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171 Cards in this Set

  • Front
  • Back
What are the general demographics for eating disorders?
Demographics- 95% female, 90% middle and upper class white, almost 100% wealthier, industrialized nations, 80% in highly educated households
Incidents- 1 in 100-150 women, 20% of college age women
What are some criteria for the diagnosis of aneroxia nervosa?
Fear of obesity
Distorted body image
Sever weight loss- over 25% of original body weight
Refusal to maintain normal body weights
What is the age of onset of anorexia?
early adolescence
describe the course of anorexia
usually unremitting unless there is intervention’
30% of those who go w/o treatment will continue until death
Rare single episodes usually in response to extremely stressful event, full recovery but high risk of relapse
Overall mortality is about 5-10%
Describe the features of anorexia
peculiar behaviors around food,
obsessive or compulsive behavior,
perfectionism,
high functioning/ goal oriented people,
What are some complications of anorexia
hypothermia,
edema (fluid accumulation) ,
amenorrhea- cessation of normal menstruation b/c not enough estrogen b/c of lack of body fat, lack of estrogen = bone loss,
muscle wasting,
lunago (downy hair covering body),
brittle nails/ skin/ hair,
weakness,
poor wound healing,
fatigue,
electrolyte imbalance which can lead to a cardiac arrhythmia which can lead to death
How is anorexia treated?
Hospitalization
Psychotherapy
Nutrition education
Drug treatment- antidepressants
How is bulimia diagnoses?
recurrent binges, compensation/ purging activity (starving, vomiting, diuretics, laxative abuse, excessive exercise), awareness of the abnormality, fear of inability to stop, depressed mood, consumption of high calories and easily digested food, hidden eating during the binge, binge may continue until pain/ sleep/ interruption/ purging, weight fluctuations
What is the age of onset of bulimia
late adolescence to early adulthood (slightly later than anorexia)
what is the course of bulimia
chronic but intermittent over many years, episodes will alternate with periods of normal eating
What are the patterns/ features of bulimia
high achievement, planned binges, rapid eating, sense of loss of control and inability to stop, disassociation from process, depression, increased incidence of substance abuse
What are some complications resulting from bulimia?
enlarged parotid glands (under jaw line), ulcers or sores of the esophagus/ pharynx/ mouth because of stomach acid, pitting of the teeth, dehydration, reflexive vomiting, rebound constipation, electrolyte imbalances which can lead to arrhythmia which can lead to death
How is bulimia treated
Outpatient psychotherapy
Nutrition education
Behavior modification
Substance abuse treatment
Drug Tx, usually antidepressant
Describe binge eating disorder
Recurrent binging without the purging behavior
Increasing body weight to above normal
Obsessive thoughts about food, weight, eating
Awareness that the behavior is abnormal, fear of inability to stop, depressed mood
What populations may be significantly effected by binge eating disorder
obese and depressed people
What is the difference between activity and exercise?
activity that is a part of the normal daily routine, exercise is non required excess activity
What is aerobic exercise
rhythmic use of large muscle groups
What is strength exercise
isolated used of specific muscle groups
How often should a "normal" person exercise
at least 3 times a week, if over worked there is not enough time to recover, if to little the benefits are not achieved
What intensity should aerobic exercise be?
60-80% of maximum heart rate
What is a general rule of thumb for calculating max heart rate?
220- age
How long do you have to exercise to receive aerobic benefit
at least 20 minutes
What is the general rule of thumb for increasing exercise intensity
increase at 10% each time
What are some strategies for preventing injury during exercise
proper warm up, good equipment (shoes, weight, etc), proper technique
What should you do to recover from an injury
reduce the stress on the injury but keep active
what is pica
eating of non food substances
what is the age of onset for pica
very young, ~1-2 years
What is pica of pregnancy
same thing as pica (eating non food substances) except during pregnancy
What are some possible causes of pica
mental retardation, neglect of children, poverty, mineral deficiencies?
