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143 Cards in this Set
- Front
- Back
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obesity
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a BMI at or above the 95th percentile for children of the same age and sex.
more than 1/3 of US adults are obese 17% of children are obese higher income men more likely to be obese lower income women more likely to be obese |
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overweight
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a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex.
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complications of obesity in childhood
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High blood pressure and high cholesterol
Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes. Breathing problems (sleep apnea, asthma) Musculoskeletal problems Fatty liver disease, gallstones, GERD Social and psychological problems, such as discrimination and poor self-esteem |
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causes of overweight and obesity
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Genetic influences do seem to be involved
Genes DO interact with: Diet and physical activity Satiety and energy balance |
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obesity gene
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Codes for the protein leptin
Acts as a hormone in hypothalamus Promotes negative energy balance Suppresses appetite Increases energy expenditure |
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prader willi syndrome
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very rare but can lead to life threatening obesity
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100 extra calories per day = ....
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10 extra pounds per year
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health care professionals use 3 indicators
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BMI
Waist circumference Disease risk profile (family history, blood lipid profile etc..) |
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problems: perceptions and prejudices
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Most obese people do not successfully lose weight and maintain the loss
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problems: dangerous interentions
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Fad diets
Exaggerated or false theories Non- prescription weight-loss products |
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weight loss strategies
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Successful strategies
Small changes Moderate losses Reasonable goals Reasonable rate of weight loss Benefits of modest weight loss Incorporation of healthy eating and physical activity |
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fad diets
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Outrageous claims
No requirements to prove the claims Do not have to support with credible research Tend to work for short time Fail to produce long-lasting results |
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vitamins different from energy yeilding nutrients in their structure
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Individual units not linked together like glucose or amino acids
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vitamins different from energy yeilding nutrients in their function
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no energy yeilded
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vitamins different from energy yeilding nutrients in their food contents
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amount measured in mircrograms (υg) or milligrams (mg) not grams
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vitamins Similarities to energy-yielding nutrients:
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Vital to life, organic, available from foods
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bioavailability
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Quantity provided by food
Amount absorbed and used by body |
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factors influencing bioavailability
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Efficiency of digestion
Nutrition status Method of food preparation Source of nutrient Other foods consumed at same time |
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precursors
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some vitamins available from foods in inactive forms
precursor is converted to active form in body When measuring person’s vitamin intake need to count- (1) amount of active vitamin and (2) amount from precursors |
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organic nature
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Can be destroyed and unable to function
Must be handled with care during storage and in cooking |
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solubility
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Affects absorption, transport, and excretion
Water-soluble Move directly into blood Most travel freely Fat-soluble Enter lymph and then blood Require transport proteins |
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toxicity
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More is NOT necessarily better
Excessive intakes can be DANGEROUS! Levels higher than UL |
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vitamins do not provide the body with....
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fuel for energy
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coenzyme
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Assist enzymes with release of energy
Without coenzyme, an enzyme cannot function |
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recomended dietary allowance (RDA)
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Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Vitamin C
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adequate intake(AI)
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Biotin, Pantothenic acid, Choline
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tolerable upper limit (UL)
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Niacin, Vitamin B6, Folate, Choline, Vitamin C
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the b vitamins: thaimin B1
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Part of coenzyme thiamin pyrophosphate (TPP) which assists in energy metabolism
Occupies site on membranes of nerve cells, important for nerve activity and muscle activity |
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thaimin : RDA, deficiency and toxicity
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RDA
Men 1.2 mg/day, women 1.1 mg/day Deficiency Malnourished and alcoholics at risk Beriberi Dry – nervous system Wet – cardiovascular system Toxicity- No adverse effects, no UL |
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thaimin food sources:
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Pork richest source
Enriched grains typically make greatest contribution to day’s intake to coserve steam or microwave foods with thaimin |
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the b vitamins : riboflavin B2
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Serves as coenzyme in energy metabolism
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riboflavin : RDA, deficiency and toxicity
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RDA- Men 1.3 mg/day, Women 1.1 mg/day
Deficiency- Inflammation of membranes Toxicity- No UL |
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riboflavin food sources and destruction
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Food sources
Milk and milk products Whole grain or enriched bread and cereal Vegans and others who don’t consume milk must rely on other sources Destruction of riboflavin Ultraviolet light (milk not sold in clear containers) Irradiation Not destroyed by cooking |
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the b vitamins: niacin
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Two chemical structures
Nicotinic acid Nicotinamide (major form of niacin in blood) Part of coenzymes Nicotinamide adenine dinucleotide (NAD) and NADP (its phosphate form) used in energy metabolism |
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niacin unique...
