Study Guide

Chapter 1:

1. What does essential mean in terms of nutrition?

  • It means it is not synthesized by the body and it must be obtained from the diet.

2. Can someone who is malnourished still be overweight?

  • Yes. If the person is eating food that do not provide adequate nutritional value, and only eat junk food, they can be malnourished and obese.

3. Which nutrients are organic?

  • Nutrients that contain carbon.

4. What are the three macronutrients? How much energy do each yield?

  • Carbohydrates: 4 Cal/g

  • Protein: 4 Cal/g

  • Fat: 9 Cal/g

5. How much energy does alcohol yield? Is alcohol a nutrient?

  • Alcohol is not a nutrient, but it does yield 7 Cal/g

6. Know nutrient calculations (% of a macronutrient in a meal, calories from a particular

macronutrient when given total calories and % of the nutrient)- see examples in slides

  • Carbohydrate: x amount of g X 4 C/g = y amount of Calories

  • Protein: x amount of g X 4 C/g = y amount of Calories

  • Fat: x amount of g X 7 C/g = y amount of calories

  • TOTAL: Carb Cal + Protein Cal + Fat Cal = total calories

Chapter 2:

1. Know the different nutrient recommendations.

  • DRI: Dietary Reference Intakes

    • RDA: Recommended Dietary Allowances

    • AI: Adequate Intake

    • UL: Tolerable Upper Intake Levels

    • EAR: Estimated Average Requirements

    • AMDR: Acceptable Macronutrient Distribution Ranges

  • Daily Values: US standards used on food labels and restaurant signs

  • The Dietary Guidelines: Offer food-based strategies for achieving DRI values

  • The USDA Eating Patterns: To plan a nutritious, healthful diet

2. Know the nutrient ranges for CHO, fat, and protein?

  • Carbohydrate: 45-65% of total calories

  • Protein: 10-35% of total calories

  • Fat: 20-35% of total calories.

3. What are the DRIs designed for?

  • Designed for health maintenance and disease prevention in healthy people. To create guidelines for people in terms of having a healthy diet. Varies between individuals, shows the optimum intake of nutrients.

4. Know the DRI lists and purposes.

  • RDA: Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97-98%) healthy individuals is often used to plan nutritionally adequate diets for individuals.

  • Adequate intakes: Intake at this level is assumed to ensure nutritional adequacy, established only when there is insufficient evidence to generate an RDA.

  • EAR: The average daily intake level is estimated to meet the requirements of 50% of healthy individuals

  • Tolerable Upper Intake Levels (UL): Maximum daily intake is unlikely to cause adverse health effects. Identify potentially toxic levels.

5. Folate is found in which foods?

  • Dark green vegetables like Kale, edamame, asparagus, spinach, broccoli, avocados,

6. Dark green vegetables provide….?

  • Folate

7. Know about probiotics, prebiotics, and resveratrol and the foods that provide them.

  • Probiotics: Living Lactobacillus or other bacteria; found in Yogurt

  • Prebiotics: Nondigestible carbohydrates (or other constituents) that intestinal bacteria feed upon; found in Yogurt.

  • Resveratrol: A phytochemical found in grapes, blueberries, raspberries, and peanuts.

Chapter 3:

1. What part of the cell is referred to as the “powerhouse” of the cell?

  • The mitochondria

2. Know about inborn errors of metabolism, specifically PKU and which amino acid is

affected.

  • Inborn error of metabolism: Genetic variation present from birth that may result in disease.

  • Phenylketonuria (PKU): Inborn error of metabolism that interferes with the body’s handling of phenylalanine (from dietary protein) and left untreated, results in serious harm to the brain and nervous system.

3. What are the body’s circulatory fluids?

  • Blood:

    • Travels within arteries, veins, capillaries, and heart’s chambers

    • Plasma: Cell-free fluid part of the blood and lymph.

