Domain 1 Flashcards
What color fruits and vegetables is calcium found in?
Orange, Green
What does crispness of vegetables depend on?
Osmotic Pressure and water filled vacuoles
What is the limiting amino acid in soy?
Methionine
Protein content of soy 1. Flour 2. Concentrate 3. Isolate
- 50% 2. 70% 3. 90%
What is textured protein products?
The end product of a series of steps producing fibers from soy beans.
What causes chemical changes during ripening?
Enzymes
What gas is used to accelerate the ripening of fruit during storage?
Ethylene
Which fruits ripen best at room temperature?
Avocados, Pears, Bananas and Tomatoes
Foods low in what lead to quick browning? How do you prevent browning?
Ascorbic Acid.
To prevent this… dip them in an acidic solution. Acids prevent enzymatic oxidation.
Density of syrup is measured in ____ by a ____
% by weight of sucrose; Brix hydrometer
Green pigments are due to____
Chlorophyll
Is chlorophyll insoluble or soluble in water?
insoluble
When Chlorophyll is heated in an acid, it turns into _______
pheophytin (olive green color)
When Chlorophyll is heated in an alkaline it turns into _______
chlorophyllin (bright green)
Yellow, orange pigments are due to____
carotenoids
Carotenoids are insoluble or soluble in water?
insoluble
What contributes to red coloring of fruits/vegetables?
Lycopenes (antioxidant, phyotochemical)
What are the two flavonoids?
Anthocyanins and Anthoxanthins
Red, blue and purple pigments are due to ____
Anthocyanins
White pigments are due to _______
Anthoxanthins
Anthocyanin are soluble or insoluble in water?
soluble
Anthocyanins turn ___ in acid and ___ alkaline
Red; blue
Anthoxanthins are soluble or insoluble in water?
soluble
Anthoxanthins are ___ in acid and ___ in alkaline
colorless; yellow
What causes astringent feeling in the mouth?
tannins
Fruit and vegetable grading system (Grade A, B, C) and who grades it?
Grade A. Desserts, Salads (fancy); Grade B. Processed (choice); Grade C. Puddings, Pies (standard)
Graded by USDA
What is milliard reaction?
The reaction between reducing sugars and proteins by the impact of heat.
10 can (#/case; Net weight; Measure; #servings)
6; 6 lbs.9oz; 13 cups; 20-25
What are the two types of protein in meat?
Collagen and Elastin
Collagen is hydrolyzed to ______ in heat.
Gelatin
What does the finish of meat refer to?
Amount of fat cover on carcass
What determines the cut of meat?
Shape of bone
Pork is a good source of _______
Thiamine
______ is high in fish canned with bones, oysters and shrimp
Calcium
What is the main contributor to meat color?
myoglobin +oxygen
Muscle protein brought about by enzymes increase ______ of the muscle?
Water holding capacity
What is MAP
Modified atmospheric packaging (air is removed and replaced with gases (CO2 or N)
Who inspects and grades meat at slaughter?
USDA
Standard grades have the _____ (least/most) marbling and prime the ______ (least/most)
Least; Most
The most tender meat cuts come from ______
Least used muscles (loin, backbone)
Medium tender meat cuts come from _____
shoulder (chuck)
Least tender meat cuts come from ______
Most used muscles (flank, brisket)
145 F is minimum safe internal temperature for_______.
Pork, Beef, Lamb, Veal, Steak, Roast, Fish
160 F is minimum safe internal temperature for _______.
Ground beef, ground veal, ground lamb
165 F is minimum safe internal temperature for ______.
Turkey, chicken , duck
Cured meats are pink from _____
Nitrites (prevents botulism)
Why does interior of meat change from red to pink to brown?
Heat denatures globin and iron is oxidized
Dry heat cooking methods
Frying, Broiling, Roasting, Grilling
Moist heat cooking methods
Braising, simmer, steam, stewing (water is involved)
Grading of eggs is based on _____
Candling (pass an egg in front of a bright light to view contents) Judged by thickness of white, location and condition of yolk – AA, A or B
Uses of Eggs:
Coagulation (custard), Leavening, Emulsification, Cooking, Processing, Storage
What is syneresis?
Liquid released from a coagulated product when too much heat is used.
What helps yolk act as an emulsifier?
Lecithin
How to measure tenderness of custard?
The larger the % sag (objective measurement) , the more tender the gel
What are the two milk proteins
80% casein, whey (lactose, lactalbumin, lactoglobulin, water soluble vitamins, minerals)
What is pasteurization?
Destroys pathogenic bacteria. 145 F for 30 min or 160 F for 15 seconds
To prevent curdling add ____ slowly and agitate.
an acid. (an acid precipitates casein).
How is cheese produced?
