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168 Cards in this Set
- Front
- Back
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Nutrition
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the study of eating habits, the nutrient content of foods, the metabolic roles of the nutrients, the chemistry of the nutrients, and the application of this knowledge toward promoting good health and preventing disease.
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Health
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A range of states with physical, mental, emotional, spiritual, and social components.
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At a maximum, health means...
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Wellness
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At a minimum, health means ...
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Freedom from physical disease, mental disturbances, emotional distress, spiritual discontent, social maladjustment, and other negative states.
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Wellness
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Maximum well-being; the top range of health states; the goal of the person who strives toward realizing his or her full potential physically, mentally, emotionally, spiritually, and socially.
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What are nutrients?
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Essential for human development and function; they must be supplied in amounts needed to maintain life.
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There are approximately how many nutrients?
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50
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What forms can nutrients be supplied?
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Nutrients can be supplied in the form of pills, tablets, or liquid or by the enteral (digestive) or parenteral non digestive) routes
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Some Essential Vitamins
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pyridoxine, cobalamin, biotin, pantothenoic acid, ascorbic acid, and choline
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Some Essential Minerals
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selenium, chromium, and molybdenum
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Where is energy derived from?
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Energy is derived from the food macronutrient molecules containing energy in bonds between carbon and hydrogen atoms. -C-H
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How is energy measured?
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Energy measured using Atwater equivalents
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What are considered non-nutrients?
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Dietary fiber and Phytochemicals (and their effects: Antioxidant, Hormonal, and Anti-cancer)
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What was the purpose of nutrient additives for fortification?
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Fortification is put in food to prevent nutritional deficiencies ]
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What are the names given to foods that have been fortified?
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Functional foods, nutraceuticals, and pharmfoods.
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Functional Foods are..
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foods that make a claim of structure-function relationship between an active ingredient and a health benefit.
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How does the FDA conduct reviews of additives?
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FDA conducts reviews of additives using animal data and risk/benefit approaches.
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Nutritional status refers to...
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the health of individuals or of a population in relation to their nutritional intake.
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Malnutrition includes...
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over-nutrition and under-nutrition
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Affluent nations provides evidence of what?
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The linkage between chronic disease and diet
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What constitutes the number one health problem of affluent societies?
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Overconsumption of food energy (in relation to energy expenditure)
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Dietitians
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Trained in the application of clinical, community, and food service with the ability to counsel clients and to offer sound nutritional advice.
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Community or public health nutritionists
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May be RDs or others who receive specialized training in public health through an MPH or similar degree
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Nutritional scientists
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Have basic training in biochemistry, physiology, nutrition sciences, statistics, and other courses prior to conducting independent laboratory investigations on human subjects or animal models and typically have a PhD or equivalent doctorate degree.
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Nutritional Anthropometry
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Measurements of the variations of the physical dimensions and the gross composition of the human body at different age levels and degrees of nutrition
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Anthropometric measurements can be used for...
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nutritional status of individuals (help with low income nations with issues of protein and energy balance) and populations (used for intervention screenings and for determination of malnutrition to further lead to nutritional surveillance)
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What do anthropometric measurement asses?
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Body size and body composition (such as body fat and fat free mass)
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Advantages of Anthropometric measurements
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Simple, safe, non-invasive, Inexpensive equipment,Relatively unskilled personnel, Methods can be precise and accurate if standard techniques and trained personnel are used, Retrospective,Mild to moderate malnutrition can be identified., Changes in nutritional status over time, and Screening tests that identify individuals at high risk
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Infants can be measured by...
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Recumbent length or Pediatric scale or spring balance (for weight)
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Knee height measurements can be used for...
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persons with severe spinal curvature, highly correlated with height.
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What can be used if height can not be obtained and is highly correlated with stature?
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Arm span
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What can measure frame size?
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Elbow length
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Underweight BMI
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<18.50
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Normal Weight BMI
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18.50-24.99
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Overweight BMI
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25.00-29.99
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Obese class I BMI
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30.00-34.99
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Obese class II BMI
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35.00-39.99
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Obese class III BMI
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≥40.00
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Skinfold thickness can be used to measure...
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triceps, biceps, subscapular, suprailiac and midaxillary, estimate subcutaneous fat depot
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Waist-hip ratio
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distinguishes between fatness in the lower truck (gynoid) and fatness in the upper truck (android), total fat deposits
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Possible Lab assessments for body composition
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Total body potassium using 40K, Total body water using isotope dilution, Water-displacement plethysmorgraphy, Air-displacement plethysmorgraphy, Total body electrical conductivity (TOBEC), or Ultrasound
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Physical Assessment can consist of...
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Environmental, social, and family factors, disease, drug use
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Where can medical history be obtained from?
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medical record, questionnaire, or interview
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A Physical Exam can be used to look at...