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Unique among B vitamins because the body can make it from the amino acid tryptophan
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niacin RDA and deficiency toxicity
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RDA stated in niacin equivalents (NE)
Body manufacturers niacin from tryptophan after protein synthesis needs have been met 1 NE= 1 mg niacin or 60 mg tryptophan Men 16 mg NE/day, Women 14 mg NE/day Deficiency- Pellagra Symptoms- 4 D’s (Diarrhea, Dermatitis, Dementia and eventually Death) toxicity: Naturally occurring, no harm |
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niacin food sources
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Protein rich foods (meat, fish, poultry, pb)
Less vulnerable to food preparation losses |
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the b vitamins Biotin
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Coenzyme that carries activated carbon dioxide
Critical in TCA cycle Delivers carbon to pyruvate to form oxaloacetate Gluconeogenesis and fatty acid synthesis Breakdown of fatty acids and amino acids |
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biotin RDA deficiency and toxicity
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Needed in very small amounts
No RDA, AI: Adults 30 υg/day Deficiencies rare Toxicity, no UL |
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biotin food sources
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Food sources
Widespread in food Produced by GI bacteria |
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the B vitamins: pantothenic acid
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Part of chemical structure of coenzyme A
Involved in 100 different steps in the synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin |
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pantothenic acid RDA deficiency and toxicity
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No RDA, AI: Adults 5 mg/day
Deficiency rare Toxicity- none reported |
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pantothenic acid food sources and destruction
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Food sources- widespread in food
Easily destroyed by food processing |
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the B vitamins: B6
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Three forms: pyridoxal, pyridoxine, and pyridoxamine
Conversion to coenzyme PLP Amino acid metabolism Urea metabolism Conversion of tryptophan to niacin or serotonin Synthesis of heme, nucleic acids, & lecithin Unlike other water soluble vitamins it’s stored exclusively in muscle tissue |
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B6 RDA deficiency and toxicity
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RDA: Adults 19- 50 years: 1.3 mg/day
Deficiency Symptoms- scaly dermatitis, anemia Alcohol causes destruction of B6 & isoniazid (tuberculosis drug) acts as antagonist Toxicity UL: Adults 100 mg/day Irreversible nerve degeneration |
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B6 food sources
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Food sources: meats, fish, poultry, fortified cereals
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the B vitamins Folate
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Known as folacin or folic acid
Primary coenzyme form – THF (tetrahydrofolate) Transfers single-carbon compounds during metabolism Convert vitamin B12 to coenzyme form Synthesize DNA Regenerate methionine from homocysteine |
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folate RDA deficiency and toxicity
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RDA: 400 ug/day adults
UL 1000 ug/day Deficiency Impairs cell division and protein synthesis Anemia of folate deficiency characterized by large, immature blood cells Neural tube defects (NTD’s)- malformations of brain, spinal cord or both Toxicity- Masks B12 deficiency |
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folate may help to prevent ______ if used 1 month before conception through 1st trimester
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neural tube defects
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folate heart disease
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Heart disease
Folate breaks down homocysteine Without folate, homocysteine accumulates which enhances formation of blood clots and atherosclerotic lesions |
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folate : cancer
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Relationship with folate complex
Sufficient folate may protect against initiation of cancer May enhance progression once cancer has begun May risk of pancreatic cancer Limited evidence suggests may risk of esophageal and colorectal cancer |
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the B vitamins: B12
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Vitamin B12 and folate depend on each other for activation
Regeneration of methionine, synthesis of DNA, and synthesis of RNA |
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B12 deficiency and toxicity
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Deficiency
Inadequate absorption Lack of hydrochloric acid or intrinsic factor Pernicious anemia Vegan diets Anemia of folate deficiency Toxicity No adverse effects, no UL |
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B12 food sources and destruction
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Found almost exclusively from animal products
Bioavailability greatest from fish and milk Destruction Microwave heating inactivates B12 To preserve use oven or stovetop |
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the B vitamins Choline
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Manufactured from methionine in body
Conditionally essential nutrient |