Warm up milk, add lactic-acid bacteria, add enzyme rennet to coagulate casein, forming the curd.
What prevents fat from separating and smoothes cheese?
Disodium phosphate
The endosperm is rich in ____
Protein
The scutellum in germ has the most _____
Thiamine
Quick cooking cereals have ____ added to increase swelling quickly?
disodium phosphate
Wheat flour is enriched with______
thiamin, riboflavin, niacin, iron, folic acid
Leavening is created by ______
steam, air or carbon dioxide
Quick breads are leavened with_____
Steam, air, chemical leavening agents (flour and egg)
What are the four ingredients in pastries?
Flour, Fat, Liquid, Salt
Straight dough method
All ingredients are added before dough is allowed to rise
Sponge method
Combine liquid with yeast and part of flour and allow batter to ferment.
Continuous bread baking method
substitutes intense mechanical energy for traditional bulk fermentation
How to adjust baking at high altitudes.
Decrease baking powder, increase liquid.
Decreased pressure causes gas to expand faster, steam forms earlier.
Starch is composed of ________
amylose and amylopectin molecules
Amylose is responsible for ______
Geletion (solidifying)
Define gelatinization
The swelling that occurs when starch is heated in water close to the boiling point.
Define retrogradation
Occurs in starches with a high proportion of amylose. After a starch paste has been cooled, it becomes less soluble and recrystallizes. It is Undesirable. (e.g. Pudding held in refrigerator for many days or harsh texture of bread after days in storage.)
What is gelatin?
Incomplete protein- no tryptophan , low in methionine and lysine. Keeps sugar and ice crystals small in candy and ice cream.
When coffee is heated above 203 F what is extracted?
Tannins-causing bitterness
Who controls additives in products?
FDA
Emulsifier
Helps two liquids mix (monoglycerides, diglycerides, lecithin, disodium phosphate)
Humectant
Retains moisture (glycerol monostearate)
Stabilizer
Preserves structure (carrageenan, pectin, cellulose, gelatin, vegetable proteins)
Anti-caking
Prevents ingredients caking together (Sodium stearate)
Nitrites
Fixes color, inhibits spores of clostridium botulinum
Propionate
Preservative, mold inhibitor
Ascorbic Acid
Prevents browning
Functional Foods
provide more benefits than the basic nutrition benefits
Examples of functional foods
conventional foods (whole foods), modified (fermented, enriched, enhanced) medical foods, special dietary foods (gluten free)
Phytochemicals
Biologically active naturally occurring chemical compounds in plant foods, act as natural defense (terpenes, carotenoids, lycopene, Limonoids, phenols, flavonoids, etc.)
Food synergy
The additive influence of foods and constituents which when eaten have a beneficial effect on health.
Pedagogy
The science of teaching children
Andragogy
Adults are mutual partners in learning
Sales promotion
Short term incentive to encourage purchases (coupons)
Personal promotion
Formal/informal presentation, health fairs, cooking demonstrations.
What are the 3 types of domains of learning?
Cognitive: acquisition of knowledge (factual learning)
Affective: acquisition of attitudes or values
Psychomotor: acquisition of muscular skills
6 steps of the plan-theory-based nutrition education
- decide behavior change goals
- explore determinants of change
- select the theory you will use
- indicate general objectives
- generate plans
- develop evaluation plan
Describe the three behavior modification methods
- positive reinforcement- encourages repetition of a given behavior
- avoidance learning- learn to escape from unpleasant consequences
- extinction- reduce undesired behavior
Describe the 5 stages of Transtheoretical Stages of Change model.
- pre contemplation
- contemplation
- preparation
- action
- maintenance
Health belief model
a person must perceive the severity for the threat to be a behavior-motivating factor.
Diffusion of innovation
how an innovation, idea or behavior spreads
- Positions: innovators, early adopters, early majority, late majority, laggards
Synergy
The groups decision is superior to what the most resourceful individual within the group could have come up with on their own.
Steps of interviewing
- preparation
- build rapport
- collect data
- closing
Non verbal communication: kinesics
physical communication (eye contact, arms folded)
Non verbal communication: paralinguistics
How the client’s message is delivered (anxious, sensitive, stuttering)
Non verbal communication: proxemics
Personal space
Ethical principle of autonomy
Respect other’s right to self-determine a course of action or support independent decision making
Cognitive behavior therapy
Focuses on identifying behaviors and thoughts that have a negative impact on desired behaviors and goals and apply strategies to change those.
Describe Motivational Interviewing(MI)
Helps client recognize and begin to resolve their concerns and problems.
