Human Nutrition Exam 2

Front 1

What is a marginal deficiency?

Back 1

A state of long-term gradual vitamin depletion in which there is evidence of personal lack of well being associated with impairment of certain chemical reactions in the body.

- The reactions impaired are those that depend on sufficient amounts of vitamins.

Front 2

What are the main points about Vitamin D about the sun and what sources does it come from?

Back 2

- 15 minutes of sun exposure to arms and face is sufficient for Vit. D synthesis in body. (we don’t make this in our bodies)

- Low amount of Vit. D. in Elderly due to reduced absorption!
- Not many natural sources (mainly come from seafood, including fish, fortified foods> milk, soymilk, cereal.

Front 3

What are two types of severe Vitamin D deficiencies?

Back 3

1) Rickets – Occurs in children which causes poor bone growth
2) Osteomalacia – Same as above but occurs in elderly. (bone break-down accelerates)

Front 4

What are some problems related to marginal deficiency in Vitamin D?

Back 4

1) Osteoporosis – occur in women more than men
2) Diabetes – causes Type II diabetes and also obesity.
3) Colon cancer (signal cell multiply)

Front 5

What do all B-vitamins have in common besides being water soluble?

Back 5

They all function as part of co-enzymes.

Front 6

What are the types of “jobs” done by B vitamins with examples (ie thiamin & energy, B6 role in the nervous system).

Back 6

Thiamin – main function: energy release pathways.

Niacin and Riboflavin – energy release serve as one function but has other ones.

B6 Vitamin – moves nitrogen, protein for energy; glycogen breakdown.
- Also B6 is involved in making nitrogen compounds from amino acids such as neurotransmitters.

Folacin – needed to make red blood cells rapidly (carry O2 needed for energy release, make ATP), also makes RNA and DNA bases.

B12 Vitamin – Cobalt vitamin or Cobalamin, one job: recycle folacin coenzymes

Front 7

What are the two extremes for food sources of B vitamins (folacin at one end and B12 at the other end).

Back 7

1. Folacin = Plants, green leafy vegetables [foliage vitamin]
2. B12 = Only animal sources + bacteria. (Eggs+meat+dairy)

Front 8

Why are the nervous system, GI tract and skin often affected by deficiencies of the energy releasing B-vitamins?

Back 8

- Cells in these tissues are metabolically active and those in the skin and GI tract constantly being replaced.

Front 9

What is the historical case of beri-beri (thiamin deficiency disease)? Today?

Back 9

Beri-Beri (thiamin deficiency disorder) case: Polished white rice in Southeastern Asia eliminates B-vitamins.

Today: Children in 3rd-world countries (can get beri-beri – thiamin deficiency disorder, due to starvation + food prob.)

Front 10

What is the historical case of pellegra (niacin deficiency disease)? Today?

Back 10

Pellagra (niacin deficiency disease) – caused by a corn-based diet, was once declared epidemic in the southeastern USA, was once misdiagnosed as an infection from a fly bile, can cause, dermatitis, dementia, and diarrhea.

- Pellegra is the only dietary deficiency disease ever to reach epidemic proportions in the U.S.

Front 11

What are the non-dietary factors/causes of B-Vitamin deficiency?

Back 11

1) Alcoholism: Causes poor intake + poor absorption of thiamin, folacin, and others.
2) Drug side effects – chemotherapy drugs (creates deficiency in Folacin)
3) Marginal Folacin deficiency – caused by pregnancy, can lead to spina bifida.

Front 12

What is Homocysteine? How is it related to B-vitamins and why is getting attention?

Back 12

- Homocysteine is a protein amino acid produced by the body. It is a breakdown product of certain amino acids that is not supposed to build up.

- Increase levels in many people with CVD.

- Marginal deficiency of B6, Folacin, B12 can cause elevated homocysteine levels!

- Important since high levels of homocysteine can decrease cognitive function in older people!

- Treatment with folacin and B12 actually increased cognitive function!

Front 13

What's the relationship of B6 vitamin and PMS? Also what's important about B6's toxicity?

Back 13

- Evidence shows that B6 vitamin can reduce PMS! (Not cure completely!)

- B6 vitamin is the most toxic of all B vitamins because of symptoms and identification.

Front 14

What are B12 Injections good for?

Back 14

- Good for 1)Pernicious Anemia- a genetic condition where you don’t absorb B12 well!
Also other situations with low B12 absorption!
- Can work for marginal deficiency in elderly (may be common due to low absorption in old people), oral intake can also work!
- No good evidence for usefulness in athletes!
Ex: Steve Nash - no reason to take B12 injections (recycle folacin - increase red blood cells, if deficient in B12, wouldn't be playing basketball)

Front 15

What is the importance of high dose of niacin?

