In the U.S., what foods do we eat too much of? -red meat (hamburgers) -candy -cheese (has a lot of saturated fat) -sugary beverages -refined grain products

What foods do we eat too little of? -fruits -veggies -fish -whole grains -low-fat dairy

5 factors that influence your food choices? -cost -time -location and availability -occupation -education

Top 10 leading causes of death in the U.S.?

1. heart disease

2. cancer

3. chronic lower respiratory infections

4. accidents

5. stroke

6. Alzheimer's disease

7. diabetes

8. Influenza and pneumonia

9. kidney disease

10. suicide

Causes of death related to diet/physical activity? -heart disease -cancer -stroke -Alzheimer's disease -diabetes -kidney disease

What is Healthy People 2020? -reduce the proportion of adults who are obese -increase the contribution of fruits to the diets of the population aged 2 years and up -increase the contribution of whole grains -reduce calories from saturated fats and sugars

What are the 6 classes of nutrients?

1. carbohydrates

2. lipids (fats and oils)

3. proteins

4. vitamins

5. minerals

6. water

Which nutrients provide energy? carbohydrates, fats (lipids), and proteins

What percentage of a typical adult's body weight is water? 50-70%

Body composition of a female? on average, 57% body water, have more fat and less muscle

Body composition of a male? on average 62% body water, have less fat and more muscle

Elements found in water? oxygen and hydrogen

Elements found in carbohydrates? carbon, oxygen, and hydrogen

Elements found in fat? carbon, oxygen, and hydrogen

Elements found in protein? carbon, oxygen, hydrogen, and nitrogen

Elements found in vitamins? carbon, oxygen, hydrogen, some nitrogen

Elements found in minerals? minerals like iron, sodium, potassium

Which nutrients are organic? carbohydrates, proteins, fats, and vitamins

What nutrients are inorganic? minerals and water

What is the definition of essential nutrient? body does not synthesize the nutrient or make enough to meet its needs, must be supplied by food

Which fatty acids are essential? linoleic and linolenic acids (vegetable oil)

What is a conditionally essential nutrient? nutrients that are normally not essential but become essential under certain conditions

What are examples of times when nutrients may become conditionally essential? serious illnesses, such as certain amino acids in those with kidney or liver disease

What are macronutrients? nutrients that your body requires large amounts of -carbs, fat, protein

What are micronutrients? nutrients that your body requires small amounts of -vitamins and minerals

How many kcals are in 1 gram of fat? 9 kcals

How many kcals are in 1 gram of carb? 4 kcals

How many kcals are in 1 gram of protein? 4 kcals

How many kcals are in 1 gram of alcohol? 7 kcals

What are the recommended percentages for carbs, protein, and fat? carbs- 55% protein- 15% fat- 30%

What are most foods a mixture of? nutrients

What is nutrient dense? supplies more vitamins and minerals in relation to total kcals

What is energy density? amount of energy a food provides per given weight of the food

What helps insure a diet's nutritional adequacy? variety, moderation, and balance

What does it mean to have variety? eat foods from EACH food group

What is moderation? eating reasonable amounts of each food

What is balance? eating an appropriate number of calories and engage in regular physical activity

Does the FDA regulate supplements? NO

Is more always better? no, for each nutrient, there is a safe range

Can the nutrients in food cure everything? no, diet is only one aspect that influences a person's health

What does malnutrition mean? bad nutrition- can be overnutrition or undernutrition

Nutrition is constantly changing based on what? -humans -food choices -environment -knowledge -others

What are empty calories? calories that don't specifically fit a food group; if you meet your food group needs, then you can have extra empty calories -ex: ice cream, soda, french fries

What are DRIs (Dietary Reference Intakes)? set of energy and nutrient intake standards

What are DRI's used for? planning and assessing diets

Who develops the DRIs? food and nutrition board

What are the components to the Dietary Reference Intakes? -Recommended dietary allowance (RDA) -Adequate intake (AI) -Tolerable upper intake level (UL)

What is an Estimated Average Requirement (EAR)? amount of a nutrient that should meet needs of 50% of healthy population

Problem with an EAR? for the average person they would need exactly this amount, but this isn't actually recommended because it doesn't account for half of the population?

