HINT 331 - MIDTERM EXAM

What is the definition of nutrition?

the science of food and nutrients and their actions in the body

everything you put in your body: how you eat it/make it/present it

What is the approach to nutrition?

Evidence based and nonjudgement, nourishes the body and soul, all foods fit and have a place, approach with grace and kindness

What is the nutrition assessment?

detects energy and nutrient levels;

uses info (health status, diet, drug use)

anthropometric (ht, wt, bone)

physical (look for clues — pale)

lab work (look at blood test and urine)

What is the Food guide?

Came into effect in 1942 during the war for rationing and ensuring healthy diet

It is an education tool to help the general population follow a health diet — had 4 categories, now has 3 groups

What is important about food labels?

Has nutrition facts on the back based upon a 2000kcal diet.

The DV% of 5 is known as a little and of 15 is known as a lot

The ingredients are listed by weight

BB — stored appropriately will be fresh, but no gaurantee

ED — do not eat/buy after the date

What are eating habits?

Have 3 meals a day, 2-3 snacks, try and have all macros at all meals, body provides hunger cues

What are the 6 principles of healthy eating?

adequacy, balance, variety, moderation, energy source, flexibility

What is the adequacy principle?

eat enough and often enough to get all essential nutrients/fiber/energy

Cornerstone of healthy eating (need to fuel to have body functions)

What is the balance principle?

Food in proportion to one another and the body’s needs — helps ensure adequacy

Each macro sends signals to the brain to indicate satiety

What is the variety principle?

eat wide selection within / amoung macro groups

The more food from a group = the more nutrients

What is the moderation principle?

get enough but not too much

include foods that brings enjoyment

What is the energy control principle?

energy in can maintain physical and metabolic activities

Nutrient density— higher density = increased nutrients but decreased energy/calories

Fewer calories is not always better

What is the flexibility principle?

Be adaptable with food choices instead of a rigid schedule

What is DRI?

Daily recommended intake

A set of nutrient intake values; umbrella term for 5 different measures

What is EAR?

Estimated Average Requirement

average daily amount of nutrients to maintain specific functions in half the popultion

What is RDA?

Recommended Dietary Allowances

average daily amount of nutrients considered adequate to meet known nutrient needs

Above the EAR, the goal intake, applicable to 98% of population

What is AI?

Adequate Intake

average daily amount of nutrients that appears sufficient to maintain criteria

use when RDA unavailable— H2O, O3, O6

What is UL or UI?

Upper Limit/Intake

maximun daily amount of nutrients that appears safe for most people and beyond that cause ADE

What is AMDR?

Acceptable Macronutrient Distribution Ranges

ranges of intake for energy yielding nutrients

% of total kcal

• C = 45-65

• F = 20-35

• P = 10-35

What is CDRR?

Chronic Disease Risk Reduction

nutrient intake suspected to reduce risk of developing chronic disease; must have evidence and sufficient info backing it

Only for Na

What are the dietary limits?

<2300mg Na/day to keep BP low

<10% of intake should be saturated fats

<10% of intake should be free sugars

What are the dietary references?

Carbs = 130g/day

Protein = 0.8g/kg

• RDA = M— 56g ; F— 46g

What are macronutrients?

Nutrients needed in large amounts (g)

Provide energy to the body

Carbs/Proteins/Fats — 4kcal/4kcal/9kcal

What are micronutrients?

nutrients needed in small amounts (mcg/mg)

Don’t directly provide energy but assist in metabolizing things for energy

vitamins and minerals

What to know about fruits/veg (food guide)?

should be ½ your plate

darky green leafy vegetable every day (vitamin C, iron)

orange vegetables 3x/wk (vitamin A)

Frozen/canned foods okay but no sugar added

Whole fruit/veg over juices

Organic (no human made pesticides; not necessarily healthier)

What to know about protein (food guide)?

Should be ¼ of your plate

Avoid processed food

Aim for plant based — legumes, nuts, tofu

Can be animal based — eggs, poultry, yogurt

What to know about whole grains (food guide)?

Should be ¼ of your plate

Whole grains is all 3 parts of the grain

• bran— outer surface, fiber

• endo— mainly starch

• germ— seed for wheat, vitamins/minerals

Whole wheat doesnt mean whole grain

Ex: barley, corn, rice, quinoa, buckwheat

What to know about water?

The single largest component of the human body

Adeq intake is based on the intake required to prevent dehydration effects

Physical activity and heat increases requirement

Young children/elderly at risk for dehydration

What is the connection of mental health and chronic disease?

people with CD suffer from depression — those with DM (30% have depression)

• those with depression are 40% likely to have DM

severe obesity and depression associated with females

your diet can decrease depression by 40%

What is important to know about the brain structure and function?

