1) Summarize the general recommendations for fluid, protein, and carbohydrate

intake for athletes.

CARBOHYDRATES

- Low to moderate intensity cardiorespiratory activity

- Less than 1 hour in duration

- 4-5 g of carbs per kg body weight

- Endurance activity of higher intensity

- 7-8 g of carbs per kg body weight

- High intensity daily training

- 8-10 g of carbs per kg body weight

PROTEIN

- Adults: .8 g/kg/day

- Recommendation for power(strength or speed) athletes: 1.2-1.7 g/kg/day

- Recommendation for endurance athletes: 1.2-1.4 g/kg/day

Strength athletes need more protein for muscle repair and growth

Endurance athletes need more protein for muscle repair and muscle growth and energy

needs

FLUID:

- 5-12 oz every 15 to 20 min under normal conditions

- Fluids with sodium are needed for exercise >2 hours and in hot conditions

- Consume 1 L of water per 1-2 pounds of weight lost

2) List the 3 energy systems used by the body during low, moderate, and high

intensity exercise.

- Low to moderate rate of energy use: aerobic metabolism

Meets prolonged demands of sustained activity: 2 min to several hours

Carbs, fats, and amino acids are continuously oxidized to provide ATP

During rest body derives most ATP from oxidation of: fatty acids and glucose

- Increased rate of energy use: anaerobic metabolism

Used during first 2-3 minutes of activity

Breakdown of glucose to pyruvate in muscle

Much of lactic acid is transported to live

Cori cycle

- The immediate energy system: atp creatine phosphate system

Uses ATP stored in muscle

Used during first 10 seconds of exercise

1) For which nutrients does the RDA/AI increase during pregnancy? For which

nutrients does the RDA/AI remain unchanged as compared to a healthy,

non-pregnant individual within the same age and gender group?

INCREASE

Proteins- 25 g per day

Carbohydrates- greater than or equal to 175 g per day

Iron- 27 mg per day

Calcium- 30 mg/day during 3rd trimester

Zinc- increase by more than 30%

Hydration- increase by 300 ML above non pregnancy intake

Increase in essential fatty acids, linoleic and alpha linolenic acid and polyunsaturated

fats

DOES NOT CHANGE

Total fat intake

2) Describe the negative impact of the following during pregnancy: caffeine, alcohol

and smoking.

Caffeine: can affect fetal heart rate and breathing, increase risk of miscarriage and low

birthweight baby, irritability in baby alcohol:FAS, growth retardation, facial abnormalities, CNS dysfunction

Smoking: miscarriage, preterm delivery, small birth weight, may impair blood flow to

developing fetus and decrease nutrients and oxygen delivery

3) identify food-borne illnesses of greatest concern during pregnancy. List specific

foods typically associated with each of these food-borne illnesses.

Listeria: found in uncooked meats and vegetable and unpasteurized milk, ready to eat

foods such as hot dogs and deli meats

Toxoplasma: parasite found in undercooked meat and cat litter

4) What are the benefits of breast-feeding for the mother and for the infant?

MOTHER

-Lose weight faster, build stronger bond, decrease risk of breast and ovarian cancer,

saves money by not buying formula

INFANT

-Less likely to experience allergies and intolerances, ear infection(otitis media), vomiting,

diarrhea,pneumonia,wheezing, other respiratory diseases, meningitis, SIDS, possible

reduce obesity

5) Identify contraindications to breastfeeding in developed parts of the world.

- Breast augmentation, breast reduction, previous breast cancer, maternal

prolactinoma, infant galactosemia, mother HIV and HTLV positive, mothers

using illicit street drugs, mother has ebola, human T cell lymphotropic virus type

1 or 2, untreated brucellosis, tuberculosis, varicella

6) Describe possible actions that could be taken to increase the global prevalence of

breastfeeding of infants during the first 6 months of life.

- Limit formula marketing, maternity leave for 6 months, strength health systems

to be more baby friendly, support mothers with group counseling and

breastfeeding tips

7) How does the composition of breast milk differ from the composition of infant

formula?

Human milk composition can vary with each session, while the difference is the composition nd the affect their digestion and absorption is in the infant

8) What is colostrum?

- First milk produced after birth, is of thinner consistency and is slightly yellowish

in color

- High in protein

- Contains maternal antibodies and serves as a laxative to clear meconium

- Frequent small meals in first few days coat baby's digestive tract and prevent

invasion of foreign substances

9) Describe the recommendations for feeding an infant during the first year of life.

High calories: 40- 50 calories per pound body weight per day

Fat: 50-60% of calories intake should come from fat

Protein: no more than 20% of total calories from protein

Breastfeeding newborns: 2-20 ml

Hydration: infants need ⅓ cup fluid per pound of body weight

10)Identify foods that may be choking hazards for infants

Nuts, whole grapes, popcorn, hot dog pieces, any large chunks of raw foods that must be

chewed, small candies, cherries and dried fruit

11) Identify nutrients of concern for infants

Iron, zinc, vitamin A, Vitamin B6

Module 14 - Nutrition for Children, Adolescents and Older Adults

1) Describe the rate of growth of children.

Growth spurt for girls usually happens before boys. According the chart girls growth

spurt was between 10-11 while boys was between 12-13

- Timing of growth spurt dependent on adolescent attaining certain critical weight

2) How do calorie requirements during childhood change in terms of calorie per kg

per day and total calories per day?

- Depends on body size, activity level, growth rate

Calories and protein needs per kg body weight per day increase in initial years of

childhood and decrease as child ages

- Total calories and protein needs overall increase

3) Describe iron-deficiency anemia in children.

