Summer 2013 Midterm Review
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Transcript of Summer 2013 Midterm Review
Nutrition HO-15 Midterm Review
Wersquoll begin the review at 900 AM
Midterm
bull a mix of multiple choice true false and matching
57 questions
bull is worth 15 of your total grade
150 points
bull everyone takes a different exam
draws from a pool
bull you will have 100 minutes to take the exam
is timed
will be available for one week
can only be accessed and submitted ONCE
Nutrients
Water
Carbohydrates
Fat
Protein
Vitamins
Minerals
Nutrients - Organic
Water
Carbohydrates
Fat
Protein
Vitamins
Minerals
Nutrients ndash Energy Yielding
Water
Carbohydrates - 4 caloriesg
Fat ndash 9 caloriesg
Protein - 4 caloriesg
Vitamins
Minerals
Nutrients ndash Energy Yielding
Nutrients
bull Nutrients - Energy YieldingMuffin 280 calories (45 g)
bull 15 g CHO 15X4 = 60 calories
bull 20 g fat 20X9 = 180 calories
bull 10 g protein 10X4 = 40 calories280 calories
Recognizing a healthy diet
Adequacy - getting enough
Balance - proportionality
Moderation - nothing in excess
Variety - wide selection
Calorie Control - not too much or too little
Research
Case Study
Laboratory
Double blinded study
Placebo controlled
Interventional
Epidemiologic
Research ndash Gold Standard
Randomized
Double Blinded
Placebo Controlled
interventional Trial
Research Designs
A 55 year old female is given a supplement of Vitamin E and is observed over 3 month to evaluate the effects on her heart health
What type of study is this
Research Designs
A 55 year old female is given a supplement of Vitamin E and is observed over 3 month to evaluate the effects on her heart health
What type of study is this
Case Study
Research Designs
200000 individuals had their LDL HDL and cholesterol measured at baseline and again at 10 years Diets were evaluated with a food frequency questionnaire The number of heart attacks was the primary end point At 10 years correlations were made between diet cholesterol and heart attacks What type of study is this
Research Designs
200000 individuals had their LDL HDL and cholesterol measured at baseline and again at 10 years Diets were evaluated with a food frequency questionnaire The number of heart attacks was the primary end point At 10 years correlations were made between diet cholesterol and heart attacks What type of study is this
Epidemiologic
Nutrient Density
Muffin 1 Muffin 2
280 calories
20 g fat (15 g saturated fat)
10 g sugar
Less than 2 daily value Fe Ca Vit A amp C
200 calories
15 g fat (2 g saturated fat)
4 g sugar (10 g whole grain CHO)
10-15 daily value Fe Ca Vit A amp C
Macronutrients
Percent of Total Calories
Carbohydrates 45-65
Fat 20-35
Protein 10-35 (10-15)
Macronutrients
Example
Carbohydrates 45
Fat 30
Protein 25
TOTAL 100
Phytochemicals
Biologically active substance in plants
Non-nutrient
May protect against chronic disease
bull Example Soy chocolate flaxseed tomatoes garlic wine tea
Anti-oxidants
Importance of Exercise
ACSM Guidelines
bull Or
Do moderately intense cardio 30 minutes a day 5 X week
bull And
Do vigorously intense cardio 20 minutes a day 3 X week
8 -10 strength-training exercises
8 - 12 repetitions of each exercise 2week
Benefits of Exercise
more restful sleep
improved bone density
lower risks of chronic disease
higher quality of life
Mouth
Stomach
Liver
Gallbladder
Pancreas
Small Intestine
Colon
Mouth - chews mixes food with saliva
Stomach -
Liver -
Gallbladder -
Pancreas -
Small Intestine-
Colon -
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver -
Gallbladder -
Pancreas -
Small Intestine-
Colon -
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver - makes bile
Gallbladder -
Pancreas -
Small Intestine-
Colon -
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver - makes bile
Gallbladder - stores bile
Pancreas -
Small Intestine-
Colon -
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver - makes bile
Gallbladder - stores bile
Pancreas - secretes digestive enzymes
Small Intestine-
Colon
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver - makes bile
Gallbladder - stores bile
Pancreas - secretes digestive enzymes
Small Intestine- enzymes break down fat protein CHO amp absorbed
Colon -
Mouth - chews mixes food with saliva
Stomach - mixes amp churns food into a chyme Denatures (uncoils) protein
Liver - makes bile
Gallbladder - stores bile
Pancreas - secretes digestive enzymes secretes insulin amp glucagon
Small Intestine- enzymes break down fat protein CHO amp absorbed
Colon - fluid and minerals absorption amp some fiber fragments absorbed
Storage Organs ndash when we eat too much
CHO Where Where
Fat Where
Protein Where
Storage Organs ndash when we eat too much
CHO Glycogen Fat
Fat Where
Protein Where
Storage Organs ndash when we eat too much
CHO Glycogen Fat
