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127 Cards in this Set
- Front
- Back
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Heme molecule |
Attracts oxygen as a part of the iron-protein complex.
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Hemoglobin
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Oxygen-carrying protein that makes its way through the red blood cells, transporting oxygen from lungs to the tissue throughout the body.
80% of iron if found within hemoglobin. |
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Food source for heme and non-heme iron.
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Heme - Meat, fish, poultry.
Non-heme - plants and vegetables, paired with Vit. C, MFP factor, cast iron pan, etc. |
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Is non-heme iron found in animal foods like beef?
Which is more bioavailable, heme or non heme iron? What percent of heme iron is absorbed? |
-Yes.
-Heme is more bioavailable than nonheme -25% of heme iron is absorbed by the body. |
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What are the roles of VITAMIN C and MFP FACTOR in the absorption of non-heme iron?
What does MFP stand for? |
MFP factor promotes the absorption of other foods eaten for non-heme absorption. MFP stands for Meat Fish Poultry.
Vitamin C keeps the iron in its ferrous state so that it is readily absorbed. |
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Phytates and fiber in a plant based diet may LOWER bioavailability of nonheme iron. Name foods that contain PHYTATES.
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Vegetables, proteins, calcium, tannic acid - bind up iron and inhibit absorption.
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Transferrin
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Body takes iron from the ferritin (small intestine) and is transported to the blood transferrin where it carries it to the BONE MARROW and other TISSUE.
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Hepcidin
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The hormone that regulates iron balance. Binds the ferroportin. Released by the LIVER.
If deficient, too much iron will enter the bloodstream. |
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Ferritin
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Captures the iron and stores it in the Small Intestine.
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Ferroportin/Hemosiderin
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A protein contained within the cells of the duodenum. Allows iron to be delivered to the blood.
IF THERE IS ENOUGH IRON, hepcidin binds the ferroportin and prevents more release. Hemosiderin - long term storage for iron. |
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CASE STUDY: You have a family history of high concentrations of iron. Your father takes multivitamins plus mineral tablets (w/ 60 mg. iron). What might you recommend?
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Your father may have hemochromatosis which is a high concentration of iron in the heart, joints, liver, and other tissue. He should get checked to be sure that he does not have toxic levels of iron in any of those areas.
He would get an IRON OVERLOAD ASSESSMENT - measures TRANSFERRIN SATURATION AND SERUM FERRITIN. |
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What is hemochromatosis? What causes it and what are the consequences?
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Hemochromatosis is the genetic failure to prevent unneeded iron in the diet from being absorbed.
The cause is strictly genetics. Consequences: Liver cancer, heart disease, arthritis, Infections dueto bacteria loving iron-rich blood. Soooo....men over 50 should not take a supplement of iron because you'll probably get hemochromatosis. |
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What groups of individuals are MOST as risk of Iron Deficiency Anemia?
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Women who are menstruating, Vegetarians (esp. vegans) and children who do not eat meat.
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What are the symptoms of Iron Deficiency Anemia?
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Blue Sclera - low immunity, lower energy, concentration, and reactivity.
Pale skin, nail beds, and eye membranes. Concave nails Lower chance of wound healing. Low resistance to cold, PICA (appetite for chalk, clay, dirty, sand, etc). Fatigue, weakness, apathy, and behavior changes. |
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Why did Egyptian youth in the 60s become zinc deficient. Explain the dietary and environmental conditions which precipitated deficiency? What were the symptoms?
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Egyptian food consisted primarily of fiber and phytates which inhibit zinc absorption.
The symptoms were growth retardation and sexual immaturity. |
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Similarities and differences of the regulation of iron and zinc absorption in the small intestine?
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Zinc - mucosal cells in the intestine store excess zinc in the metallothionein (only releases when zinc is needed in the blood) before going into blood, transported by ALBUMIN.
Iron - mucosal cells store excess iron in the mucosal ferritin (a storage protein that stores in the small intestine). |
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What is metallothionein?
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Releases excess zinc through the albumin into the blood when needed.
