237 Nutrition Final

vitamin D deficiency - rickets

* 1880-1920
* 90% of children deficient
* smoke from coal-burning fires blocked UV rays
* affects bone development
* now put into milk products

thiamin (vitamin B1) deficiency - beri beri

* 1st observed in Japanese navy crew who ate only polished white rice (husk, bran and germ removed)
* lethargy and fatigue, affects CV, nervous, muscular, and endocrine systems
* eventually led to paralysis and muscle degeneration

niacin deficiency - pellagra

* 3 D’s
* dermatitis
* diarrhea
* dementia
* early 1900s, southeast USA corn was main diet
* this vitamin in corn is not very available for absorption
* must be caught early to be fully corrected

vitamin A deficiency

* leading cause of preventable childhood blindness
* incr risk of diarrhea and measles
* 1st sign = night blindness (usually)
* affects: membranes, skin, bones, tear development
* corneal abrasion+tears not produced

beta-carotene

* precursor to vitamin A
* found in:
* dark green veggies
* deep orange fruits+veg
* no upper tolerable limit but can turn skin yellow-orange in high amounts
* must be split in 2 to form vit A

retinol

* pre-formed vitamin A
* found in animal products with fat
* used in some acne medications but dangerous for developing fetus (miscarriage, birth defects, death)
* ex. accutane

iodine deficiency - goiter

* required for production of thyroid hormone
* leads to hypothyroidism
* inability to tolerate cold, weight gain, fatigue
* can lead to intellectual disabilities in children if deficient during pregnancy+not treated
* \~30% of world is at risk
* swelling in neck due to large thymus gland
* more common in women and over age 60

which vitamins are water-soluble?

B vitamins + vitamin C

\*except for B12 (stored in liver up to 1 year)

not safe in high doses: B6, niacin, vit C

4 methods to minimize nutrient loss

1. refrigerate fruits + veg
2. reduce contact with air to dcr oxidization
3. wash fruits+veg before cutting
4. steam or stir fry, avoid high temps for long times
* ex. boiling, you dump out nutrients with water

folate (B9)

* natural form
* water soluble
* found in:
* leafy greens
* legumes/lentils
* liver
* fortified grain products
* \*law to dcr neural tube defects

folic acid

* synthetic form of folate (B9)
* MORE bioavailable than natural form found in food (50% synthetic absorbed vs only 30% natural)

folate deficiency

* reduces DNA stability
* induces+accelerated carcinogenesis
* heart health
* causes homocysteine to accumulate in blood
* leads to heart attack, stroke, blood clots
* fetal health
* neural tube defects
* spina bifida (treatable)
* anencephaly (fatal) part of brain+skull missing

vitamin C

* antioxidant
* protects tissues from oxidative stress caused by free radicals
* cofactor in collagen formation
* +assists in preventing bruising
* \*\*deficient= incr risk of hemorrhage
* cofactor in other reactions
* conversion of tryptophan → serotonin (controls mood) and norepi (incr HR)
* fatty acid transport into mitochondria for energy metabolism
* making of hormones ex. thyroxine
* released with stress hormones
* reduces blood histamine
* excess results in:
* nausea, abdominal cramps, excessive gas, diarrhea

vitamin C needs

* 10mg to prevent scurvy
* 100mg to saturate body pool
* DRI:
* 75mg/day for females
* 90mg/day for males

vitamin D

* bone growth
* incr blood \[Ca and Phosphorus\]
* incr absorption from intestine
* incr reabsorption from kidneys
* mobilization from bones to blood
* cancer
* breast, prostate, colon dcr with incr intake
* multiple sclerosis; rheumatoid arthritis
* 400IU supplement dcr risk 40%
* synthesis+activation
* skin: 10-15 mins sunlight 2-3x per week
* food sources:
* fortified dairy products+margarine
* fish oils
* egg yolk
* \*supplement recommended
* reduced production:
* age (70+)
* sunscreen
* institutionalized individuals at high risk
* DRI:
* 600IU adults
* 800IU for over 70yrs

vitamin B12

* water soluble
* important for erythropoiesis + neurological function
* low stomach acidity/intestinal disorders can affect absorption
* deficiency:
* anemia+neurogical disorders
* PN, heart palpitations, weight loss, low BP
* sources:
* fish, meat, poultry, eggs, milk products
* fortified foods

free radicals

* attack+steal electrons from other cells
* damage phospholipid bilayer
* “robbers that are deficient in energy”

phytochemicals

biologically active compounds of plants believed to confer resistance to chronic disease

what do phytochemicals do in plants?

