Chapter 7: diets, functional foods

Question 1

The 2020-2025 Dietary Guidelines for Americans present 3 options for healthy eating patterns at 12 different calorie levels:

Answer 1

1. Healthy US Style Eating Pattern
2. Healthy Vegetarian Eating Pattern
3. Healthy Mediterranean Style Eating Pattern

*When used, these increase functional foods

Question 2

Define “functional food”

Answer 2

Whole foods OR fortified, enriched, enhanced foods that have potential beneficial effect on health when consumed as part of a varied diet on a regular basis

Typically provides benefit beyond energy, nutrients (i.e. phytochemicals), other bioactive compounds

Question 3

Define Nutraceutical

Define Phytochemical

Answer 3

Sometimes used interchangeably. “Functional foods” can be categorized under either

Nutraceutical - food or parts of foods with health benefits and the ability to treat disease

Phytochemical - chemicals within plants that have medicinal properties

*these are the compounds that could impact carcinogenesis

Question 4

Only ______% cancers are d/t genetic errors, while most are influenced mainly by modifiable risk factors

Answer 4

10

Question 5

______% of Americans have an eating pattern low in fruits, vegetables, and dairy

Answer 5

80%

Question 6

More than half the population is meeting or exceeding _______ food and _____ food recommendations.

Answer 6

Grain, protein

Question 7

Food manufacturers are adding _____ ______ ______ flour to products to increase whole grain content

Answer 7

Fermented brown rice flour

Question 8

Define “Resistant Starch”

Answer 8

A prebiotic - doesn’t get digested in the small intestine, thus ferments in the gut to feed probiotics

Question 9

______ _______ flour can be added to flour/other products to prevent DNA damage in cells and move foods through the GI tract faster (which reduces colon cancer risk)

Answer 9

Green banana

Question 10

What are 8 sources of resistant starch?

Answer 10

1. Banana (content drops as they ripen)
2. Legumes
3. Beans
4. Brown rice
5. Quinoa
6. Lentils
7. Raw oats
8. Raw potato starch

Question 11

Resistant starch recommendations for physiological benefits versus actual consumption by Americans

Answer 11

6g/meal versus 5g/day

*very difficult to achieve with Western diet

Question 12

_______ is the best non-fish source of omega-3 fatty acids in the form of a-linolenic acid

Answer 12

Flaxseed

Question 13

_______ is quite similar to soy in regard to phytoestrogen properties & amino acid profile

Answer 13

Flaxseed

Question 14

Lignan is a component of ______ fiber found in flax which has ____________ properties

Answer 14

Insoluble

Phytoestrogen

Question 15

Gut microbes ferment dietary fiber, resistant starch, and B glucan to produce ____________

Answer 15

SCFA (such as Butyrate)

Question 16

Chicory root is one of the best sources of __________-______ _______, which through fermentation in the LI creates SCFA

Answer 16

Inulin-like fructans

Question 17

Benefits of inulin as a functional food ingredient

Answer 17

Improves glucose tolerance, promotes bowel regularity, improves absorption of Mg & Ca, increases healthy bacteria in the gut while reducing pathogenic sources

Question 18

Approximately ______% of starch in oats is resistant starch and they also contain ______________ (provides antioxidant, anti-inflammatory properties)

Answer 18

25%

Avenathramides

Question 19

Algae is already used as a thickening agent in food, but nutrient benefits include high quality ______________ & source of ___________

Answer 19

Protein (similar to eggs)

Omega-3 fats (provides both DHA & EPA)

Question 20

T/F: Cancer patients are more likely to use dietary supplements than the general population

Answer 20

True (20% americans, 23% cancer patients)

Though <25% recommendations from supplements come from healthcare providers

Question 21

Define dietary supplement

Answer 21

products taken PO that provide ingredients intended to supplement the diet; may include vitamins & minerals, herbals & botanical products, amino acids, and other nutritive dietary substances

Question 22

There is a lot of overlapping agencies that participate in regulating supplements

1. Regulated by (2)
2. Enforcement of regulation (2)
3. Monitors (but does not regulate) (2)

Answer 22

1. Regulated by the FDA & FTC (federal trade commission)
2. State Attorney Generals Office & Department of Justice
3. CDC

Question 23

The burden of taking action against any unsafe dietary supplement is assigned to the ________________

Answer 23

FDA

Question 24

Consumers can report adverse affects associated with dietary supplements to the __________ ________ Program

Answer 24

FDA Medwatch Program

(Though poison control gets many more calls)

Question 25

These 3 supplements have been banned in the USA d/t serious liver toxicity

Answer 25

1. Chaparral (Larrea tridentate)
2. Ephedra sinica
3. Comfrey (symphytum)

Question 26

This supplement is unsafe d/t liver toxicity but still available in the US

Answer 26

Mentha pulegium (pennyroyal)

*LiverTox website for more info

Question 27

______% of supplement users engage in potentially harmful supplement use

(i.e. beta carotene & smoking, vitamin e and anticoag/platets, phytoestrogen w/ hormone dependent cancer treatments)

Answer 27

18%

Question 28

______% of pharmaceuticals are derived from plants

Answer 28

40%

Question 29

The _______________ enzyme system is important to drug metabolism, particularly w/ detoxification

Diet supplements may influence the activity of these enzymes

Answer 29

Cytochrome p-450 (CYP)

Question 30

T/F: Dietary supplements are required to undergo premarket evaluation

Answer 30

False, this is why adverse side effects may not be recognized until reported by consumers

Question 31

Hypericum perforatum (St Johns Wort) may reduce concentrations of some drugs including _______ & ________

Answer 31

Imatinib & Irinotecan

Question 32

These 4 herbal products may interfere with cytochrome p-450 substrates

Answer 32

1. St Johns Wort
2. Garlic
3. Ginseng
4. Ginko balboa

*Milk thistle is of concern but has not been shown in human studies

Question 33

These are the only 4 botanical supplements shown to cause drug-nutrient interactions

Answer 33

1. St John’s Wort
2. Goldenseal
3. Echinacea
4. Garlic

Question 33

Supplements providing _____% DV are safe/likely adequate for healthy people, but important to evaluate the needs of the individual for those with cancer

Answer 33

100%

Question 34

Explain why healthy cells tend to do OK with antioxidant supplements but cancer cells do not

Answer 34

Cancer cells have higher levels of oxidative stress than normal cells. This creates more ROS (reduced oxygen species)

Antioxidants cancel out these ROS to create balance, thus becoming dependent on antioxidants. This balanced environment allows them to grow/develop.

Question 35

Research on antioxidant supplements during cancer treatment

Answer 35

Very mixed. May protect healthy cells and reduce side effects BUT this may reduce the effectiveness of treatment.

Likely depends on the type of cancer, mechanism of treatment, and the antioxidant itself

Question 36

Recommendations for antioxidant supplements

Answer 36

Use with GREAT caution. Should probably avoid d/t potential for tumor protection and reduced survival

Grant leeway for those undergoing palliative regimens