- at greatest risk: children in low income families

- Influence on mood and attention span, may impair learning

4) Which group of children is at greatest risk?

Low income families

5) Identify good sources of iron for children.

Lean meat, peanut butter, fortified breakfast cereals, grains apricots

6) Why is lead toxicity a health concern for children?

-Inhibits iron absorption

-Inhibits enzyme needed to synthesize hemoglobin

7) Describe how overweight and obesity is classified and determined in children and

adolescents.

- Calculate BMI for child

- Plot on growth chart for BMI for age

- Compare to national standar

BMI FOR AGES

85th to less than 95th percentile: overweight

95th percentile or greater: obese

Less than 5th percentile: underweight

8) Identify poor eating habits commonly seen in teens and associated health

consequences.

Skipping meals, inadequate consumption of calcium rich foods, nutrient poor food

selection away from home, dieting due to body image issues, alcohol use

9) List social, psychological, physical and physiological aspects of aging and the

impact each can have on nutrition.

SOCIAL PSYCHOLOGICAL

- Living alone: lack motivation to cook meals

- Depression: overeating or undereating

- Anxiety: reduction in digestive secretions

- Economic constraints

PHYSICAL PHYSIOLOGICAL

- Loss of teeth and xerostomia(dry mouth): difficulty chewing and swallowing

- Loss of neuromuscular coordination: cooking and feeding oneself is difficult

- Impaired hearing and vision: age related macular degeneration

- Loss of muscle mass: reduced basal metabolism and calorie needs

-Arthritis

- Diminished sense of taste and smell

- Decreased secretion of digestive enzymes:decreased micronutrient absorption

- Slowing of gastric motility: constipation

10)Identify risk factors for undernutrition in the elderly.

- Older adults who are often hospitalized are malnourished

- Little or no appetite

- Problems with chewing or swallowing

- Consuming inadequate amounts of nutrients

- Eating fewer than two meals a day

Module 15 - Eating Disorders

1) Identify the document that serves as a reference for diagnosing eating disorders.

- Diagnosis of an eating disorder requires assessment of patient by a physician or

psychologist

- Criteria found in: diagnostic and statistical manual, fifth edition(DSM-V)

Disorders defined in DSM-V

- Anorexia

- Bulimia

- Binge eating disorder

- OSFED

- Unspecified feeding or eating disorder

2) Describe the characteristics of the following eating disorders: anorexia nervosa,

bulimia nervosa, and binge eating disorders.

Anorexia- refusal to maintain body weight at or above a minimally normal weight for

age and height

Characterized by: intense fear of gaining weight or becoming fat, poor body image,

amenorrhea may occur, generally underweight

Bulimia- eating large quantities of food in short period of time, binging, feeling loss of

control, followed by purging, laxative use, dieting, excessive exercise, usually normal

weight

Binge Characterized by: recurrent episodes of binge eating, lack of compensatory

behaviors to control weight

3) Identify the categories of OSFED and describe each.

- Atypical anorexia nervosa: weight is at or above the normal range

- Bulimia nervosa(of low frequency and or limited duration):

frequency : <1 episode per week

Duration: < 3 months

- Binge eating disorder

frequency : <1 episode per week

Duration:< 3 months

- Purging disorder: recurrent purging to influence weight or shape in the absence

of binging

- Night eating syndrome: recurrent episodes of night eating

Eating after waking from sleep or excessive food entail after evening meal

4) Identify the components of the female athlete triad.

Disordered eating, amenorrhea, osteoporosis

Osteoporosis- increased risk of stress fracture, low bone density

Amenorrhea- delayed menarche, absence of menstrual cycle

Disordered eating- anorexia, bulimia

5) What is muscle dysmorphia?

Type BDD is which individuals focu son their muscularity and believe they are never

muscular enough

Complications arise due to measures taken to increase muscle mass

6) Identify risk factors for disordered eating behavior.

Dieting, cultural pressure, body dissatisfaction, teasing, poor self esteem, puberty,

family, athletics

7) Discuss how societal influences contribute to development of eating disorders in

women and men.

- Social changes coincide with onset of puberty( more traumatic for girls)

- Portrayal of ideal female body in media influences opinion of self

8) Identify family characteristics that are associated with an increased risk of

developing eating disorders.

- Not accepting individuality

- Overprotectiveness

- Infallibility in rules

- Inadequate boundaries

- Inability to effectively communicate or express feelings

9) Describe health complications of anorexia nervosa, bulimia nervosa, binge eating,

and muscle dysmorphia.

Anorexia- heart failure, kidney failure, multiple organ failure, illnesses such as

pneumonia, 5-20% of anorexia nervosa patients die

Bulimia- stomach ruptures, heart failure due to loss of electrolytes and other minerals,

irregular menstrual cycles, diminished libido, addictions and or compulsive behavior,

clinical depression, anxiety, and other psychiatric illness, increased risk of suicidal

behavior

Binge- generally associated with obesity, high blood pressure, high cholesterol,

cardiovascular disease, type 2 diabetes, gallbladder disease, joint problems, depression

Muscle dysmorphia- increase training intensity, steroids use(AAS) which leads to

reduced testicular size and enlarges breasts, acne, high blood pressure, high LDL

cholesterol, low HDL cholesterol, liver cancer, aggressive behavior, hepatitis B and C

viruses, human immunodeficiency virus

10)Describe the type of approach used to treat eating disorders.

- Most use multidisciplinary treatment approach : individual therapy, family

therapy, complementary therapies, cognitive/ behavior therapy, nutrition

counseling with registered dietitian