What are the principles of MI
- express empathy
- develop discrepancy (between where he is and where he wants to be)
- avoid arguments
- roll with resistance
- support self efficacy
Explain the 4 steps of the educational process
- assessment
- planning
- implementation
- evaluation of outcomes
2 types of evaluation of educational outcomes
Formative: Made during the course of education
Summative: designed at planning stage but conducted at the end (did we achieve what we planned)
Nutritional informatics
the intersection between nutrition, information and technology
Types of nutritional informatics
- electronic health record
- personal health record
Patient centered medical home (PCMH)
focuses on the relationship between the patient and personal physician
describe legislation
The interaction between the legislative, executive and judiciary branches
describe the legislative branch
(congress, senators, representatives) may introduce and enact a law and can override a veto by the executive branch
describe the executive branch
(president) may veto legislation or sign it into law
describe the judiciary branch
may disregard a law if it considers it in violation of a person’s basic rights and freedoms
Stages of how a bill becomes a law.
- legislation enters as a bill or a resolution
- the bill is sent to committees.
- the committee revises bill during a markup session and puts it into final form
- needs approval from both houses (representatives and senate) and the president
- differences between the two houses are worked out in a joint house-senate conference committee and ultimately pass a reconciliation bill
- appropriations must be passed to provide funding
- formulate regulations that interpret and operate the law
Describe the federal trade commission (FTC)
Regulates content of food ads; enforces truth in labeling; challenges product claims when product crosses state lines
describe the Food and Drug Administration (FDA)
ensures safety of some domestic and important food products
Describe federal communications commission (FCC)
licenses radio and tv
Child Nutrition Reauthorization covers which educational programs _______
NSLP, SBP, CACGP, SFSP, SMP, WIC
Describe the farm bill
Covers national and international nutrition education, research and funding
Describe the older Americans act
funds nutrition programs in the community and those that are homebound
Describe the 7 steps in research
- Identify a relevant and important topic
- Develop well-considered research question
- research question leads to a hypothesis
- prepare research protocol: methodology to solve the problem
- organize methods and materials
- collect and analyze data
- study results and make decisions
Describe meta-analysis
a formal, defined system that combines the result of numerous small studies to increase the strength of belief in the observed effect.
Descriptive vs analytical research
descriptive: describes state of nature at a point in time. provides baseline data and monitors changes over time. Establishes associations among factors but does not allow causal relationships to be determined.
analytical: tests hypotheses concerning the effects of specific factors of interest and allows causal associations to be determined.
Describe the 4 types of descriptive research
- Qualitative - explore a phenomenon of interest as a prelude to theory development. Data is collected through interviews, observations, questionnaires.
- Case report- report of observations on one subject or more than one subject.
- Surveys- research designed to describe and quantify characteristics of a defined population; defined time frame; pinpointed problems.
- Correlation studies or ecological studies- compare frequency of events in different populations.
Describe the 5 types of analytic research
- experimental model- uses experimental and control groups
- Quasi-experimental design- time series. series of measurements at periodic intervals before the program begins and after the program ends.
- cohort studies- cohort= any group whose members have something in common. carried out over a long period of time (longitudinal) and prospective (future-oriented)
- case control studies- focus on specific disease. both groups recall past behaviors to study how the groups differ
- cross-sectional studies/prevalence- one time data collection counting all of the cases of a specific disease among a group of people at a particular time.
What is the gold standard of the experimental model?
Randomized control trial with comparison placebo control group.
Define the institutional review board
committee established to review and approve research involving human subjects to ensure it is conducted within all ethical and federal guidelines.
relevance or validity
ability to measure phenomenon it intends to measure.
internal validity
tests whether the difference between the two groups is real.
external validity
tests whether or not a generalization can be made from the study to a larger population.
define reliability and give examples of reliability in experiments.
consistency or reproducibility of test results.
examples:
- test, then retest
- parallel forms: two separate but similar forms of the same test at the same time
- split halves: divide the test in half
-precision: amount of variation that occurs randomly
tools for analysis of variance
ANOVA- asks whether the difference between samples is a reliable one that would be repeated.
define sensitivity in statistical evaluation
proportion of afflicted individuals who test positive
define specificity in statistical evaluation
proportion of non afflicted identified as non afflicted
define variables in statistical evaluation
characteristics that may have different values from observation to observation
- nominal (non ordered) variables that fit into a category with no special order (gender, race, marital status)
- rank order (ordinal scale)
- numeral discrete (data with numbers) e.g. number of clinic visits
- numerical continuous (underlying continuous scales) e.g. blood pressure
Levels of significance is measured by a p-value. the lower p value, the _____ the significance of your results
Higher
p<0.0001 very very significant, reliable results
p>0.5 not very significant, not reliable results
Mortality
rate of death
Morbitity
rate of disease
inferential statistics
techniques that allow conclusions to extend beyond an immediate data set
nonparametric test
does not depend on a normal distribution
dichotomous scores
only two events are possible (heads, tails)
continuous scores
measured on a continuous scale
pilot study
scaled down version of a larger investigation
chi square test
Determines if a difference between observed data and expected data is due to chance, or if it is due to a relationship between the variables you are studying.