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Choline RDA deficiency and toxicity
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Adequate intake (AI): Men 550 mg/day, Women 425 mg/day
UL: Adults 3500 mg/day Deficiencies are rare |
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Choline food sources
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Common sources
Milks, eggs, peanuts |
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vitamin C
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Antioxidant
Defends against free radicals Protects tissues from oxidative stress Enhances iron absorption Cofactor in collagen formation Matrix for bone and tooth formation |
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vitamin C roles in stress
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Adrenal glands release vitamin C and hormones into blood
Types of stress that increase vitamin C Ie. Infections, burns, use or oral contraceptives and cigarette smoking |
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vitamin C recommendations
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Prevent overt symptoms of scurvy
Absorption maximum 200 mg Higher vitamin C levels for smokers |
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vitamin C deficiency SCURVY
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Gums bleed easily around teeth
Capillaries under skin break spontaneously Inadequate collagen synthesis causes hemorrhaging, muscles including heart degenerate Wound healing impaired Psychological signs include hysteria and depression Sudden death caused by massive internal bleeding |
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vitamin C toxicity
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Gums bleed easily around teeth
Capillaries under skin break spontaneously Inadequate collagen synthesis causes hemorrhaging, muscles including heart degenerate Wound healing impaired Psychological signs include hysteria and depression Sudden death caused by massive internal bleeding |
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vitamin C food sources
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Citrus fruits, strawberries, papayas, mangos
Dark green vegetables Potatoes Vulnerable to heat and oxygen |
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water soluble vitamins
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B vitamins and Vitamin C
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fat soluble vitamins
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vitamins A D E K
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fat soluble different from water soluble
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Insoluble in watery GI juices so require bile for digestion and absorption
Travel through lymphatic system Many require transport proteins in bloodstream Excesses are stored- primarily in liver and adipose tissue Can eat less than daily needs without ill effects Not readily excreted so risk of toxicity is greater |
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vitamin A
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1st fat-soluble vitamin recognized
Precursor – beta-carotene |
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3 forms of vitamin A
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Retinol
Retinal Retinoic acid |
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vitamin A and beta carotene digestion and storage
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Digestion and absorption of vitamin A
Several proteins participate Storage After absorbed via lymph system it arrives in the liver where it’s stored Transport protein Retinol-binding protein (RBP) picks it up from the liver and carries it in the blood Cellular receptors for vitamin A Cells that use vitamin A have special protein receptors |
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vitamin A and beta carotene roles
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Promoting vision
Participating in protein synthesis and cell differentiation, thereby maintaining the health of epithelial tissues and skin Supporting reproduction and growth |
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retinol
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Supports reproduction
Major transport and storage form |
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retinal
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active in vision
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retinoic acid
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Regulates cell differentiation, growth, and embryonic development
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vitamin A deficiency
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Vitamin A status
Depends mostly on adequacy of stores 90% stored in liver Depends on protein status because RBP serves as vitamin’s transport carrier Consequences of deficiency Risk of infectious diseases Blindness Death Infectious diseases Measles severity Malaria, lung diseases, and HIV Night blindness Inadequate supply of retinal to retina Blindness (xerophthalmia) Lack of vitamin A at the cornea Develops in stages |
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another A deficiency Keratinization
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Change in shape & size of epithelial cells
Skin becomes dry, rough, and scaly Normal digestion and absorption of nutrients from GI tract falters Weakened defenses in respiratory tract, vagina, inner ear, and urinary tract |
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vitamin A toxicity
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Toxicity is a real possibility
Preformed vitamin A from animal sources Fortified foods Supplements Children are most vulnerable |
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vitamin A toxicity: beta carotene
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Beta-carotene