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Mouth, Eyes, Skin, Nails, Cardiovascular, Gastrointestinal, Musculoskeletal, Neurologic
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Palpation
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tactile examination (feeling)
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Percussion
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assessment of sounds to determine shape or borders of organs, etc
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Auscultation
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listen to body sounds with naked ear or stethoscope
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Functional observations that can be obtained from a physical assessment
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-Immune function-delayed hypersensitivity reactivity and total lymphocyte count
-Strength-handgrip -Biochemical assessment |
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Biochemical assessment is used primarily to...
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detect subclinical deficiency states, but also to confirm a clinical diagnosis
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Static biochemical tests
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measure either a nutrient or its metabolites in fluids, tissues, or urine.
Test should reflect total body content or the tissue store most sensitive to depletion |
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Functional tests
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aim to measure the extent of the functional consequences of a specific nutrient deficiency and hence, have greater biological significance that the static tests. Test should measure the first limiting biochemical system which affects health and well-being.
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Common biochemical assessments
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-Protein/ Energy status- N (nitrogen) balance, albumin, transferrin, prealbumin, retinol binding protein, creatinine, immunocompetence
-Anemia-RBC count, Hb, Ht, ferritin, homocysteine, Schilling test (vit. b12 def.) -Malabsorption-fecal fat -Chronic Disease-serum lipoproteins for CVD, CRP for inflammation, oxidative stress |
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Basic Metabolic Panel
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-glucose
-calcium -sodium potassium -CO2 -chloride -blood urea nitrogen (BUN), -creatinine |
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Comprehensive Metabolic Panel
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-add albumin
-total protein -alkaline phosphate -alanine aminotransferase -aspartate aminotransferase -bilirubin |
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Complete Blood Count
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-PEM (polymer electrolyte membrane)
-anemias |
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Urinalysis
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-kidney disease
-acidosis -diabetes -infections |
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Dietary References were first published in...
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-1941 until 1989
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what was the primary goals for Dietary Reference Intakes
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prevent diseases caused by nutrient deficiencies and to reduce the risk of chronic diseases such as osteoporosis, cancer, and cardiovascular disease
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AI's are used when...
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an RDA cannot be determined and there is not enough information on certain nutrients
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Dietary References were first used in the...
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Military
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RDA's are set at...
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two standard deviations above the mean of a population
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The Dietary References that deal with individuals
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RDA's and AI's
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The Dietary References that deal with groups
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UL's and EAR's
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EAR (estimated average requirement)
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a daily nutrient intake value that is estimated to meet the requirements of half of the healthy individuals in a life stage and gender group.
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Assessment for groups using DRI's
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-EAR = inadequate intakes
-AI = for mean intake -UL = % risk for toxicity |
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Assessment for individuals using DRI's
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-RDA = nutrient adequacy
-AI = used when RDA is not available -UL = toxicity -EER = energy needs |
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Macronutrient ranges for groups
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Fats = 20-35%
Carbs = 45-65% Proteins = 10-35% |
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Group assessments are done using...
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a probability approach or an EAR Cut-Point Method (mean intakes are not very helpful in reporting group data)
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Dietary assessment using DRIs involves...
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comparing usual nutrient intakes with nutrient requirements and examines the probability of inadequate or excessive intake.
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Dietary planning aims...
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to optimize the prevalence of diets that are nutritionally adequate without being excessive.
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Healthy 2020 plan improvements includes...
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-Healthier food access
-Health care and work-sites settings -Weight Status -Food insecurity -Food and nutrient consumption -Iron Deficiency |
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Dietary guidelines for 2005 focused on...
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-Adequate nutrients within calorie range
-Weight mgmt -Physical Activity -Food groups to encourage -Decrease saturated and trans fats -Carbs -Decrease Na and Increase K -Food Safety |
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Dietary guidelines are mediated by the...
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DGAC (Dietary Guidelines Advisory Committee)
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The dietary guidelines is the basis of the...
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Supplemental Nutrition Assistance Program (SNAP) which is the old food stamp program, school lunch and WIC
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What % of Americans follow the dietary guidelines?
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3%
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Physical fitness should include...
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-Cardio-respiratory = running
-Strength = weight lifting -Flexibility= yoga |
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Grain and Cereal guidelines (FGP)
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6-8 oz
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Vegetables (FGP)
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2-3 cups
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Fruit (FGP)
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1 1/2 - 2 cups
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Dairy (FGP)
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3 cups
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Meat, poultry, fish, and beans (FGP)
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5 - 6 1/2 oz
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Fats, oils, and nuts (FGP)
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5 - 7 tsp
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Key points about the food guide pyramid
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-Variety
-Proportionality -Moderation -Activity |
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If the population is above the EAR then...