It also releases transferrin for transport of iron through the body. |
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4 good sources of zinc:
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Poultry, shellfish, meats, cheese.
Protein-rich foods |
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Role of iodide in the body?
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Integral to THYROID HORMONES which regulate body temp, metabolic rate, reproduction, growth, blood cell production, nerve and muscle function, etc.
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Effects of iodine deficiency during pregnancy on the outcome in the infant?
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Cretinism: Mental and physical retardation.
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What is the effect of iodine deficiency on the thyroid gland?
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The thyroid gland will enlarge to trap as much iodine as possible which will result in a goiter.
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When/where were goiters prevalent in the US?
How was it resolved? |
In the mountain area during the 1930s.
Iodized salts. |
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Role of fluoride in reducing tooth decay?
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Fluoride is important because it replaces hydroxyl group in hydroxyapatite and forms a STRONGER compound, FLORApatite.
This makes the teeth stronger and resistant to decay. *appetite - you want to eat. hydroxyapatite/florapatite. |
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What are the functions of chromium within the body?
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Chromium maintains glucose homeostasis by enhancing the activity of the hormone insulin.
A deficiency - elevates blood glucose --> impairs glucose tolerance, insulin response, and glucagon responses occur. |
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Name the phytochemicals
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Lycopene
Flavonoids Curcumin Resveratrol |
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Lycopene
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Powerful antioxidant, relative of Beta-carotene
found in tomatoes |
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Flavonoids
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Yellow pigment, antioxidants.
Citrus, oregance, purple grapes, black and green tea. |
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Curcumin
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May inhibit enzymes that activate carcinogens.
Turmeric. |
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Resveratrol
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Protects arteries from high fat diets
Red wine. |
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Role of the placenta in providing nutrients to the fetus and in the regulation of fetal growth.
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Transfers nutrients to the fetus's blood and picks up waste products.
Placenta performs respiratory, absorptive, and excretory function that the fetus's lungs, digestive system and kidneys will provide after birth. |
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Explain the concept of "critical period" of embryonic development.
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The time of intense development and rapid cell division - those cellular activities can only occur at those times.
Occurs in the FIRST trimester |
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Why do formulations of vitamin/mineral supplements omit preformed vitamin A (retinol)?
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Preformed vitamin A is toxic so don't need a vitamin of it. Just retinol, not beta carotene so do not take supplements of it.
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What public health measure is now in place to reduce the incidence of neural tube defects?
Was it successful? |
Fortified grains (with folic acid) to reduce the incidence of neural tube defects.
Yes, it was successful in reducing the incidences by about 25%. |
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Describe spina bifida
Why are all pregnant women NOT at risk of neural tube defect? |
The incomplete closure of the spinal cord and its bony encasement.
Not all women are at risk because they have proper levels of folic acid. |
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Cautionary advice to give a pregnant woman in terms of caffeine, alcohol use, and fish consumption.
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Limit caffeine to one cup a day (2 cans of soda a day)
No alcohol Eat fish high in fat, low in mercury - 12 oz. weekly [light tuna, cod, catfish, crab, salmon]. Don't consume fish oil tablets. |
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DIR - 330 kcal/day for pregnant women.
Real intake - 500 kcals. Why 330 when 500 is necessary? |
The body has fat reserves around the thighs from pregnancy. The mom only needs to eat 330 kcals because the other 170 can be provided by the body.
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Breastfeeding vs. Formula
[for baby] |
Provides the appropriate composition of nutrients. Contains immune factors which reduces the risk for GI infections and long chain fatty acids for brain/vision development.
Infants are exposed to a variety of flavors through breast milk and thus may try greater variety of foods as toddlers. Low risk for adult obesity and reduced risk for heart disease. |
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Breastfeeding vs. Formula
[for mom] |
Contracts uterus to pre-pregnancy size
Delays menstruation so iron is conserved. Can protect against ovarian/breast cancer. Can help with losing weight. etc. |
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What nutrients need to be supplemented int he frist 6 months for the baby?
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Vitamin K - at birth
Vitamin D - drops after 2 months. Iron and Fluoride - by 6 months. |
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A woman wants to get pregnant - what nutrients should she pay attention to before pregnancy and continue to get adequate amounts of during pregnancy?