Brain is metabolically expensive

• 2% of body weight

• consumes 20% of energy

• composed of 80% fat

Nerve cells = neurons (made up of fat)

What are neurotransmitters and examples?

how neurons communicate

Ach, dopa, glut, hist, NE, sero,

What is Ach?

NT

for muscle movement and memory

What is dopamine?

NT

learning and emotion

What is glutamine?

NT

flexibility and memory — linked to Alz/PD

What is histamine?

NT

wakefullness and feeding

What is NE?

NT

stress and sleep

What is serotonin?

NT

mood and appetite

What is the gut-brain connetcion?

It is bidirectional — microbiota and CNS

has direct communication via neurons

The gut is like the second brain — has 100mil neurons and NT— Ach, NE, serotonin

What is gut microbiota?

A part of the microbiome in the gut

Everyones microbiota is unique and you want homeostasis in the biota

It can change overtime — genetics, diet, age

What is the microbiotas impact on nutrition?

It breaks down otherwise indigestible food and produces nutrients when doing so (vit K, B12, folic acid SCFA)

protects body from pathogens

What is an important SCFA?

butyrate

It is produced when there is fermented fibre, it provides energy to colon cells and decreases colon cancer

What are probiotics?

they restore microbiota balance and help treat/prevent conditions

You can take them through supplements

Are identified by their genus/species

Need to be backed by evidence to be given the term probiotic

What are prebiotics?

Food for probiotics, help beneficial bacteria and fuel SCFA production

Can find it in garlic and bananas

Dose = 1.5-10g/day

What are fermented foods?

When a microbial transformation occurs (carbs to acids)

Ex: yogurt, keifer, kombucha

Does not meet the criteria for probiotics

Impacts health because it changes the nutrition of raw ingredients

What are the four areas of nutritions impact on MH?

Brain development, NT production, energy, and inflammation

What is the brain development impact of nutrition on MH?

Need essential fatty acids (for the myelin sheath)

Need omega 3 (for brain development and structure) — ALA, DHA, EPA

What is the NT production impact of nutrition on MH?

nutrients are precursors and cofactors

amino = tryptophan

mineral = zinc

B vitamins = 1/2/3/6

What is the energy impact of nutrition on MH?

macronutrients provides glucose (fuel), carbs increase serotonin and dopamine

What is the inflammation impact of nutrition on MH?

chronic inflammation — causes brain changes

If you increase O3 = anti-inflam properties

If you have poor O6:O3 = pro-inflam properties

What is the BG impact on MH?

fluctuations in BG impact mood

insulin decreases BG — Epi released — increased craving for carbs — mood swings

Want to emphasize fibre and regular meals

What are the nutrition approaches to MH?

have a whole diet (nutrient focus — will feel better if you eat better), avoid restriction, have mindful eating

What are the specific nutrients that help MH?

antioxidents, phytochemicals, vitamin D, fluids, other vitamins/minerals

What are antioxidants with MH?

They neutralize free radicals and counteract oxidative damage

The brain is active and has easily oxidized substances in it

What are the other nutrients with MH?

vit C - kiwi

vit E - almond

caroten - beets/carrots

selenium - fish/beef

zinc - meat/lentils

phenols - onion/apples

What are phytochemicals?

compounds in plants that have antioxidant properties

What are the types of phytochemicals?

flavanol — onion/apple

anthocy — blue/red/purple plants

flavanones — citrus fruit

What is vitamin D with MH?

decreases mental illness, regulates enzymes, protetcs neurons

What is fluids with MH?

brain relies on flow, so even 1% dehydration impacts cognitive function

What is the anti-inflammatory diet?

Inflammation impacts the brain and you can get it from diet (red meat, margarine, sugar) and other sources (depression hx or stress)

Want to reduce inflammation

• colourful fruit/veg, decreased GI foods, omega 3

What is the mediterranean diet?

It is based on the diet of those who live by the sea

Reduces inflammation/CV risk/stroke/cancer and increases longevity

Rich in antioxidants, anti-inflam, omega 3

Focuses on whole and minimally processed foods

What is the MIND diet?

medi DASH (HTN) for neurodivergent

Targets cognitive decline and dementia

Has antioxidants and anti-inflammatory properties

What is the low GI diet?

addresses BG fluctuations

GI is a measure of how fast a carb increases your BG

High GI = increased depression

What are the impacts on caffeine and alcohol on MH?