Found in many fruits and vegetables Inefficient conversion Overconsumption from food Yellow skin Overconsumption from supplements Antioxidant becomes prooxidant Alcohol consumption and tobacco use |
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vitamin A and beta carotene recommendations
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Expressed as retinol activity equivalents (RAE)
Supplements often measured in International Units (IU) |
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vitamin A food sources
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Animal sources
Liver and toxicity concerns Plant sources Vitamin A precursors Bioavailability Colors of food |
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vitamin D
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Not an essential nutrient
Body synthesizes Sunlight Precursor from cholesterol Activation of vitamin D Two hydroxylation reactions Liver Kidneys |
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vitamin D roles
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Active form of vitamin D is a hormone
and bone growth |
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vitamin D deficiency
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Overt signs are relatively rare
Insufficiency is quite common Contributory factors Dark skin, breastfeeding without supplementation, lack of sunlight, not consuming fortified milk Creates a calcium deficiency (ricketsOsteoporosis and Osteomalacia) |
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vitamin D toxicity
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Most likely of the vitamins to have toxic effects
Raises blood calcium concentrations Forms stones in soft tissues May harden blood vessels Can cause death |
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vitamin D food sources
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Oily fish and egg yolks
Fortified milk and sunlight |
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vitamin E
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Alpha, beta, gamma, and delta
Position of methyl group Alpha-tocopherol - vitamin E activity in the body |
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vitamin E is an antioxidant so it
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protects cells and their membranes
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vitamin E deficiency
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Primary deficiency is rare
Secondary deficiency Fat malabsorption |
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vitamin E toxicity
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Liver regulates vitamin E concentrations
Toxicity is rare UL is 65 times greater than recommended intake for adults |
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vitamin E food sources and destruction
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Widespread in foods
Destroyed by heat processing and oxidation |
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vitamin K
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Can be obtained from non-food source
Bacteria in the GI tract Acts primarily in blood clotting Prothrombin Metabolism of bone proteins Osteocalcin Low bone density |
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vitamin K deficiency
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Primary deficiency is rare
Secondary deficiency Fat absorption falters |
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vitamin K toxicity
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Not common
No adverse effects with high intakes No UL |
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vitamin K sources
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GI tract
Half of person’s need Stored in liver Food sources Green vegetables Vegetable oils |
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function of fat soluble vitamins together
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Vitamins E and A
Oxidation, absorption, and storage Vitamins A, D, and K Bone growth and remodeling Vitamins E and K Blood clotting |
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arguments for vitamin and mineral supplements
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Improve nutrition status
Improve body defenses Reduce disease risks |
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arguments against vitamin and mineral supplements
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Supplement users are more likely to have excessive intakes
Issues with children |
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misleading claims
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Organic or natural vitamins
High potency claims Marketing strategy Fake vitamins “Green” pills Stress relief |
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Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial
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The purpose of the study was to determine whether certain vitamin supplements would prevent lung cancer and other cancers in a group of 29,133 male smokers in Finland.
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Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial process:
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Study participants took a pill daily for 5-8 years that contained one of the following:
50 milligrams (mg) alpha-tocopherol (a form of vitamin E) 20 mg of beta-carotene (a precursor of vitamin A) Both 50 mg alpha-tocopherol and 20 mg of beta-carotene Placebo |
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Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial outcome:
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Men who took beta-carotene had an 18% increased incidence of lung cancers and an 8% increased overall mortality. Vitamin E had no effect on lung cancer incidence or overall mortality.
