Dietary Recommendation For Disease Preventon

Question 1

Compare the mediterranean diet compared to western diet

Answer 1

Both diets have 38% fat but with different composition:

Mediterranean diet has more MUFA and less saturated fatty acids leading to a high oleate/palmitate ratio.

Increased olive Oil (oleic acid)

Decreased saturated fat

Increased fish oils, nuts(omega 3)

Increased plant food sources

Decreased red meat

Serum levels:
Decreased total cholesterol
Decreased LDL cholesterol
Triacylglycerols

Increased HDL cholesterol

Question 2

Describe extra virgin oil

Answer 2

1. Contains 75% of oleic acid (18:1) and is the main oil used in the Mediterranean Diet.
2. Virgin olive oil does not only contain oleic acid it also contains high amounts of antioxidants which are lost when the oil is refined. Use extra-virgin olive oil.
3. Oleocanthal is a natural phenolic compound that has been shown to have anti- inflammatory potency similar to ibuprofen.
4. Virgin olive oil (50 ml/day) decreases IL-6 and C-reactive protein.
5. More studies are needed to establish the protective role of extra-virgin olive oil on the inflammatory status in humans.

Question 3

What is the significance of DHA?

Answer 3

Docosahexaenoic acid
(DHA 22:6,w3) is needed for heart and brain metabolism in all stages of life!

1. Fetus: obtains DHA from the blood of the mother. Important for brain growth.
2. Neonate: obtains DHA via human breast milk or formula. Important for further brain and vision development. DHA can be enriched in milk via the maternal diet.
3. Infants, children and adults: obtain DHA via a diet rich in w3 fatty acids mainly from fish or supplements. Important for heart, brain functions and vision.
4. Elderly adult: may need an enriched-DHA diet as to prevent possible loss of memory and cognitive functions (dietary supplements from fish and krill-oil are available).

Question 4

How can we modify a diet for healthy vision and prevent age-related macular degeneration?

Answer 4

1. DHA provides the necessary fluidity and binds rhodopsin which is needed in humans in large amounts in the lamellar membranes of rods and cones.
2. A diet rich in carotenoids, especially lutein and zeaxanthin is associated with reduced risk of ARMD and its dietary intake is recommended as treatment for patients. Both carotenoids are found in dark-leafy greens and are selectively taken up into the retinal cells of the macula. They are the primary pigments and absorb >90% of blue light.

Question 5

What foods are rich in carotenoids?

Answer 5

Lipid phytonutrients with bright colors can prevent disease and promote health

Lutein

Zeaxanthin

B-Carotene

Lycopene

Question 6

In a healthy individual, nitrigen intake equals,nitrogen output

Question 7

Describe positive nitrogen balance

Answer 7

Dietary amino acids are used for protein synthesis and less urea is formed.
Nitrogen intake exceeds nitrogen excretion.

Causes:
Positive nitrogen balance is found in tissue growth during childhood, pregnancy or recovering from an emaciating illness. Note: this requires the dietary uptake of all dietary essential amino acid

Question 8

Describe negative nitrogen balance

Answer 8

Dietary amino acids are less used for protein synthesis and more urea is formed.
Low Nitrogen IN
High Nitrogen OUT

Nitrogen release exceeds nitrogen intake.

Causes:
a. Inadequate dietary protein and lack of dietary essential amino acids.
b. Increased tissue protein degradation (muscle).
c. Physiologic stress: trauma, burns, illness or
surger

Question 9

A diet rich in leucine…

Answer 9

Promotes muscle growth

Leucine-rich diet:

1. Stimulates protein synthesis in muscle leading to a positive nitrogen balance
2. Reduces muscle loss with aging
3. Spares muscle proteins during weight loss

Question 10

Describe gut microbial metabolism

Answer 10

Gut microbial metabolism and human health:
The food you eat affects the health of your gut.

• Microbiome: > 100 trillion microorganisms.
• Probiotics are friendly bacteria found in the gut: Lactobacillus and Bifidobacterium
• Gut-liver axis is an emerging area of interest in the microbial-mammalian metabolic axis.
• Individuals with certain diseases have a different mix of bacteria in their intestines compared to healthy individuals

Question 11

What is the importance of dietary plant fiber?

Answer 11

Plant food with fiber is important for healthy digestion and may prevent disease

1. Soluble (water-soluble) fiber can be found in: a. Oat bran, nuts, seeds and psyllium.
   b. Fruits and vegetables.

Digestion:
a. Attracts water and turns into a gel during digestion
which is fermented by bacteria.
b. Delays gastric emptying and slows digestion.
Benefit:
a. Extended feeling of fullness (satiety).

2. Water-insoluble fiber can be found in:
   a. Whole grain products: whole wheat and wheat bran. b. Vegetables.
   Digestion:
   a. Insoluble in water and adds bulk to stool.
   b. Helps food pass more quickly through stomach and
   intestine.
   Benefit:
   a. Stool softener.