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The population is mostly doing well
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DASH diet
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(Dietary approaches to stop hypertension)
-moderate meat -increase fruits and dairy -increase K -decrease Na |
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TLC
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(Therapeutic lifestyle change)
meant to decrease heart disease |
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What are Exchange lists?
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Foods listed together because they are alike.
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Culture
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A set of beliefs, knowledge, traditions, values, and behavioral patterns that are developed, learned, shared, and transmitted by members of a group.
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Culture is..
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learned not biological
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Multicultural is...
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-fluid and confounding
-everyone has a "worldview" |
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Worldview
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value and significance of one's own cultural heritage and world view as a starting point for understanding others who are culturally different from them
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the ETHNIC model
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Explanation
Treatment Healers Negotiation Intervention Collaboration |
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the LEARN model
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Listen
Explain Ackowledge Recommend Negotiate |
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the BATHE model
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Background
Affect Trouble Handling Empathy |
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the GREET model
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Generation
Reason Extended Family Ethnic Behavior Time living in the US |
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the explanatory models approach
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Ethnic Identity
What is at stake? The illness narrative Psychological stresses Influence of culture on clinical relationships Problems of cultural approach |
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Dietary Acculturation
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The process that occurs when members of a minority group adopt the eating patterns/food choices of the host country
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What things should be considered when planning a diet for an individual?
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specific preferences in regard to cultural, religious and ethnic beliefs and choices should be considered.
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Mortality rates from several chronic degenerative diseases are often lower for...
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vegetarians
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Muslims
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promote the concept of eating to live, not living to eat; they advise not eating to capacity and always sharing food.
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Fasting for Muslims
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Fasting occurs for 3 days a month and during Ramadan
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Not excepted Muslim foods
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Pork and pork products are forbidden, including gelatin
Alcohol is not used, even in vanilla extract and other preparations |
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Early Chinese immigrants came for...
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the gold rush in California in the 1850s.
They were mostly men |
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Different consumption of carbs in the North and South of China
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Wheat consumed in North
rice in south of China |
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Native African foods
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-watermelon,
-black-eyed peas -okra -sesame -taro |
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New Africa foods
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-cassava
-corn -chiles -peanuts -pumpkins -tomatoes |
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Braceros
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legal papers for work but remain Mexican citizens
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Thermic effect of food
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the increase in energy expenditure associated with the consumption of food.
(Also called diet-induced thermogenesis or specific dynamic action) |
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TEF accounts for...
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10% of TEE
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TEF varies with...
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-composition of diet
-spicy food -caffeine -nicotine. |
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Energy expended in physical therapy (EEPA)
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the most variable component of TEE and may be 10% of TEE in bedridden person and 50% of TEE in an athlete.
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EEPA includes energy expended...
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in voluntary exercise and during involuntary activities such as shivering, fidgeting, and maintaining postural control.
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Respiratory Quotient (RQ)
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Moles of CO2 expired/Moles of O2 consumed
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Whys to measure physical activity
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-Doubly labeled water
-Caltrac Monitor-vertical plane -Tracmor Monitor-multidimensional (3 planes) -Heart rate monitor -Physical Activity Questionnaire |
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What is the problem with estimating energy requirements?
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People typically underreport from 10 to 45%.
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Harris-Benedict equations
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-Derived on one population
-Accurate predictions occurred in 45-81% of normal weight individuals with overestimations occurring more often than underestimations -Accuracy in obese was 38-64%. |
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Mifflin-St. Jeor equations
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-Validated on normal, overweight, obese and severely obese individuals.
-Accurate predictions occurred in ~82% of normal weight individuals with overestimations and underestimations being about equal -Accuracy in obese was 70% |
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Owen equations
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-Validated on normal, obese, and severely obese males and females
-Accurate predictions occurred for ~73% of individuals with underestimations occurring more than overestimations -Accuracy in obese was 51% |
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Which equation is more likely to estimate RMR within 10% measured?
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The Mifflin-St Jeor equation
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Ireton-Jones equation
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-Better in ICU settings
-can be used for all BMIs and non-hospitalized patients -better to use actual body weight than ideal body weight for obese. |
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EER equations are...
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Closer approximation to actual EE
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Functional genomics
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the scientific discipline concerned with the interpretation of the function of a DNA sequence, which involves the interaction of the genome and its environment
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Molecular nutrition
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the study of nutrient-gene interaction.
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Nutrigenetics
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investigates the mechanisms by which genetic variation affects the interaction between bioactive dietary components and the health and disease potential of individual persons.
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Nutrigenomics
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the study of the way bioactive food components effect specific genes, proteins, and metabolites.
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Proteomics
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the study of the way specific proteins and bioactive food components interact.
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Epigenetics
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the occurrence of gradual diversification and differentiation of gene functions due to bioactive food components or other environmental factors.
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Nutritional preemption
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the process of disease risk reduction via nutritional intervention approaches through a greater understanding of nutrigenomics, proteomics, and metabolomics
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Each chromosome contains...
