NUTRITION FINAL UCI – Flashcards

• Essential ORGANIC substances • Needed in small amounts (mcg or mg) • Yield NO ENERGY, but facilitate energy-yielding chemical rxn • Is absent from a diet, it will produce deficiency signs and symptoms

- No all ingested minerals can be absorbed - Minerals from animal products are better absorbed because plant products contain BINDERS i. Animals

- Fat- Soluble Vitamin: (A, D, E, K) o Can only be absorbed in presence of fat o Transported like fat in chylomicrons, VLDL, LDL o Main function to support proper cell growth and reproduction o Stored in fat tissue and ilver o Deficiency most common in individuals w/ fat malabsorption - Water- Soluble Vitamin: (B and Cs) o Dissolve in water o Excess secreted, not stored o Subject to losses when exposed to heat, O2, light o MAIN FUNCTION: coenzyme to participate in energy metabolism o 50-90% of B vitamins are absorbed o Marginal deficiency more common o Toxicity possible with supplements rare from foods • Most Toxic: Niacin & B6 (cause neurologyical damage)

- B vitamins involved in energy metabolism: thiamin, riboflavin, niacin, biotin, pantothenic acid. - B vitamin involved in protein metabolism: vitamin B6. - B vitamins involved in cell division: folate and vitamin B12.

o Calcium, Magnesium, Potassium, Sodium o HIGH sodium intake associated with increase in BP: 1/3 of individuals are sodium sensitive o ADEQUATE AMOUNT of Ca, Mg, and K have shown to reduce BP (DASH diet) o Magnesium and Potassium also involed in proper heart function

o D, K, Calcium, Magnesium, Phosphorus, Fluoride o Vitamin D: aids absorption of Ca from kidneys and small intestine o Magnesium: aids Ca absorption into bone o Vitamin K: involved in maintaining bone structure and bone density o 85% of body phosphorus is in bone; key component of bone and teeth structure o Fluoride: proper balance needed for teeth; hardens tooth enamel and stabilizes bone minerals

o FAT SOLUBLE: Vitamin A, D, E, K o Can be absorbed in fat/ can be stored in fat tissue and liver o MAIN FUNCTION? to support proper cell growth and reproduction o WATER SOLUBLE: Vitamin B & C o Dissolve in water o Subject loses when exposed to heat, O2 and light o MAIN FUNCTION: coenzyme to participate in energy metabolism

o Precursor: a precursor to a vitamin in an inactive substance that later converts to a vitamin (or enzyme, vitamin or hormone) o Beta-Carotene

o Vitamins A, C, E, Selenium, Zinc

• Unstable oxygen molecules an oxygen molecule with one or more unpaired electrons

• Antioxidants capture free radicals

• Measured by O2 radical absorbance capacity

• Major Mineral: o Require >100 mg /day o Ca, Phosphorus, Magnesium, Sodium, Potassium, Chloride, Sulfur • Trace Mineral o Require <100mg /day o Iron, Zinc, Copper, Iodine, Chromium, Selesnium, Fluoride, Manganese

o Minerals o Do not contain Carbon (oinorganic) o Maintain skeletal structure o Maintain fluid balance o CANNOT be destroyed o 21 found in the body

• Bone structure, cell membrane integrity, transport of ions, muscle action, nerve impulses, regulates blood vessel wall muscle tone, helps regulate blood pressure, aids blood clotting, acts as cofactor for enzymes. When levels fall, intestinal absorption increases, bone withdrawal increases, and kidney excretion diminishes; these processes are regulated by a system of hormones and vitamin D.

• Dairy products, beans, green leafy vegetables, almonds • Calcium deficiency can cause Vitamin D deficiency, Osteoporosis (bone development and disintegration), raise BP

• Vitamin E: acts as an antioxidant in reducing risk for heart disease and some cancers • B6, B12, Folate Combines o Required to metabolize HOMOCYSTEINE a byproduct of methionine (amino acid) metabolism o High homocysteine levels are associated with increased risk of heart disease (atherosclerosis)

• Minerals from animal products are better absorbed because plant products contain BINDERS o Substances natureally found in foods that bond to minerals so they cannot be absorbed from digestive system • Oxylates • Phylates • Fiber

• Fiber and phytates bind zinc, limiting its bioavailability; large doses of iron inhibit zinc absorption; large doses of zinc inhibit iron and copper absorption

• Trace minerals are more toxic than other major minerals • Greatest risk of toxicity comes from taking supplements • Limit intake to ;150; of RDA