What are some ways to incorporate exercise into your life
make it fun/ recreational, transportation, necessary activity: mowing the lawn, snow shoveling
What is the difference between aerobic and anaerobic exercise
aerobic exercise- system can keep up with the oxygen demand, anaerobic- system can't keep up with the oxygen demand
What is the basic unit of energy in the body
ATP
How is energy obtained from ATP
loss of a phosphate group to ADP releases energy, the reaction is reversible (add a phosphate back) to store energy
How is energy stored in the immediate energy system
small amount of energy stored in cells as creation phosphate, it is rechargeable like a battery, emergency powerful physical response
how long does energy from the immediate system last
about 10 seconds
What type of energy is used to maintain blood sugar
liver glycogen
What does muscle glycogen do
used to power muscle, body tries to conserve it, does not help to maintain blood sugar
Describe anaerobic glycolysis
glucose is broken into 2, 3 carbon molecules called pyruvate, no oxygen is required, energy is released as ATP
Describe aerobic metabolism
pyruvate is broken into carbon dioxide and water, requires oxygen
why does lactic acid build up
after high intensity w/o enough oxygen a build up of pyruvate as lactate, muscles become acidic enzymes that complete glycolysis
How is fat metabolized
beta oxidation, carbon dioxide + water+ energy (ATP)
requires oxygen, lower intensity exercise, fat comes from intramuscular, visceral, and subcutaneous
How many calories are stored in the body as fat? as glycogen?
fat- 40,000 kcals (lean person)
glycogen- 2,000 kcals
What is unique about the brain and its energy needs?
The brain is an obligate glucose user, it is the only source is can use. The body undergoes gluconeogenesis and breaks down protein to make glucose
What type of fuel is used when the body using at rest
70-90% fat
What type of fuel is used during high intensity, short duration exercise
carbs primary fuel 80-90%, comes from muscle glycogen, build up of lactate
What type of fuel is used when exercise is over an hour
60-80% fat, the remainder is aerobic metabolism of CHO
What is "hitting the wall"
abrupt onset of fatigue, intensity goes down, reflects glycogen depletion (after about 2-3 hours of exercise)
What are the benefits of a high carbohydrate diet to exercise?
better glycogen stores, better performance, better training, more fitness
Describe a good diet for an exerciser/ athlete
carbohydrate at least 55%, fat 20-35%, protein 10-15%, food pyramid diet is consistent with this
What is the RDA for protein for a normal person? an active person?
normal- 0.8g/ kg body weight
active- 1-1.5 g/kg body weight
What should you eat before exercise
low glycemic index carbohydrate, avoid fatty foods because they are slow emptying
What should be consumed during exercise
consume ~100-200 calories of high glycemic index cards every 20 -45 minutes after prolonged exercise (sports drink, energy bar, cookies, bannana etc)
What should be consumed after exercise
need to support lean tissue synthesis, maintain blood sugar, restore glycogen, eat high GI food within 20 minutes and a balanced meal within 2 hours when enzymes for glycogen synthesis peak
What precent of the body is water and how is it distributed
water is 50-60% of body mass, blood plasma 90%, muscle 72%, fat 20-35%
What are the functions of water
universal solvent, medium for chemical reactions, electrolytes, homeostasis, buffer, transportation, lubrication, temp. regulation
WHat is water responsible for transporting
cells, nutrients, gases, wastes
How is water used for lubrication
saliva, tears, synovial fluid
Why is water important for temperature regulation
high specific heat, constriction of capillaries, perspiration
When does our sense of thirst kick in
when we lose about 1% of our body weight in water
How is water absorbed
no digestion required, free water (not in food) is 80% absorbed in small ingestion, the rest in large intestine, water in food is absorbed in the large intestine
Which direction does fluid shift
water moves from areas of low concentration to high concentration, it follows salt
How is water excreted
kidneys, GI tract- feces, skin through sweat, skin and lungs (insensible losses),
How much water is typically lost in a day
2-3 liters depending on temperature, humidity, activity
What part of the body regulates water and electrolytes
kidneys
How much water loss does sweat produce
1-3 liter per hour
how fast can water be absorbed
about 1 liter an hour
What amount of water loss can effect performance?
