Nutrition Final - All Units

Define “health”

State of complete physical, social, and mental wellbeing. Not merely the absence of disease.

Define “nutrients”

Essential substances your body needs in order to grow and stay healthy

Six categories of nutrients

1. Carbs

2. Protein

3. Minerals

4. Vitamins

5. Lipids/fats

6. Water

Define the functions of nutrients

1. Energetic - Provide energy (carbs/lipids)

2. Plastic - Form and maintain structures within the body (protein)

3. Regulatory - Regulate metabolic processes (minerals and vitamins, hormones/enzymes)

Define “metabolism”

Set of chemical reactions that take place in the different cells of living beings and from which they obtain energy and synthesize the substances they need.

Four components of diet

1. Availability

2. Selection

3. Appetite

4. Nutritional Needs

What are essential nutrients?

These cannot be synthesized internally/in sufficient quantities, so we must get them through our diet.
Ex: Macronutrients and micronutrients needed to survive. Vitamin C, A, etc.

What are non essential nutrients?

These can be generated by the body, and also absorbed through food.
Ex: Vitamin D, biotin.

What factors influence when we eat?

1. Hunger (physiological factor)

2. Appetite (psychological factor)

3. Meal time (sociological factor)

Factors to when we stop eating

1. Satiation - Psychological and physiological factors. Perception of food as well as stomach volume.

2. Satiety - The feeling of fullness that continues after eating

Factors that influence why we eat what we eat

1. Personal preference

2. Habit

3. Tradition

4. Social interactions

5. Availability, convenience, economy

6. Positive and negative associations with food

7. Emotional comfort

8. Values

9. Body weight and image

10. Nutrition and health benefits

Organs that influence eating behavior?

1. Hypothalamus - Maintain homeostasis. Hunger and thirst, body temp both controlled by this organ.

2. Pituitary gland - Controls growth hormone, consumption of nutrients impacts the effectiveness of this gland

3. Pancreas - Secretes insulin and inhibits hunger

4. Upper small bowel - inhibit hugner

5. Colon - Peptide 5, this organ stimulates hunger

6. Lower small bowel - Inhibit hunger

7. Fat cells - Inhibits hunger

8. Stomach - Ghrelin, stimulates hunger

Define “nutrients” (unit 3)

Substances with a defined chemical structure contained in food/beverages that are essential for the health and activity of the body since they provide energy, form and maintain structures, and regulate metabolic processes of the organism.

Function and sources of carbohydrates

Carbs used for energy. Found in cereals, potatoes and other starchy root vegetables.

Function and sources of protein

Protein helps build and maintain structures within the body. Protein is found through meats, plant based sources such as legumes, eggs, etc.

Digestive process of carbohydrates

1. Mouth - Amylase found in saliva starts breaking carbs into small polysaccharides

2. Stomach - Stomach acid inactivates amylase

3. Small intestine - Continue breaking down polysaccharides

Digestion of fiber

1. Mouth - Fiber crushed

2. Stomach - Fiber delays gastric emptying

3. Small intestine - Fiber not digested, delays absorption of other nutrients

4. Large intestine - Bacteria ferments certain fibers, fiber attracts water, binds to cholesterol and bile to carry it out of the body

Protein digestion

1. Stomach - Pepsin breaks down protein into smaller polypeptides

2. Small intestine - Enzymes from pancreas break down proteins further. Enzymes from epithelium break down small polypeptides into amino acids.

Fat/lipids digestion

1. Small intestine - Lipase from pancreas breaks down lipids into glycerol, fatty acids, and monoglycerides

Definition of fibers

Indigestible carbohydrates from plants that regulate digestive health, nutrient absorption, promote feeling of fullness, lower cholesterol, etc.

Insoluble fiber is found in cereals with fiber, whole grain, brussel sprouts, legumes.

Soluble fiber found in oats, barley, fruits like strawberries/raspberries, carrots, etc.

Define “vitamins”

Organic compounds essential for the maintenance of normal metabolic functions and growth. Classified into water soluble and fat soluble groups. The human organism is unable to synthesize them.

Fat soluble vitamins

Vitamins:

A - Retinol

D2/D3

E

K1

Must be ingested with fats, held in fatty tissues and liver until needed.