B12 Ca Iron Zinc

• Iodine Deficiency: Thyroid gland enlarges, creating a goiter • Niacin Deficiency: Pellagra—dermatitis, diarrhea, dementia • Thiamin Deficiency: Beriberi—loss of appetite, pain in limbs, shortenss of breath, swollen feet or legs

• Iron deficiency o MICROTIC: immature, small red blood cells that can't deliver enough O2 to cells • B12 Folate deficiency o MACROCYTIC: smaller number of larger blood cells that cannot deliver enough O2 to the cells

Over-fatness from positive energy balance Underweight from negative energy balance

3500 (fat)

Hunger - physiological need for food: increases food intake Appetite - physiological desire for food: increase food intake Satiation - feeling full and satisfied after eating Satiety - feeling fullness after a meal inhibits eating until the next meal and how much time passes before each meal

Basal Metabolism Rate (50-65%) - when we sit and lounge around without much activity/daily activities Physical Activity (25-50%) - when we get out and do actual activity such as running, working out, etc. Thermic Effect of Food (5-10%) - amount of energy expenditure above the resting metabolic rate due to the cost of processing food for use and storage

Weight can be determined through stepping on a scale whereas body composition measures body fat

Central obesity is the excess fat around abdomen and around the trunk. Its relationship of the disease is that it causes more inflammation and insulin

(men > __102 cm__, women > __88 cm___).

Men > .95 , Women > .8

Calorimeter

Skinfold - can be accurate if trained to do it Underwater Weighing, Bioelectrical Impedance - painless Dual Energy X-Ray - doesn't work on obese people

Body fat = Obesity = Young death, hypertension, heart attack, stroke, diabetes, hernias, arthritis, gout

Body fat = Obesity = Young death, hypertension, heart attack, stroke, diabetes, hernias, arthritis, gout

Thermogenesis is the generation and release of body health associated with breakdown of body fluids

Increases BMR - thyroxine, environmental temperature, stress, fever, body composition, growth, height, and age Decreases BMR - age, fasting/starvation, malnutrition The largest component of energy expenditure is physical activity

It differs because of height and the amount of fat and muscle

Having a low BMI is not good, nor is a high one. Having a middle ground is perfect.

Heart disease, starvation

3500 kcals x 3 lb = 10500 10,500 / 7 days = 1500 per day 1500 per day

-it is an indicator of obesity or underweight -3500 kcals x 3 lb = 10500 10,500 / 7 days = 1500 per day 1500 per day

Underweight: 30 Morbidly obese :+30

a. Disease prevention: 30 minutes most days b. Weight Management: 60 minutes most days c. Weight Loss: 60-90 minutes most days

CDC: - 150-300 minutes of moderate intensity - 75-150 minutes of vigorous intensity - Muscle strengthening activities on 2 or more days per week targeting all major muscle groups Surgeon General: - 30 minutes most days

- Physical: chronic disease risk reduction, improvements in body composition - Psychological: reduces anxiety and depression, improves sleep, increases in QOL

- Casual Exercisers (16-18kcal /lb) Moderate activity with desired weight loss 2-5g/kg. Active for 1hr/day: 5-7 k/kg. Protein (endurance) = 1.2-1.4 g/kg (strength)= 1.6-1.7g/kg. Fat 20%-35% of total kcals - athletes need more calories, protein and other nutrients than the average sedentary person

- Anaerobic: heavy weight-lifting, all types of sprints, jumping rope, hill climbing, interval training, isometrics, or any rapid burst of hard exercise - Aerobic: running, cycling, cross country, skiing, stair stepping, jogging, fast walking, swimming, rowing

The body's use of glucose during physical activity depends partially on how much glycogen is in storage, and this depends partly on the amount of carbohydrate eaten. Intensity of exercise influences the body's use of glucose —high intensity activities require more glycogen. Degree of training to perform the activity is a factor because the level of oxygen in the muscle influences the body's use of glucose. During oxygen debt, glucose is metabolized rapidly and pyruvate molecules accumulate in the muscle tissue. Duration of activity affects use of glucose during exercise—within the first 20 minutes of exercise, the body primarily uses glucose

Adults building muscle mass

- Sodium, - Potassium - Chloride ( can cause hyponatremia or hypernatremia)

- Fluid lost through sweat must be replaced to avoid dehydration. - Water is adequate for exercise that lasts less than 45 minutes. - For endurance exercise over 45 minutes, a sports drink with CHO and electrolytes is needed. - - 10 to 12 servings of water or other fluids should be consumed each day.

