Nutrition

Six classes of nutrients

• carbohydrates
  • starch
  • fiber
  • sugar
  • provide energy
  • simple sugars
  • small molecules
  • found naturally in fruits, vegetables, and dairy
  • table sugar
  • glucose
• Complex carbs
  • many simple sugars joined
  • hundreds of glucose units
  • broken down during digestion
  • absorbed into bloodstream
• fiber
  • bonds between sugar molecules
  • cannot be broken down
  • passes through small intestine
• Protein
  • amino acids
  • growth and maintenance
  • energy
  • regulate body processes
  • main structural material in the body
  • provide calories, immune factors, enzymes, etc.
• Lipids
  • fatty acids
  • cholesterol
  • phospholipid
  • oils
  • liquid at room temp
  • healthier fats
  • solid fats
  • solid at room temp
  • less healthy
  • growth and maintenance
  • regulate body processes
  • enable chemical reactions
  • release energy in carbs, lipids, and protein
• Minerals
  • major
  • trace
  • growth and maintenance
  • regulate body processes
  • do not provide energy
  • critical to nervous system function, water balance, structural systems, etc.
• Water
  • growth and maintenance
  • regulate body processes
  • do not provide energy
  • solvent and lubricant
  • vehicle for transporting nutrients and waste
  • medium for temperature regulation and chemical processes

Macronutrients

• energy yielding nutrients
• water included
• needed in large amounts

micronutrients

• needed in small amounts
  • vitamins and minerals

essential nutrients

• characteristics
  • at least one specific biological function of the nutrient must be identified in the body
  • omission of the nutrient from the dietary pattern must lead to a decline in certain biological functions
  • Replaced the omitted nutrient in the dietary pattern before permanent damage occurs will restore normal biological functions
• Carbohydrate
• Essential fatty acids
• protein
• vitamins
• minerals
• water

Sources of Nutrients

• quantities
  • 500 grams (1 lb) protein, fat, and carbs combined
  • 20 grams minerals
  • Less than 300 milligrams vitamin
• Nutrient content differs from the nutrient composition of the human body

Energy (Calories/Kcal) providing nutrients

• carbs: 4kcal/g
• protein: 4 kcal/g
• fat: 9 kcal/g
• alcohol: 7kcal/g

Percentages

• part of a total when the total represents 100 parts

Them metric system

• Centimeter is 1/100 of a meter
• 2.54 cm equals 1 inch
• a gram is about 1/30 of an ounce (an ounce is 28 g)
  • 5g is about 1 tsp
• 1 pound is 454 grams
• a kilogram is 1000 grams, equivalent of 2.2 pounds
• to convert weight in pounds to kilograms, divide by 2.2
• a gram can be divided into 1,000 mg or 1,000,000 mcg
• liters are divided into 1,000 units called milliliters
• 100 milliliters is a deciliter
• one teaspoon equals about 5 milliliters
• 1 cup is about 240 milliliters
• one quart (4 cups) equals almost 1 liter

Regulatory nutrients

• no energy
• vitamins
• minerals
• water

Scientific method

• make observations that generate questions
• formulate hypotheses to explain events
• review current scientific literature that relates to the question
• design studies, perform tests, collect data
• analyze data and draw conclusions
• share with peers
• conduct more research to confirm or refute findings

Control group

• group you don’t change
• doesn’t get the test

Placebo

• false medicine

single blinding

• test subjects don’t know if they are getting placebo or real

double blinding

• scientist doesn’t know who gets what

observational studies

• cohort
• prospective or follow-up
• retrospective
• case control
• cross-sectional

cohort study

• consistent group followed over time

prospective or follow-up study

• follow up in the future

retrospective study

• looking back

case control study

• control two groups

cross sectional study

• one point at a time

Experimental study

• randomized controlled trials
• animal or in-vitro studies

epidemiological studies

• studying a population

hierarchy of scientific evidence

• meta-analysis and systemic review
• randomized controlled trials
• cohort studies
• case-control studies
• cross-sectional studies and surveys
• case reports and case studies
• animal and in-vitro studies
• editorials and expert opinion papers

Dietary Reference Intakes (DRI)