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Calcium, Iron, Folate, B12.
Reduces the risk of problems for mom and baby - be physically active and take multivitamins. |
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What nutrients show a dramatic increase in absorption during pregnancy
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Calcium and iron
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What are the changes in energy needs in each trimester of pregnancy?
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1st trimester = +0 kcal/day
2nd trimester = +340 kcal/day 3rd trimester = +450 kcal/day |
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What advice would you give a woman regarding caloric intake and weight gain?
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Gain only a few pounds the first trimester and then one lb./week for the last two trimesters.
Underweight - 28 - 40 lbs. Normal weight - 25 - 35 lbs. Overweight - 15-25 lbs. Obese - 11-20 lbs. |
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What is colostrum?
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It is a serum that is produced within the first few days of delivery. It is high in antibodies and white blood cells.
Helps intestinal tract mature and grow. |
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What is the "let down" reflex?
What causes "let down" to happen? |
Let down is when the breast milk is pushed to the front of the breast when the baby begins to nurse.
"Let down" is caused when the hypothalamus signals the pituitary gland to releases the hormone oxytocin which pushes the breast milk and has a calming affect over the mother. |
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What is nursing bottle tooth decay? How do you prevent this?
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When you put down a baby with a bottle, the juice (esp. if carbohydrates) will bathe the teeth and cause the teeth to decay.
Prevent this by not giving a baby a bottle of juice or milk when they are laying down. |
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What should be the first solids introduced to the infant? When and why?
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iron-fortified cereal to provide the baby with sufficient amounts of iron.
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Why shouldn't infants and children under age 2 years be fed honey or corn syrup?
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Increased risk of botulism - deadly.
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What strategies are useful to try if a child is reluctant to taste a new food?
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Continue to provide opportunities for teh child to try the food.
Be patient, stick to a routine, try dips with vegetables, mix into other foods, gro a garden, get child involved in food purchase and prep. Minimize distractions (no tv) Don't be a short order cook. |
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What is the WIC program? Who does it serve?
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WIC program [Women Infant Children Feeding Program] provides poor families with nutritional advice and vouchers to get proper nutrition so that the baby can grow and develop properly.
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By 6 months, a baby is in the 25th percentile for weight and 50th percentile for height - what does this mean?
Why are CDC charts used to track growth? |
25% of babies are at the same weight or lower.
50% of babies are at the same height or shorter. This means that the baby may be a picky eater but is not underweight/malnourished. CDC charts are used to track the norm for growth and development. |
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What is colostrum and why is it important for the newborn?
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Colostrum contains nutrients that are high in antibodies and white blood cells. This can help reduce the risk of sickness/diseases and can prevent negative problems in childhood.
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Why should an infant [in the first 6 months] not be fed cow's milk?
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It is too high in protein and can damage the kidneys and can cause bleeding in the intestines.
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Why is infant cereal or pureed meat important as second foods for 6 month old infants?
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Iron is really important for a baby esp. afte 6 months because they don't have the iron provided by the mother anymore. Meat heme iron and fortified cereal have the iron necessary for proper development.
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What could be the consequence of a young child drinking too much juice? how much is too much?
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It can lead to diarrhea and excessive amount of kcals which displace other nutrients.
Juice should be [if necessary] served 4-6 oz. daily and should be diluted. |
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Why do women have a lower tolerance to alcohol than men?
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They absorb alcohol more rapidly than men.
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What liver enzyme plays a major role in eliminating alcohol from the body?
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Alcohol dehydroginaze.
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What is the Wernick-Korsakoff syndrome?
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Chronic alcoholism - make up stories that alcoholics think are true but we know they are not. Caused by a deficiency of thiamin.
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What is the PRIMARY FACTOR that differentiates one amino acid from another?
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Amino acids differ due to their SIDE CHAINS/SIDE GROUPS.
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What are the pathways that pyruvate can participate in? Which of these is irreversible?
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Pyruvate can either go to Lactate or Acetyl CoA.