Vitamin A functions

• Vision process

• Protein synthesis and cell differentiation in epithelial tissue

• Reproduction

• Growth of bones

• Deficiency increases risk of infectious disease

• Orange, squash, carrots, pumpkin, spinach, liver

Vitamin D

• Non essential, synthesized in the presence of sunlight

• Bone growth

• Immunity, CNS, skin, muscle and reproductive organs

• Deficiency in children causes bone malformations, in adults leads to osteoporosis and osteomalacia

• Excess leads to kidney stones and hardening of blood vessels

• Fish, eggs, liver, mushrooms

Vitamin E

• Formation of erythrocytes, muscles, and other tissues

• Main function as an antioxidant

• Needed to form male sex cells

• Deficiency leads to destruction of red blood cells (anemia), muscle degeneration, and reproductive disorders

• Many fruits and vegetables

Vitamin K

• Essential for blood clotting

• Non essential vitamin

• Bone building

• Very rare to have a deficiency, usually caused by drugs

• Found in egg yolks, liver, leafy green vegetables

Water soluble vitamins

• Vitamin C

• B1

• B2

• B3

• B5

• B6

• B8

• B9

• B12

Vitamin C

• Antioxidant

• Growth and maintenance of gums, blood vessels, bones, and teeth

• Role in immunity

• Deficiency leads to scurvy

• Found in many fruits and vegetable s

Vitamin B

These work together in energy metabolism. Several form part of the coenzymes that assist enzymes in release of energy from macronutrients.

Define “slow carbs”

• Better for blood sugar control than simple carbs

• Low glycemic index

• Complex carbs

• Examples include whole grain products, legumes, fruits, starchy vegetables including squash and sweet potatoe

Define “fast carbs”

• Simple carbs

• White flour products

• Flavored yoghurts

• Fruit juices, sodas, snacks etc

Define “minerals”

Inorganic elements that always retain their chemical structure. Cannot be destroyed by heat or acid. In some cases the presence of minerals effect the absorption/metabolism/excretion of another one.

Health effects of starch and fibers on diabetes?

Whole grains reduce the risk of type 2 diabetes. Soluble fibers trap nutrients and delay their transit through the GI tract so glucose absorption is slowed.

Relevance of GI index to diabetics?

Diabetics need to pay attention to their blood sugar, when the glycemic index spikes so does the blood sugar. Fast carbs raise blood sugar, slow carbs prevent these spikes.

Define “glycemic index”

Value that indicates the rate of elevation of blood glucose after the consumption of a food containing carbohydrates, and expressed as a percentage.

Importance of omega 3

These are essential fats that the body cannot make on its own. They have an antioxidant effect and lower cardiovascular risk.

What is the “biological value” of a protein?

Biological value depends on digestibility and essential amino acid component. Digestibility depends on the source of protein and other foods eaten with it. Animal proteins are the highest. Essential amino acid content, the dietary protein must supply 9 essential amino acids. For protein synthesis to take place essential amino acids have to be present at the same time in sufficient quantities.

How to create a “complex protein”?

To create complex protein nutrition, combine "incomplete" plant-based proteins (grains, legumes, nuts, seeds) to get all essential amino acids, like pairing beans with rice, nut butter on whole-grain bread, or hummus with pita; or simply eat a varied diet of animal sources (meat, dairy, eggs) and plants, as your body naturally combines amino acids over the day.

What does basal metabolism depend on?

Varies on age, sex, weight/height, (metabolic stress) and body composition. In adults, the recommended intake decreases with age.

Energy balance calculation

EB = income - expenses

*Balance controlled by hypothalamus, efficiency of energy production, and endocrine balance

Total energy expenditure - determined by metabolic rate and physical activity

Formula - TEE = ( BMR x PAEE ) + TEF

(TEF - Thermic effect of food, PAEE - physical activity energy expenditure)

BMR: Basal metabolic rate

Harris Benedict Formula

PAEE - Physical Activity Energy Expenditure

Easiest to change

Thermic effect of food

• Energy body uses to digest food

• 10% of BMR

Dietary Reference Intake (DRI)

• Nutrient reference values in a healthy population

• Indicators of good health and prevention chronic disease, adverse effects of excess intakes of nutrients

• Based on 4 reference values

4 reference values DRI

• Estimated average requirement - estimated to meet the requirements for a specific criterion of adequacy of half of the healthy individuals of a specific age, sex, and life-stage

• Recommended dietary allowance - daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a particular life-stage and gender group

• Adequate intake - recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people who are assumed to be maintaining an adequate nutritional state.