* give pigmentation and flavour
* promote chemical reactions + used in metabolism
* protect from bacteria, fungi, animals, and environmental oxidants

are phytochemicals essential?

NO

phytochemicals as antioxidants

protect against oxidative damage

reduce risk of certain types of cancer

__garlic, carrots, tomatoes, berries, tea, grapes__

phytochemicals and hormonal action

**isoflavones** found in __SOY__

imitate human estrogens and help dcr menopausal symptoms and osteoporosis

phytochemicals and stimulation of enzymes

**indoles** found in __cabbages and broccoli__

stimulate enzymes that make estrogen less effective

could reduce risk of breast cancer

phytochemicals and interference with DNA replication

**Capsaicin** found in __hot peppers__

* protects DNA from carcinogens

**Saponins** found in __beans__

* interfere with DNA replication + prevent multiplication of cancer cells

phytochemicals and physical action

* some bind physically to cell walls
* prevent adhesion of pathogens to human cell walls
* **proanthocyanidins** are responsible for this in __cranberries__
* reduce risk of UTIs and improve dental health

are health benefits of phytochemicals associated with foods or supplements?

foods

solanine - green potato

* natural plant defense against insects and fungi
* toxic to humans
* diarrhea, vomiting, fever, headache, paralysis

aflatoxins - *aspergillus* fungi

* grows on nuts/peanuts, dried foods, grains, spices
* can cause liver cancer with chronic exposure
* discard nuts/peanuts that look moldy, discoloured or shrivelled

oxalic acid - turnip greens, __spinach__, rhubarb

can bind to calcium and irritate the stomach and cause kidney stones

\*\*when binds to calcium, forms an insoluble complex that is excreted in the feces

phytates - __whole grains__ and legumes

* bind minerals (iron and zinc)
* cooking, sprouting, fermentation can reduce
* \*\*can bind to calcium and form an insoluble complex, decreasing absorption of calcium

selective breeding

done with crops / animals for centuries

choose desirable qualities and breed to maintain

ex. wild corn = 5 kernels per stalk, not sweer

ex. chickens used to lay 50 eggs/yr now lay 245

genetic engineering

* modifying genetic material of living cells so they produce new substances or perform new functions
* insert gene from one organism into another

antisense mirror image gene

binds to native gene and prevents synthesis of softening protein, extending shelf life of fruits/veg

rennin

used to coagulate milk in cheese production

from calf stomach but now mass produced in bacteria

^saves time, money, space

biopharming

using animals and plants to produce drugs (vaccines)

plant based vaccines

* don't provide immunity in same level as injected vaccines
* human risks
* allergic reaction
* ecological risks
* field grown GMO plants / cross contamination
* social resistance to GMOS

“golden rice”

genes from daffodil and bacteria put in rice to incr beta carotene content

helping dcr vit A deficiency

1 cup = 50% of RDA for adult

genetically assisted agriculture

90-95% of canola crops GM to withstand herbicides

__soy, corn, sugar, beets, potato, alfalfa (hay)__ and 80% of Hawaiian papayas

what are the 3 main issues of concern for human health with biotechnology?

1. allergenicity (ex. peanut genes into banana)
2. gene transfer (ex. antibiotic resistance to GI tract)
3. outcrossing (migration of genes from GM to conventional crop)

what are the 3 most common cancers?

1. lung
2. breast/prostate
3. colon/rectum

cascade of steps of cancer

1. initiation (carcinogen → permanent genetic change ie DNA damaged)
2. promotion (tumour)
3. progression (incr in size/mutations)
4. metastasis (invade tissues/blood)

what are the 6 factors affecting cancer development?