Lactate - when energy is needed quickly (sprinting, anaerobic) Acetyl CoA - When energy is need more slowly (Biking, Aerobic) Acetyl CoA is IRREVERSIBLE. |
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What happens within the body when fasting after the first day or so?
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After stored glycogen is depleted, the body uses other processes to convert amino acids to glucose.
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What minimum % of grains should be whole grains?
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50%
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What are nutrient dense foods? Examples
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Measure of the nutrients a food provides relative to the amount of kcals the food provides.
...eggs fruits, cereal, toast Breast has a low energy density, but a high nutrient density. |
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What are energy dense foods? Examples.
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A measure of the energy (kcals) in a food relative to its weight...high energy = gain; low energy = lose
Coffee and donuts is high in energy density but low in nutrient density. |
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Whole grains vs. refined grain
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Whole grain has the entire grain (bran, endosperm and germ)
Refined grain only has the endosperm. |
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What are the DV's and how are they calculated? Which nutrient DV's are based on RDA's (or AI's) What is the DV for total fat fora person eating 2000 kcal/day.
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"A DV is often, but not always, similar to one's RDA or AI for that nutrient. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers determine the level of various nutrients in a standard serving of food in relation to their approximate requirement for it. The label actually provides the %DV so that you can see how much (what percentage) a serving of the product contributes to reaching the DV."
65 g of total fat for a 2000 kcal diet. |
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Insoluble and soluble dietary fiber.
What is the benefit of soluble fibers in terms of heart disease? |
Soluble fiber lowers the risk of development of heart disease and diabetes.
CCK makes it happen. Fiber gets caught with bile, fiber and bile are excreted. When bile is excreted the liver must make more; therefore, it will use cholesterol in the body. Through doing so, blood cholesterol gets lowered when you eat soluble fiber. Insoluble fiber speeds up GI transit time and adds bulk to excretion. |
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Physiological fuel values for carbohydrate, protein, fat, alcohol.
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Carbohydrates - 4 kcal
Protein - 4 kcal Fat - 9 kcal Alcohol - 7 kcal |
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When muscles utilize glucose they produce pyruvate. What is the metabolic process to convert lactate to glucose?
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Pyruvate turns into lactate; lactate will be taken to the liver and converted back to glucose; this process requires ATP. It is converted back to glucose and reutilized in the body --> cori cycle.
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Main principles associated with a healthy diet?
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Adequacy+Moderation+Balance = Healthy Diet.
Adequacy, Balance, Kcal Control, Nutrient Density, Moderation, Variety. |
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Functional Food
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Healthy food claimed to have a health promoting or disease prevent property.
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Enriched food
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Nutrients are added to them.
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Fortified food
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Provide nutrients in populations where a certain vitamin or mineral is not available.
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Organic food
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Made in a way that limits the use of synthetic materials during production.
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What happens in the mouth during digestion and absorption?
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Chewing (mastication) grinds food and begins to mechanically digest it.
The food is mixed with salivary amylase. Carbohydrate digestion begins HERE. |
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What happens in the stomach during digestion and absorption?
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Adds acid, enzymes and fluid - churns, mixes, and grinds food to a liquid mass called CHYME.
The epithelial lining of the stomach contains gastric pits where glands are located which excrete juices containing water, enzymes and HCL --> this kills bacteria from the food. The pyloric sphincter controls the flow of chyme from the stomach to the SI. HCL breaks down and denatures PROTEINS. |
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What happens in the SI during digestion and absorption?
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Secretes enzymes that digest all energy contained nutrients into SMALLER nutrient particles.
Cells of wall absorb nutrients into blood and lymph. The SI is broken into the Duodenum, Jejunum, and Ileum. Most of the absorption occurs mostly in the SI where nutrients are broken into smaller nutrients. |
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Large Intestine
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Reabsorbs water and minerals; Passes water (fiber, bacteria, and absorbed nutrients) along with water to the rectum.
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Anabolism - with examples
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Reactions where small molecules are put together to build large ones.
Making of glycogen, triglycerides and proteins (REQUIRES ENERGY). |
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Catabolism - with examples.