How is the EAR utilized? used to figure out the RDA/AI to get it to 97-98% of the population- in a given age/gender group

How is an RDA utilized? represents a person's nutrient intake goal -meets the needs of nearly all 97-98% of healthy individuals in a life stage/gender group

How is an AI utilized? used when not enough information is available to determine human requirements -"best guess" -ex: vitamin K, sodium

How is a UL utilized? highest average amount of a nutrient that is likely to harm most people when consumed on a daily basis -usually get to UL's using dietary supplements

According to the AMDR's, what percentage of total daily kcals should be supplied by carbohydrates, fat, and protein? carbs: 55% protein: 15% fat: 30%

What is a food group plan? Diet planning tools that sort foods into groups based on nutrient content and then specify that people should eat certain amounts of foods from each group

Draw MyPlate

What are the major food groups that are a component of MyPlate? -grains -dairy foods -protein foods -fruits -veggies -oils -empty cal foods or beverages

General recommendations for grains? whole grain pasta, whole grain bread, whole grain cereal

Whole grain food equivalents? equal to 1 grain -1 slice of bread -1 small tortilla -1 cup ready to eat cereal -1/2 cup cooked rice, pasta, or cereal -5 small whole-wheat crackers

General recommendations for dairy foods? make fat-free or low-fat choices; fat-free or low-fat milk (cow, soy, almond), low fat cheese, Greek yogurt

Dairy foods equivalents? -1 cup of milk -1 cup of yogurt -1.5 oz. natural cheese -1/3 cup shredded cheese 2 oz. processed cheese

General recommendations for protein foods? make lean or low fat choices; fish, legumes, eggs, lean meat, nuts, seeds

Protein foods equivalents? -1 oz. cooked lean pork, ham, poultry, fish -1 egg -1 tbsp of PB -1/2 oz. nuts -1/4 cup cooked beans -2 tbsp. hummus

General recommendations for fruits? variety; no more than 1/3 as a fruit juice -apples, blueberries, oranges, dried fruit

Fruit equivalents? -1 small apple -8 large strawberries -1 cup diced melon -1 cup applesauce -1/2 cup dried fruit

General recommendations for veggies? variety from all live subgroups several times a week -dark green, orange, and deep yellow, legumes, starchy, other

Veggie Equivalents? -1 cup raw/cooked veggies -1 cup mashed potatoes -1 cup veggie juice -2 cups leafy greens -1 large sweet potato *count legumes as either a protein or veggie, not both

General recommendations for oils? select from healthy sources -olive oil -canola oil -fatty fish -nuts -avocado

Oils Equivalents? -1 tbsp oil -2 tbsp salad dressing -4 large olives -1/2 medium avocado -2 tbsp peanut butter -1 oz. nuts -empty calorie foods can be added in moderation

What does a whole grain contain and why is it beneficial to health? -intact, ground, or flaked seeds of cereal grains -more fiber and micro-nutrients

What is Healthy Eating Plate? (compared to MyPlate) diary not included, less grains and more veggies, more healthy proteins and healthy oils

What is the Mediterranean pyramid? (compared to MyPlate) -puts larger emphasis on veggies, fruits, whole grains, olive oil, legumes, and nuts -should have fish and seafood at least twice each week -should eat meats and sweets less often -wine in moderation

What is required as part of the Nutrition Education and Labeling Act of 1990? packaged foods must have: -name of products -name and address of manufacturer -net content in terms of weight, measure, count -nutrient content

Describe how ingredients are listed on the ingredient list -ingredients listed in descending order by weight

What are daily values and how are they utilized? generic term, only used for food labels -based on 2000 cal diet -use DVs to compare products, how much of a nutrient

Compare the new FDA food label to the "old" food label, which is still found on many products - what are key differences?