The men taking both supplements had outcomes similar to those taking beta-carotene alone |
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water:functions
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carries nutrients and waste products, maintains structure of large molecules, participates in metabolic reactions, serves as a solvent, acts as a lubricant and cushion, aids in regulation of body temp, and maintains blood volume.
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water: thirst
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thirst and satiety influence water intake in response to changes sensed by the mouth, hypothalamus and nerves
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water: dehydration
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body water output exceeds input
Signs: fatigue, vague discomfort, loss of appetite, thirst, spastic muscles, loss of balance |
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water: intoxication
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rare, but can occur with excessive water ingestion and kidney disorders that reduce urine production.
symptoms: confusion, convulsions and death |
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water: sources
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water, beverages, foods, fruits and vegetables(70-99%) and many meats and cheese (30-79%)
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water losses and recommendations
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kidneys, skin, lungs, and GI tract (feces)
average lost in a day: 2.5 liters recommendations: AI-men 3.7 L, Women 2.7 L |
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major vs. trace minerals
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major: essential mineral nutrients the human body requires in relatively LARGE amounts >100 mg per day
trace: essential mineral nutrients the human body requires in relatively SMALL amounts <100 mg per day |
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bioavailability
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the rate at and the extent to which a nutrient is absorbed and used
food binders: chemical compounds in foods that combine with nutrients to form complexes the body cant absorb. |
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sodium:roles in the body
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maintains normal fluid and electrolyte balance (acid base balance) principal cation of extracellular fluid, essential for nerve impulse transition and muscle transaction.
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sodium: food sources
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salt (40% sodium), PROCESSED FOODS (75% of sodium in diet)
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sodium: AI vs. dietary guidelines
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AI: adults:1,500 miligrams per day
dietary guidelines: Upper limit-2,300 mg per day |
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DASH diet
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dietary approaches to stop hypertension
reduce sodium intake to lower blood pressure |
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sodium: toxicity
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acute: edema, and high blood pressure
chronic: hypertension |
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sodium: deficiency
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conditions causing a deficiency: hyponatremia
symptoms: headaches, confusion, stupor, seizures and coma. |
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potassium: roles in the body
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maintains fluid and electrolyte balance, maintains cell integrity, aids in nerve impulse transmission and muscle contraction
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potassium: food sources
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whole foods, meats, milk, fruits, veggies, legumes
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potassium: deficiency
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irregular heart beat, muscular wekaness, glucose intolerance, bone turnover, kidney stones, salt sensitivity, high blood pressure
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potassium: toxicity
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no upper limit
muscular weakness, vomiting, if given into a vain can stop the heart |
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calcium: roles
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helps minimize bone loss, mineralization of bones and teeth, regulates muscle contractions, helps in clotting of blood, transmission of nerve impulses,
MOST abundant mineral in body |
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calcium: absorption
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adults absorb 30% of calcium ingested, stomachs acidity is calcium soluble (absorbed here).
supports absorption: vitamin D, stomach acid and lactose (infants only) inhibit absorption: fiber fitate and oxalate, lack of stomach acid, vitamin D deficiency |
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calcium: food sources
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milk and milk products, fortified juices
99% of calcium is found in bones and teeth nd 1% found in bodily fluids |
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calcium: osteoporosis
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the bones become porous and fragile due to loss of minerals
peak bone mass: late 20's risk factors: female gender, older age, small frame, family history, personal history of fractures, estrogen or testosterone deficiency, sedentary lifestyle, inadequate intake of Calcium and vitamin D, diet excessive in protein, sodium and caffiene, smoking, alcohol abuse, low body weight and certain medications measuring bone mass: bone mass decreases over time |
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iron: roles in the body
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part of proteins hemoglobin and myoglobin (in muscles), necessary for energy metabolism
switches back and forth between- ferrous iron: reduced state and ferric: oxidized state |
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iron: absorption
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body conserves iron, stores iron in cells of small intestine.
factors that ENHANCE: MFP factor (peptide released during digestion of meat fish and poultry), vitamin C and INHIBIT: fitates (legumes, grains and rice), vegetable proteins (soybeans, legumes, nuts), calcium, tanic acid (tea and coffee) |
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iron: dietary sources
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heme: only found in animal foods
non heme: found in both plant and animal foods |
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iron deficiency
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most common nutrient deficiency
state of having depleted iron stores. most common during vulnerable stages in life: pregnancy, infants and young children and adolescense |
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3 stages of iron deficiency
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1. iron stores diminish- look at levels of cerum, ferritin.