- We burn more calories when we eat before exercise and it improves energy and endurance levels. It's not necessary to eat if we only exercise under 45 minutes, but if it's over and especially for endurance, then eating is a must to replenish nutrients and fluids. Calories and fluids should be consumed right after workouts.

Sports drinks, drinks that contain electrolytes

Carbohydrates / Glucose

Water, glycogen, and muscle tissue

No, the optimal amount is at least 7

- 16 to 24 ounces

- Hyponatremia is a condition that occurs when the level of sodium in the blood is too low. Symptoms include nausea, headache, confusion, and fatigue. - Hypernatremia is when there is a high concentration of sodium in the blood. Symptoms include thirst, restlessness, and fatigue.

- The micronutrient content of fruits and vegetables has an important role to play in maintaining health and optimizing exercise performance, energy production and tissue recovery during periods of exercise training.

Before exercise - Enough fluid, high in carbohydrate, moderate in protein, and low in fat • During exercise - Adequate fluid, some carbohydrate; sodium and other minerals for longer exercise • After exercise - Replenish fluid, electrolyte and

- Water carries nutrients and waste products throughout the body; - helps to form the structure of macromolecules; - actively participates in chemical reactions; - fills the cells and the spaces between them; - serves as the solvent for minerals, vitamins, amino acids, glucose, and many other small molecules; - acts as lubricant around joints; serves as shock absorber inside the eyes, spinal cord, and in pregnancy, the amniotic sac; - aids in the body's temperature regulation.

- Water Intake - water, other beverages, fruits, vegetables, meat, cheese, and the byproduct of metabolism - Water Excretion - water losses occur through urine output, water vapor from the lungs, sweating, and feces

1.0 to 1.5 mL/kcal expended for adults (approximately 2-3 liters for a 2,000 kcalorie expenditure) • 1.5 mL/kcal expended for infants and athletes • ½ cup per 100 kcal expended • Adequate Intake for males is 3.7 L/day. • Adequate Intake for females is 2.7 L/day.

- Antidiuretic Hormone - hormone that participates in water conservation, maintain fluid balance, stimulates kidneys to conserve water

Electrolytes attract water, water follows electrolytes (solutes, osmosis, osmotic pressure) - Hypothalamus reponds to high Na concentrations in blood stimulating pituitary gland--> pituitary releases ADH-->body regulates blood volume

Microbes, insects, parasites, rodents, moisture, dryness, air (oxidation), light, time, mishandling of foods, centralized food production

- The refrigerator should be less than 40 degrees Fahrenheit o 1-2 days: raw ground meats, raw sausages, raw fish, poultry, gravy o 3-5 days: raw steak, chops, cooked meats, vegetables, mixed dishes, ham slices, mayo salads o 1 week: hard cooked eggs, bacon, hot dog (opened package), whole/half ham, smoked sausage o 2-4 weeks: raw egg, bacon, hot dog (unopened), dry sausage, most aged processed cheeses o 2 months: mayonnaise (open jar), dry cheese

- 40-140 degrees Fahrenheit. - Bacteria grows quickly. Do not store it in the range for more than 2 hours. It also depends on the temperature outside

2 hours

- Inadequate Cooling (63%) - food is in between the hot danger temperature and cold danger temperature. It is lukewarm so a lot of bacteria can grow

- Generally Recognized As Safe

-It is the Pure Food and Drug Act. It prevents the intentional addition of a harmful substance to food. No substance that is known to cause cancer in animals or humans at any dose level shall be added to foods. It was used to prevent the use additives or chemicals to deceive consumers of the quality of the product.