Back 15

- Used as treatment to increase HDL-cholesterol (good kind).

Niacin can raise HDL-cholestrol by 15-35%, making niacin the most effective drug for raising HDL!

Front 16

What the importance of Biotin (B-7 vitamin) and raw egg whites?

Back 16

Biotin (B7 vitamin) aids in fat and carbohydrate metabolism.

Protein called avidin in raw egg whites binds biotin and inhibits its absorption. Consuming many raw egg whites eventually lead to the deficiency disease for Biotin.

Front 17

What are the functions of Vitamin C?

Back 17

- Reducing agent – gives electrons out.
1) Collagen Shaping – formation of triple helix
2) Antioxidant Activity (prevent cancer-causing nitrosamines)
3) Enhances and increases Iron Absorption (reduces the charge of the iron from +3 to +2)
4) Immune Function.

Front 18

How much Vitamin C do we need?

Back 18

RDA – 90 mg for adult males.
RDA – 75 mg for adult females.
- Only enough to saturate tissues (Vit. C is water soluble so will float in blood; > RDA will see Vitamin C in urine)
- RDA can increase blood cells, fluid Vit. C; useful maybe for antioxidant function, immune function?
- Really high Vitamin C can be useful but is very questionable! (mixed results)
- 2000 mg is upper level (UL) limit before becomes toxic. E.g. 20 glasses of orange juice.

Front 19

What raises Vitamin C needs?

Back 19

1) Birth control pills – reason is not because of collagen but the baby.
2) Burns, surgical tissue removal – connective tissue replacement
3) Smoking – free radicals destroy Vitamin C, also damages tissues and lungs – means need more collagen.
4) Extreme physiological stress – military in subarctic, marathon runners, others, etc.

Front 20

What are the vitamin C food sources?

Back 20

- Found in fruits and vegetables; some real high; some not.

Foods include: Orange, cooked brussel sprouts, grapefruit juice, red peppers, kiwi fruits, etc.

Front 21

Does Vitamin C cure or prevent the common cold (if deficient and if non-deficient)?

Back 21

- If deficient, Vit. C does probably prevent the common cold.
- After a marathon run, Vit. C can prevent a cold.
- If not deficient or very physically stressed, for cold prevention or severity: Probably no.
- If not deficient: cold duration: high dose of Vit. C - probably little effect in some people.
- A small lowering of severity may occur in some non-deficient people.
- In high body stress situations, Vit. C has some effect on prevention, severity, and the duration of a cold.

Front 22

What are macro and trace minerals?

Back 22

- Macro minerals (high amounts in body) – Calcium and Phosphorus.
- Trace minerals (tiny amounts in body –) Iron, Zinc, and Copper.

Front 23

What are the 2 most abundant body minerals?

Back 23

Calcium and Phosphorus.

These two are the major minerals we need per day vital to health required in the diet in amounts greater than 100 milligrams per day.

Front 24

What are the sources of water?

Back 24

- Water comes from drinking water + other fluids + foods (ex: celery) + body processes.

Front 25

What is the definition of an electrolyte?

Back 25

A compound that ionises when dissolved in suitable ionising solvents such as water.

- Major contributor to body fluid charges.

Front 26

When are times that you should drink more water beyond thirst signal?

Back 26

1) Excess sweat
2) Prevent Kidney stones (due to insoluble subs. In kidney – can’t filter out, supposedly more powerful then child birth)
3) During infections

Front 27

What are the main electrolytes?

Back 27

Main electrolytes: Sodium (Na), Potassium (K), Magnesium (Mg), Chloride (Cl), Phosphate, and Protein.

6 main electrolytes!

Front 28

How are Na and K distributed?

Back 28

Sodium-Potassium pump pushes Sodium (Na) out and Potassium (K) in cells.

Front 29

What are the 3 situations that can promote both Sodium and Potassium depletion?

Back 29

Sodium-Potassium depletion occurs when the body loses a lot of electrolytes.

1) Diarrhea – especially infants.
2) Vomiting – especially infants.
3) Diuretics – promotes the production of urine.

Front 30

What's the relationship of sweating to sodium depletion?

Back 30

- Sweating can deplete sodium but only if it’s for a long period of time combined with low sodium intake.

- Only depletes sodium not sodium and potassium!

Front 31

What are the symptoms of Na and K (Sodium-Potassium) deficiency?

