for Older
Adults and/or Low-income Persons

-The Older Americans Act (OAA): provides support services to help older adults remain healthy and independent
-OAA Nutrition Program
-Supplemental Nutrition Assistance Program (SNAP)
-Meals on Wheels
-Senior Farmer's Market Nutrition Program

foods to avoid for infants

- sweets
-hot dog slices
-canned veggies
-nuts
-whole grapes or cherries
-honey and corn syrup

Impact of Childhood Obesity

-begin puberty earlier
-stop growing at a shorter height
-develop greater bone and muscle mass "stocky"
-atherosclerosis may begin to develop: high levels of cholesterol, triglycerides, LDL cholesterol
-high BP
-increase risk for getting type 2 diabetes and respiratory diseases
-emotional and social problems

prevention/treatment of childhood obesity

Prevention
-specific eating and physical activity behaviors by the American Medical Association
-limit sugary beverages
-eat recommended amount of fruits and veggies
-eat age appropriate portions of foods
-limit screen time
-60 min of physical activity a day

Treatment
-to improve long term physical health through permanent healthy lifestyle habits
-diet, physical activity, psychological support and behavioral changes
-obese children and families should adopt the same healthy eating and activity