t test
tests significance between the means of two different populations. tests null against alternative hypothesis.
where is glycogen stored in the body?
liver and muscles
define gluconeogenesis
conversion of non carbohydrate sources into glucose (from glycerol and amino acids)
Cellular oxidation
oxidation reaction in which glucose is oxidized and oxygen is reduced
which coenzymes are essential in energy production?
pantothenic acid, thiamin, riboflavin, niacin
define enzymes
proteins, organic catalysts that control reaction
define coenzyme
enzyme activators
define substrate
substance upon which an enzyme works
define cofactor
assists enzymes; minerals
hormones
chemical messengers that trigger enzymes (example: thyroxine regulates metabolism and rate of oxidation)
anabolism
synthesis of a more complex substance
catabolism
breakdown; releases energy
what 3 things contribute to total energy expenditure (TEE)
basal energy expenditure
energy expended in physical activity
thermic effect of food
What are the measures of energy utilization
basal metabolic rate
resting metabolic rate
weight control
calorimetry
what is basal metabolic rate measuring/how is it measured
measures oxygen consumed; measured by protein bound iodine (PBI). measured in the morning after a fasting state.
what factors influence basal metabolic rate?
sex, age, body composition, endocrine glands, exercise
define resting metabolic rate
energy expenditure measured similarly to basal metabolic rate
define indirect calorimetry
measures oxygen consumed and carbon dioxide excreted using a portable machine .
define direct calorimetry
measures heat produced in respiration chamber
formula of respiratory quotients
RQ= Vco2 expired/Vo2 oxygen consumed
RQ if carbohydrates alone are being consumed
1
RQ if fats alone are being consumed
0.7
RQ if protein alone is being consumed
0.82
3 monosaccharides
glucose, fructose, galactose
3 disaccharides
sucrose (glucose and fructose)
maltose (glucose and glucose)
lactose (glucose and galactose)
5 polysaccharides
starch (glucose chains)
cellulose (resistant to digestive enzyme amylase, adds bulk)
pectin (non-digestible, thickening quality, fruits)
glycogen (animal starch, from glucose, stored in muscle and liver)
dextrin (intermediate product of starch breakdown)
define sorbitol
alcohol from glucose; absorbed more slowly than glucose by passive diffusion; converted to fructose; excess may cause diarrhea
3 main functions of carbohydrates
- energy
- protein sparing action- allows most of protein to be used for tissue synthesis
- regulation of fat metabolism- a carbohydrate restriction leads to ketosis
which 3 amino acids have sulfur
cysteine, cycstine, methionine
Amino acids have an acid and a base, what are they?
Amino group (NH2)- base
Carboxyl group (COOH)- acid
What are the essential amino acids?
threonine, valine, tryptophan, isoleucine, leucine, lysine, phenylalanine, methionine, histidine (TV TILL PMH)
which amino acids are conditionally essential during catabolic stress?
arginine, glutamine
what is the precursor for serotonin and niacin
tryptophan
simple proteins
amino acids
conjugated proteins
simple plus non protein substance (lipoprotein)
derived
fragments from simple and conjugated (peptide)
2 main functions protein
- tissue synthesis, maintains growth, regulates body processes.
- inefficient energy source- nitrogen must be removed first
soybeans are low in _____ amino acid(s)
methionine
legumes are low in _____ amino acid(s)
methionine, cystine and tryptophane
gelatin is low in ______ amino acid(s)
methionine, cystine and tryptophan
3 types of fats
- simple (triglycerides- 3 fatty acids, 1 glycerol) - most food
- compound (simple fat plus other component)- example is phospholipids
- derived (fat substance derived from a simple or compound fat by hydrolysis or enzymatic breakdown; fatty acid, glycerol, steroid)
describe saturated fatty acids
all available bonds of carbon chain are filled with hydrogen; solid and hard at room temperature
describe unsaturated fatty acids
one or more double bonds
monounsaturated fatty acids
one double bond
polyunsaturated fatty acids
two or more double bonds
Most polyunsaturated fatty acid
safflower
most unsaturated fatty acid
olive
2 essential fatty acids
- linoeic acid (w-6) - deficiency causes eczema, poor growth rate and petechiae
- a-linolenic (w-3)- for retinal function and brain development
explain the structure of fatty acids
- straight hydrocarbon chains terminating in a carboxyl group (cooh) at one end and a methyl group (CH3) at the other end
- classified by the number. of carbons in the chain, the position of the first double bond and the number of double bonds.