Back 31

1) Many system dysfunctions
2) Cramps (nervous system, muscle)
3) Muscle Tetany
4) Heart Failure

Front 32

What are the more common causes of cramps from potassium (K) depletion?

Back 32

- Not a lot of research to support
- More common causes of cramps: dehydration and mechanical issues (in muscle contraction)

Front 33

What are the effects of sodium and blood pressure; sodium sensitivity?

Back 33

Sodium sensitivity – where one’s kidneys don’t throw out Sodium very well! It retains sodium which increases blood pressure!

Ex: One eats a big mac and fries and is barely phased by change in blood pressure, another eats the same meal and has a dramatic rise in blood pressure!

Front 34

What are other factors that control blood pressure?

Back 34

1)Sodium (Na) Sensitive people – kidneys don’t throw out Na well! (Blood pressure goes up!)
2) Genetics (increase/decrease BP)
3) Race (increase/decrease BP)
4) Atherosclerosis (hardening of arteries>increases BP> CVD)
5) Free radicals (bullets; can damage lungs, BP increases)
6) Obesity (increase BP)
7) Diseases (can increase or decrease BP)
8) Exercise (can lower BP)
9) Drugs can either decrease or increase BP. (e.g. caffeine, stimulants, nutrition supplements)
10) Various nutrients and phytochemicals

Front 35

Does Potassium have an effect on blood pressure?

Back 35

-Potassium intake probably has an effect on blood pressure, but many studies can’t distinguish Potassium effect from the other health effects of the foods studied.
- I.e. dash diet.
- Possibly K to Na ratio important.
- May be other benefits of increased potassium.
- No current RDA

Front 36

What are the food sources of potassium? Is Banana is the best source?

Back 36

Kidney beans, yogurt, orange juice, banana, soybeans, etc.

Banana: Best Source? Good source, but other foods are just as good if not better.

Front 37

What's the RDA for Potassium?

Back 37

No Current RDA for Potassium due to the lack of information!

Front 38

What are the two main functions of calcium?

Back 38

1) Bone Structure – formation, store and structure bones composed of calcium phosphate.

2) Regulatory functions (not sensitive to diet): volume control, muscle contractions, IC signaling, etc.

Front 39

Which one is better preserved during calcium and/or vitamin D deficiency?

Back 39

Regulatory functions are preserved better!
- Calcium leaves bone to preserve the regulatory functions.

- You lose the bones function better!

Front 40

What are the best calcium sources? (meaning high bioavailability or absorption and high calcium content)?

Back 40

- Dairy products are both (e.g., milk, cheese, etc.)
- Another good source are fortified products and vegetable like kale; low in oxalate.

Front 41

What are poor calcium sources? (relatively high calcium content, low bioavailability or absorption)

Back 41

- Ex: Spinach (low absorption due to being high in oxalate)

Front 42

Is osteoporosis strictly a calcium deficiency?

Back 42

No, not strictly a calcium deficiency since it has multiple causes with only 1 factor being not storing enough calcium.

- Usually occurs later in life and affects more women than men.

Front 43

What does the bone density line graph show?

Back 43

-This graph shows that women A’s bone mass peaks around age 30 and bone loss speeds up after menopause. This way even at an old age, the woman had a healthy bone density and showed no evidence of osteoporosis.

Front 44

What factors affect osteoporosis risk?

Back 44

1) Dietary Calcium – osteoporosis is not a straight calcium deficiency
2) Vitamin D intake and production – helps prevent osteoporosis.
3) Genetics/Race – Asians have high risk, Africans low risk of osteoporosis.
4) Estrogen/ Hormones – prevent osteoporosis.
5) Weight Bearing exercise – helps prevent osteoporosis
6) Other Nutrients/Phytochemicals – important for bone health

Front 45

What are the non-bone functions of Calcium?

Back 45

1) Helps regulate/reduce blood pressure
2) Lower risk of colon cancer – caused by excess cell multiply, calcium brings balance, slows down.
3) Weight control??? – calcium can help with weight loss, especially dairy calcium sources. Many studies show this but studies also disprove this!

Front 46

How do you prevent osteoporosis?

Back 46

1) peak bone mass as high as possible at age 30.
2) slow bone loss as much as possible after menopause.

Front 47

What are some of the non-dairy sources of calcium?

Back 47

- Black-strap molasses, collard greens, tofu, fortified orange juice, fortified soy-milk, kale, soybeans. – all of these are great sources of calcium!

- Shows that there are non-dairy sources such as kale with good bio-availability/absorption.

Front 48

What are some of the concerns of consuming calcium with other foods?

