Exam 1 Nutrition, Health, and Wellness NR228

Label meaning of serving size

The amount of a product that is most commonly consumed

Monosaccharides

glucose, fructose, galactose

-Have one sugar molecule

--Most fruits, vegetables and honey

Disaccharides

sucrose, lactose, maltose

-Have 2 sugar molecules

--Sugar and milk

Polysaccharides

Have many sugar molecules

--Rice, potatoes, corn, and wheat

Function of carbohydrates

Provide energy

-Liver is important organ

-Brain and CNS crave carbs as fuel but can not store them

-Protein sparing effect if carbs is sufficient for energy needs, protein wont be sacrificed to supply energy

-Dietary fiber not fat

-Naturally occurring sweeteners (sucrose and fructose)

Sugar alcohols

sorbitol, mannitol, xylitol

When reading a food label, how can you know what ingredients make up most of the product?

The first three ingredients listed will have the highest percentage

PKU patients should not have what type of sugar? Why?

Aspartame or anything containing aspartame

-Because their bodies cannot break down excess phenylalanine, resulting in a buildup that causes medical problems

Glycemic Index

Ranking of foods according to how it raises blood glucose levels compared with a reference food

Glycemic load

the amount of carbohydrate in a food multiplied by the glycemic index of the carbohydrate

Fiber

A tough complex carbohydrate that the body cannot digest

What are the functions of water?

Provides shape and rigidity to cells

Helps regulate body temp

Acts as a lubricant

Cushions body tissue

Transports nutrients and waste products

Acts as a solvent

Provides a source of trace minerals

Participates in chemical reactions

Minerals for blood health include

Iron, Zinc, Copper

Minerals for bone health

Calcium, Phosphorus, Magnesium, and Fluoride

What are the food trends we are experiencing in this country

Alot more eating out so more sodium, fat and calories

Simple carbs

Simple carbs vs complex carbs

Simple includes monosaccharides and disaccharides

Complex includes polysaccharides excluding glycogen

digestive problems through the life span

Infants- immature GI tract may allow proteins to be absorbed without complete digestion, can result in allergic responses

Lactose Intolerant- may occur once primary growth need for nutrients contained in milk is met OR could occur in adulthood

--older adults may experience it when secretion of enzymes decreases

Mid adults- gallbladder disease and peptic ulcers

Older adults- constipation and diverticulosis

Minerals for energy and metabolism

Iodine, Chromium, Phosphorus, Sulfur, Iron and Zinc

True or false: Minerals are stable when cooked

TRUE

Nephrotic syndrome

Glomerular membrane becomes permeable to proteins. Leaking into the urine, and lacking in the blood

S/S-

Chronic kidney disease

Large amounts of dilute urine In early stages, followed by oliguria and finally anuria as disease progresses

-Nitrogen retention of Urea producing Axotemia

-Metabolic acidosis

-Hypertension and anemia

Nutrition therapy in kidney disease

Based on the severity of the disease, presence of metabolic abnormalities, and treatment modality

-Length of disease

-Degree of impaired kidney function

-Individual clinical symptoms

Foods to avoid high in NA+ / K+

Table salt

Processed foods

Canned foods

Butter and milk

White potatoes (with skin)

Bananas

Mango, raw

Pomegranate, raw

Avocado

Green, beets, spinach, cooked

Insulin

A hormone produced by the pancreas or taken as a medication by many diabetics

45 to 65% of adults total calorie intake comes from

Carbs

Type 1 diabetes S/S

Polyuria

Polydipsea

Polyphagia

Weight loss

Type 2 diabetes S/S

Polyuria

Polydipsia

Frequent fatigue

Frequent infections (UTI)

How do we diagnose diabetes?

A 1 C 6.5 or higher

Fasting BG 126 or higher on 2 occasions

Oral GTT 200 or higher 2 hours post eating

Basic goals of care for diabetes

-Glycemic control and medication

--Insulin and oral hypoglycemic agents

-Optimal nutrition 1 carb serving= 15 G

-Physical activity: minimum of 150 min/week moderate aerobic activity and 2x/week resistance training

-Diabetes self-management education/support

-Psycho social assessment and care

What should glucose levels be at different times?