Question 12

Outline the changing nutrition needs of the human life cycle

Answer 12

1. Neonates and infants: Optimal nutrition from human milk or formula and additions.
2. Childhood and adolescence:
   a. Tissue growth and development need all nutrients in large amounts. b. Food rich in proteins for a positive nitrogen balance.
   c. Increased requirements for minerals and trace minerals.
3. Adulthood:
   a. Maintenance of body weight requires a healthy diet.
   b. Healthy adults are mainly in nitrogen balance.
   c. Less amino acids are needed when compared to infancy. d. Women need less iron after they stop menstruating.
4. Seniors and elderly:
   a. The diet needs to reduce the aging process.
   b. Increased intake of vitamins D and E and DHA.
   c. Water uptake is critical and food needs to be easily digestibl

Question 13

What foods rich in vitamins can prevent disease and promote a healthy body?

Answer 13

1. Fruits and vegetables are rich in vitamins and trace minerals.
2. Oily fish contains vitamin D and omega-3 fatty acids.
3. Milk contains vitamins B and calcium and can be fortified with vitamin D

Question 14

What foods prevent against oxidative damage?

Answer 14

Food that protects against oxidative damage contains trace minerals and natural antioxidants
Natural radical scavengers (antioxidants) in food
1. Phenolic antioxidants
2. Ascorbate and vitamin E (work together).
3. Carotenoids

Enzymes that protect against ROS need
Zinc Copper Manganese Selenium Iron (heme)

Question 15

What is the significance of spices?

Answer 15

Some spices are used all over the world
They have antioxidant, anti-inflammatory, analgesic, antiseptic and anti-microbial functions!

1. Cloves rank as richest source of antioxidants.
2. Cinnamon appeared 2800 BC in Chinese medical writing.
3. Rosemary is used in food and also as anti-septic oil.
4. Ginger acts mainly in the intestines.
5. Turmeric is also found in curry both contain curcumin (antioxidant). 6. Garlic has many functions: it acts strongly as antibiotic

Question 16

What is the significance of different condiments?

Answer 16

Mustard:

a. Low in calories (no sugar).
b. Contains phytonutrients and selenium.
c. Contains turmeric and paprika.

Ketchup:

a. High in sugar, often HFCS.
b. Has lycopene from tomatoes.
c. Can be made at home without sugars.

Mayonnaise:

a. High in calories.
b. High in fats.
d. High in sodium.
e. Can be made at home with olive oil and low salt

Question 17

What are the characteristics of poprocessed food and and foods with additives?

Answer 17

• Processedfood:
– Nitrites and Sulfites and Sodium Benzoates prevent discoloring of food
and stop fermentation.
– The American Cancer Society recommends less consumption of processed meats to avoid nitrites.

• Commonfoodadditives:
 – Ascorbate (antioxidant)
– Aspartame (sweetener)
– Taurine (antioxidant)
– Niacin (anti-bacterial properties)

Question 18

What is salt?

Answer 18

High salt intake (table or sea salt) increases blood pressure and raises the risk of CHD and stroke.

Recommended: Healthy adults shall reduce their salt intake!

Question 19

What are the types of salt?

Answer 19

1. Table salt:
   a. Usually from salt mines and once minced is refined to NaCl. b. Calcium silicate is added to prevent clumping (anti-caking).
2. Sea salt:
   a. Usually unrefined salt directly from a living ocean or sea. b. Contains mostly: NaCl 97%, KCl 2%, trace minerals 1%.
3. Iodized salt:
   a. Iodine is added to table or sea salt to prevent hypothyroidism.

Question 20

Contrast artficial sweetners and sugars

Answer 20

Sugars:
1. White sugar (refined) is most commonly used. (Sugarcane) 2. Brown sugar is white sugar combined with molasses.
3. Maple Syrup is formed from xylem sap of maple trees.
(Artificial syrup is formed from sugar, molasses and water) 4. Honey is formed by bees and contains glucose, fructose,
antioxidants and other bioactive compounds.

Artificial sweeteners:

1. Aspartame: (methyl-aspartyl phenylalanine): Equal, NutraSweet 2. Saccharin: Sweet’ N low, Sugar Twin
2. Sucralose: Splenda
3. Plant extract: Stevia

Question 21

Describe howw color can be a food additive

Answer 21

1. Natural colors extracted from other food sources.
   a. Anthocyanins are flavonoids in fruits and vegetable with vivid red to blue or dark purple colors.
   b. Beet root and paprika are often used to color food.
2. Artificial colors approved by the FDA.
   Artificial colors are coded by an E-number which is given after clearance by
   the European Food Safety Authority and it indicates that it can be used safely in food.

Question 22

What are the general dietary recommendations toprevent diseases?

Answer 22

1. Maintenance of ideal weight.
2. No trans fats.
3. High consumptions of fresh fruits and vegetables.
4. Use of herbs and spices with many beneficial compounds
5. Limited intake of salted or pickled foods, food preserves, artificial sweeteners and artificial food color.
   Small changes can make a big difference!