Back 48

Eat calcium with:
1) Too much protein: Excretion (negative effect) & absorption increases (positive effect), may have a slightly overall positive effect.
2) Too much Sodium or Phosphorous: If Calcium intake is high, may not matter!
3) Caffeine: If Calcium intake is high, may not matter!

- All these concerns may be bad if calcium intake is low!

Front 49

Where is the majority of the body's phosphorus located and is deficiency common?

Back 49

-Main function: Inside the bone
- Electrolyte, ATP.
Food sources: milk, cheese, meat, bread and grains, some vegetables, etc.
- Deficiency is rare! – found in many of our daily foods plus the absorption is very high!
- Deficiency occurs in a few medical conditions!

Front 50

What types of people need to restrict Phosphorus intake?

Back 50

- Kidney dialysis (non-functioning kidneys) patients need to restrict Phosphorus since it will build up and cause toxicity.

Front 51

What are the food sources of magnesium?

Back 51

High magnesium: High in chlorophyll foods – i.e. spinach
Plant sources are good, animal products supply some magnesium.
- Not extremely easy to get the RDA.
- Ex: Spinach, squash , wheat germ, Raisin bran, etc.

Front 52

What's odd about Magnesium's UL intake?

Back 52

Magnesium's UL of 350 mg/day is < less than its RDA of 400 mg.

Reason for low UL: Refers to nonfood sources; some supplements are good laxatives. Don't want to take too much supplements due to toxicity!

- Magnesium toxicity especially occur in people who have overused over-the-counter medications that contain magnesium such as laxatives.

Front 53

What are the causes and symptoms of Magnesium deficiency?

Back 53

- Can cause: Muscle, heart, mental problems, fatigue, etc.

- Most common cause: increase urine Mg excretion due to alcoholism (moderately low intake of Magnesium + high excretion), certain drugs and diseases.

Symptoms??? (wide-ranging) Fatigue, cramps, muscle problems, brain problems, anxiety, etc.

Front 54

What are areas of Magnesium interest being researched?

Back 54

1) Bone: Plays a role
2) Kidney stone prevention: Likely helps.
3) Lower Blood pressure, other Cardio-vascular disease: likely helps.

- Lots of one and done studies!

Front 55

What are the functions of iron?

Back 55

1) Iron-Oxygen Transport: iron in hemoglobin binds oxygen & deliver it to tissues
2) Enzymes – involved in energy release pathways
3) Enzymes – immune function requires iron!
4) Enzymes – Drug processing & detoxification in the liver.
5) Other Proteins – energy release pathways

- Iron is used as part of many enzymes, some proteins, and compounds that cells use in energy production. Also, needed for brain and immune function and contributes to drug detoxification in the liver!

Front 56

What is the difference between severe iron deficiency and marginal iron deficiency?

Back 56

Severe Iron deficiency: Cause anemia and reduction of other functions (everything shuts down)

Marginal iron deficiency: Not cause anemia! But still reduction of other functions (decrease energy and immune function)

Front 57

What is the absorption for heme iron and what food sources does it consist of?

Back 57

Heme Iron: Mainly meat, good absorption about 1/3 absorption rate which is about 3 times more efficient than nonheme iron
- RDA assumes some HEME Iron intake. (need less of heme iron than non-heme iron.)
- Meat can increase iron absorption for other foods (help non-heme iron get more absorption)

Front 58

What is non-heme iron and how well does the iron absorb in foods?

Back 58

Nonheme Iron: Grain products, some meats, eggs, milk, vegetables, etc.
- Plants, supplements – Non-heme (% RDA deceptive)
- Non-heme iron absorption is low by factors such as oxalates (ex: spinach, phytates – carries iron out of body)
-Non-heme iron absorption is high by factors such as Vitamin C, Meat protein factor – 3-time winner since it naturally helps absorb iron!, ex: pasta w/meat sauce)

Front 59

What are the many groups prone to Iron deficiency?

Back 59

1) Women-menstruating years (problematic even past these years)
2) Teenage girls (don’t eat a lot of meat!)
3) Pregnant women (increase blood capacity for body, increase need for iron!)
4) Elderly women, some elderly men (decrease appetite, poor absorption)
5) Vegetarians – due to not eating meat!
6) Children age 1-5, picky eaters – limit nutrients due to selectivity of food.
7) Internal bleeding men and women – cause RBC to break, inefficient> need iron.

Front 60

What is the main defense for Iron toxicity?

Back 60

-Intestinal cells.
- A protein grabs the iron and carries it out when the cells are eliminated.