  • Lymph:

    • Fluid that moves from the bloodstream into tissue spaces and then travels in its own vessels, which eventually drain back into the bloodstream.

4. What hormones are produced and released by the pancreas and what do they do?

  • Insulin: Released when the blood glucose level is increased, helps trigger metabolism

  • Glucagon: Released when the blood glucose level is reduced, tells the body it needs to eat and helps maintain blood glucose levels until more nutrition is provided.

5. Where does digestion begin in the body?

  • The mouth: Chews and mixes food with saliva, produces an enzyme that starts breaking down the food, before it reaches the stomach.

Chapter 4:

1. What are carbohydrates (CHO)?

  • Simple carbohydrates: Sugars;

    • Monosaccharides: Glucose, fructose, and galactose

    • Disaccharides: Lactose (glucose + galactose), Maltose(glucose + glucose), and sucrose (glucose + fructose).

  • Complex carbohydrates: Polysaccharides: Compounds composed of long strands of glucose units linked together.

    • Starch, glycogen, and fiber

2. Know the different monosaccharides and disaccharides.

  • See above.

3. What is the storage form of glucose in the human body?

  • Glycogen

4. What is lactose intolerance?

  • Impaired ability to digest lactose due to reduced amounts of the enzyme lactase. Insufficient production of lactase enzyme of the small intestine which splits the disaccharide lactose into the monosaccharides glucose and galactose.

5. What do insulin and glucagon do to blood glucose?

  • Glucagon: Helps release glucose from storage to increase the blood glucose levels.

  • Insulin: Stimulates glucose storage as glycogen to reduce the blood glucose levels.

6. What is Hemoglobin A1c?

  • Measures the percentage of hemoglobin (a blood protein) with glucose attached to it. It assesses blood glucose control over a longer period of time.

Chapter 5:

1. What are the 3 classes of lipids? Know each in detail.

  • Triglycerides: Three fatty acids attached to a glycerol molecule

    • Saturated: No double bonds, solid at room temperature, animal fats

    • Unsaturated: Double bonds Create kinks and results in bent structure.

      • Polyunsaturated fats: Two or more double bonds

      • Monounsaturated fats: One double bond.

      • The Bonds are double bonded carbons.

  • Phospholipids: Glycerol containing two fatty acids and a phosphorus molecule.

    • Soluble in water and fat.

    • Emulsifier: Mixes fat and water

    • Part of cell membrane

    • Contain polar and nonpolar portions: Hydrophilic head and hydrophobic tails

  • Sterols: Contain multiple rings of carbon with side chains of carbon, hydrogen, and oxygen.

    • No glycerol backbone

    • Animal and plant sources

2. Know about cholesterol. What is cholesterol?

  • A sterol that our body makes and that we consume in animal products.

  • Important precursor or many hormones:

    • Sex hormones; testosterone, estrogen, and progesterone

    • Vitamin D

    • Cortisol

    • Aldosterone.

  • Provides structure and rigidity to cell membranes.

3. Know the role of CCK (Cholecystokinin).

  • A hormone made from enterocytes in response to fatty acids in chyme, that stimulates the release of pancreatic lipase and bile to digest the fatty acids.

  • Released in the small intestine which is the primary site of fat digestion.

4. Know the roles of lipoproteins:

  • They serve as transport vehicles for lipids from the small intestine and liver to cells of the body.

    • Chylomicron: A triglyceride that carries dietary fat from the small intestine to the cells

    • VLDL: A triglyceride that carries lipids made and taken up by the liver to cells

    • LDL: A cholesterol that carries cholesterol made by the liver and from other sources to cells.

    • HDL: A protein that contributes to cholesterol removal from cells, and in turn, excretion of it from the body.

5. Know the parent member of linolenic acid and linoleic acid.

  • Linolenic acid is the parent member of Omega-3 fatty acid.

    • Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) play critical roles in regulating heart disease, cancer prevention, promoting healthy tissue functioning by amassing in membranes, brain function, and vision.