Fat Fat
Protein Where
Storage Organs ndash when we eat too much
CHO Glycogen Fat
Fat Fat
Protein Fat
Note protein is not stored to a great extent
Carbohydrates
bull Simple or Complex
Carbohydrates
bull Simple or Complex
Simple
Simple Carbohydrates
Monosaccharides
Disaccharides
Complex Carbohydrates
fiber
glycogen
Starch
Fiber
Glycogen
Fiber
Which part of the wheat kernelHas fiber
Which part of the wheat kernelhas fiber Bran
Which part of the wheat kernel has starch
Which part of the wheat kernelhas fiber Bran
Which part of the wheat kernel has starch Endosperm
Which part of the wheat kernel has nutrients amp protein
Which part of the wheat kernelhas fiber Bran
Which part of the wheat kernel has starch Endosperm
Which part of the wheat kernel has nutrients amp protein Germ
Which part of the wheat kernel is not edible
Which part of the wheat kernelhas fiber Bran
Which part of the wheat kernel has starch Endosperm
Which part of the wheat kernel has nutrients amp protein Germ
Which part of the wheat kernel is not edible Husk
List the appropriate sequence of events which happen after you eat a plain white bagel
I Starch starts to breakdown into maltose in the mouth
II Maltose breaks down into glucose in the small intestines
III Glucose is absorbed from the small intestines into the bloodstream
IV The pancreas secretes insulin in response to high blood glucose
V Insulin transports glucose from the bloodstream into cells
VI Blood glucose decreases
Diabetes (Type I amp II)
Onset
bull Type 1bull Type 2
Diabetes (Type I amp II)
Onset
bull Type 1-typically childhoodbull Type 2-typically adulthood
Diabetes (Type I amp II)
Causebull Type 1bull Type 2
Diabetes (Type I amp II)
Causebull Type 1 - autoimmune diseasebull insulin secreting cells
impairedbull Type 2 - acquiredbull insulin resistance obesity
genetics diet
Diabetes (Type I amp II)
Insulin Secretion
bull Type 1bull Type 2
Diabetes (Type I amp II)
Insulin Secretionbull Type 1 - no natural insulinbull Type 2 - enough or too much insulin
Lipids
P
LIP
IDS Triglycerides (TG)
asymp95 of all lipids in foods and the human
body
Phospholipids For example lecithin
Sterols For example cholesterol
Fats
Percent of Calories from Fat
bull Hamburger ndash 500 caloriesndash 25 g saturated fat
Percent of Calories from Fat
bull Hamburger ndash 500 calories
ndash 25 g saturated fat
25 g X 9 caloriesg = 225 calories
Percent of Calories from Fat
bull Hamburger ndash 500 caloriesndash 25 g saturated fat
25 g X 9 caloriesg = 225 sf calories225 sf calories 500 calories =
45 = 45
Percent of Calories from Fat
bull Hamburger ndash 500 caloriesndash 25 g saturated fat
25 g X 9 caloriesg = 225 calories225 calories 500 calories = 45 = 45
45 of the calories in the burger are from saturated fat
LDL and HDL
What is LDL
What is HDL
LDL and HDL
What is LDLbull Low density
lipoprotein
What is HDLbull High density
lipoprotein
NOT ACTUALLY CHOLESTEROL
LDL and HDL
What is LDLbull Low density lipoproteinbull Transports cholesterol to
tissuesbull ldquobadrdquo cholesterol
What is HDLbull High density lipoproteinbull Scavenges cholesterolbull ldquogoodrdquo cholesterol
LDL and HDL
How do you lower LDL
How do you increase HDL
LDL and HDL
bull Lower your intake of saturated fat and trans fat
How do you lower LDL
bull Exercise
How do you increase HDL
Trans Fats
Essential Fatty Acids
EFAs are which type of fatty acid
Saturated fatty acid
Monounsaturated fatty acid
Polyunsaturated fatty acid
Essential Fatty Acids
EFAs are which type of fatty acid
Saturated fatty acid
Monounsaturated fatty acid
Polyunsaturated fatty acid
Structure of Proteins
Peptide Bond
Structure of Proteins
Roles of Proteins
Enzymes
Structural
Hormones
Precursors (neurotransmittersvitamins)
Antibodies
Fluid Balance
Buffers
Blood Clotting
Provide Energy
Protein digestibility
Which types of proteins are best absorbed by the body
Protein digestibility
Which types of proteins are best absorbed by the body
bull Animal sources asymp 90+bull Legumes asymp 80-90bull Grains asymp 70-90
bull Moist heat increases digestibilitybull Dry heat decreases digestibility
Digestion and absorption
Complementary Proteins
Amino acids from one protein source complement the amino acids from another protein source to form a complete protein
Wasting
bull When the amine group has been removed it means the amino acid has been wasted
Protein Energy Malnutrition
Protein Energy Malnutrition
Marasmus
Chronic protein and energy deficiency
Severe wasting
Matchstick arms
Protein Energy Malnutrition
Protein Energy Malnutrition
Kwashiorkor
Protein malnutrition
Acute onset (1-3 yr)
Edema (legsbelly)
Fatty liver
DRI Protein
bull DRI protein examplendash 130 lb sedentary 35 yr femalendash 130 lb X 1kg22 lb = 59 kg
DRI Protein