Before meals= 70 - 130 mg/dL

Bedtime= 90-150 mg/dL

Two hours after meals= less than 180

The affects of an illness on blood glucose levels

It can elevate levels

-Test urine for ketones

-Check at least 4x a day when sick

-Call doctor when levels are 250 mg/dL or higher

-Never omit diabetic medications

Exercise and its effect on blood glucose levels

Avoid exercise if fasting levels are equal or greater than 250

Ingest added carbohydrates if glucose levels are below 100

Exercise when levels are between 100-200 or about 30-60 min after meals

**Monitor before and after exercise

People with diabetes should not exercise when...

Insulin level is at its peak

Type 1 glucose control can be compromised if food and insulin are not adjusted with exercise

•T2DM: patients may be at risk for hypoglycemia when taking oral agents and exercising.

Nutrient balance for glycemic control

-Eat more fruits and vegetables

-Choose higher fiber food and more whole grains

-Keep in mind liquids digest quickly and raise blood sugar levels faster than solids

-Limit high fat, lower GI food (like chocolate bars)

Erikson's stages

Mistrust vs. Trust

Shame vs. Autonomy

Guilt vs. Initiative

Inferiority vs. Industry

Role confusion vs. Identity

Intimacy vs. Isolation

Generativity vs. Stagnation

Despair vs. Integrity

Maslow's hierarchy of needs

(level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization

Metabolism

Set of processes through which absorbed nutrients are used by the body for energy and to form and maintain body structures and functions

-comprised of catabolism and anabolism

Absorption

Movement of digested nutrients through the gastrointestinal mucosa and into the internal environment

Digestion

A group of process that break complex nutrients into simpler ones, facilitating their absorption

Mechanical digestion

Physical breakdown of large pieces of food into smaller pieces

Chemical digestion

Process by which enzymes break down food into small molecules that the body can use

6 dimensions of health

physical, social, intellectual, emotional, spiritual, environmental

Health literacy

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

An adequate eating pattern will include..

Assortment, Balance, and Nutrient density

__________ addresses the value of eating a variety of foods from every food group

Assortment

As eating pattern exhibiting balance will include..

Foods from all the food groups in quantities so essential nutrients are consumed in proportion to one another

What is nutrient density?

Assigns value to a food on the basis of a comparison of its nutrient content with the kcal the food contains

Essential and non essential nutrients

Essential nutrients- when the body requires this nutrient for growth but lacks ability to manufacture enough to meet the body's needs

Non essential nutrients- other nutrients that the body can make

Essential nutrients

Provide energy

Regulate body processes

Aid in growth and repair of body tissues

Carbs, Lipids, Proteins, Vitamins, Minerals, Water

Undernutrition and Overnutrition

Undernutrition- not enough energy or nutrients compared with DRI values

Overnutrition- consumption of too many nutrients and too much energy compared with DRI values

Malnutrition

condition resulting from an imbalanced nutrient and/or energy intake

-Both under and over nutrition

What are the two types of vitamins?

fat soluble (A,D,E,K)

water soluble (B,C)

Dietary Reference Intakes (DRIs)

Set of dietary standards intended to prevent nutrient deficiency diseases and to reduce the risk of chronic diet-related disorders

-Takes into account the availability of nutrients, food components, and the use of dietary supplements

Estimated Average Requirement (EAR)

the amount of a nutrient needed to meet the basic requirements of half the individuals in a specific group that represents the needs of a population

Recommended Dietary Allowance (RDA)

the level of nutrient intake sufficient to meet the needs of almost all healthy individuals of a life-stage and gender group

Adequate Intake (AI)

the approximate level of an average nutrient intake determined by observation of or experimentation with a particular group or population that appears to maintain good health

Acceptable macronutrient distribution ranges (AMDRs)

Daily percentage energy intake values for the macronutrients fat, carbohydrates, and protein

Estimated Energy Requirement (EER)

Aims to maintain good health by providing energy intake levels to maintain individuals body weights within specific age, gender, height, weight, and physical activity

What are food descriptors?