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Reactions which large molecules are broken down to smaller ones.
Glycogen - glucose Triglycerides - glycerol and fatty acids Protein - amino acids BIG TO SMALL - hydrolysis. |
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What system carries fat-soluble and large fats tot he body?
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Chylomicrons
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What is the primary site of absorption of nutrients within the small intestine?
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Villi.
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Name the different sphincters.
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Upper esophageal sphincter
Lower esophageal sphincter Pyloric sphincter Illeocecal valve |
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Upper Esophageal Sphincter
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Allows passage of food from mouth to esophagus.
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Low esophageal sphincter
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Allows passage of food from esophagus to stomach and prevents back flow into the esophagus.
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Pyloric Sphincter
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Allows passage from stomach to small intestine; prevents back flow into the stomach.
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Illeocecal valve
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Allows passage from smal intestine to large intestine; prevents back flow from LI to SI.
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Gastrin
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Responds to food in stomach.
Secreted from the stomach wall Stimulates stomach glands and HCL is secreted into the stomach. |
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CCK
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Responds to fat in the Small Intestine.
Secreted form the intestinal wall Stimulates gallbladder and pancreas Bile is secreted into the duodenum and bicarbonate and enzyme rich juices secreted into the SI. |
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Secretin
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Responds to chyme in the SI, secreted from the duodenal wall, stimulates the pancreas and bicarbonate rich juices secreted into the SI.
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What types of molecules get absorbed into the portal blood vessels and which types are absorbed into lymph vessel?
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Non-essential nutrients (fat-soluble vitamins, cholesterol) do not go into blood directly. They enter the Small intestinal cell where they are packed as chylomicrons.
Lymphatic System-essential Nutrients [Monosaccharides, amino acids, water soluble vitamins, minerals, and small fatty acids] absorbed DIRECTLY into bloodstream. The liver is the first organ water-soluble nutrients and other substances pass through. |
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Bile - made, function, role of gall bladder
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Bile is made in the liver from Cholesterol.
Bile emulsifies fat int he duodenum and breaks it down into smaller particles of fat. Bile is stored int he gall bladder until need. |
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Long-term complications of uncontrolled diabetes...
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heart attack, stroke, high blood pressure, disease, blindness, infections, and limb amputations.
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Monosaccharides
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6-carbon compounds -
glucose (blood sugar) fructose (fruit sugar and sweetest) Galactose (part of disaccharide lactose - milk sugar), single sugars. |
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Disaccharides
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Need monosaccharide enzymes to digest each of the disaccharides.
Disaccharides include Maltose (glucose+glucose) Sucrose (fructose_glucose) Lactose (galactose+glucose) |
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Polysaccharides
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Long glucose chains; differ depending on the shape of the bonds.
Include starch, glycogen, and cellulose. Large molecules of monosaccharides (starches and fiber). |
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What determines the hardness of fat at room temp?
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Saturated fats are solid at room temperature.
They are more resistant to oxidation. It alter texture - flaky crusts. |
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What advantages are there to consuming EPA and DHA in the diet?
Main sources of EPA and DHA. |
EPA and DHA are two long chain omega-3 fatty acids that can be synthesized in the body's cells from linolenic acid - they provide nutrients, minerals, and proteins and are low in saturated fats. Maintains the healthy functioning of the brain and retina.
Fish, supplements [fish oil], breast milk |
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How does atherosclerosis develop?
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When atheromatatous plaque builds on artery walls and leads to inflammation. The development of plaque can cause atherosclerosis to develop. A buildup with clots and platelets causes blockage and can lead to tissue death.
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Risk factors of coronary heart disease?
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High blood cholesterol, diabetes, cigarette smoking, hypertension, family history, age.
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What are the recommendations for Reducing coronary heart disease risk?
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-Limit total fat in the diet
-Weight management -Replace saturated fat with mono/polyunsaturated -Limit intake of added sugar -Consume fatty fish at least twice a week for omega-3 fatty acids. -Use soy products in place of animal foods that are high in saturated fat and cholesterol. -Limit alcohol consumption to 1 drink/day W; 2 drink/day M -Exercise 30 min/day -Reduce exposure to tobacco smoke -Increase intake of soluble fiber. |
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LDL
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High in cholesterol.