- Warmth, moisture, nutrients

a. Staphylococcus i. Found in meats, poultry, egg products ii. Symptoms include skin infections, pneumonia, food poisoning, toxic shock syndrome, blood poisoning iii. Incubation period can be from days to years iv. Treatment is penicillin v. Wash hands vigorously and under fingernails with soap and water before handling or preparing food b. Salmonella i. Found in eggs, meat, and poultry, but can also be in fruits and vegetables ii. Symptoms include diarrhea, fever, abdominal cramps, vomiting iii. Incubation period is 12-72 hours iv. Treatment can be getting plenty of fluids and rest. Antibiotics may be necessary v. Prevent it by avoiding high risk foods, keeping food properly refrigerated before cooking, and clean hands with soap and warm water c. Escherichia- Coli i. Found in undercooked ground beef, unpasteurized milk and juice, soft cheeses made from raw milk, and raw fruits and vegetables ii. Symptoms include severe bloody diarrhea, severe abdominal pain, and vomiting iii. Incubation period is 1-10 days iv. Treatment is to drink plenty of fluids and get rest v. Prevent it by avoiding undercooked ground beef, using a food thermometer to make sure the ground beef is cooked d. Hepatitis A i. Found in raw or undercooked shellfish from contaminated waters, raw produce, contaminated drinking water, uncooked foods ii. Symptoms include diarrhea, dark urine, jaundice, fever, headache, nausea, abdominal pain, and loss of appetite iii. Incubation period is 28 days average iv. Treatment is rest yourself and the liver. The body will clear it by itself v. Prevent it by getting vaccinated and avoid raw oysters and other shellfish e. Norovirus i. Found in produce, shellfish, foods infected by workers, or any other foods contaminated with vomit or feces from an infected person ii. Symptoms include diarrhea, vomiting, nausea, stomach pain iii. Incubation period is 12-48 hours iv. Treatment is to drink plenty of liquids and get rest v. Prevent is by washing hands frequently with soap and running water, avoid bare contact with ready-to-eat food f. Listeria i. Found in ready-to-eat deli meats and hot dogs ii. Symptoms include fever, stiff neck, confusion, weakness, vomiting iii. Incubation period is 3-70 days iv. Treatment is from antibiotics v. Prevent it by not drinking raw milk and foods with raw milk, rinse raw produce thoroughly under tap water before eating

- ORGANIC growing and processing food that prohibits the use of most conventional pesticides, petroleum-based fertileizers, GMOs, and irradiation. Animmals are raised on organic feed with no antibiotics or growth hormone with access to the outdoors. a. Refers to the way farmers grow and process agricultural products (no antibiotics, hormones (rBGH, rBST), pesticides, irradiation, or bioengineering(GMO)) b. Encourage soil and water conservation and reduce pollution c. The USDA seal needs approval from Organic Foods Production Act (OFPA)and National Organic Program (NOP)

- Persistence: the extent to which a contaminant lingers in the environment or body a. Level 1: Plant and plankton at the bottom of food chain eat contaminated toxic chemicals? Level 2: small fish/animals eat the bottom feeders? Level 3: contaminants become further concentrated in larger fish that eat the small fist +level 1 ? Level 4:if contaminants arent lost along the way people ultimately receive all the toxic chemicals from Level 1

1) fresher/tastes better/more nutritious 2) support local economy 3) provides fair wage for farmer 4) food reaches you in the least amount of time

The USDA organic seal may be seen on raw, fresh, and processed products that contain organic agricultural ingredients. • To use the seal, at least 95% of the ingredients must be organic. (NO antibiotics, hormones, pesticide, irradiation, bioengineering)

- buying organic food - wash fruits and veggies throughly before eating - Environment: organic farming practices reduce pollution and conserve water and soil

- Achieve a healthy body weight (not under/overweight people - Focus on Nutrition (Ca, Fiber, Mg, Vit E/C, Crotenoids, K+, Fe, Folic Acid) - Medical Checkups (Look up medications for; iron status, diabetes, lipids, thyroid, vaccinations) - Visit the Dentist (dental cleaning can cause bacteria to go down to the baby in the first trimester - Assess Medications and Dietary supplements - Abstain from alcohol, tobacco, caffeine (may take a while to withdraw from those substances)

- 2 weeks: zygote embeds within the uterine wall - 2-8 weeks: Embryo - 5-6 weeks: can hear the heart beat - week 8-birth: fetus - Newborn infant: around 7.5 lbs

- Week 1-13 (1st trimester): no need to increase kcal intake - Week 14-26 (2nd trimester): +330 kcal/day - Week s 27-40 (3rd trimester): +450 kcal/day (nbaby gaining about an ounce/day) - KEY NUTRIENTS: o B12 and folate o Calcium, Phosphorus, Magnesium o Iron (increase from 18mg? 27mg) o Omega 3 (need at least 300 mg DHA daily)

- Underweight: gain 28-40 lbs - Normal weight: 25-35 lbs - Over weight: 15- 25 lbs - Obese: at least 15 lbs - Twin pregnancy: 35-25 lbs