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genes
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A gene
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a segment of a chromosome that encodes instructions that allow a cell to produce a specific protein
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The human genome is estimated to have...
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20,000-24,000 genes
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Exon
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The parts of a gene that provide the specific “instructions” or information (the coding region) for making protein
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Intron
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noncoding stretches of DNA
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The coding sequence from the exons is used to produce...
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mRNA
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Mutations occur in...
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somatic cells
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single-nucleotide polymorphism (SNP)
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-The most common type of mutation
-Occur approximately every 1000-2000 nucleotides in the human genome. |
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High-penetrance gene
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- increases individual’s risk of disease appreciably (Quite rare)
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This is used in Familial hypercholesterolemia-liver lact functional receptors for cholesterol
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Ex-vivo gene therapy
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Things to consider when using medicine for genetic healing
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-Know genotype
-Predict risk of disease -Learn how people react to environment |
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Diet and gene together...
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can cause disease
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One main reason for revisions regarding the exchange list
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was meant to include vegetarians and vegans
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PKU disease
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-an autosomal recessive disorder
-Phenyalanine can not be converted into tyrosine because the enzyme needed to convert Phe is missing -Causes mental retardation |
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Biotransformation
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a multistep process, the primary function of which is to stabilize xenobiotics so they can be excreted more readily.
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Biotransformation phase 1
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the chemical is oxidized (activated) to a more soluble form.
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Biotransformation phase 2
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the activated intermediate is conjugated to a molecule that further increases water solubility of the compound; elimination occurs subsequently in urine or bile.
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Cytochrome P450 genes
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are a multigene family responsible for Phase 1 metabolism.
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Obesity can be affected by SNP's related to...
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-Sensitivity to fat in the diet
-Resistance to exercise induced weight loss |
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Techniques used to form genetic tests
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-Proven biological function=change activity of protein
-Plausible biological role=produce a change in amount of fat absorbed or change in CHO metabolism -Evidence from clinical studies of different response to certain diets or physical activity |
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Lipid Absorption Fatty acid binding protein 2 (FABP2)
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Thr54Thr- increased TGL & long chain fatty acids absorption (less responsive to low calories and aerobic activity than Ala polymorphism)
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Peroxisome proliferator-activated receptor-gamma (PPARG) protein
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Ala12Ala-more weight loss, less sensitive to fat
Pro12Ala-less weight loss Pro12Pro-more sensitive to amount of fat in the diet, more resistant to weight loss, increased risk of diabetes |
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Fat Mobilization in Response to Catecholamines B-2 adrenergic receptor (ADRB2) protein
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Gln,Gly, and Arg increase risks for obesity and being sedentary
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Fat Breakdown or Lipolysis B-3 adrenergic receptor (ADRB3) protein
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Arg64Arg-increased obesity in sedentary, increased exercise aided weight loss, diminished risk with increased exercise
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endurance is...
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an anaerobic exercise
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Ca levels best read by...
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Serum ionized Ca levels rather than serum Ca
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Decrease serum albumin
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Displays long term decrease of protein
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Nutrition screening
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Is the process of identifying characteristics known to be associated with nutrition problems
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MUST
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Malnutrition Universal Screening Tool-based on BMI, weight loss, and acute disease
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Population Nutritional Assessments
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determine associations between nutrient intakes and health in populations
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National Nutrition Monitoring and Related Research Program is under the joint direction of
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USDA and DHHS
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Dietary Intake Methods: 24 Hour Recall
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Quantities estimated in household measures using food models as memory aids or to assist in quantifying portion size.
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Estimated Food Record
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Record of all food and beverages “as eaten” (including snacks), over periods from one to seven days. Quantities estimated in household measures.
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Diet History
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Interview method consisting of a 24-hr recall of actual intake, plus information on overall usual eating pattern, followed by a food frequency questionnaire to verify and clarify initial data.
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Diet history information can be used for...
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national food policy development, for food fortification planning, and to identify food patterns associated with inadequate intakes.
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Food frequency questionnaire
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-good for qualitative data
-can show comparison with the prevalence or mortality statistics or a specific disease. |
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Level One: Mean nutrient intake of group
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A single 24-hr recall, or single weighed or estimated food record, with large number of subjects and adequate representation of all days of the week
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Level Two: Proportion of population “at risk”
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Replicate observations of each individual or a subsample using 24-hr recalls or weighed or estimated 1-day food record
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Level 3: Usual intakes of nutrients in individuals for ranking within a group
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Multiple replicates of 24-hr recalls or food records or a semiquantitative food frequency questionnaire
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Level 4: Usual intakes of foods or nutrients in individuals for counseling or for correlation or regression analysis
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Even larger number of recalls or records for each individual. Alternatively, a semiquantitative food frequency questionnaire or a dietary history can be used.
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