Made form VLDL fragments, function is to bring cholesterol to body's cells, if high, increase risk for heart disease. |
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HDL
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High in protein
Made int he liver and small intestine. Brings cholesterol back to liver with possible secretion. If high, decreases risk of Heart disease. |
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T or F
Fat can be used to make glucose in the body |
False, it can't be used
Fatty acids go straight to acetyl CoA therefore they cannot make glucose. |
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T or F
Adding sterols to food make them structurally similar to cholesterol |
True.
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How are fats transported through the body after they are absorbed within the Small intestine?
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Triglycerides first go to the small intestine.
Fat goes through the lymph as Chylomicron Triglyceride then goes to other tissues and muscles - like adipose tissues in the muscle. The smaller chylomicron attaches to the liver Miscelles in the lumen of the SI --> into enterocyte --< chylomicron --> lymph system --> thoratic duct near heart --> blood strea --> body cells. |
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To reduce blood glucose _________ is secreted
When the body needs glucose ____________ is the hormone that causes the liver to break down __________ to raise blood glucose. |
Insulin; Glucagon; Glycogen
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Stages of Iron Deficiency Anemia
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1. INCREASED utilization of IRON STORES; serum ferritin FALLS.
2. Depletion of iron stores; serum iron falls; transferrin levels increase, hemoglobin synthesis decreases. 3. Hypochromic and microtyic erythrocytes are produced. |
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Name all the Trace Minerals
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Iron
Zinc Fluoride Iodine Copper Selenium Chromium Manganese Fluoride |
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Purpose of Selenium
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Protects body against free radicals
"food is best" |
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Copper
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Rarely a deficiency
Energy Metabolism along with HEMOGLOBIN SYNTHESIS. UL of 10 mg/day |
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Excessive intake of fluoride
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Fluorosis
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Iron intake: men vs. women
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Men - 8 mg/day
Women - 18 mg/day - when 50: 8 mg/day |
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Chromium
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Lipid and Carbohydrate metabolism.
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Potential benefits of Alcohol
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High HDL, Low LDL.
Decrease in blood clotting Increases coronary blood flow. |
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Alcohol absorption
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Alcohol is absorbed by the stomach and makes its way to the liver. Alcohol that can't be immediately absorbed circulates through the body until it can enter the liver.
All other metabolic processes stop to absorb and excrete alcohol. |
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T or F
Alcohol enhances antidiuretic hormon resulting in the gain of body water |
false.
It suppresses antidiuretic hormone which results in the loss of body water |
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The stages of Liver Damage
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1. Fatty liver - can happen after one night of heavy drinking but usually goes away.
2. Fibrosis. Cirrhosis - most advanced stage of liver deterioration; irreversible. |
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Deli meat consumption during pregnancy
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Listeriosis - can cause miscarriage and stillbirth
20x more likely to obtain during pregnancy. |
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Why no cow's milk during the first year??
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-Contain CASEIN and may cause intestinal bleeding and milk anemia.
-Use whole cow's milk after 12 months (2-3 cups) -Switch to reduced-fat cow's milk after 2 years of age. |
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How many meals and snacks does a child need in a day?
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3 meals with 2-3 snack in between.
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Effects of obesity in children
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-Have different growth patterns
-Puberty comes earlier -Increased bone and muscle mass -Appear stocky -Psychological development - picked on, not included. *Physical and social health. |
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Puberty - girls vs. boys
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girls - 6", +35 lb.
boys - +8", +45 lb. |
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What is a food jag?
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Only wanting to eat certain types of foods.
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What nutrient do most teenagers need more of to support their rapid growth and other physical changes?
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Iron.
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Which nutrient is of MOST concern of pregnant women?
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Folate - for proper neural tube development.
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Breast milk is deficient in the following vitamins:
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Vitamin K
Vitamin D Folate Iron Fluoride Sodium |