1. added sugars now clearly labeled

2. calories from fat has been deleted

3. serving sizes are more realistic

4. calories are bigger and bolder

What nutrients must be listed on the NEW food label? -added sugars -nutrients of Public Health concern; vitamin D, calcium, iron, and potassium

Which restaurants must provide calorie labeling? if there are 20 or more locations of the restaurant, calorie information must be listed for standard menu items -other nutrition information available to consumers

What is a health claim? specific wording requirements; CANNOT "diagnose, mitigate, or treat disease" -must have statement "as part of a healthy diet"

Who approves health claims? FDA; examples include reduced sugar, fat-free, and high fiber

What does it mean to have reduced sugar? at least 20% less than the original

What does it mean to be fat-free? less than 0.5g fat per serving

What does it mean to be high fiber? more than 5g fiber per serving (must also be low-fat)

List the order of the primary components of the GIT -mouth -pharynx -esophagus -stomach -small intestine -large intestine (colon) -rectum -anus

What are the accessory components to the GIT? -teeth, tongue, salivary glands, liver, gall bladder, pancreas

Digestion: breaking down large food molecules into nutrients the body can use

Absorption: uptake and removal of nutrients from the GIT and into blood or lymphatic vessels

What are the components of the oral cavity (mouth)? teeth, tongue, salivary glands

What do the teeth do in digestion? break food into smaller pieces

What does the tongue do in digestion? initiates swallowing reflex; has taste-buds

What do the salivary glands do in digestion? secrete saliva

What are the components of saliva? -water-99% -salivary amylase (breaks down starch) -mucus -lysozymes (antibacterial) -lingual lipase in infants (helps maximize healthy fats)

Where are taste buds located on the tongue? most are located on the underside of tongue and the tip for protection

What are the five basic tastes? sweet, salty, sour, bitter, umami

What happens to taste buds as you age? number of taste buds decrease

Are infants born with a preference for sweet or salt or is that preference developed? born with a physiological preference

What order should solid foods be introduced to an infant's diet? -rice cereal -green veggies -orange veggies -fruit -mixed dishes

What is anosmia? complete inability to detect odors

What is hypoguesia? diminished ability to taste

What is ageusia? total loss of taste

Recommendations for someone with a taste smell disorder? use spices and think about texture

What role does the esophagus play in digestion? muscular tube (food pipe) from pharynx to stomach (10 inches)

What prevents food from entering the trachea? Epiglottis prevents bolus from entering trachea

Anatomically, what is a sphincter? thickened areas of circular muscle -controls flow of GIT

Location of the upper esophageal sphincter? between pharynx and esophagus

Location of the lower esophageal sphincter? between esophagus and stomach

Location of the plyoric sphincter? between stomach and small intestine

Location of ileocecal sphincter? between the illeum and large intestine

What role do sphincters play? Controls the flow of GIT

Peristalsis Involuntary waves of muscle contraction that keep food moving along in one direction through the digestive system

What are the three layers of muscle of the stomach wall? -longitudinal muscle -circular muscle -transverse (diagonal) muscle

Why are they important? stomach can expand and acts as a mixing bowl for chyme -can contract and relax interchangeably

What are the key functions of the stomach? -food reservoir (typical meal 4-6 cups, maximum 16 cups) -production and secretion of gastric juices

What are the components of gastric juice? mucus, HCl, intrinsic factor, enzymes, gastrin

Mucus provides protection in stomach

HCl changes what happens in the stomach

Intrinsic factor absorbs vitamin B12; decreases with age so you may need vitamin B12 shot

Gastrin hormone secreted in the stomach that stimulates secretion of HCl and increases gastric motility

What s the PH of chyme in your stomach? 2.0

How long does it take your stomach to empty? about 4 hours

What does fiber do? delays stomach emptying and keeps you fuller longer

What is CCK and what does it do? -It improves digestion by slowing down the emptying of food from the stomach and stimulating the production of bile in the liver as well as its release from the gall bladder -increases the release of fluid and enzymes from the pancreas to break down fats, proteins and carbohydrates