• RDA, UL, AMDR, EER, AI

RDA

• recommended dietary allowance

AI

• Adequate intake

UL

• Upper limit
• safe amounts before toxicity

EER

• Estimated energy requirements
• set as an average (not 98% of population)
• individualized
  • age, gender, height, weight, physical activity

AMDR

• acceptable macronutrient distribution range
• what percentage of calories should come from different macros

AMDR carbs

• 45-65% Kcals

AMDR protein

• 10-35% Kcals

AMDR fat

• 20-35% Kcals

Dietary guidelines grains

• half consumes should be whole

dietary guidelines vegetables

• variety
• a lot of color

dietary guidelines dairy

• low fat

dietary guidelines protein

• lean protein

dietary guidelines oils

• not a food group
• oils over sold fats

Vegetable equivalents

• any vegetable or 100% vegetable juice
• legumes
• frozen
• dried
• potassium, fiber, folate, vitamins A & C
• 1/2 cup green bean = 1/2 cup vegetable
• 1 cup spinach = 1/2 cup vegetable

Fruit equivalents

• any fruit or 100% fruit juice
• potassium, fiber, folate, vitamins A & C
• 1/2 cup strawberries = 1/2 cup fruit
• 1/2 cup 100% juice = 1/2 cup fruit
• 1/4 cup raisins = 1/2 cup fruit

Protein equivalents

• Animal and plant proteins
• protein, vitamin B12, iron, zinc, and magnesium
• 1 egg = 1 oz protein
• 1 tbs peanut butter = 1 oz protein
• 1 oz almonds = 2 oz protein

Grain equivalents

• whole and refined grains
• fiber, B vitamins, minerals
• 1 oz = 1 slice of bread
• 1 cup cold cereal = 1 oz
• 1/2 cup cooked cereal, rice, or pasta = 1 oz

Dairy equivalents

• milk, yogurt, cheese, fortified soy milk and yogurt
• NO butter, cream cheese, sour cream, or cream
• Protein, calcium, vitamin D, vitamin B12, potassium, phosphorus
• 1 cup milk, yogurt or soy milk = 1 cup
• 1-1/2 oz natural cheese = 1 cup

Monosaccharides

• one component
• glucose
• fructose
• galactose

Disaccharides

• sucrose: glucose + fructose
• lactose: glucose + galactose
• maltose: glucose + glucose

polysaccharides

• complex carb
• amylose
• amylopectin
• glycogen

starch

• beans, bread, etc.

glycogen

• stored in liver and muscle

Fiber DRI

• Men 38 g/day
• women 25 g/day

Fiber benefits

• natural laxative
• food sources for bacteria in large intestine
• speeds movement through GI tract
• lowers blood cholesterol levels
• decreases risk of colon cancer
• lowers caloric intake

Fiber risks

• causes gas and bloating
• lowers caloric intake
• consume water with it or causes GI issues
• removes some minerals

Mechanisms and “digestion” of fiber

• not digested like other carbs
  • cannot be absorbed
• delays glucose absorption
• bacteria digest some fiber in colon
• maintains healthy gut bacteria
• bind to cholesterol compounds bile
• bind remove carcinogens

Food sources of fiber

• Fruits (1/2 cup = 1-2 g fiber)
• vegetables (1/2 cup = 1-2 g fiber)
• beans (1/2 cup = 7 g fiber)
• avocado (1/2 = 7 g fiber)

Primary lactose maldigestion

• most common form
• deficient production of the enzyme lactase impairs digestion of lactose
• normal pattern of physiology that begins to develop around ages 3-5
• present in about 65% of the population

secondary lactose maldigestion

• temporary
• lactase production is decreased in response to another condition

Congenital lactase deficiency

• lactase production absent from birth

lactose maldigestion symptoms

• bloating, cramps, and diarrhea, when lactose is consumed
• bloating and gas causes by bacterial fermentation of lactose in the large intestine
• diarrhea is caused by undigested lactose in the large intestine

lactose intolerance

• when significant symptoms develop after lactose intake
• lactose maldigestion and intolerance are not a milk allergy
• nearly all individuals with decreased lactose production can tolerate 1/2 to 1 cup of milk with meals
• hard cheese and yogurt are more easily tolerated

Signs of diabetes

• polydipsia - increased thirst
• polyphagia - increased appetite
• polyuria - frequent urination (vision changes, weight loss)