• Tolerable upper intake level - highest level of continuing daily nutrient intake that is likely to pose no risk of adverse health effects

How to use DRIs

They apply to healthy people. Need to be adjusted for malnourished people or with medical problems. 2. Recommendations are not minimum requirements. They target most of the people and do not account for individual variation in nutrient needs (registered dietitian can help determine if recommendations should be adjusted. 3. Variety of food (mixtures of nutriens) : excess intakes are unlikely. 4. Recommendations apply to average daily intakes. Depending on the nutrient, deficiency develops more rapidly ( Ex. Thiamin and vit C : days or weeks) or more slowly (vit. A and Vt B12 : months or years) 5. Each DRI category serves a unique purpose - EAR: develop and evaluate nutrition programs for certain groups - RDA: goals for individuals - UIL: serve as reminder specially upon supplements

Nutrition science definition

relationship between the body’s physiological functioning and the essential elements from the food we eat.

Bromatology definition

Combines the science of biology, physics and chemistry to study the nature of food

Dietetics definition

Connects food to nutrition and health

Processed food

• Loss of valuable nutrients and the gain of sugar, fats, and salt

• Their value in the diet depends on the starting food and how it was processed.

• Sometimes processed foods are fortified (nutrients that were not present originally are added) to improve their nutrient contents

New food

Food which has been designed using genetic engineering techniques

• Gm food

• Functional food

• Pro/prebiotics

• Nutraceuticals

• Super food

Genetically modified food

• Biodiversity can decrease

• Non target organisms can be harmed

Probiotics

• Live microorganisms

• Produces certain vitamins

• Improve the immune response

• Protects against pathogens

• Reduce symptoms of poor lactose absorption

Prebiotics

• Food ingredients that the body cannot digest and therefore stimulate growth intestinal microbiota

• Ex: soluble fiber

Functional food

• Natural or processed, enriched component that provides significant health property regardless of its nutritional value

• Beneficial effect reached with usual amounts consumed in diet

• Consumed daily, reduce risk of chronic diseases, provide nutrients

Nutraceuticals

• Isolated from food products, sold as drug

• Beneficial physiological effects and protect against chronic diseases

• Ex: capsules with flavonoids

• Dietary supplement in non food form

Super food

Foods whose nutrient content confers a health benefit over and above that or other foods.
Ex:

• Blueberries

• Pomegranate

• Chia seeds

• Ginger

• Turmeric

• Green tea

Nutritional characteristics of cereals

• Most abundant protein gluten

• High iron, K+, phosphorus, Ca

• Vitamins B, no vit. C

• Fiber and vitamins when consumed in whole grain form

Potatoes

• Low protein, fat free, starch

• High fiber and folic acid

Acrylamide

• Caused by maillard reaction

• Golden brown color on food, linked to cancer

Nutritional characteristics of sugar

• Absorbed quickly in intestine, high glucose in blood after consumption

• Honey composed rapidly absorbed carbs, B/C vitamins

• Antimicrobial and fungicidal

• Royal jelly higher nutritional value

Nutritional components of lipids

• Oil, butter, margarine

• Higher saturated fatty acids

• Butter high vitamin A

• Fat same in butter/marg

Nutritional components of milk

• Calcium, vit D/lactose, little iron

• Dairy proteins high biological value

• Yoghurts contain probiotics, fats and protein easier to digest than in milk

• Cheese high protein, Ca, Vit A/D

Nutritional components of proteins

• Contains all essential amino acids

• B vitamins

• Low Vit A/C/folic acid

• Fish good for B vitamins and omega 3

• Eggs high bio value, A/B vitamins

Nutritional components of legumes

• compliment cereals rich in methionine and low in lysine

• Meals that combine legumes and cereals achieve a good nutritional balance: lentils with rice, chickpeas with noodles, legumes with bread or beans with corn

• High protein high fiber

• K+

Nutritional components of nuts

• Low carbs, high protein

• Easily absorbed minerals

Nutritional components of vegetables

• Low cal

• Carbs

• High water content

• Rich in fiber, low in fat

• No cholesterol

• Vit A/C/B/folic acid

Nutritional components of fruits

• High carbs, high sugar

• Many vitamins

• Fiber and pectins

• High water content

• Antioxidants

How to calculate BMI

Weight in kg/height² (M)

Below 18.5 underweight, over 25 overweight

Waist to height ratio

• assesses the accumulation of central fat and results from the division of the perimeter of the waist in cm between the height in cm.