understand how to name fatty acids (example linoleic acid)
18:2w6
18 carbons, two double bonds, the first double bond is at the 6th carbon
hydrogenation
the process of adding hydrogen (at the double bond) to unsaturated fatty acids to increase saturation and stability
trans fatty acids
hydrogens are across from each other; pack tightly; influence membrane fluidity and could be harmful to cell function
cis fatty acids
hydrogens on same side at the double bond; most natural fats and oils
2 functions of fat
- energy, insulation, depresses gastric secretion so delays emptying
- has less oxygen, more carbon than carbohydrates so provides more energy (more carbon atoms for oxidation)
fat soluble vitamins
A, D, E, K
sources of vitamin A
yellow, orange fruits; dark leafy green vegetables, cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato
sources of vitamin D
sunlight, egg yolk, fortified milk
sources of vitamin E
vegetable oils, whole grains, green vegetables, almonds
sources of vitamin K
spinach, kale, broccoli, green, leafy vegetables
sources of B1
grains, wheat germ, pork, liver
sources of B2
liver, kidney, meat, milk
sources of niacin
protein, peanuts, ready to eat cereals, chicken, rice, yeast, milk
sources of folate
fortified dry cereal, liver, kidney, green leafy vegetables, citrus fruits, lentils, beans
sources of B6
meat, wheat, corn, yeast, pork, liver, ready to eat cereals
sources of B12
liver, meat, milk, kidney, eggs, fish, cheese
sources of pantothenic acid
animal food, grains, legumes
sources of vitamin C
citrus fruits, potatoes, papaya, dark green, yellow vegetables
sources of biotin
liver, kidney, egg yolk, yeast
sources of myo-inositol
outer husks of cereal grains, dark leafy green vegetables
sources of calcium
diary products, leafy vegetables, legumes
sources of iron
animal foods, meats, fish, poultry, cereals, vegetables
sources of magnesium
milk, bread
sources of zinc
meat, liver, eggs, fish
sources of iodine
seafood, salt
sources of flouride
soil, water
sources of copper
liver, kidney, shellfish
sources of selenium
soil, grains, meat, fish, poultry, dairy
sources of manganese
whole grains, legumes, nuts
sources of chromium
yeast, oysters, potatoes, liver
sources of sulfer
meat, eggs, fish, poultry
sources of choline
fat in eggs, milk , liver, soybeans
deficiencies in vitamin A
night blindness, dry scaly skin
deficiencies in vitamin D
rickets, osteomalacia
deficiencies in vitamin E
hemolytic anemia
deficiencies in vitamin K
Hemorrhage
deficiencies in vitamin B1
beriberi, muscle weakness, foot drop, memory loss, tachycardia
deficiencies in vitamin B2
growth failure, cheilosis (cracked lips), angular stomatitis, magenta tongue
deficiencies in niacin
pellagra, dermatitis, diarrhea, dementia, beefy, bright red tongue, symmetrical, pigmented rash
deficiencies in folate
megaloblastic, microcytic anemia, diarrhea, fatigue
deficiencies in vitamin B6
seizures, anemia, dermatitis, glossitis, peripheral neuropathy
deficiencies in vitamin B12
macrocytic, megaloblastic anemia
deficiencies in pantothenic acid
paresthesia in feet
deficiencies in vitamin c
scurvy, poor wound healing, bleeding gums, petechiae
deficiencies in biotin
muscle pain, dermatitis, glossitis
deficiencies in calcium
tetany
deficiencies in iron
pale tongue, fatigue, anemia, spoon shaped nails, pale conjuctiva
deficiencies in magnesium
tremors
deficiencies in zinc
reduced immune function, alopecia, poor wound healing, hypogeusia
deficiencies in iodine
goiter
deficiencies in fluoride
dental caries
deficiencies in copper
anemia, neutropenia, wilson’s disease, genetic absence of liver enzyme
deficiencies in selenium
myalgia, cardiac myopathy
deficiencies in chromium
insulin resistance
How is concentration of electrolytes expressed in mEq
mEq= (mg/atomic weight) x valence
normal ranges of cations (Na, K, Ca, Mg)
Na 136-145
K 3.5-5
Ca 4.5-5.5
Mg 1.5-2.5
normal ranges of anions (Cl, P)
Cl: 96-106
P: 3-4.5
High potassium sources
meats, bananas, oranges, tomato, potato, cantaloupe
Low potassium sources
apple, cranberry, blueberry, carrots, corn
anasarca
extreme, generalized edema and swelling of skin due to effusion of fluid into extracellular space. Low serum protein leads to edema and ascites
How are acids and bases regulated in the body?