1. genetic factors
2. immune factors
3. environmental factors
4. dietary factors - initiators (step 1)
5. dietary factors - promoters (step 2)
6. dietary factors - anti-promoters

nitrosamines

* strong carcinogens
* naturally occurring or formed via processing
* alcohol + processed meats
* nitrates used as preservatives combine with amines in the stomach to form this

name the 5 carcinogen groups

group 1: carcinogenic to humans

* processed meats

group 2A: probably carcinogenic to humans

* red meats

group 2B: possibly carcinogenic to humans

group 3: unclassifiable as to carcinogenicity in humans

group 4 : probably not carcinogenic to humans

what is the largest promotor of cancer with respect to diet?

fat

* can oxidize at high temps and with time alone
* → oxidative stress in body
* stimulates bile release
* bacteria can convert bile to cancer-causing compounds

fiber is protective against _____ cancer

colon

recommendations for reducing cancer risk (6)

* choose diet rich in a variety of plant based foods
* maintain healthy weight and be active
* drink alcohol in moderation if at all
* select foods low in fat and salt
* prepare and store foods safely
* do not smoke or use tobacco in any form

charring and burning food can cause ___ to form

heterocyclic amines (HCAs)

* mutagenic (can damage DNA)

what factor is associated with stomach scancer?

salt preserved foods

what factors are associated with colorectal cancer?

saturated fat, red meats

what factor is associated with liver cancer?

alcohol

what factor is associated with lung cancer?

smoking

what factor is associated with prostate cancer?

high fat intake

what factors are associated with breast cancer?

obesity, alcohol, early puberty (incr exposure to estrogen)

mineral charge

allows minerals to combine with minerals of opposite charge to form stable compounds

* helps assist in maintaining water levels in body
* assists in neutralizing acidic or basic bodily fluids
* minerals = components of proteins and enzymes

calcium

99% in bones + teeth, \~1% in muscle, blood, and other body fluids

found in: milk products, fish bones, tofu, greens, legumes

3 types of calcium supplements

1. purified calcium
* carbonate (most common, w meals)
* citrate (doesn’t require gastric acid)
* gluconate, lactate, or phosphate
2. calcium mixtures
* Mg, vit D, zinc
3. powdered calcium
* caution: bone meal, oyster shell, dolomite

which calcium supplement is best for the elderly and why?

citrate

* w/ age, acidity in stomach decreases
* citrate does not require gastric acid to be broken down

why should iron and calcium supplements be taken separately?

they chelate together, and neither can be absorbed

osteoporosis occurs if a person is deficient in:

calcium, phosphorus, or vitamin D

peak bone density occurs at approximately ___ years

30

most common types of fractures/bone loss in women

spinal vertebrae, hip, and wrist/forearm fractures

iron

* found in: liver, beef, prune juice, dried fruit, beans and lentils, cereal
* most stored in *hemoglobin*
* small amounts stored in *myoglobin*
* (storage/transport of O2 in muscle cells)
* required by many enzymes to function
* toxic in high amounts

iron DRI for men and women

men: 8mg/day

women: 18mg/day

^women must consume 2500 cals for 15mg

_____ can increase non-heme iron absorption and even reverse the inhibiting effect of such substances like tea and calcium phosphate

vitamin C

these can decrease iron absorption:

* tea
* coffee
* calcium and phosphorus
* phytates, tannins, fiber

heme vs non heme iron

heme: only in animal sources (also contain non-heme)

non-heme: all iron in plant sources=non heme

^ less efficiently absorbed by the body

causes and symptoms of iron deficiency

* causes:
* blood loss
* low intake
* symptoms:
* exhaustion, paleness, short attention span, irritability, susceptibility to infection, rapid HR
* can cause __irreversible__ impairments in mental development of infants and children

____ can increase iron absorption

alcohol

iron toxicity can lead to:

liver damage, diabetes, heart failure

sodium and hypertension

“silent killer”

leads to heart disease, kidney disease, strokes, decline in brain function, poor circulation in legs, and sudden death

6x higher risk if overweight

higher BP=higher risk of health problems (normal 120/80)

what are dietary supplements?

vitamins, mineral pills, herbal remedies, proteins and amino acids, fish oils, probiotics, homeopathic medicines, essential fatty acids etc.

when should you take a multivitamin pill and why?

with a meal bc it boosts body’s ability to absorb and decreases nausea

USP verification requires:

* contains ingredients listen on the label, in the declared potency and amounts
* does not contain harmful levels of specified contaminants (eg. Lead, mercury, microbes, pesticides)
* will break down and release into the body within a specified amount of time
* has been made according to FDA current Good Manufacturing Practices using sanitary and well-controlled procedures

how and when to take iron

* with a meal or glass of juice
* avoid taking with tea or coffee
* if anemic, not at same time as Calcium

how and when to take calcium

* calcium carbonate with a meal
* divide large doses
* Ca + vitamin D is a good idea
* in winter
* if no multivitamin taken

vitamin E - natural vs. synthetic

natural 2x as potent and more rapidly absorbed and maintained in tissue than synthetic but is more $$$

vitamin C - natural vs. synthetic

natural and synthetic have equal potency

pills, foods, rose hip extracts all the same

herbal supplements

* considered natural, tf healthier and safer
* many have health benefits, but research lacking
* some have hazardous side effects and may interact with prescription medications
* not for children under 12, pregnant/lactating women, kidney or liver damage, immunocompromised, or undergoing surgery

how are herbal supplements regulated?

* classified as dietary supplements, not drugs
* no vigorous testing done by Health Canada or FDA
* now required to have a natural product number (NPN). safe, effective, and high quality
* **responsibility still lies with consumer to be informed**

creatine

* incr bioavailability of PCr in muscle cells
* incr ATP synthesis (fuel for cellular processes)
* brief high intensity exercise
* PCr can be synthesized from amino acids
* vegetarians may benefit from this
* no evidence of well controlled studies to support health concerns

creatine monohydrate reccomendations

\~0.3g/kg/day for 5-7 days then 3-5g/day thereafter to maintain elevated stores

DHEA - prohormone

* weak androgen that needs conversion to more potent testosterone
* assumption: incr testosterone, incr performance
* not proven
* __on the list of banned substances by WADA__
* alters testosterone:epitestosterone ratio
* >6:1 disqualification from olympics
* “doping”
* NOT SAFE

for any supplement consider:

1. no expert body of nutrition experts recommend routine use of supplements
2. food is more than the sum of its nutrients
3. taking supplements of single nutrients in large amounts may have detrimental effects on nutritional status and health
4. vary substantially in quality
5. focusing on supplements can take attention away from improving lifestyle

____ was found to cause lung cancer when isolated into a supplement

beta-carotene

true or false: water is not an essential nutrient

false

___% of the adult body is water

60%

daily fluid recommendations

varies based on diet, activity, temp, humidity

aim for 1.0-1.5ml/cal expended

true or false: water in foods contributes to our intake

true

where does our water intake come from?

* 31% from plain water
* 44% from other beverages
* 25% from foods

fluid loss can occur through:

* heat
* sweat loss of 1-2L/hr exercising in heat
* cold
* cold induced diuresis → incr fluid loss
* dehydration
* dcr ability to dissipate heat = incr body temp

water toxicity

* rare
* leads to:
* hyponatremia
* accumulation of water in the brain and lungs
* confusion, severe headache, nausea, vomiting, seizure, coma, death
* dilutes blood

water intoxication has occurred in:

* endurance athletes who consume too much water
* infants given over diluted formula or too much water
* patients with psychotic disorders taking meds that produce cravings for water

fluid replacement - exercise

* 500 ml 2 hours before exercise
* 150-300ml every 20 minutes during
* less than 60 minutes = water best replacement
* more than 60 minutes = dilute glucose and electrolyte solutions

fluid replacement - 3 guidelines

1. volume
* small volumes at regular intervals to prevent bloating
2. temperature
* cool (5-10°C) maximizes absorption
3. composition
* >10% CHO may inhibit gastric emptying resulting in diarrhea, nausea, cramping
* 6-10% glucose or sucrose absorbed rapidly and provides energy for prolonged exercise

recommended values for sports drinks

* CHO source:
* glucose, glucose polymer, sucrose
* \[CHO\]
* 6-10%
* sodium content
* 10-20
* potassium content
* 2.5-5.0
* osmolality mOsm/L
* 250-360

electrolyte replacement

* 1kg weight loss = 1L sweat
* only necessary in extreme conditions as average meal contains 1-3g sodium
* recommended for athletes who :
* sweat excessively (>1.2L/hour)
* have “salty sweat”
* participate in exercise lasting more than 2 hrs

salt tablets can cause ___ to prevent this ____

gastric distress and nausea

dissolve in water

potassium losses are easily replaced by foods such as___

fruits and vegetables

mineral water

taken from underground reservoirs between layers of rock. contains dissolved minerals from the rock