What is secretin and what does it do? stimulates the release of pancreatic juices (enzymes, bicarbonate)

What is dumping syndrome? disorder that occurs when a large amount of chyme flows too rapidly into the small intestine

Symptoms of dumping syndrome? abdominal fullness, nausea, sweating, rapid heart rate, weakness, and cramping

Treatment for dumping syndrome? -changing the types of foods eaten -eating smaller meals -taking certain medications -surgery to repair plyoric sphincter

What are the three parts to the SI? duodenum jejunum ileum

What are the functions of the small intestine? -longest part of GIT -large surface area (size of tennis court) -digestion is completed -major site of nutrient absorption -receives secretions from gall bladder (bile) and pancreas (enzymes/bicarbonate)

Importance of the villi? finger like projections that maximize nutrient absorption

Importance of the microvilli? hair like projections to trap nutrients

Importance of crypt? important for secretion of intestinal juices

What is simple diffusion? down the concentration gradient; does not require supplied energy; does not use a carrier molecule

What is facilitated diffusion? -Doesn't require energy -transporter required -Moves down the concentration gradient

What is active transport? energy and transporter required

What is osmosis? diffusion of water across a selectively permeable membrane

What is endocytosis? actively transporting molecules into the cell by engulfing it with its membrane

Describe the enteroheptic circulation of bile In the liver, bile is made from cholesterol, then it goes to the gall bladder where it is stored and pushed to the small intestine through contractions whenever fat is eaten, when bile is released into the duodenum of the SI it stabilizes fat and breaks it down, then the bile is reabsorbed from the ileum of the SI and goes back to the liver.

Why is bile important? it is essential for fat digestion and absorption; have to have bile to absorb fat soluble vitamins: A, D, E, K

What is bile made from? cholesterol

What dietary recommendations would you make for a person who does not have a gallbladder? Without a gall bladder, bile goes directly from the liver into the SI and the fat is constantly dripping into the SI, therefore a person should eat a low-fat diet

How is the pancreas important for digestion and absorption? -secretes bicarbonate and enzymes that are important for digestion -pancreatic amylase breaks down starch -transporting nutrients away from GIT following absorption through a blood vessel or lacteal vessel

What substance is secreted to help neutralize the acidic chyme entering the SI? bicarbonate

Which nutrient must enter the lymphatic vessels (lacteals) before the blood vessels? fats and fat soluble vitamins: A, D, E, K

To what organ do most nutrients go following absorption from the SI? large intestine

List the different parts of the large intestine -ascending colon -transverse colon -descending colon -sigmoid colon

What are the main functions of the LI? Receives remaining water and undigested material through ileocecal sphincter, little absorption- primarily water and salts, bacterial production, formation and storage of feces (individualized 18-70 hrs)

Describe the bacterial composition of the LI -healthy colon is home to 10 trillion bacteria from 400 different species

What is a prebiotic? food components that beneficial bacteria in the LI use for fuel; doesn't contain bacteria- fiber

What is a probiotic? contains bacteria and has to survive the acidity of the digestive system; yogurt and sour kraut

What is constipation? having fewer than 3 bowel movements per week or stools that are difficult to eliminate

Treatment for constipation? eat more fiber, increase water intake, seek help for anxiety and depression, and create a regular routine

What happens whenever a person experiences heart burn? the esophageal sphincter is not working properly and the HCl from the stomach goes back up into the esophagus causing burning

What are 6 specific foods that are considered trigger foods for heartburn? alcohol, coffee, chocolate, peppermint, tomato based product, and spicy foods

In addition to avoiding certain foods, what else can someone do to prevent heartburn? -eat smaller portions and do not over eat at meal times -lose excess body weight

What can someone do to minimize the symptoms of heartburn? -take an antacid to neutralize excess stomach acid and relieve discomfort