Front 61

What are the causes of iron toxicity? Its effect in children vs. adults?

Back 61

Causes:
1) High intake of iron
2) Bypasses the Maginot line of defense
3) Repeated blood transfusions (iron bypasses the intestine, the main defense)
4) Genetic Iron retention disease (no export, Iron stays in the body), treated with blood removal.

Children vs. Adults:
- A very high Iron intake can cause one to be overwhelmed > more easily in children than adults.

Front 62

What are the functions of zinc?

Back 62

Functions of Zinc:
1) Stability (stabilize proteins, many roles in enzymes, other proteins in cell membranes-receptors, lowers free radical protection, holds shape/structure of protein)
2) Catalyst
3) Large # of enzymes – impact over 200 enzymes
4) Indirect antioxidant effect – aids in prevention of oxidative damage to cells.
5) Not all enzymes are equally sensitive to dietary Zinc (can get Zinc in system, but not going to the right place)

Zinc mainly has 2 functions: one in Stability and another in Enzymes.

Front 63

What are the top 3 good food sources of Zinc?

Back 63

Beef is #1, Other Meats (chicken, ham, etc.) #2, Seeds/Grains #3.

- Fruits are poor sources; milk ok if drink a lot, absorption rate of supplements/fortified foods are just fair.

Front 64

What is the cause and symptoms of Zinc deficiency in the Middle East and elsewhere?

Back 64

Cause:
Unleavened bread – insoluble zinc complex (dissolvable so not absorbed, phytate in the bread lowers zinc absorption)

Symptoms:
1) Stunted growth (& development especially in children)
2) Zinc deficiency – low intake and low absorption 3rd world children (e.g. less developed countries)
3) Diarrhea (lose other nutrients) – poor immune function.

Front 65

What are the moderate deficiencies of Zinc: causes/types of people involved and prone?

Back 65

- Wide variety of symptoms due to receptors + varying co-circumstances
- Symptoms not fully identified
- Picky eating children – poor growth, not based in genes
- Elderly – lowish intake and absorption
- Vegetarians – lowish intake and absorption
- Diabetes, alcoholism, down’s syndrome: High needs for zinc!
- Others > Zinc helped with Down’s syndrome.

Front 66

What do we currently know about zinc lozenges and zinc for treatment of macular degeneration (age-related eyesight loss)?

Back 66

Zinc Lozenges: - may help in reducing colds!
- Supposedly get high concentrations in nose
- Studies too par, data too conflicting to draw conclusions.

Zinc and macular degeneration (age-related eyesight loss):
- Aging related eye sight loss; no known cure> “wet and dry”
- Large studies – AREDS (Age related eye degenerate study) – zinc supplementation produced a moderate help in one subgroup especially with other antioxidants; AREDS II underway
- Zinc and bioavailability – companies already make $50,000 – no need to get study proven.

Front 67

How is copper discovered as essential?

Back 67

Copper combines with Iron (Fe) to cure certain Anemias.

Front 68

What are the functions of copper?

Back 68

1) Changes charges in Enzymes
2) Discovered as essential by combining with Iron to cure certain Anemias.
3) One enzyme glues collagen strands and strands of another tough protein called elastin.

Front 69

What are some enzyme actions from Copper including Superoxide Dismutase? (SOD)

Back 69

- Eliminates one type of free radical (oxygen radical with one unpaired electron)
- Put antioxidant research on the map
- 3 forms – Cytoplasm (Cu), mitochondria, outside cells (Cu).
- Also contains Zinc.

Front 70

What's the most common cause of Copper deficiency?

Back 70

Most common cause: High dose Zinc supplements – compete with cytoplasm for absorption!
- Symptoms: Anemia, low count for certain white cells.
If unchecked: nerve damage (not really reversible)

Front 71

What are the food sources for copper?

Back 71

Best foods either eaten infrequently or in small amounts if frequent.
- Ex: Shellfish, cocoa, soy protein, kidney beans, nuts & seeds.
- RDA is 900 mg but Fried beef liver has 3800 mg, 1 power bar has 700 mg!

Front 72

What are the experts opinions on the new RDA for copper?

Back 72

- Experts feel the New RDA is too low!! (want people to eat the old RDA!)
- Some conditions raise needs (arthritis, kidney dialysis patients)
- So, many people marginally deficient.

Marginal copper deficiency: Exciting or trivial? Will it better our lives? (in next 20 years)

Front 73

Does stress really cause long-term Blood pressure increases?

Back 73

It might! (No concrete answer, other factors as well).

- Emotional and psychological stress not physical!