  • Linoleic acid is the parent member of Omega-6 fatty acid.

    • Arachidonic acid: Starting material for making eicosanoids

Chapter 6:

1. Know the conditionally essential amino acids.

  • Tyrosine - Precursor = Phenylalanine

  • Cysteine - Precursor = Methionine, serine

  • Proline - Precursor = Glutamate

  • Arginine - Precursor = Glutamine, glutamate, aspartate

  • Glutamine - Precursor = Glutamate, ammonia

2. What does it mean if an amino acid is conditionally essential?

  • Rate limitations to synthesis or improper organ function.

3. What is Sickle Cell Anemia?

  • A disorder where the amino acid valine displaces the amino acid glutamic acid at one site in the protein strand, causing the red blood cell to change to sickle shape and lose function.

  • The sickle shaped blood cells hook onto each other and cause clots that can cause sickle-cell crisis that involves a lot of pain.

4. Know about protein digestion. What are the enzymes involved and what is the process?

  • Stomach:

    • The gastric cells release the hormone gastrin which stimulates the release of gastric juice

    • Hydrochloric acid present in gastric juice denatures the quaternary, tertiary, and secondary protein structures in food. It uncoils the protein’s strands.

  • Pepsin:

    • An enzyme that breaks down the denatured proteins

    • Polypeptide chains are broken down into smaller units

    • Requires an acidic environment to function.

Chapter 9:

1. What is visceral fat?

  • Fat stored in the abdominal cavity.

2. What is basal metabolism (BMR)?

  • Sum of all involuntary activities necessary to sustain life, excluding digestion

3. Know about female athlete triad:

  • Energy Insufficiency:

    • Restrictive dieting (inadequate energy and nutrient intake)

    • Overexercising

    • Weight loss

    • Lack of body stores

  • Menstrual dysfunction

    • Diminished hormones

  • Low bone density

    • Loss of calcium from bones.

Chapter 7:

1. Know which vitamins are fat-soluble vitamins and which are water-soluble vitamins?

  • Fat soluble:

    • Vitamin A

    • Vitamin D

    • Vitamin E

    • Vitamin K

  • Water soluble:

    • Thiamin (B1)

    • Riboflavin (B2)

    • Niacin (B3)

    • Folate

    • Vitamin B12

    • Vitamin B6

    • Vitamin C

    • Biotin

    • Pantothenic acid

2. Know the difference between fat-soluble and water-soluble vitamins in terms of

absorption, storage, and excretion, specifically.

  • Fat soluble:

    • Absorbed like fats, first into the lymph, and then into the blood

    • Travel with protein carriers in watery body fluids; stored in the liver or fatty tissues.

    • Not readily excreted; tend to build up in tissues.

  • Water soluble:

    • Absorbed directly into the blood

    • Travel freely in watery fluids; most are not stored in the body

    • Readily excreted in the urine

3. What is the plant-derived precursor of vitamin A?

  • Beta-carotene

4. What are the three active forms of vitamin A?

  • Retinol (stored in the liver)

  • Retinal

  • Retinoic acid

5. What foods contain beta-carotene?

  • Plants

6. Know the consequences of vitamin A deficiency.

  • Night blindness

  • Xerophthalmia and blindness

  • Keratinization of the cornea

  • Xerosis

  • Xerophthalmia: Progressive hardening of the cornea of the eye that can lead to blindness

  • Essential for epithelial tissue

  • Necessary for immune system

7. What foods are rich in beta-carotene?

  • Orange-colored fruits and vegetables

  • Dark green vegetables

8. Know the roles of vitamin D.

  • Calcium regulation: Acts at three body locations to raise calcium level

    • Skeleton: Warehouse for stored calcium

    • Digestive tract: Increases absorption of calcium from food

    • Kidneys: Recycle calcium

  • Hormone: Acts at the genetic level to affect how cells grow, multiply, and differentiate.