Type 1 diabetes

• autoimmune disease
• body destroys cells that make insulin
• insulin injections matched to carbs eaten

Type 2 diabetes

• 90-95%
• insulin resistance
• body is producing insulin but it cannot enter the cell
• pancreas is not releasing insulin
• genetics and obesity are risk factors
• treatments can come from oral medication or a closely monitored diet

consequences of elevated blood glucose

• damage cells in the body
• develop blindness
• damaged kidney (dialysis)
• higher risk of heart attack or stroke
• damage nerves (diabetic neuropathy)
• increases risk of infection

Function of fat in the body

• fuel and energy
• store energy
• insulate and protect organs
• digestion of large fat into smaller fat
• absorption of fat soluble vitamins in small intestine
• transport lipid soluble materials through lymph and blood
• formation of phospholipid bilayer
• composition of myelin
• regulation and communication
• chemical messengers directing growth, development, immune function, and central nervous system

Saturated fatty acids

• carbons connected by single bonds
• linear
• solid at room temp

Unsaturated fatty acids

• carbon chain has one or more double bonds
• kinks in fatty structure
• liquid at room temp

Monounsaturated fatty acid

• only one double bond

polyunsaturated fatty acid

• two or more double bonds
• omega-3
• omega-6

Cis fatty acid

• hydrogens on same side of carbon-carbon double bond
• more kinked

Trans fatty acids

• hydrogens on opposite of double bond
• more linear
• increase bad cholesterol
• decrease good cholesterol

Linoleic acid: omega-6

• decrease good and bad cholesterol
• essential

alpha-linolenic acid: omega-3

• essential
• healthier for heart
• lower blood pressure
• prevent blood clots
• protect against irregular heart beats
• reduce inflammation
• brain vision function

Triglyceride structure

• 3 fatty acids attached to a glycerol backbone
• diglyceride = 2 fatty acids
• monoglyceride = 1 fatty acid

Triglyceride function

• main form of lipids in foods and body

Phospholipid structure

• glycerol + fatty acids+ phosphorus compound

Phospholipid function

• body can produce all needed phospholipids (non-essential to diet)
• cell membrane structure
• fat digestion, absorption, and transport

Sterol structure

• waxy substance
• multi-ringed

Sterol function

• body can produce all needed sterols
• cell membrane structure
• form hormones and bile acids

Rancidity

• unsaturated fatty acids most susceptible
• decomposing oils (odor and sour stale taste)
• prevention: limit exposure to light, heat, and oxygen; hydrogenation

Saturated fat properties

• lots of hydrogens
• more linear shape

Saturated fat foods

• coconut oil
• butter
• animal products

Saturated fat health implications

• bad for health, clog arteries, linked with cardiovascular disease

Monounsaturated fat properties

• 1 double bond

Monounsaturated fat food sources

• olive oil
• avocado
• nuts

monounsaturated fat health implications

• better for health
• kinked so doesn’t clog arteries nearly as much
• lowering bad cholesterol

Polyunsaturated fat properties

• 2 or more double bonds

Polyunsaturated food sources

• vegetable oils
• fish
• flaxseed
• nuts

Chylomicron

• made in the small intestine
• carries dietary fat from small intestine to cell

VLDL

• very low density lipoprotein
• made in the liver
• carries lipids (mostly triglycerides) made in liver to cells

LDL

• low density lipoprotein
• created from VLDL
• carries cholesterol made by liver to cells (bad cholesterol)

HDL

• high density lipoprotein
• made in the liver
• removes cholesterol from cells, takes to liver for disposal (good cholesterol

Development of cardiovascular disease

• plaque buildup
• associated with inadequate blood circulation in the heart and brain

Plaque buildup for cardiovascular disease

• atherosclerotic plaque
• can begin building in childhood
• usually undetected for a long time

Atherosclerosis

• plaque that builds in arteries
• probably first developed to repair damage in a blood vessel
• a healthy blood vessel is smooth and flexible
• can be seen in arteries throughout the body
• continues to build up once damage has occurred
• rate of buildup directly related to the amount of LDL in the blood
• oxidized LDL particularly responsible