Helps consumers who try to control their intakes of specific nutrients and food components

EX: light fat, low fat

Food descriptor include

Free- contains only a tiny or insignificant amount

Low- no more than 3g of fat per serving

Lean- less than 10g of fat, 4g of saturated fat, and 96mg of cholesterol

Extra lean- less than 5g of fat, 2g of saturated fat, and 95mg of cholesterol

Reduced, Less, Fewer- contains 25% less of a nutrient or calorie

Light/lite- 1/3 fewer calories or half the fat of original

More- 10% more of daily value of a vitamin, mineral, or fiber than the usual single serving

Good source of..- 10%-19% of the daily value for a particular vitamin, mineral, or fiber in a single serving

Labeling definitions for organic foods

100% organic- USDA seal is optional

Organic- 95% or more organic ingredients... USDA seal is optional

Made with organic ingredients- at least 70% organic ingredients

Less than 70% organic ingredients- organic ingredients denoted in ingredient list only

What are the two functions of food labels?

1. to help consumers select foods with the most health-providing qualities

2. motivate food companies to enhance the nutritional value of food products

Food labels must include

-single serving size

-number of servings in the package

-percent daily values

-amount of each nutrient in one serving

What nutrients are included on the food labels?

Energy (Kcal), fat, total food energy, food energy from fat, total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrates, dietary fibers, sugars, added sugars, protein, vitamin D, calcium, iron, potassium

New food label

Still based on what Americans typically eat.

Vitamin A & C are no longer required to be on there because it is not a concern anymore

includes added sugars, Vitamin D and Potassium

Information at top of food label

Top nutrients listed includes those most important to health of consumers

What organ is major in digestion and has the most absorption take place?

The small intestine

Daily intake ranges set to provide energy and nutrients while offering reduced risk of chronic disorders

45% to 65% of kcal intake from carbs

20% to 35% of kcal intake from fat

10% to 35% of kcal intake from protein

enriched foods

nutrients lost during processing are added back into food (B vitamins and Iron)

-fiber is not added back to enriched foods

most refined grains are ______ which means stuff is added back into it

enriched

Sources of fiber page

Soluble VS. Insoluble

soluble- dissolve in fluids, including pectin mucilage, psyllium seed husk, guar gum, and other related gums

insoluble- do not dissolve in fluids and provide structure and protection for plants.. cellulose, hemicellulose, and lignin

Examples of soluble and insoluble food sources

Soluble- kidney beans, split peas, lentils, chickpeas, navy beans, soybeans, apples, pears, bananas, grapes, citrus fruits, oat bran, oatmeal, barley, corn, carrots, white potatoes

Insoluble- whole grains, brown rice, whole-wheat pasta, oatmeal, unrefined cereals, popcorn, nuts, vegetables, wheat bran, seeds, peanut butter, broccoli (leafy greens)

Recommended levels of fiber intake

25g to 38g per day

-Many Americans do not consume enough

Composition of simple carbs

sugars

Carbohydrates composed of carbon, hydrogen, and oxygen

Benifits of high fiber in disease prevention

Can reduce risk of some cancers, heart disease, and diabetes

Ideas to increase fiber intake

Increase gradually until eating at least 6 servings of whole-grain breads and cereals and 5 servings of fruit and vegetables and legumes each day

Why is it important to increase fiber intake slowly?

Increasing fiber intake too quickly can lead to bloating, gas, cramps, abdominal discomfort and diarrhea

Artifical sweeteners

Nonnutritive substances produced to be sweet tasting; however they provide no nutrients and few if any kcal

--function is to replace naturally sweet substances such as sugar, honey, and other sucrose containing substances

Based on a 2,000 calorie diet, with my plate in mind, what is the recommended amount of fruits, vegetables, grains, dairy and protein a person should have?

Fruits- 2 cups

Vegetables- 2 1/2 cups

Grains- 6 oz

Dairy- 3 cups

Protein- 5 1/2 oz

1 oz = ___ cups

1/2 cups

How is glycogen stored

As small granules mainly in the muscles and liver

How much water should a M/F drink each day?