9. Know about vitamin D deficiencies and their characteristics.

  • Rickets:

    • Early in life

    • Characterized by abnormal growth of bone and manifested in bowed legs, outward-bowed chest deformity (pigeon chest), and knobs on ribs

  • Osteomalacia:

    • Deficiency in adults

    • Characterized by an overabundance of unmineralized bone protein

  • Osteoporosis:

    • A weakening of bone mineral structures caused by calcium loss that occurs commonly with advancing age

    • Results in fractures.

  • People who could be affected:

    • People who restrict fish and dairy, may not get enough Vitamin D to meet food recommendations.

    • Strict vegetarians and people with milk allergies or lactose intolerance

    • People living in northern areas of North America; anyone lacking exposure to sunlight.

    • Dark-skinned people, their breastfed infants, and their adolescent children often lack vitamin D.

10. What are the roles of vitamin E?

  • Antioxidant guarding against oxidative damage by free radicals.

  • Reduces inflammation

11. What can occur in premature infants with a Vitamin E deficiency?

  • Erythrocyte hemolysis

12. Know the roles of vitamin K (specifically drug interactions). In other words, what drug

interferes with Vitamin K and vice versa?

  • Roles

    • Blood clotting

    • Bone-protein synthesis

  • Drug interference:

    • Warfarin is a drug used to prevent the formation of clots in the circulatory system, so it interferes with vitamin K’s blood clotting properties.

13. Know about vitamin K and the associated deficiencies.

  • Can result in uncontrollable bleeding

  • Bruising easily

14. Know the roles of vitamin C.

  • Connective tissues:

    • Enzymes involved in the formation and maintenance of collagen.

      • Collagen: Forms the base for all the connective tissues: bones, teeth, skin, and tendons.

    • Carnitine and hormone production:

      • Carnitine - important compound for transporting fatty acids within the cells

  • Antioxidant activity:

    • Protects iron and promotes its absorption

    • Prooxidant outside the body

  • Supports the immune system.

15. Know the diseases associated with thiamin deficiency.

  • Beriberi:

    • Characterized by loss of sensation in the hands and feet, muscular weakness, advancing paralysis, and abnormal heart action,

    • Forms: Wet, characterized by edema (fluid accumulation), and dry, without edema.

  • Wernicke-Korsakoff syndrome:

    • Nerve damage from a deficiency of thiamin in alcoholism

    • Characterized by mental confusion, disorientation, memory loss, jerky eye movements, and staggering gait.

    • Alcohol impairs absorption of thiamin and quickens its excretion in the urine.

16. Know the disease associated with niacin deficiency.

  • Pellagra: Occurs among poorly nourished people and particularly among those with alcohol addiction.

17. What are the 4 Ds associated with pellagra?

  • Diarrhea

  • Dermatitis

  • Dementia

  • Death

18. Know about folate and what can happen with folate deficiency.

  • Anemia

  • Diminished immunity

  • Abnormal digestive function

  • Increased risk of cancer

19. Know about B12 malabsorption, specifically in terms of intrinsic factors.

  • Caused by a lack of intrinsic factor (pernicious anemia):

    • Intrinsic factor: Made by the stomach and is necessary for absorption of vitamin B12 and prevention of pernicious anemia.

20. What is the DRI for folate?

  • 400 micrograms/day

21. What foods are rich in folate?

  • Leafy green vegetables and raw or lightly cooked vegetables.

22. Know about pernicious anemia.

  • Causes of pernicious anemia:

    • Inborn gene defect for intrinsic factor

    • Intestinal diseases, surgeries, stomach infections

    • Intake of common diabetes drug

    • Increasing age

23. Know the food sources of vitamin B12.

  • Only animal sources: Steak, tuna, pork, chicken, milk products.