Macrophages

• the body sends white blood cells to locations of cholesterol accumulation on blood vessel walls
• attempts to destroy it
• surrounds fatty deposit and produces lipid-loaded foam cells
  • develops plaque
• blood vessels stiffen over years
  • cannot dilate or constrict to accommodate normal changes in blood pressure throughout the day
  • Creates blood clots

Blood clotting

• normal and necessary process that prevents blood loss
• in some people they form too frequently
• in areas already partially blocked by plaque it can cut off blood flow

Total fat

• AMDR of 20-35%
• no RDA for fat

Essential fatty acids

• linoleic acid
• alpha-linolenic acid

Essential fatty acid deficiency

• first signs in the epithelial tissues because they are rapidly turned over
• skin becomes flaky and itchy
• wound healing slows
• may experience diarrhea
• hair may fall out or lose pigment
• more vulnerable to infections
• among children growth may be restricted

Linoleic acid (omega-6)

• men 17g/d
• women 12g/d

Alpha-linolenic acid (omega-3)

• men 1.6g/d
• women 1.1g/d

Saturated fat

• limit intake to less than 10% total calories

Cholesterol

• 2/3 made by cells
• 1/3 comes from a typical dietary pattern
• 875g made each day in your body
• about 180-325g consumed per day
• cholesterol synthesis is usually well regulated
• AHA sets no specific dietary limits
• intake has little impact on blood cholesterol levels
• keep intake as low as possible while meeting needs for essential nutrients
• sources of high cholesterol usually high in saturated fat

Omega-3 fatty acids

• In seafood
• regulate body processes
• promote heart health and protect brain health
• reduce inflammation associated with rheumatoid arthritis
• fatty acids taken up by cells and incorporated into cell membrane
• used to synthesize signaling molecules that influence blood clotting, inflammation, and heart rhythm
• lower risk for sudden cardiac death, coronary heart disease, and ischemic stroke
• normal blood clotting can be impaired with excessive amounts
• AHA recommends 2 or more servings of fatty fish each week or fish oil supplements

Generic amino acid structure

• peptide bond links amino acids together
• many linked amino acids make a protein
• both essential and non-essential amino acids needed for protein synthesis
• DNA shows the body what amino acids to link and in what order

Making a protein: DNA

• DNA contains the information necessary to produce proteins
• mRNA transcripted from from the DNA
  • leaves the nucleus
  • attaches to a ribosome
  • ribosome “reads” it
  • amino acids coded by three nucleotides in a row
  • ribosome sends info to tRNA
  • tRNA hooks amino acids together to make protein

Protein digestion

• stomach
  • protein denatured
  • protein to peptide
  • acids in the stomach start to uncoil the protein
  • get polypeptides
• small intestine
  • enzymes break down proteins
  • long chain proteins
  • enzymes clip peptide bonds
  • di-peptide
  • tri-peptide
  • amino acid
• protein absorption
  • absorbed out of the small intestine into the liver
  • need a transporter
• amino acid metabolism and use in cells
  • build protein
  • altered for another compound
  • dismantled to make nonessential amino acid (transmission)
  • used as energy (deamination)
• Transamination
  • transfer of amino group (N) to another acid-side chain to form a new non-essential amino acid from an essential amino acid
• Deamination
  • amino group (N) removed, converted to urea
  • acid-side chain metabolized like carb or fat

Functions of protein

• body structures, growth, and maintenance

• fluid balance

• acid base balance

• build enzymes, hormones, and compounds

• immune system

  • uses proteins as materials to make antibodies and other things

• providing energy and glucose

• nitrogen or protein balance

  • \

  • adding body tissue

  • growing children

  • pregnant women

  • \

  • losing body tissue

  • very old people

  • nitrogen equilibrium

  • healthy adult meeting nutrient needs, notably protein, and calorie needs

Sources of high quality protein

• animal products

Sources of low quality protein

• legumes
• grains
• can still be balanced if you eat both

Protein requirements

• RDA for protein 0.8g/kg healthy body weight
• AMDR = 10-35%
• spread throughout the day
• 20g each time you eat
• insufficient evidence for UL

Amino acid supplements

• can easily overload transporters for protein
• other amino acids can’t be transported
• become deficient in other amino acids