acids release hydrogen ions, bases pick up hydrogen ions
define a buffer
mixture of acid and base components to protect against a strong acid or strong base
Role of the lungs in regulating acid/base balance
control supply of carbonic acid. amount altered by rate and depth of breathing. Hypoventilation-retention of acid; hyperventilation-loss of acid
role of kidneys in regulating acid/base balance
kidneys control bicarbonate (base). If kidneys retain bicarbonate-level of base increases, and if kidneys release bicarbonate-level of base decreases.
acidosis from respiratory system.
retention of CO2 by lungs (decreased ventilation) to compensate, kidneys increase absorption of base
alkalosis from respiratory system
loss of carbonic acid (increased ventilation). to compensate, kidneys excrete additional base
acidosis from renal system
kidneys either produce or retain too much hydrogen or kidneys excrete too much base. to compensate, respiration increases to remove CO2 to decrease carbonic acid.
alkalosis from renal system
loss of hydrogen due to loss of acid or increased retention of base. to compensate, ventilation decreases to retain CO2 to make carbonic acid
weight gain guidelines for pregnant women
28 - 40 lb for underweight
25-35 lb for normal weight
15-25 lb for overweight
11-20 lb for obese
calorie guidelines for pregnant women
+340 kcal 2nd trimester
+452 kcal 3rd trimester
during lactation:
+330 kcal first 6 months
+400 kcal 6-12 months
recommended hemoglobin/hematocrit levels during pregnancy
hemoglobin 11 g/dl
hematocrit 33%
weight gain trends for pregnant women
1 lb/month first 3 months; 1 lb per week thereafter
pregnant adolescents are at higher risk for deficiencies in
zinc, iron and calcium
recommended supplements for pregnant women
ferrous sulfate (30 mg) during 2nd and 3rd trimesters – not to be taken with milk, tea or coffee
folic acid 400 mcg
What hormone develops the placenta after implantation
progesterone
DRI recommend ___ linoic acid during pregnancy
1.4 g/day and 1.3 g/day during lactation
- for development of fetal nervous system
Normal birth weight
2500-4000 grams (5.5-9 lb)
Low birth weight
<2500 g (<5.5 lb)
very low birth weight
<1500 g (<3.3 lb)
extremely low birth weight
<1000 g (<2.2 lb)
small for gestational age
<10th percentile birth weight for gestational age
appropriate for gestational age
10-90th percentile birth weight for gestational age
large for gestational age
> 90th percentile birth weight for gestational age
calorie/protein/water/fat needs for 0-6 month old
calorie: 520 (female) 570 (male)
protein: 9.1 g
water: 125-155 ml/kg (depends on age)
Fat: minimum of 30 g per day
calorie/protein/water/fat needs for 7-12 month old
calorie: 676 (female) 743 (male)
protein: 11 g
water: 1.5 ml/kcal
Fat: minimum of 30 g per day
parameters for 0-6 months old (weight, length)
weight 6 kg
length 24 inches
parameters for 6-12 months old (weight, length)
weight 9 kg
length 28 inches
parameters for hemoglobin and hematocrit in newborns
hemoglobin (16.5-19.5)
hematocrit (49-54%)
prolactin
stimulates milk production
oxytocin
moves milk through ducts
kcal/oz human breast milk
20
colostrum
yellowish transparent fluid secreted from the breast during the first few days. Has more protein, less fat and carbohydrates than mature milk.
human composition of milk vs cows milk
Human: 7% PRO, 28% CHO, 55% FAT *has more lactalbumin
Cows: 20% PRO, 30% CHO, 50% FAT
how much vit D and fluoride do breast fed infants need from birth per day
vit d 400 IU
fluoride 0.25 mg
Describe infant formula
20 kcal/oz; need 2/5 oz/lb/day
higher protein, more iron than human milk, less antibodies
formula fed babies only need fluoride supplementation after 6 months
hyperbilirubinemia
unconjucateqd bilirubin levels elevated within the first week of life as a result of increased breakdown of red blood cells or decreased intestinal mobility. Encourage 9-12 feedings/day to promote hydration and intestinal motility
at what age do fetal iron stores decrease?
3-4 months
When should solid foods be introduced to an infant?
4-6 months
when sitting posture can be sustained and extrusion reflex diminishes. Start with iron fortified cereal then strained fruits/veg
when should large finger foods be introduced?
6-8 months
when infant can secure food with a palmar grasp
when should small finger foods be introduced?
9-12 months
when infant can secure food with pincer grasp
why should infants have one serving of vit c rich foods by 6 months?
to enhance iron absorption from non-heme sources
RDA of protein for ages 1-3, 4-8. 9-13
1-3: 13 g
4-8: 19
9-13 34 g
how long is length used to describe height?