24. Know the roles of vitamin B6.

  • Conversion of tryptophan to niacin

  • Synthesis of hemoglobin and neurotransmitters, the communication molecules of the brain. (Ex. Tryptophan to serotonin).

  • Maintenance of a normal blood glucose concentration

    • Assists in releasing stored glucose from glycogen

  • Immune function and steroid hormone activity

  • Normal development of the fetal brain and nervous system

    • Deficiency during this stage causes behavioral problems later.

25. Know biotin and pantothenic acid.

  • Both important for energy metabolism

  • Biotin:

    • Coenzyme for carbohydrate, fat, and protein metabolism

    • Gene expression

    • Intestinal bacteria release absorbable biotin

    • In a wide spread of foods

    • No UL set

  • Pantothenic acid:

    • Key coenzyme that makes possible the release of energy from the energy nutrients

    • Participate in the synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin

    • Deficiency diseases rare.

26. List what could be some benefits for taking a vitamin supplement?

  • People prone to vitamin deficiencies require supplements

    • Habitual dieters

    • Elderly people with diminished appetite

    • People with wasting illnesses

    • People who omit entire food groups (Vegetarians or vegans)

    • People who lack knowledge or money eat properly.

    • People with lactose intolerance

  • At certain life stages, people may have increased nutrient needs

    • Menstruation

    • Pregnancy and lactation

    • Newborns

    • People recovering from surgery

  • Appetite and physical stress can impair nutrient status.

    • Addiction to alcohol and drugs

    • Medication use

27. What are some arguments against taking vitamin supplements?

  • Food rarely causes nutrient imbalances or toxicities

    • Supplement users are more likely to have excessive intakes of certain nutrients, notably iron, vitamin A and niacin.

    • Supplement contamination and safety.

Chapter 8:

1. What is the difference between major minerals and trace minerals?

  • Major: > 100 mg/day

    • Calcium, phosphorus, potassium, sulfur, sodium, chloride, magnesium

  • Trace: < 100 mg/day

    • Iron, zinc, copper, manganese, iodine, selenium.

2. What are the “shortfall nutrients”?

  • Calcium, potassium, magnesium, and iron.

3. What is the most indispensable nutrient?

  • Water

4. Know about water balance (specifically water intoxication).

  • Water enters the body through liquids and foods, and some water arises as a by-product of the body’s metabolic processes. Water leaves the body through the evaporation of sweat, in the moisture of exhaled breath, in the urine, and in the feces.

5. Where are the storage facilities of calcium? Which one serves as a storage bank?

  • Storage facilities: 99% in bones and teeth

  • Bones serve as the storage bank for calcium.

6. When does peak bone mass occur?

  • The highest bone density attained by an individual is in the first three decades of life.

7. What is the most abundant mineral in the body?

  • Calcium

8. What is the second most abundant mineral in the body?

  • Phosphorus

9. Know the roles phosphorus play in the body

  • Phosphorus salts are critical buffers, helping to maintain the acid-base balance of cellular fluids

  • Essential for growth and renewal of tissues due to being a part of DNA and RNA of every cell.

  • Involved in metabolism of energy nutrients.

  • Phosphorus compounds act as cofactors, assisting many enzymes in extracting energy form nutrients

  • Phosphorus forms part of the molecules of the phospholipids that are the principal components of cell membranes.

  • Present in some proteins.

10. Know which minerals patients with chronic kidney disease, receiving dialysis, should pay close attention to?

  • Sodium

11. Know the roles magnesium plays in the body.'

  • Cofactor for hundreds of enzymes

  • Needed for the release and use of energy from the energy-yielding nutrients

  • Part of the cellular protein-making machinery

  • Critical to nerve transmission, muscle contraction, and heart function

  • Works with calcium for proper functioning of the muscles.

12. Know the roles of sodium.

  • Major part of fluid and electrolyte balance

    • It is the chief ion used to maintain the volume of fluid outside cells

  • Helps maintain acid-base balance

  • Essential for muscle contraction and nerve transmission

13. What is the condition of sodium deficiency and what causes it?

  • Hyponatremia

  • Having too little sodium in the blood.