Consequences of too little protein

• malnutrition
• slow growth
• impaired immune system
• impaired nutrient absorption
• impaired brain and kidney function

Kwashiorkor

• enough calories but not enough protein
• swollen liver
• bloated stomach

Marasmus

• low calories and low protein
• very skinny
• dark hair starts to turn red
• possible hair loss

Nutrigenetics

• the branch of nutritional genomics that examines how variations in genes can affect nutritional health
• Studying how genetic variations can affect individual nutrient requirements

Nutrigenomics

• the many ways dietary components affect gene expression
• particularly as it relates to development and treatment of nutrition relate diseases such as cardiovascular disease
• how nutrients or other diary components can influence gene expression
• generalized nutrient recommendations may not apply to all individuals within a population group
• research obesity, diabetes, cardiovascular disease, celiac disease, cancer, osteoporosis, and alzheimer’s

cardiovascular disease genetic link

• defective gene can delay cholesterol removal from the bloodstream
• creates a risk factor for development of cardiovascular disease
• gene interaction study will allow for personalized treatment plans

obesity genetic link

• a variety of genes are involved in the regulation of body weight
• specific gene variations have been linked to the propensity to overheat and alterations in metabolism
• how people live and environmental factors that influence them allow each person’s genetic potential to be expressed

diabetes genetic link

• both type 1 and type 2 are influenced by genetics
• more than 200 genes identified as a possible cause
• only sensitive and expensive testing can identify who is at great risk
• lifestyle can affect genetic expression

cancer genetic link

• about 10% of cancers have a genetic link
• the rest are related to environment and lifestyle factors

Components of energy expenditure

• basal metabolic rate 60-80%
• physical activity 15-30%
• thermic effect of food 8-15%
  • digestion falls here not under BMR

energy balance

• balance weight maintenance
  • energy input and output are equal
• positive balance weight gain
  • energy out is less than energy in
• negative balance weight loss
  • energy is less than energy out

BMI calculation

• weight (lbs) x 703/height (in)^2

BMI categories

• <18.5 kg/m2 = underweight
• 18.5-24.9 kg/m2 = normal weight
• 25-29.9 kg/m2 = overweight
• \   > 30 = obese

Percent body fat

• no set number for best body fat
• men: more than 40 inches unhealthy
• women: more than 35 inches unhealthy

Definition of healthy weight loss

• 1-2 pounds a week weight loss
• maintain weight loss long term (1 year or more)
• no regain
• healthy relationship with food
• physical activity

Vitamin A functions

• gene regulation
• tissue development
• immune system regulation
• reproduction
• growth
• bone remodeling
• vision

Vitamin A deficiency

• rough skin
• increases risk for eye infection
• thickening of the cornea

vitamin A toxicity

• fat soluble makes it a concern for toxicity
• too much during pregnancy can lead to birth defects
• liver damage

vitamin A food sources

• liver
• egg yolks
• fortified milk

beta-carotene food sources

• dark leafy greens
• orange/yellow vegetables
• from pre-formed

Vitamin E functions

• antioxidant
• blood clotting

Vitamin E food sources

• polyunsaturated oils (plant oils, vegetable oils)
• nuts and seeds
• egg yolks

Vitamin D functions

• bone development
• absorbing calcium from the GI tract
• can get calcium out of the bones into bloodstream
• can decrease calcium loss from kidneys
• maintains healthy calcium levels

vitamin D deficiency

• soft bones osteomalacia (adults)
• rickets (children)

Vitamin D toxicity

• calcification of soft tissues
• symptoms
  • nausea and vomiting
  • loss of appetite
  • feeling of weakness

Vitamin D food sources

• fatty fish (salmon)
• fish liver oil
• egg yolks
• milk fortified with vitamin D
• body can manufacture vitamin D from the sun

Vitamin K functions

• blood clotting
• bone development

vitamin D food sources

• dark leafy greens
• cabbage family (broccoli, brussel sprouts)

Thiamin functions

• coenzyme

Thiamin deficiency

• berri-berri
  • stiffness
  • weakness
  • muscle pain
  • nerve problems
  • poor coordination
  • edema (wet berri-berri)

