Nutrition exam 2

Supplementation of folic acid may mask which vitamin deficiency? 

B12 – It can alleviate the anemia that is caused by a vitamin B12 deficiency  

Are vitamin supplements necessary? Who would benefit from them? 

It would be better to get vitamins through diet rather than supplements 

People who would benefit are 

• People who consume less than 12oo cal/day 

• Vegans who do not eat animal products  

• People with poor appetite or illness 

• Older adults  

• Women who are pregnant or going to be pregnant  

differences between fat and water soluble vitamins

Fat Soluable (ADEK) – Fat and oil parts of food. Absorption by being encased in chylomicrons that enter the lymphatic system before circulating in the blood. Transportation through the blood by attaching to proteins

Water Soluble (B complex and C): Absorbed directly into blood

fat soluble vs water soluble vitamin storage

Fat soluble: Stored primarily in the liver and adipose tissue

Water soluble: Minimal storage so must be consumed daily.

fat soluble vs water soluble vitamin excretion

fat soluble: slowly via bile into feces. Toxicity can occur

water soluble: quickly in urine so toxicity is rare

What can affect Vit D synthesis in our environment?  

• The body can get all the vitamin D needed if exposed to optimal sunlight and liver and kidney function are normal 

• Living below the 37-degree line  

• Sunscreen blocks the synthesis of vitamin D

How is Vit D affected in older adults?  

• less skin synthesis, less intake, less sun, and reduced kidney activation 

• Less calcium reabsorption, so osteomalacia  

• Older adults usually have loss of liver and kidney function  

Interaction between vitamin K and anticoagulants 

• Vitamin k is essential for the synthesis of prothrombin and blood clotting factors. 

• Vitamin K opposes the effect of anticoagulants like warfarin (which clots blood).

• Consistency in vitamin K intake is crucial to maintain safe and effective coagulation 

• Veggies like spinach and green leafy foods have vitamin K 

food sources of vitamin C 

Citrus fruits and juices  

food sources of vitamin E

Seeds, nuts, vegetable oils, avocados, leafy veggies  

food sources of vitamin B12

animal products

food sources of vitamin D

Fortified foods (Milk, yogurt, cheese, cereal)

How do antibiotics affect fat soluble vitamins?  

lower vitamin K production and reduce absorption of vitamins A, D, and E by disrupting gut bacteria and fat digestion

Vitamin A intake

• Preformed vitamin A is found in animal sources

• Excess supplementation can cause toxicity, leading to liver damage, headaches, and birth defects

• Provitamin A is found in deep yellow and orange fruits and dark green leafy veggies 

impact of vitamin A

• Vision, reproduction, growth, and immune system functioning 

• Too much causes CNS changes, bone and skin changes, and liver problems  

what is beta carotene a form of

vitamin A

What is niacin used to treat in large doses?  

lower LDL and raise HDL 

niacin is also a form of…

vitamin B3

Folic acid and pregnancy – timing of supplementation and what it prevents 

• Upper limit is 1000mcg 

• AI before conception and during the first trimester reduces neural tube defects 

Function of Thiamin in the body  

• AKA vitamin B1 

• Metabolism of carbs and branched-chain amino acids 

Role of phytonutrients /phytochemicals 

Phytochemicals – Plant chemicals. When eaten in the “package” of fruits and veggies, chemicals work together with nutrients to promote health and fight off free radicals  

phytonutrients- plant compounds that support health by acting as antioxidants, reducing inflammation, boosting immunity, and helping prevent chronic diseases.

Vitamin C – which patients would benefit from increasing their intake? 

Smokers, elderly, dialysis, burns, critically ill 

How often should you ingest water soluble vitamins? Is that the same as fat soluble vitamins?  

• Daily, since they cannot be absorbed 

• Not the same as fat soluble because those can be absorbed in adipose tissue or liver 

Which vitamins are also antioxidants? 

• A, C, E, and beta carotene  

• Beta carotene – yellow, red, and orange veggies and helps eyesight  

are vitamins Susceptible to heat, light, and air?

yes

Function of water in the body 

• 60% of body weight 

• Transports nutrients and oxygen to cells 

• Solvent for vitamins, minerals, glucose, amino acids  

• Metabolic reactions 

• Eliminates waste products 

• Mucus and other lubricating fluids  

When is thirst reliable and when is it not a reliable indicator? 

Not reliable for children and the elderly  

Insensible losses and how it is affected

Sweat and breathing  

How do minerals differ from the other substrates we have learned about this semester 

Inorganic compounds and cannot be broken down 

Sources of sodium in the diet / excretion / body’s way of regulating levels 

• Homeostasis is maintained by peeing  

• Salty meal triggers thirst  

• Increased stimulates the kidneys to excrete more sodium  

• Decreased stimulates aldosterone to increase sodium reabsorption 

AI of sodium in the diet recommended is:  

1500 mg/day for 14+

How do minerals react to heat and light  

unaffected- but minerals help the body absorb heat and light

Selenium & manganese toxicity 

• Selenium – Rare. Hair, nails, skin loss

• Manganese – Not common. Can result from diabetes, celiac, alcohol abuse, aging, or medication. affect nervous system

Phosphorus in the food supply 

• Animal sources, nuts, whole grains, legumes 

• Also a big pervasive  

High Potassium containing foods 

Bananas, avocados, potatoes, and lentils  

What are you concerned about for patients that only drink bottled water?  

Fluoride deficiency  

Calcium 

• Leaches out of bones if a patient stops consuming calcium,  to make up for low blood calcium levels which is bad  

• Largest mineral content

When does a positive energy balance occur?  

Intake exceeds output (body mass increases) 

Review how to calculate total calories in a food using kcal/gm for CHO, Pro & Fat 

Fat times 9, protein and carbs times 4, alcohol times 7 

Thermic effect of food and what impacts it 

• 10% of calories spent on processing food

• Affected by the composition of food, frequency of eating, and portion size  

Central obesity definition for men & women (waist circumference)  

• Defined by excess fat accumulation around the waist 

• More than 40in for men and more than 35in for women  

BMI calculation

Kg/m^2  

categories of BMI (obesity classes); 

Overweight as more than 25 and obese as more than 30 

WHC; waist circumference and what disease risks are of concern (slide 21) 

• Waist measurement /height “keep waist to less than half of height” 

• Diabetes, dyslipidemia, hypertension, and cardiovascular disease  

• Apple-shaped is at risk  

Metabolism is made of what 3 parts? And what %does each part contribute to overall metabolism /daily caloric needs 

BMR (60%), physical activity (30%), and thermic effect of food (10%) 

How many minutes of physical activity are recommended per week of moderate-intensity exercise/activity?

150-300 minutes a week 

1lbs=3500cal/day 

• 500cal/day leads to loosing 1lbs a week  

• 3500/7=500