14. What is the DRI for sodium?

  • 1500 mg for healthy, active young adults

  • 1300 mg for 51-70 years of age

  • 1200 mg for elderly

15. Know about the DASH diet.

  • Increased intakes of potassium-rich fruits and vegetables

  • Adequate amounts of nuts

  • Fish

  • Whole grains

  • Low-fat dairy products

16. What are the roles of potassium?

  • Fluid and electrolyte balance

  • Cell integrity

  • During nerve impulse transmission and muscle contraction, potassium and sodium trade places briefly across the cell membrane. The cell then pumps them back into place

  • Heartbeat

17. Can potassium help lower blood pressure?

  • Yes

18. Know what can happen with a deficiency in potassium.

  • Dehydration, heart failure, muscle weakness, paralysis, confusion.

19. Know which mineral plays a special role as part of hydrochloric acid, which maintains

the strong acidity of the stomach, necessary for protein digestion.

  • Chloride

20. Know the principal food source for chloride.

  • Salt

21. Know the deficiencies of iodine.

  • Goiter: Enlargement of the thyroid gland due to an iodine deficiency, enlargement due to and iodine excess is toxic goiter

  • Cretinism: Severe mental and physical retardation of an infant caused by the mother’s iodine deficiency during pregnancy.

22. Know the roles of zinc.

  • Protects cell structures against damage from oxidation

  • Makes the heme of hemoglobin

  • Assists the pancreas with its digestive and insulin functions and helps metabolize carbohydrate, protein, and fat

  • Special zinc-containing proteins associate with DNA and help regulate protein synthesis and cell division.

  • Functions critical to normal growth before and after birth

  • Needed to produce the active form of vitamin a in visual pigments.

  • Affects behavior, learning, and mood

  • Assists in proper immune functioning

  • Essential to wound healing, sperm production, taste perception, normal metabolic rate, nerve and brain functioning, bone growth, and normal development in children.

23. What is the role of hepcidin?

  • Regulates blood iron levels

24. Know the promotors and inhibitors of iron.

  • Promotors:

    • Heme form of iron

    • Vitamin C

    • Meat, fish, poultry factor

  • Inhibitors:

    • Nonheme form of iron

    • Tea and coffee

    • Calcium and phosphorus

    • Phytates, tannins, and fiber

25. What is the heme iron? What is nonheme iron?

  • Heme iron: Iron containing part of hemoglobin and myoglobin from meat, poultry, and fish.

  • Nonheme iron: From plants and meat.

    • Impaired by tannins (compounds in coffee and tea that bind iron) and phytates (compounds present in plant foods (whole grains) that bind iron and prevent absorption).

26. What is the difference between normal and anemic blood cells?

  • Normal: Round, red

  • Anemic: Shrunken, and diminished in color.

27. Know the characteristics of iron-deficiency anemia.

  • A form of anemia caused by lack of iron and characterized by red blood cell shrinkage and color loss.

  • Anemia: A condition of inadequate or impaired RBCs; a reduced number or volume of RBC along with too little hemoglobin in blood.

28. Know the signs of iron deficiency (specifically Pica).

  • Fatigue, apathy, and a tendency to feel cold.

  • Children become restless, irritable, unwilling to work or play

  • Pica: A craving and intentional consumption of nonfood substances; ice, chalk, starch, clay, soil, and other non food substances.

29. What is hemoglobin? What is myoglobin?

  • Hemoglobin: The oxygen-carrying protein of the blood; found in the red blood cells carries oxygen from the lungs to tissues throughout the body

  • Myoglobin: The oxygen-holding protein of the muscles

30. Know the toxicity of fluoride

  • Fluorosis: Discoloration of the teeth due to ingestion of too much fluoride during tooth development.