2-3% of body weight
What are some symptoms of heat stroke
dehydration, over heating, electrolyte loss
what are some permanent effects of heat stroke
reduced heat tolerance, kidney failure, death
What happens when a person is over hydrated
over dilution of electrolytes, hyponatremia- too little sodium, hypokalenia- too little potassium, can lead to heart arrhythmia
What is unique about electrolyte replacement drinks
isotonic (same concentration as gut) solution that promotes rapid absorption
What should you drink after exercise
do not need sports drink, drink water and eat a bit of salty food, and fruits or veggies for potassium
How much water should be consumed based on physical activity
1-1.5 liters per 1,000 kcals burned
WHat three states can micronutrient intake be in
deficient, adequate, toxic
WHat % of the population is included in the RDA
98%
Describe vitamins in general
essential nutrients, no energy content (non caloric), organic, needed in microscopic quantities
How are vitamins classified
based on solubility, water soluble and fat soluble
WHat are the fat soluble vitamins
A, D, E, K
Why is there a higher risk of toxicity with fat soluble vitamins
the body can't excrete the fat so the body stores the surplus in the body, deficiencies develop over prolonged periods of time
What happens to excess water soluble vitamins
body excretes the excess, deficiencies are rapidly developed, low risk of toxicity
What are some functions of vitamin A aka. retionol
mucous and tear production, immune function, cellular differentiation
WHat are the consequences of a vitamin A deficiency
night blindness, complete blindness, illness and infection, cancer (failure of differentiation), keratinization (hard nail like deposits), xerophthalmia- dry eyes from lack of tears
What are some sources of vitamin A
retinal (preformed)- milk, liver, fish oil, eggs
pro vitamin (body finishes synthesis) beta carotene from orange and yellow fruits and veggies and dark green leafy veggies
What is the only form of vitamin A that can cause toxicity
retinal, the body does not process excess beta carotene
What constitutes an acute toxic does of vitamin A
over 100 times the RDA
what constitutes chronic toxicity of Vitamin A
about 10 times the RDA
What are some consequences of vitamin A toxicity
liver enlargement, CNS problems, cognitive/ behavioral problems, teratogenicity- can cause birth defects with even two times the RDA
What does Vitamin D do
calcium absorption, bone metabolism
What are the consequences of vitamin D deficiency
children- rickets- bones don't form right, bow legged
adults- osteomalacia- weak bones that lack minerals
What are sources of vitamin D
can make vitamin D from cholesterol using UV light from the sun, should get about 15 min/ day of sun exposure, fortified milk, other fortified foods
What levels cause vitamin D toxicity. What are the consequences
5 times the RDA in children, over absorption can lead to deposits in the kidneys and soft tissue
What are the fat soluble vitamins?
A D E K
What are the functions of vitamin E
antioxidant
What does an antioxidant do
prevents oxidative damage to cells, free radicals are a result of metabolic processes, they can cause mutation to DNA which can lead to cancer
Describe a vitamin E deficiency
rare to see a deficiency with symptoms but marginal intakes are common because vitamin can be reduced or destroyed during food processing
What are good sources of vitamin E
whole grain, wheat germ, seed oils
What does vitamin K do
needed for the synthesis of blood clotting factors
What happens in a vitamin K deficiency
defective blood clotting, drugs sometimes given to block vitamin k and thin blood to prevent heart disease
What foods are good sources of vitamin K
dark green leafy veggies, cabbage family (Cabbage family: collars, kale, mustards, turnip greens, bok choy, broccoli, spinach, lettuces)
What does vitamin C do
Collagen synthesis
Antioxidant
Enhanced iron absorption
Synthesis of various compounds
Enhances immune response
what is a deficiency of vitamin c called
scurvy
In what type of diet do we see vitamin c deficiency
low in fruits and veggies
What are some symptoms of vitamin C deficiency
Lack of collagen: bleeding gums- teeth failing out, old scars open, poor would healing
Iron deficiency anemia (shortage of red blood cells- lower oxygen carrying capacity leading to weakness, exhaustion, lethargy, irritability, insomnia)
which class of vitamins poses lower risks of toxicity
water soluble because the body readily excretes excess, fat soluble vitamins are stored in the body with the fat
What are good sources of vitamin c
fruits, especially citrus, kiwis, veggies especially peppers
In general, what are the B vitamins involved in
co enzymes, energy release
in general, what do b vitamin deficiencies look like
All cells effected
Symptoms are very generalized- weakness, exhaustion, irritability insomnia
Tend to cluster- deficient in one B vitamins usually means deficiencies in others
Very difficult to diagnose
Best treated by whole foods
What foods are good sources of b vitamins
Whole grains
Protein foods- meat, fish, poultry, beans, dairy products
Veggies (not as much)- dark green leafy veggies
what are the common b vitamins
Thiamin, riboflavin, niacin, folate (folic acid),Cobalamin (B 12),Pyridoxine (B-6),Pantothenic Acid, biotin
what does thiamin do
co enzyme involved in energy release
what is a thiamin deficiency called and what happens
called beriberi- I can’t I can’t, weakness, tired, loss of strength and coordination, often see in impoverished populations living on white rice with few animals products, usually compounded with other B vitamin deficiencies, in US often seen with alcoholics (poor absorption and intake), found in proteins, whole grains
what does riboflavin do
Co enzyme involved in energy release
what does a deficiency of riboflavin look like
In connection with other B deficiencies
Seen in food deprivation
Diets that lack animal products or green leafy veggies
What foods are good sources of riboflavin
Milk
Green leafies
Animal products
What does niacin do
Co enzyme
Energy release
What is a deficiency of niacin called and what are the symptoms
Called Pellagra
Common in southwest until 1940s
Associated with the 3M diet (meat -pork fat, meal- cornmeal, and molasses)
Symptoms of Pellagra- the 4 D’s - dermatitis, diarrhea, dementia, death
Often see in populations that subsist largely on corn, there is niacin in corn but it is not bioavalible unless the corn is treated with lime (calcium carbonate), this is seen in Latin American countries
What type of diet is associated with niacin deficiency?