Thiamin food sources

• whole grains
• enriched grains
• pork
• nuts and seeds

Riboflavin functions

• coenzyme

Riboflavin deficiency

• cracks around the mouth
• sore throat
• light sensitivity

Riboflavin food sources

• milk
• fortified grains
• dark leafy greens

Niacin functions

• coenzyme

niacin deficiency

• pellagra
  • dermatitis (skin rash)
  • diarrhea
  • dementia
  • death

niacin toxicity

• causes low blood pressure
• flushing

niacin food sources

• rich protein foods
• meat
• fish
• poultry
• eggs
• corn

folate functions

• coenzyme
• DNA synthesis

folate deficiency

• spina bifida
• anemia from red blood cells dividing improperly

folate food sources

• dark leafy greens
• enriched grains
• dried beans
• oranges

vitamin B12 functions

• used in metabolic processes where folate is found
• coenzyme

vitamin B12 absorption

• hydrochloric acid releases B12
• intrinsic factor absorbs B12

vitamin B12 deficiency

• deficiency in intrinsic factor leads to B12 deficiency
• pernicious anemia
• nerve damage

vitamin B12 food sources

• only in animal products
• fortified soy

vitamin B6 functions

• over 100 different functions
• coenzyme
• tryptophan conversion to niacin

vitamin B6 deficiency

• weakness
• tiredness
• irritability

vitamin B6 toxicity

• nerve damage

vitamin B6 food sources

• meat
• fish
• poultry
• dried beans
• leafy greens
• avocado
• bananas

vitamin C functions

• connective tissue formation
• antioxidant

vitamin C deficiency

• scurvy

vitamin C toxicity

• megadose
  • nausea
  • vomiting
  • diarrhea

vitamin C food sources

• citrus
• potatoes
• tomatoes
• strawberries
• green peppers

Sodium functions

• fluid and electrolyte balance
• nerve transmission
• sodium glucose transport system

Sodium food sources

• highly processed foods
• salt

Potassium functions

• fluid and electrolyte balance
• nerve impulses
• muscle contractions

Potassium food sources

• bananas
• potatoes
• fruits and vegetables

Magnesium functions

• part of enzyme complex
• bone development

Magnesium food sources

• nuts
• beans
• whole grains
• dark green leafy vegetables

Calcium function

• bone density
• used in processes to maintain blood pressure
• used in blood clotting processes
• essential for muscle contraction
• used in neurotransmission processes
• activates cellular enzymes

Calcium food sources

• 25-30% absorbed
• milk
• yogurt
• cheese
• fortified drinks

Iron functions

• hemoglobin
• iron absorption

Heme Iron food sources

• animal flesh
• meat, fish, or poultry

Non Heme Iron food sources

• whole grains
• enriched grains
• dark greens
• legumes
• animal flesh

increasing non heme iron absorption

• consume non heme product with vitamin C
• use a cast iron pan
• consume non heme iron with acidic food
• consume non heme iron food with meat, poultry, or fish

Decreasing non heme iron absorption

• oxalates (spinach)
• grains and legumes
• calcium
• tea

Iron deficiency

• iron-deficiency anemia
• women more susceptible to deficiency

Iron toxicity

• causes stomach ache
• damages GI tract
• in real high doses can damage heart

Zinc functions

• growth
• DNA synthesis
• makes protein essential to wound healing

Zinc deficiency

• poor growth
• poor healing

Zinc toxicity

• too much can interfere with absorption of iron or copper

Zinc food sources

• meat, poultry, or fish
• high protein foods
• whole grains

Selenium functions

• antioxidant

Selenium food sources

• brazil nuts
• most meats

Iodine functions

• makes hormone thyroxin
• becomes part of thyroxin

Iodine food sources

• iodized salt
• seafood
• dairy products

Iodine deficiency

• goiter (adults)
• congenital hypothyroidism (babies)
  • mom low iodine while pregnant

Fluoride functions

• preventing cavities

Fluoride food sources

• fluoridated water
• fluoride supplements

Fluoride toxicity

• fluorosis (brown spots on teeth)

Physical consequences of anorexia nervosa

• low blood pressure
• irregular menstrual cycles
• infertility
• poor pregnancy outcomes
• ammenoriah
• delayed puberty in children
• low bone density
• often cold
• dry skin
• insomnia
• dehydration and malnutrition
• poor thought process

consequences of bulimia nervosa

• abnormal heart rhythm
• swollen neck glands, irritation, and infections of the throat
• dental cavities
• tearing of stomach or esophagus
• urinary tract infections