bull DRI protein examplendash 130 lb sedentary 35 yr femalendash 130 lb X 1kg22 lb = 59 kgndash 59kg X 08gkg = 47g proteinday
DRI Protein
bull DRI protein examplendash 130 lb sedentary 35 yr femalendash 130 lb X 1kg22 lb = 59 kgndash 59kg X 08gkg = 47g proteinday
ndash 47g X 4 calg = 188 caloriesndash 188 cal1800 calories = 10 total calories
DRI Protein
bull DRI protein examplendash 130 lb sedentary 35 yr femalendash 130 lb X 1kg22 lb = 59 kgndash 59kg X 08gkg = 47g proteinday
ndash 47g X 4 calg = 188 caloriesndash 188 cal1800 calories = 10 total calories
ndash 10-15 of total calories from protein-most Americans
ndash 10-35 of total calories
Vitamins
bull Dissolve in waterbull Easily absorbed and transportedbull Not stored in significant quantitiesbull Rarely toxic from food sources
Water Soluble ndash Vitamin C amp B
bull Do not dissolve in waterbull Need fat to be absorbedbull Stored extensivelybull Can reach toxic levels
Fat Soluble ndash Vitamin A D E amp K
What are the main functions of Vitamin A
What are the main functions of Vitamin A
Vision
bull body linings and skinbull For growth of bones and teeth
Growth and maintenance
Immune defenses
bull What happens in Vitamin A deficiency
bull What happens in Vitamin A deficiency
night blindness
Keratinization
Can toxicity develop from Vitamin A Beta-carotene
Vitamin A YESbull From supplements or fortified foods
Beta-carotene NO
Can toxicity develop from Vitamin A
What are the roles of Vitamin D in the body
What are the roles of Vitamin D in the body
Regulation of blood calcium
Regulation of phosphorus
Raises blood calcium levels
What happens in Vitamin D deficiency
Vitamin D Deficiency
RICKETS
Most people are not receiving ENOUGH vitamin D because of the lack of sun exposure
Vitamin D Deficiency
What are the best sources of Vitamin D
What are the best sources of Vitamin D
Sunshine
Fortified milk
Mushrooms
What is the main function of Vitamin E
What is the main function of Vitamin E
Antioxidant bull quenches free radicals
bull protects cellular structures from oxidative damage
What is the main function of Vitamin K
What is the main function of Vitamin K
Synthesis of blood clotting proteinsbull Interferes with function of blood
thinnersSynthesis of bone proteinsbull Adequate intake may reduce risk of hip
fracture
Vitamin K
Vitamin K is synthesized by bacteria in the intestines
Vitamin K is given at birth because the intestines are sterile
What are the roles of Vitamin C in the body
What are the roles of Vitamin C in the body
Maintenance of connective tissuesbull Formation of collagen
Cofactor in the production of carnitine
Antioxidant
Restores Vitamin E to itrsquos active form
Supports the immune system
Boosts Iron absorption
What condition develops in Vitamin C deficiency
Scurvy
Vitamin C Deficiency
Vitamin C
Does not prevent colds
Vitamin C reduces histamine
What is the main function of the B vitamins
What is the main function of the B vitamins
Part of coenzymes
Energy metabolism
New cell synthesis
Thiamin deficiency results in what condition
Thiamin deficiency results in what condition
Beriberi (affects nerves)
Loss of sensation in hands and feet
muscular weakness
advancing paralysis
What condition develops in Niacin deficiency
What condition develops in Niacin deficiency
Pellagra
Diarrhea
Dermatitis
Dementia
Death
Source of Niacin
Tryptophan can be converted to niacin
Tryptophan is in most proteins
What condition results from folate deficiency in pregnancy
Folate Deficiency
Neural tube defects
Fortification of food is important - Most women donrsquot know they are pregnant for weeks
Folate Deficiency
What condition results from Vitamin B12 deficiency
What condition results from Vitamin B12 deficiency
bull Pernicious Anemia
Is Pernicious Anemia more likely to develop from lack of intake or malabsorption
What condition results from Vitamin B12 deficiency
bull Pernicious Anemia
Is Pernicious Anemia more likely to develop from lack of intake or malabsorption
bull Malabsorption
bull Absorption of Vitamin B12 requires intrinsic factor (IF)
Who is at risk for Pernicious anemia
Who is at risk for Pernicious anemia
Vitamin B12 is only found in animal sources
Elderly - most at risk
Strict Vegetarians
Can Vitamin B6 can be toxic from supplements
Can Vitamin B6 can be toxic from supplements Yes
A single B6 supplement can deliver 2 grams of the vitamin the equivalent of bull 3000 bananasbull 3800 chicken breasts
Toxicity UL O1 gram
bull numb hands and feet
Calcium
What other function does calcium have besides formation and maintenance of bone structure
Most abundant mineral in the body
Calcium
Nerve transmission
Transport of ions
Blood pressure
Blood clotting
Muscle contraction
Which mineral assists with muscle relaxation
Which mineral assists with muscle relaxation
Magnesium
Which mineral is part of RNA and DNA