3 GI disorders characterized by frequent diarrhea? -irritable bowel syndrome -inflammatory bowel disease -dumping syndrome

irritable bowel syndrome condition characterized by intestinal cramps, abdominal bowel movement, diarrhea and constipation

inflammatory bowel disease characterized by by chronic inflammation of the GI tract, diarrhea, rectal bleeding, abdominal cramps, fever, and weight loss

Dumping syndrome condition of overeating and causes plyoric sphincter to empty stomach contents in SI too quickly

Which disease most likely causes frequent diarrhea? irritable bowel syndrome because it is characterized by abnormal bowel function, particularly diarrhea

How would you rule out that the GI disorder is not celiac disease? stop eating gluten for a few weeks and see if you feel better- if you don't then it is not celiac disease

What are 3 dietary recommendations to prevent and/or control diarrhea?

1. drinking replacement fluids that contain sodium

2. drinking replacement fluids that contain potassium 3.drinking replacement fluids that contain simple sugars like glucose

What are potential negative consequences of diarrhea? -severe dehydration -could be a sign of a GI disorder or malnutrition

Why would someone be experiencing both heartburn and diarrhea? if the person is under a lot of stress; stress needs to be reduced to regulate hormone levels and regulate the GI tract

Are carbohydrates an organic nutrient? -yes, contains carbon

simple carbohydrates monosaccharides and disaccharides

Glucose -sugar containing 6 carbons -most important monosaccharide in the body because because it is the primary fuel for muscle and other cells

Fructose same chemical formula as glucose, but slightly different structure -found in honey, fruit, and some veggies -body has little need for fructose but some cells can convert fructose into glucose or into fat

Galactose same formula as glucose and fructose, but different structure -not commonly found in foods -needed component of lactose found in milk

Maltose glucose + glucose

Sucrose glucose + fructose

Lactose glucose + galactose

complex carbohydrates have 3 or more monosaccharides bonded together

Polysaccharides Carbohydrates that are made up of more than two monosaccharides

Oligosaccharides 3-10 monosaccharides; most common are raffinose and stachyose

Starch and Gylcogen polyssacharides that contain hundreds of glucose molecules bound together into large, chainlike structures

Draw the structure of glucose

How are galactose and fructose structurally the same? Different? -all have 6 carbons -galactose and fructose have a hydroxyl group on the opposite side

What type of reaction forms disaccharides? condensation reaction

What are examples of foods rich in simple sugars? soda, candy, fruit juice, dairy, honey, syrup

What is HFCS and how is it the same/different from table sugar (sucrose)? High Fructose Corn Syrup

• can be made from processing of corn -is about 50/50 fructose and sucrose

Describe the simple carbohydrate consumption patterns of American adults

• we eat ~32 tsp of sugar every day

• guys consume more sugar than girls

What are general characteristics of artificial sweeteners?

• synthetic compounds

• elicit intense sweet taste

• kcal-free

What are the most common alternative sweeteners?

• Aspartame (Equal/Nutrasweet)

• Saccharin (Sweet 'N Low)

• Sucralose (Splenda)

In general, are alternative sweeteners safe? according to the Academy of Nutrition and Dietetics, nonnutritive sweeteners are safe when consumed "within acceptable daily intakes, even during pregnancy"

What recommendations do you have for someone consuming artificial sweeteners? everything in moderation

What are the three classes of polysaccharides? starch, glycogen, dietary fiber

Describe and contrast starch and glycogen. Both are complex carbohydrates

• Glycogen in more highly branched

• Starch is only found in plant foods

• Glycogen is only found in animal foods

Why is dietary fiber nondigestible? human digestive enzymes cannot break apart bonds

What are examples of soluble and insoluble sources of fiber? soluble: pectin, gum, hemicellulose insoluble: cellulose, hemicellulose

What are potential health benefits of consuming soluble fiber?