0-36 months
how long is weight for age used to describe BMI
0-2 years
how long should head circumference be measured until?
until 3 years old
how long should it take a newborn to regain 6% loss of birth weight?
10-14 days
when should birth weight be doubled? tripled?
doubled: month 4-5; tripled: one year
how long is normal gestation?
40 weeks.
Example: an infant born at 28 weeks is 12 weeks premature. when he is 4 months old, his corrected age would be 1 month. (4 months-12 weeks)
Macronutrient needs for adults (in %)
45-65% carbohydrates
20-35% fat
10-35% protein
RDA protein for males 14-18 years old
52 grams
RDA protein for females 14-18 years old
46 grams
RDA protein for males >/= 19 years old
56 grams
RDA protein for females >/=19 years old
46 grams
Adequate intake for calcium for pregnancy/ lactation
</= 18 years old 1300 mg
> 18 years old 1000 mg
Adequate fiber intake for adults under 50
Men 38 ; Women 25
Adequate fiber intake for adults over 50
Men 30; Women 21
adequate fluid intake for adults >19 years old
Men: 3.7 L/day
Women: 2.7 L/day
adequate sodium for adults >19
1.5 g/day
adequate intake (g/day) for linolenic acid; linoleic acid
linolenic acid: males= 1.6, females= 1.1
linoleic acid: males= 17, females =12
What causes constipation in the elderly
decreased gastric motility, decreased HCL secretion
Elderly are usually deficient in what?
calcium , iron, folate, B6/B12
how much water should athletes be drinking for every 1 lb body weight lost
16 oz
Pre activity hydration recommendations
10 ml/kg high sodium containing beverage prior to activity that is 1-4 hours long
during activity hydration recommendations
hydration should equal 100% of body weight lost plus 5.5-15% CHO and 55-164 mEq Na for vigorous activity
after activity hydration recommendations
within 1-2 hours after activity. should equal 100-150% of fluid lost in exercise and contain 6-7.6% CHO and 57.5-1159 mg/dl Na.
at rest, what are our primary energy source
fat (80-90%)
carbs (5-18%) and protein (2-5%)
exercise above 60-65% of maximal oxygen uptake, what is needed as the fuel source
Carbohydrates
herbals, botanicals and supplements are regulated by the ______
Dietary Supplement Health and Education Act 1994
purpose of black cocosh
ease menopause symptoms
purpose of echinacea
prevent moderate cold symptoms
purpose of Ephedra
promote weight loss
Purpose of garlic
may lower cholesterol, blood pressure
purpose of ginger
antiemetic
purpose of ginkgo biloba
vasodilation
purpose of ginseng
immunity and endurance
purpose of kava
relieve anxiety
purpose of milk thistle
may help protect the liver
purpose of st john’s wort
antidepressive, serotonin-enhancing
purpose of licorice root
ulcers
purpose of saw palmetto
relieve symptoms of enlarged prostate
purpose of valerian root
calm nerves
purpose of yohimbe
sexual dysfunction
What are the three large glands in the mouth
parotid, submaxillary, sublingual
Describe the route in which food takes during digestion
enters the oral cavity/mouth. food passes into the stomach via the esophagus through the cardiac valve into the fundus. food is forced into the small intestine through the pyloric valve. Complete digestion and absorption of food takes place in the small intestine. undigested food and water pass through the ileocecal valve into the large intestine.
where is bile produced and stored
produced in the liver and stored in the gall bladder.
where is glycogen stored and glucose synthesized?
the liver
describe the function of the hormone CCK cholecystokinin
released from duodenum when fat enters. contracts the gall bladder releasing bile and stimulates the pancreas
describe the function of the hormone secretin
released from duodenum, stimulates flow of pancreatic juice (bicarbonate) and water into the duodenum, inhibits gastric acid secretion
What macronutrients are being chemically digested in the mouth?
carbohydrates by the enzyme amylase
what macronutrients are being chemically digested in the stomach?
carbohydrates by the enzyme amylase
Protein undergoes proteolysis
What macronutrients are being absorbed in the small intestine?