2. decrease in transport iron (transferrin) 3. iron deficiency- lack of iron limits hemoglobin production and hematocrit levels decline. behavior of iron deficiency-pica: craving consumption of non food substances (ice,chalk, starch) none contain iron |
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iron overload
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hemochromatosis: caused by genetic failure to prevent unneeded iron in the diet from being absorbed
excess iron may cause hemosidorosis: a condition characterized by deposits of iron storage protein hemosiderin in the liver, heart, joints and other tissues treatment: chelation therapy |
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iron supplements
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iron in a supplement is less well absorbed than in food.
vitamin C doesnt enhance iron from supplements taken only with physician prescription |
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iodine vs. idodide
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indespensible to life
iodine: to nutrient in foods iodide: nutrient in the body |
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iodine major roles
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part of thyroid hormones which regulate body temp, metabolic rate, reproduction, growth, blood cell production and nerve and muscle production.
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iodine deficiencies
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thyroid hormone producton declines.
a goiter: enlargement of thyroid gland most common cause of preventable mental retardation and brain damage cretanism: congenital disease characterized by mental and physical retardation. caused by a sever iodine deficiency during pregnancy |
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iodine toxicity
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interferes with thyroid function, enlarges thyroid gland, can cause a goiter in an infant during pregnancy
UL: 1,100 ug (micrograms) per day |
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iodine sources
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dietary: iodized salt, plants grown in iodine rich soild, processed foods
geographic: ocean |
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physical actiity vs. exercise
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physical activity: bodily movement produced by muscle contractions that substantially increase energy expenditure
exercise: planned, structured and repetitive body movements that promote or maintain physical activity |
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fitness benefits
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promotes overall health, reduces risk of: heart disease, cancer, stroke, type II diabetes and hypertension
restful sleep, optimal body composition, optimal bone density, resistance to infectious diseases, low incidence of anxiety and depression, strong circulation and lung function, strong self image |
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developing fitness
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GOALS: develop enough flexibility, muscle strength and endurance to meet everyday demands of life. to achieve a reasonable body weight and body composition
CONDITIONING MINIMIZE RISKS of overuse injuries: be active all week, use proper equipment |
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nutrition and athletes: dietary recommendations
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carbs: eat a high carb diet, 8g/carb per kilogram of body weight. take glucose periodically during activities that last more than 1 hour. eat carb rich foods right after activity (60g of carbs)
proteins: needs are greater for athletes in training. RDA Adults .8, power athletes: 1.2-1.7 endurance athletes: 1.2-1.4 fats: when they consume high fat diets, performance is impaired. endurance athletes should consume 20-35% |
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hydration
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adequate fluid intake before, during and after is necessary.
after exercise athletes should drink about 16-24 fluid ounces for every pound of body weight lost during exercise to replace sweat lost |
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goals of beverages
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-to replenish water loss from sweating and breathing
-to regulate temperature (prevent heat stroke) -drink extra fluid in the days before an event |
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supplements
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no vitamin or mineral supplements required if athlete is consuming adequate energy from variety of foods to maintain body weight
do not enhance performance of well nourished people a multi-vitamin/mineral supplement may be appropriate if athelete is dieting, ill, recovering from injury or has specific nutrient deficiency |
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enhanced water vs. energy drinks
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similarities: both are fluids
differences: energy drinks contain caffiene, also make you feel full so you arent replenishing fluids as much as you should be |
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when each should be used
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energy drinks should not be used for fluid replacement during athletic events.
enhanced water can be used during atheltic events |