M= 13 cups a day

F= 9 cups a day

Hard water

water that contains high amounts of minerals such as calcium and magnesium

Soft water

water containing sodium (replaces minerals)

Constipation can be caused by lack of water because

Obligatory water excretion of at least 500 mL must be performed daily to clear body of waste products

Risk of water intoxication is indicated by...

low sodium levels

Why is it important to instruct patients not swallow toothpaste or mouthwash?

Bc they often contain significant amounts of sodium

Foods high in sodium

Condiments (pickles, olives, ketchup, soy sauce, salad dressings, etc)

Breads/Starches (salted crackers, potato chips, corn chips, popcorn, pretzels, dehydrated potatoes)

Meats/meat substitutes (cured, smoked and processed meats, hot dogs, canned salmon and tuna, all cheese except low sodium and cottage cheese, peanut butter

Beverages (buttermilk and instant hot cocoa mixes)

Soups (canned soups, dehydrated soups, bouillon)

Vegetables (sauerkraut, hominy, pork and beans, canned tomato and veg juices)

Fluid Volume Deficit (FVD) causes and S/S

Causes: diarrhea, vomiting, high fever, stomach/intestinal viral infections, flu, sweating, diuretics, polyuria

S/S: infrequent urination, decreased skin elasticity, dry mucous membranes, dry mouth, drowsiness, lightheadedness, disorientation, orthostatic hypotension, extreme thirst, nausea, slow or rapid breathing, sudden weight loss

What hinders calcium absorption

Aging

Binders such as phytic acid and oxalic acid

Dietary fat

Dietary fiber

Drug use

Excessive phosphorus intake

laxative use

Sedentary lifestyle

What factors favor calcium aborbtion

Acidity of digest mass

Bodys needs for higher amounts (pregnancy)

Lactose

Sufficient vitamin D

Magnesium food sources

whole grain, green leafy vegetables (broccoli),legumes, hard water

Difference between hemeiron and nonhemiron and where we get them from

Heme iron: iron found in animal sources of meat, fish, and poultry, and its more easily absorbed

Nonheme iron: plant sources such as vegetables, legumes, dried fruits, whole-grain cereals, and enriched grain products

**animal sources of iron contain both irons

**Egg yolks contain iron the iron in them do not absorb as well as other heme from other sources

Liquids that dont count as water and why they are not counted as water

Coffee, tea, alcohol and soft drinks

These act as diuretics increasing water loss

Soft drinks do add water to the body but they contain sugar, salt, and various chemicals

Foods as sources of water include

Milk, cheddar and cottage cheese, icecream

Apples, grapefruit, grapes, melons, oranges

Asparagus, carrots, cucumber, lettuce, potato, spinach, sweet potato, tomatoes

Beans (cooked), bread, fruit punch, gelatin, meats, oatmeal (cooked), poultry, soups

Nutritional needs for the diabetic

Total fat, saturated fat, cholesterol, fiber, vitamins and mineral intakes are the same for people with or without diabetes

Carbohydrates are based on eating habits, blood glucose and lipid goals

Sucrose food only eaten as occasional substitute for carbs

Protein 15% to 20% of daily Kcal

Alcohol should be consumed with food and regarded as an additional energy

what does vitamin D have to do with glycemic and A1c control

Vitamin D deficiency is linked to the onset of diabetes through its role in maintaining normal release of insulin by pancreas

Helps reduce inflammation that leads to insulin resistance

blood test levels for diagnosis of diabetes and prediabetes

Diabetes- A1c- 6.5 or above Fasting plasma glucose- 126 or above. Oral glucose tolerance test- 200 or above

Prediabetes- A1c- 5.7 to 6.4. Fasting plasma glucose- 100 to 125. Oral glucose tolerance test- 140 to 199

Normal- A1c- about 5. Fasting plasma glucose- 99 or below. . Oral glucose tolerance test- 139 or above

Risk factors for type 1 diabetes

Hereditary or genetic

True or false: people with type 1 diabetes with no complications and have good blood glucose control may exercise at all levels

TRUE