Binge eating disorder

• 1/3 are males
• binging without purging
• have to binge at least twice a week for at least six months

Foods that pose danger for microorganism growth

• undercooked meat, fish, and poultry
• melons
• honey (for infants less than 1 year)
• raw produce grown close to the ground
• sprouts
• cooked vegetables
• cooked pasta or rice
• unpasteurized juice or milk

Preventing food-borne illness

• clean, separate, cook. chill

Food cooking temperature

• 145 F
  • steaks and roasts
  • beef, lamb, veal, pork
  • fish
• 160 F
  • ground meat
  • NOT poultry
  • eggs
• 165 F
  • poultry
  • whole and ground
  • casseroles
  • stuffing
  • leftovers
• Temperature danger zone
  • 40-140 F
  • do not stay in danger zone for more than 2 hours

Nutrient needs pregnancy: Energy

• 1st trimester pre-pregnancy kcals
• 2nd and 3rd trimester average 300 extra kcals

Nutrient needs pregnancy: protein

• 25 extra grams of protein a day
• RDA 1.1 g/kg

Nutrient needs pregnancy: folate

• 600 mcg a day
• important for neural tube development
• first 28 days of pregnancy
• women who might become pregnant should consume folate before pregnancy
• deficiency can cause spina bifida

Nutrient needs pregnancy: iron

• red blood cells produced during pregnancy and need iron for that
• baby builds up iron during pregnancy
• body adapts absorption during pregnancy
• 27mg
• prenatal supplement

Pregnancy weight gain low BMI

• 28-40 lbs

Pregnancy weight gain normal BMI

• 25-35 lbs

Pregnancy weight gain high BMI

• 15-25 lbs

Pregnancy weight gain obese BMI

• 11-20 lbs

Managing nausea during pregnancy

• small frequent meals
• never get totally hungry
• eat slow
• sit up after eating
• dry toast, crackers

managing constipation during pregnancy

• high fiber foods
• sufficient amount of liquid
• physical activity

managing heartburn during pregnancy

• gastric juices in the esophagus
• small frequent meals
• liquid between meals
• sit up after eating
• limit greasy, fatty, and spicy foods

breastmilk quantity

• based on baby’s demand
• diet impacts quantity of milk production
• 750 extra cals a day to produce breastmilk

benefits of breastfeeding for infants

• decreases risk of infections, such as diarrhea, respiratory disease, and ear infections
• reduce risk of food allergies and intolerance

benefits for mothers

• decreases risk of several chronic diseases later in life, including hypertension, cardiovascular disease, diabetes, and some cancers
• potential for delayed ovulation, thus reducing chances of pregnancy in the short term

infant food 0-4 months

• tongue thrusts out
• only breastmilk/formula

infant food 4-6 months

• baby can sit up
• control their head
• start babies on sold food (puree, baby food)

infant food 6-8 months

• can grasp with fingers
• hold cup
• mashed food

infant food 8-10 months

• hold cup and bottle
• sit unsupported
• grab for food
• well cooked pasta, cooked beans, tiny bread pieces, cereal, yogurt

infant food 10-12 months

• can hold spoon
• more texture and variety

infant food 1 year

• can eat most food
• modify texture for choking
• can have cow’s milk
• can have honey

prevent childhood obesity

• timing
• plan meals
• new foods
• juice
• breakfast daily
• more fruits and vegetables
• family eat together
• physical activity
• good sleep

Nutrition for the elderly

• increased fat stores, decreased muscle mass
• decreased sense of thirst
• decreased bone density
• decreased GI function
• don’t need as many calories
• protein, carb, iron, and fat intake remains the same
• vitamin A absorption increases
• vitamin D synthesis decreases
• vitamin B12 supplements needed
• calcium absorption needs supplement

Malnutrition risk for the elderly: DETERMINE

• Disease
• Eating poorly
• Tooth loss/mouth pain
• Economic hardship
• Reduced social contact
• Multiple medication
• Involuntary weight loss/gain
• Needs assistance
• Elderly (over 80)