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23 Cards in this Set

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Functional Foods
foodstuffs specifically modified to alter the structure, metabolism, ort physiological function of the body
Nutraceuticals
purified, concentrated, or modified components of food or natural products that alter the structure, metabolism or physiological function of the body
Phytosterols (plant sterols)
-sitosterol, stigmasterol, campesterol
 cholesterol absorption   plasma LDL
Omega 3 FA's
ALA (18:3), EPA (20:5), DHA (22:6)
 TG, anti-inflammatory, brain development
Soy Isoflavones
genistein, diadzein, coumestrol
Prevent heart disease, osteoporosis, cancer ?
Cholesterol
Important component of cell membranes
Only animals make cholesterol
Cholesterol is inefficiently absorbed by the human intestine (~50% efficiency)
There is very wide person-to-person variability in absorption efficiency
Dietary cholesterol can raise LDL levels, but its impact on LDL is also variable
Cholesterol Absorption
Enterocyte uptake from intestine and resecretion into lymph as chyomicrons
Phytosterols continued
Plants make Phytosterols (plant sterols)
-sitosterol, stigmasterol, campesterol, avenasterol, brassicasterol, and stanols
Unlike cholesterol, phytosterols are poorly absorbed by the intestine (<1% efficiency)
It has been known since the 1950’s that phytosterols inhibit cholesterol absorption
Only recently has the full mechanism of the phytosterol effect been elucidated

A single methy group separates absorbable from non absorbable

phytosterols will happily join the micelles but then abcg spits them back out, not incorporated into chylos
Cholesterol Absorption Modulates Hepatic Cholesterol Metabolism
chylomicrons get delivered to liver then altering hepatocyte cholesterol. Diet, liver synthesis and LDLr reuptake are the 3 sources of cholesterol in the liver.

by reducing cholesterol absorption LDL levels go down as the liver up regs its LDLr uptake
Plant Sterol Margarines
Each 1 tablespoon serving contains 0.85 grams of plant stanol esters
Dose: 2-3 Tablespoons per day
Low saturated fat, no trans fats
Clinical studies of Stanol Margarines
Over 40 placebo controlled trials reported
Can achieve up to 14% lowering of plasma LDL when used alone as “monotherapy”
Could produce up to a 30 mg/dl reduction in LDL when used to replace butter in the diet
Can produce up to a 10% additional LDL lowering when taken along with a statin
Palatable, safe, no effect on fat-soluble vits.
Comes in lower calorie (“lite”) versions
Omega 3 FA's
Highly unsaturated ( 3 double bonds)
-Linolenic acid (18:3) (ALA)
Essential fatty acid – must obtain from the diet
Precursor for longer 3 fatty acids
Eicosapentaenoic acid (20:5) (EPA)
Precursor for prostanoid synthesis
Docosahexaenoic acid (22:6) (DHA)
Major component of structural phospholipids in the brain (30%) and in the retina (50%)
Maternal intake during pregnancy may affect neonatal retinal and brain development
Omega 6 FA's
Highly unsaturated ( 2 double bonds)
Linoleic acid (18:2) (LA)
Essential fatty acid - must obtain from the diet
Precursor for arachidonic acid synthesis
-Linolenic acid (18:3) (GLA)
Non-essential precursor for prostanoid synthesis
Arachidonic acid (20:4) (AA)
Substrate for the synthesis of prostaglandins, leukotrienes, and other bioactive prostanoids
Established Clinical Benefits of Omega 3s
Cardiovascular -  Risk of ASCVD
Lower plasma triglycerides
Lower blood pressure
Anti-arrhythmic effect
Reduce platelet aggregation
Reduce sudden death after MI
Psychiatric Disorders
Reduce incidence/severity of depression
May reduce aggressive behavior
presence of DHA and EPA
inhibit first step in arachodonic acid causing inflammation.
EPA also inhibits cox 2 and 5 lox pathway causing less inflamm effects
Possible clinical effects of Omega 3s
Anti-Inflammatory Activity
Rheumatoid Arthritis
Asthma
Inflammatory bowel disease
Psoriasis
Neuro-Behavioral Disorders
Neonatal visual/neural development
Benefit in ADHD and Autism ?
Benefit in memory disorders ?
Clinical Studies of Omega-3 Eggs
Makrides et al. Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants. Am J Clin Nutr 75:1084-92, 2002
Infants 6-12 mo old were fed no eggs, four regular egg yolks/wk, or four 3-enriched egg yolks/wk
Red cell DHA content was 30-40% higher in infants fed 3 eggs compared with regular eggs or no eggs

Smuts CM et al., A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol 101:469-79, 2003.
350 subjects between the 24-28th week of pregnancy consumed regular or DHA-enriched eggs until parturition
Gestation length increased by 6.0  2.3 days (P =.009) in the DHA-enriched egg group. Birth weight, length, and head circumference also increased (P =0.06-0.18)
Soy
Epidemiologic studies have found a very low incidence of heart disease, cancer, and osteoporosis in Asian populations
The risk for these disorders increases with time in Asian immigrants to Western countries, thus suggesting a dietary factor
Soy and soy foods are a major component of the diet of many Asian countries
Soy contains estrogen-like phytochemicals with E2 receptor agonist-antagonist activity
Soy Hypothesis
Soy isoflavones, by their estrogen receptor agonist-antagonist action, protect against ASCVD and estrogen-sensitive disorders
Addition of soy and/or soy isoflavones to the Western diet can lower the risk of ASCVD and estrogen-sensitive disorders
Soy Products
Whole soybeans – fresh, roasted, soy butter
Soy flour and soy protein isolate - soy dogs, soy burgers, soy sausage, energy bars
Soy Milk – flavored soy drinks, non-dairy creamers, puddings, ice cream
Traditional Asian foods: Tofu, Tempeh, Miso, (soy sauce does not contain isoflavones)
Concentrated isoflavone supplements
Phytoestrogens
look like 17 estradiol
Evidence for Soy Efficacy
small effect on plasma LDL levelsand hot flashes but evidence for other actions is weak.
Good Soy
Alternative protein substitutes
Lower cost than animal source protein
Lower fat content than most meats
A "Green" Food
Consume fewer resources and less energy to produce than animal protein
Expand the vegetarian repertoire