• It is considered that there is abdominal obesity when the value of WHR is > 0.5

• DIVIDE WAIST BY HEIGHT

Waist to hip ratio

• Results from the division of the perimeter of the waist in cm between the perimeter of the hips in cm

Skin folds

• Lipocalibrators

• Triceps fold

• Abdominal fold

• Subscapular fold

• Suprailiac fold

• Estimate total BF

Electrical bioimpedance

• Body composition based on conduction properties of the human body

• The fat mass has high impedance/resistance due to the lack of fluids.

24 hr recall

Nutritional reference values

• Carbs 55-60%

• Proteins 10-15%

• Fats 30%

• Fiber 30-50g per day

Recommended frequency food groups

Lactic period

• Breast milk only recommended food until 6 months as single source of energy

• Artificial breast feeding every 3 hours

• Beikost period when introduction of non-dairy foods from the 4th-6th month

Diet in puberty

• Family loses influence on eating behavior, friends fashion and media take over

• High biological value proteins needed

• Ca, Zinc, iron recommended

• Regular meal times without skipping any

• Wholegrain bread and cereals

• Fish, legumes, cereals

• Reduce processed foods

• Drinking water with meals

Diet in older age

• Osteoarthritis, back pain, hypertension and vision problems

• It is necessary to avoid the associated CALORIC-PROTEIN MALNUTRITION, as it is an indicator of FRAGILITY

• Omega 3 needed

• More proteins

Food sources with Ca+

• Cheeses

• Oregano

• Cinnamon

• Milk

Marasmus

• Due to energy supply deficit or poor use of nutrients. Slow evolution

Protein malnutrition/kwashiorkor

Due to protein intake deficit. Rapid evolution

Mixed malnutrition/cachexia

Energy supply deficit + protein hypercatabolism that increases needs. Rapid evolution

Anorexia

• Self induced weight loss

• Distorted body image

• Restrictive/purgative

• Mainly effect women 12-25

• Refusal to gain weight

• Amenorrhoea

Bulimia

• Suffers episodes of binge eating, followed by a great feeling of guilt and a sense of loss of control.

• Fasting episodes

• Inappropriate compensatory behaviours at least twice a week for a period of at least 3 months

• Self-evaluation is exaggeratedly influenced by body weight and body shape

Vigorexia

• Obsessed with having muscular body

• Addiction to physical activity

• Excessive exercise to achieve larger muscles

Orthorexia

• Obsession with eating healthy food

• Elimination of some food groups that are not nutritionally replaced by others

Permarexia

• People constantly on a diet, worried about weight and calories

• Diuretics, vitamins, fibre

• High levels of exercise to control weight gain

• Think they know a lot about nutrition

Obesity definition

• Problem in which an individual accumulates an excessive level of fat for their age and sex, which exceeds the levels of overweight

• Excess fat mass under skin and around organs

Overweight definition

Treated as if they have central obesity, hypertension, type II diabetes. Not as large as obesity.

Bariatric surgery

• Treatment morbid obesity

• For Pi who have a BMI greater than 40 kg / m2 or 35 kg / m

• Most common is reduction of stomach volume, others reduce the length of the intestine

Obesity risks

• Risk of metabolic syndrome - develops a set of symptoms that increase the risk of cardiovascular disease and type 2 diabetes mellitus which may compromise health

• Hypertension

• Dyslipidemia

• Type 2 diabetes

Obesity treatment

• Achieve WL behavior

• Self control

• Physical exerciser

• Goal to lose 5-10% of initial weight maintained over time

• Decrease 500 calories per day

• Psychological support behaviors

Distributions of fat tissue

• Homogeneous or generalized distribution

• Abdominal or android distribution: the accumulation of fat is in the abdominal region

• Gluteal-femoral or gynoid distribution: fat accumulates in the hip and gluteal-femoral region

Types of artificial nutrition

• Enteral

• Parenteral

Enteral

• Nutrients given directly to digestive system by means of implanted tubes

• Used for unconscious patient, swallowing disorders, intestinal failure, CNS disorders, stroke

• Nasogastric for short term, ostomy for long term

• Postpyloric if there is aspiration risk

• Gastric if no risk

Parenteral nutrition

• Intravenous supply of all nutrients

• Go directly into bloodstream, bypassing digestive process and the liver filter

Parentral vs. Enteral Diagram

Diet plan for diabetics

• Increase fiber intake

• Cooking increases GI, al dente

• Fresh fruit and natural juices

• No alcohol, avoid sweeteners

• Normal lipids

• Nephropathy present restrict protein

• regular exercise

• Avoid tobacco, alcohol, other drugs

• Fast absorbing carbs when hypoglycemic