carbohydrates by maltase, sucrase, lactase, pancreatic amylase
protein
fat
How long does gastric emptying usually take for a meal
2-6 hours
where is most digestion completed by
middle of the jejunum
peristalsis
rhythmic movements of small intestine
describe bacterial digestion
-large intestine absorbs water, salts, and vitamins synthesized by bacteria
-colonic salvage: anaerobic fermentation and absorption of end-products of carbohydrate, fiber and amino acid breakdown
- converts malabsorbed carbs and fibers into short changed fatty acids and gases H2 CO2 N CH4
sources of glucose
dietary, liver glycogen, products of intermediate metabolism
dietary sources come from carbohydrates (100%), protein (58% from glucogenic amino acids-alanine especially) and fat (10% from glycerol*fatty acids and muscle glycogen do not contribute to the body’s supply of glucose)
Uses of glucose
energy, storage (glycogenesis, lipogenesis), small amount is converted into other carbohydrate compounds (e.g. ribose needed to form RNA and DNA)
describe insulin
released from BETA cells of pancreas
-increases cell permeability to glucose; fosters glycogenesis and lipogenesis
describe glucagon
released from ALPHA cells of pancreas
- induces glycogenolysis
describe glucocorticoids
protein is converted into glucose (gluconeogenesis)
describe epinephrine
released by the adrenal medulla
- stimulates sympathetic nervous system
-stimulates liver and muscle glucogenolysis (glycogen to glucose)
- decreases release of insulin from pancreas DURING catabolic stress; blood sugar rises
describe growth hormone, ACTH adrenocorticotropic
insulin antagonists
Where does glycolysis occur?
in the cytoplasm
what is the end product of aerobic glycolysis
pyruvate
what is the end product of anaerobic glycolysis
lactate
Where does the krebs cycle occur?
in the mitochondria
full oxidation of 1 molecule of glucose yields how many ATP?
38
Describe protein metabolism
amino acids enter intestinal villi capillaries and then most are transferred into the portal blood stream and to tissues.
nitrogen balance formula
[protein intake (g)/6.25] - [urinary urea nitrogen + 4]
How to determine the quality of protein in foods
Biological value: uses nitrogen balance techniques to determine the fraction of absorbed nitrogen retained for growth and maintenance.
Net protein utilization: measures the amount of protein actually used (Nintake-Noutput/ Nintake)- scores higher in animal products
Protein digestibility corrected amino acid score: represents amino acid score after correcting for digestibility. protein coefficient of digestibility estimates % protein in each food category that is actually digested.
Protein anabolism
synthesis: DNA deoxyribose nucleic acid
Protein catabolism
pyridoxine is involved.
1. step one is deamination- splitting off the NH2 by hydrolysis in liver
2. NH2 is converted into ammonia (NH3)
3. most ammonia is converted to urea and excreted by the kidneys and some is converted into purines and some is used to make nonessential amino acids through transamination.
4. the remainaing carbon chain is a ketoacid; it can be oxidized for energy.
define transamination
transfer of amino group to a ketoacid to form a new amino acid
What hormones stimulate protein anabolism
pituitary growth hormone, insulin, thyroid hormone, testosterone
what hormones stimulate protein catabolism
adrenal steroids (glucocorticoids)
what are the end products of fat digestion
monoglycerides, diglycerides, glycerol, fatty acids
which products of fat digestion are absorbed directly into the portal blood?
glycerol, short chained fatty acids (<12 carbones), some phospholipids
which products of fat digestion combine to bile salts to form micelles?
monoglycerides, diglycerides, long chained fatty acids
describe cholesterol
found in all cells, important in cell structure, some absorbed with bile salts. Most absorbed with cholesterol esterase–> converted into cholesterol esteres –> excreted by liver as bile
describe lipogenesis
synthesis/deposition
-adipose= most active site : fatty acids+glycerol to triglycerides
-liver= synthesizes fat but should not store fat. to prevent fat accumulation, lipotropic factors produce lipoproteins which transfer fatty acids out of the liver.
understand lipoproteins
chylomicron largest (mostly made of triglycerides)
VLDL is half size of TG
LDL is smaller (mostly made of cholesterol)
HDL is rich in protein
lipolysis
breakdown of fats by hydrolysis.
oxidation forms acetyl coA which enters the Krebs cycle
hormones used in lipolysis
growth hormone, glucagon- insulin antagonist
glucocorticoids, thyroxine, epinephrine, ACTH increase rate of fat mobilization
hormones used in lipogenesis
insluin (anabolic)
normal fat metabolism vs abnormal fat metabolism
normal- requires adequate carbs for complete fat oxidation
abnormal- inadequate carbs results in incomplete fat oxidation and buildup of ketones
describe active transport
most nutrients (glucose, amino acids, Na, K, Mg, Ca, Fe)
-sodium pump
- needs energy from ATP; sodium plays
describe simple diffusion
some water and electrolytes
-higher to lower concentration: intestine to blood to lymph
describe passive diffusion
carrier facilitated-water soluble nutrients
- higher to lower concentration
describe the hypothalamus
key brain structure involved in the control of food and energy intake
serotonin
a neurotransmitter that increases carbohydrate appetite
leptin
produced by fat cells in response to food intake, induces satiety
ghrelin
produced in the stomach and intestine stimulated appetite and growth hormone secretion