Associated with the 3M diet (meat -pork fat, meal- cornmeal, and molasses)
What are the 4 D's , the symptoms of niacin deficiency
4 D’s - dermatitis, diarrhea, dementia, death
What is the precursor to niacin
tryptophan- an amino acid that can be made into niacin
What types of food are good sources of niacin
Preformed found in meat, fish, peanuts
Protein food are best but there are lesser amounts in whole grains
What symptoms are associated with niacin toxicity
Flushing- high dose causes rush of blood flow to skin, burning sensation
Higher chronic intakes can lead to liver and kidney damage
Raise HDL- can be used to treat heart disease but should be done under the supervision of a physician
WHat are the functions of folate (folic acid)
DNA formation
Protection against heart disease and cancer
WHat is significant about the relationship between folate and vitamin B 12
Folate can mask a B 12 deficiency
What happens in a folate deficiency
Can’t synthesize DNA- rapidly growing cells can’t divide- cells get very big which causes:
Megaloblastic anemia-red blood cells are big and few, can’t carry enough oxygen
What risks are associated with a low intake of folate during pregnancy
Low intakes of folate are associated with a higher risk of neural tube defects such as Spina bifida
What foods are good sources of folate
dark green leafies, orange jucie, beans
What does Cobalamin (B 12)do
Regenerates folate
Maintenance and development of myelin sheaths of the nerve fibers
What happens in a What does Cobalamin (B 12) deficiency
Nervous system damage (adults), this damage in children is irreversible
Can’t regenerate folate- causes folate deficiency anemia- pernicious anemia
Absorption involves intrinsic factor which is secreted from the stomach lining, the two bond together are then are absorbed
Most commonly seen in the elderly because production of intrinsic factor decrease
Can be masked by Folate, B 12 deficiency causes a secondary folate deficiency, taking in a folate substitute will cure the anemia but not the neurological factors
What foods are good source of Cobalamin (B 12)
All animal products- meat, fish, poultry, eggs, dairy (less)
Plant products have none- problem for vegans
Well stored by the body (unique for water soluble vitamin), deficiencies develop slowly
Vegans should use supplements or fortified foods (cereals, soymilk, multivitamin)
What does Pyridoxine (B-6) do
Synthesis of amino acids (all would be essential without B6)
Synthesis of hemoglobin (protein inside RBCs that transports oxygen)
Synthesis of neurotransmitters
Energy release
what happens in a deficiency of Pyridoxine (B-6)
Anemia
Neurological problems
Quite rare
what foods are sources of Pyridoxine (B-6)
wide variety of foods
WHat are symptoms of vitamin of Pyridoxine (B-6)
Was used to treat PMS
1000x the RDA daily for 2 years- irreversible neurological damage
What does Pantothenic Acid do/ deficiency/ sources?
B vitamin
Involved in energy release
Deficiencies are rare
Tons of sources
What does Biotin do/ source/ deficiency?
B vitamin
Coenzyme
Energy release
Widespread sources, rare deficiencies
Why is water important to proper mineral function
The charge on the ions pull the water in = osmotic pressure, Dissociate in water to form ions, Osmotic pressure causes fluid shifts, ls act as buffers and stabilizer pH, they absorb an release H+ to control pH
What are some properties common among all minerals?
Involved in fluid balance, Acid base balance
What is the most common mineral toxicity? Deficiency?
iron is both, compare to vitamin A that also is commonly toxic and deficient
What are the functions of calcium
Bone
Transmission of nerve impulses
Maintaining muscle tone (w/o calcium the muscles can’t relax after contraction)
Various metabolic roles
How is the blood calcium level regulated
•The concentration of calcium in blood is in flux with that in bone, they go back in forth,
The concentration of calcium in the blood is maintained in a narrow range
Bone is the calcium reservoir, extra/ lack in the blood- add/ take away from bone
Describe the absorption of calcium
it is vary variable,
high during childhood (75%) and pregnancy (50%), lower in adults (30%)
low intakes can be compensated for by a higher absorption rate but this is not sufficient to fully account for the deficit
What are the general recommendations for calcium intake
Peak bone mass is acquired by about age 30
High intake to about age 24 to maximize bone mass
Moderate intake after to maintain bone mass
WHat are good sources of calcium and how do they vary in their absorb-ability
•Dairy products- 30% absorbed (milk, yogurt, cheese), low fat versions have more calcium, high fat (ice cream) has less because fat displaces calcium, none in butter or cream
Veggies (50% absorbed) dark green leafies (kale, collards, mustards, turnip greens, bok choy)
Veggies (5% absorbed) contain oxalic acid that binds with the calcium making it insoluble (spinach, chard)
Other plant foods (20% absorption) almonds, sesame, beans
Miscellaneous sources- fish bones, stock made from bones, calcium fortified foods (tofu, orange juice, soy milk) stone ground wheat flour, tortillas that are ground with lime (helps niacin intake as well)
What does phosphorus do? What are the sources?