C — ST benefits = alert/attentive, but worsens anxiety symptoms and impacts sleep

A — immediate calming but excess consumption can worsen anxiety, has LT effects

What are the main functions of carbohydrates?

energy, protein sparing, fat metabolism, GI tract, body compounds

What is the energy function of carbs?

glucose is preferred fuel for blood cells, the brain and NS

1g = 4kcal

What is the protein sparing function of carbs?

enough carbs ensures that protein is being used for growth and synthesis

And muscles dont need to be broken down for energy

What is the fat metabolism function of carbs?

fat burns in a carbohydrate flame (fat wont burn efficiently without carbs)

What is the GI tract function of carbs?

fibre, decrease cholesterol

What is the body compound function of carbs?

are a part of the cell membrane, RNA/DNA and mucous

What is the structure of a carbohydrate?

a saccharide = sugar

6 C, 12 H, 6 O

What is a monosaccharide?

glucose, galactose and fructose (mostly in fruit)

What is a disaccharide?

maltose = glucose and glucose

sucrose = glucose and fructose

lactose = glucose and galactose

What is lactose intolerance?

The inability to digest lactose

The disaccharide is absorbed with extra water and becomes food for bacteria

It occurs on a continuum (worsens with age)

Most can tolerate ½ cup of milk

Will damage the villi (decreases nutrient absorption)

What are symptoms of lactose intolerance?

gas, blood, diarrhea, cramping

How do you manage lactose intolerance?

spread out intake, combine with other foods, use lactose free

What are oligosaccharides?

few; 3-10 C

prebiotic for the gut, do not digest well cause gas

Found in beans and kale

What are polysaccharides?

many; complex C

Makes starch, cellulose and glycogen

Starch = storage of C in plants

Glycogen = storage of C in animals

What is cellulose?

Fibre

Nondigestable plant wall (causes GI bulking)

Phytic acid with fibre binds to minerals (can’t absorb)

What is the metabolism of carbs?

50% for body energy

10% for liver/muscle stores of glycogen — hold 300g

Excess becomes TG = fat

If decreased carb intake— fat becomes ketones and causes acid base inbalance

What is BG regulation?

Stimulates breakdown of liver glycogen to release glucose, works with the stress response (need glucose to run away)

insulin — causes glucose to go into cells when BG high

glucagon — cause pancreas to release glucose when BG low

What is GLP-1?

a glucagon like peptide release in the lower GI , stimulates satiety

Obesity drugs stimulate that receptor

What are carb food sources?

fruits/veg, whole grains, limited in nuts/seeds, none in meat

How much carbs?

Need minimum of 130g/day

Should be 45-65% of total calories

Fibre = 25 F, 35 M

Sugar = 5% (new)

What are enriched foods?

when nutrients have been added back into foods after being lost in processing (usually begin in the food — bread)

What are fortified foods?

When nutrients are added to foods that arent naturally present (vit A/D added to milk)

What is Celiac disease?

an autoimmune disease; the villi in the intestine become nonfunctional (due to inflammation damage causing malnourishment) and foods do not digest

Body creates antigens to gluten and “eats” itself when it is present

What are gluten free foods?

certified oats, quinoa, rice

gluten hides — used as a binder in foods and pharmaceuticals

How do you diagnose celiac disease?

s/s = gas, bloating, illness after gluten ingested

Need a blood test, biopsy of SI

What are other GI disorders?

Chrons, colitis, IBS — need low FODMAP to manage

What is leaky gut?

its to do with the gut lining permeability (epithelial becomes compromised and allows toxins to enter — triggers chrons)

What is FODMAP

Fermented

Oligosacchardies - fructans

Disaccharides - lactose

Monosaccharides - fructose

and

Polyps — sugar alcohol

Foods: fruit, dairy, wheat, legumes, sweeteners

What is a low FODMAP diet?

80% of people with IBS would benefit

Want to limit fiber and any food high in fructose, lactose, fructans, galactans, polyps

What are high FODMAP foods to avoid?

Raspberries, onion, apples, sour cream, candy, HFCS, cream cheese

What are the 3 steps to take for a low FODMAP diet?

1. elimination diet for 4-6 weeks until symptoms lessen

2. reintroduce one food at a time

3. identify food and find balance in diet without FODMAP that triggers symptoms

What do you need to know about sugar?

All sugar is metabolized the same way and ends up in the blood as glucose

Brown sugar just has molasses in it

Honey as antioxidants and is sweeter

What do you need to know about sugar and disease?

Sugar is linked to DM, obesity, cavities, decreased mood, CVD

Excess sugar causes inflammation and increases blood TG

What is the only direct link to health with sugar?

To dental issues (tooth decay and cavities)

Long exposure to sugar promotes acidic environment and bacteria act on enamel

What are sugar substitues?

Sugar alcohols (mannitol/sorbitol), have few kcal, no dental impacts, cause gas and lower GI response

What is aspartame?

A sugar sub

It is widely used, people have reported rxns to it, it comes from 2 amino acids, can not heat it

100/dL in the blood to be toxic

What is sucralose?

A sugar sub

It comes from sugar but has chlorine replacing a H and O (thought to pass through the body), is “heat stable” but if heated generates toxins, alters GLP-1