• delays stomach emptying

• slows glucose absorption

• may lower blood cholesterol levels (oatmeal) -is someone has diarrhea

What are potential health benefits of consuming insoluble fiber?

• increased fecal bulk

• speeds passage through GIT (whole grains) -if someone is constipated

What are potential health benefits of consuming both types of fiber? reduce risk for diabetes

• promote optimal body weight

• reduce risk for heart disease

• promote healthy GIT

• reduce risk for colon cancer

What advice do you have for young adults wanting to increase their dietary fiber intake?

• start slowly

• drink plenty of fluids

• know your body

Explain the digestion of carbohydrates, including where it begins and important enzymes Mouth

• salivary amylase (STARCH)

• chewing tears fiber in foods Stomach

• acidity of stomach halts starch digestion

• fiber delays stomach emptying Small Intestine

• pancreatic amylase - starch broken down to maltose

• maltase, sucrase, lactase

• intestinal cells now absorb monosaccharides Large Intestine

• fiber and resistant starches enter LI unchanged

• fermentation of fiber - byproducts = gas + short chain fatty acids (SCFA)

Contrast the actions of insulin and glucagon.

• Insulin: secreted in response to HIGH blood glucose levels

• Glucagon: secreted in response to LOW blood glucose levels

How do humans store glucose in the body? Where is most stored? Glucose is stored as Glycogen

• 1/3 in LIVER (can be used to inc. BG levels)

• 2/3 in MUSCLES (need more glycogen for movement)

Describe blood glucose regulation - what happens to blood sugar levels and hormone secretion following consumption of a carbohydrate-rich meal? Meal

1. Elevated glucose

2. Pancreas releases insulin

3. Glucose enters cell

4. Glucose used for energy or may be converted into glycogen

5. Normal blood glucose Fasting

6. Dropping blood glucose

7. Pancreas releases glucagon

8. Breakdown of glycogen to glucose

9. Synthesis of glucose from certain amino acids

10. Recovery of normal blood glucose level

What is lactose intolerance and how is it treated?

• inability to digest lactose, lack of lactase

• 30-50 million Americans

• symptoms: nausea, abdominal pain, gas, diarrhea

Hypoglycemia condition that occurs when blood glucose level is too low

hyperglycemia abnormally elevated blood glucose levels

Be familiar with fasting blood glucose levels associated with normal, pre-diabetes, and diabetes

• Normal: 70-99 mg/dL

• Pre-diabetes: 100-125 mg/dL

• Diabetes: 126 mg/dL or more

Compare and contrast Type 1 and Type 2 diabetes. Type 1:

• autoimmune disease

• pancreas stops producing insulin Type 2:

• insulin becomes RESISTANT (may be produced, but does not do its job)

What are contributing factors to type 2 diabetes?

• obesity

• individuals who are physically inactive (sedentary), overweight

• genetically related to a close family member with type 2

• Americans who have Hispanic, Native American, Asian, African, or Pacific Islander ancestry are more likely to develop it

List at least three signs/symptoms of diabetes excessive thirst

• frequent urination

• blurry vision

• foot pain

• sores that don't heal Type 1 specifically:

• increased appetite with weight loss

• fruity breath

• fatigue

• confusion

Symptoms for type 2: blurred vision numbness thirst excessive urination can be pre-diabetic for years

What does hemoglobin A1c tell you about a person's health?

• marker of average blood glucose levels over the past 2 to 3 months

• elevated in diabetes Normal: 4.5-5.7% Pre-diabetes: 5.7-6.4% Diabetes: 6.4% or above

How is type 1 diabetes treated? Medications:

• insulin pump/shots

What recommendations do you have for the treatment and management of diabetes from a dietary and lifestyle standpoint? focus on whole grains, vegetable, fruits, legume, poultry, fish, and low-fat dairy foods

• monitor (limit) simple sugar and starch intake

• carbohydrate counting

• Type 2: if overweight, try to lose weight

• reduce added/refined sugars

• watch your carbs - count them, watch portions, choose good ones

• regular exercise