•Bone
•DNA
•Energy release (ATP-ADP)
abundant sources
What does magnesium do
•Most in bone
•Bone maintains blood levels
•Muscle contraction
•Hundreds of enzymes
What happens in a magnesium deficiency
•Not often seen, need extenuating circumstances
•Poor intake (dietary deficiency)
•High losses (vomiting, diarrhea
What are the sources of magnesium
•Abundant
•Greens, grains
What does sodium do
•Major positive extracellular fluid
•Nerve impulses
•Muscle contraction
•Deficiencies are rare
What happens in acute sodium excess?
•Excess concentration in blood stimulates thirst
•Dilute with water and increase blood volume, stimulates urination
•Lose excess water and salt
•Kidneys regulate water and electrolytes
What is the difference between systolic and diastolic blood pressure
systolic =pressure of the heart contraction
diastolic = pressure between heart beat
Why is systolic pressure higher than diastolic
• Systolic will be higher than diastolic because to move the blood you have to overcome the residual pressure before the blood can move again
What values are defined as high blood pressure
greater than 140/90
Why might a single reading of blood pressure give misleading results?
blood pressure can be temporarily increased by stress, exercise etc
What are some long term consequences of high blood pressure
High blood pressure contributes to the development of atherosclerosis, heart attack, stroke, congestive heart failure (pumping against a high pressure wears out the heart
Describe the setup of the DASH study
3 different groups
control- low intake of fruits, veggies, dairy
fruit/veggie group: high intakes of fruit and veggie but no extra dairy
fruit veggie dairy group: high intakes of all, fruit, veggie, dairy
What were the results of the dash study
those who had high intakes of fruits and veggies decreased bp by 7/3, those with high fruits, veggies, and dairy decreased bp by 11/6
what is the effect of food processing on the sodium potassium ration
food processing increases the sodium potassium ratio: more sodium, less potassium, fresh foods are usually the opposite
what are the functions of potassium?
•Major positive ion of intracellular fluid
•Transmission of nerve impulses
•Maintain heartbeat
Which positive ion is extracellular, which is intracellular
sodium is extracellular, potassium is intracellular
what factors can cause a short term potassium deficiency?
•Short term losses can be cause by diuretics, diarrhea, excessive or prolonged sweating, purging (eating disorders)
What is a possible consequence of chronically low potassium levels
•Low levels of potassium can lead to a cardiac arrhythmia , which can result in death, seen in eating disorders or prolonged hot weather exercise
What foods are sources of potassium
fruits and veggies
What are the functions of chloride
•Major negative ion
•Acid base balance
•Fluid balance
•Stomach acid
•Major source is salt
WHat is the function of sulfur
component of several amino acids
What are the functions of iodine
•Component of thyroxine (thyroid hormone)
•Thyroid hormone regulates BMR (thought iodine deficiency is not usually the cause of overweight)
What happens in an iodine deficiency?
"Goiter"- thyroid enlargement
WHat causes iodine levels to be low in food sources
poor soil concentration of iodine
Why don't we see as many iodine deficiencies as we used to?
•Iodine added to salt to compensate for low soil levels
•Dairy products are now an iodine source because iodine is used as a disinfectant
•Bakery products added iodine products as dough conditioners
what are the functions of iron
•Component of hemoglobin the part of the RBCs that transports oxygen
•Component of myoglobin- carrier of oxygen in muscle cells
•Enzyme systems
WHat happens in an iron deficiency
•Most common mineral deficiency
•Iron is pretty well stored so stores must be depleted first
•Unable to synthesize hemoglobin, unable to produce RBCs, leads to undersized and too few RBCs- anemia
What can cause an iron deficiency/ when are demands higher
•Can be caused by a dietary deficiency- low intake from food deprivation, eating foods with low nutrient density
•Increased needs for iron- pregnancy, growth in childhood, blood loss: injury, parasites, menstruation (pre –menopausal women have higher iron need)