- Unpasteurized food products (cheese, milk, juice) and undercooked meats/fish, smoked meats - ;200mg caffeine, no Deli meats. (No nitrite) - No alcohol - Sodium nitrate - Artificial coloring - Sugar substitutes - Refer to CSPI's ;chemical cuisine; - Sprouts: can hold bacteria - No organ meat- too much Vit A and Iron - MSG - No raw meat, eggs, fish - Herbal supplements or teas - Hot dogs + deli meats, unless heated to steaming

- Caffeine directly crosses the placenta - If pregnant woman consumes ;200mg of caffeine 2x more likely to have a miscarriage

- NO, alcohol crosses the placenta freely and is directly toxic. Can lead to fetal alcohol syndrome. o Limits O2 to the fetus o Slows cell division which can cause abnormalityes in organ o Affects fetal brain cell divison o Interferes w/ nutrient transport to fetus o Before fertilization, alcohol can damage the ovum/sperm, leading to abnormalities in the child.

Gestational Diabetes: diabete towards the 24th week of pregnancy Preeclampsia: s a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys

- Breast fed babies are less likely to be sick.

- Breast Milk: Water, Protein, Carbs, DHA/ARA, Fat, Vitamins, Minerals Breast Milk: everything formula has + Enzymes, growth factors, anti-parasites, anti-allergies, anti-viruses, hormones, antibodies

- Breastfeeding mothers need more fat and less protein and carbohydrates in their diet. o Breastfeeding: 39% Carbs, 55% Fat, 6% Protein o Regular Diet: 53% Carbs, 26% Fat, 21% Protein

- HIV in industrialized nations (not a contraindication in a developing world)

1) Develop a written breastfeeding policy that is routinely communicated to all health-care staff 2) Train all health-care staff in the skills necessary to implement the breastfeeding policy 3) Inform all pregnancy women about the benefits and management of breastfeeding 4) Help mothers initiate breastfeeding witin 30 minutes of birth 5) Show mothers how to breastfeed and how to maintain lactation, even if they need to be separated from their infants 6) Give newborn no food or drink other than breast milk, unless medically indicated 7) Practice rooming-in, allowing mothers and infants to remain together 24 hours a day. 8) Encourage breastfeeding on demand 9) Give no artificial nipples or pacifiers ro breastfeeding infants 10) Foster the establishment of breastfeeding support groups and refer mothers to them to discharge from the facility

- The WHO/UNICEF International Code of Marketing of Breast milk substitutes o No ads of breast-milk substitutes to the public o No donations of substitutes and supplies to maternity hospitals o No free samples to mothers o No promotion in health services o No company personnel to advise mothers o No gifts or personal samples to health care workers

- Prompted concern about marketing of infant formula in poor countries - In poor countries o Formula needs to be mixed with water, which is often contaminated in 3rd world countries? 6-25x more likely to die from diarrhea, 4x more likesly to die from pneumonia o Poor mothers use less formula powder than necessary. Infants receive inadequate nutrition from weak solutions of formula o Breast milk has many natural benefits that are lacking in formula

- Around 6 months/ readinesss o Tongue movement o Can sit up w/help o Head and Neck control o Can keep food in his mouth, eat from spoon o Show desire, rejection of foods o Will open mouth or lean forwardd when food is offered

- 1st Solid Food: used to say iron-fortified rice cereal, not its thought that anything goes! o Great started foods: avocado, banana, applesauce, cereal (made from brown rice, oats, barley or millet) • Introduce food one at a time • Include iron-rich food source (meat) • NO Cow's milk, honey until after 1 yr • Although baby is eating solids, formula/breast milk still main source of nutrients - Mashed up food / Purees - Baby Led Weaning: independent manner of feedings for babies. Instead of offering food on a spoon give them something they can pick up (PALM OR GRASP)

- Calories: Adequate to maintain desirable weight - Protein: 1gm/kg body weight (greater protein turnover rate) - Calcium: 1200-1500 mg/d (to prevent bone loss, ? risk for osteoporosis); take w/ Vit. D, Mg - Vitamin D needs increase: o Decreased ability to synthesize in skin o Less sun exposure (lack of mobility?) o Less dairy intake (lactose intolerance) o Kidneys can't metabolize as efficiently o Need more sun or supplement

bone mass vs muscle depleting

- Limited finances - Living alone - Lack of social services and/or personal assistance - Depression - Medication interactions - Alcohol/drugs (addiction) - Poor dentition - Dementia