Fat,CHO, water and micronutrients for adults Flashcards
Why omega 6 to omega 3 is very important
Eicosanoid products derived from omega-6 PUFAs (such as prostaglandin (PG) E2 and leukotriene (LT) B4 synthesized from arachidonic acid (AA)) are more potent mediators of thrombosis and inflammation than similar products derived from omega-3 PUFAs
omega 3 and omega 6 compete for the same enzyme desaturase
Requirements for omega 6 and omega 3 are set based on
-AI for C18:2n-6 and C18:3n-3 established based on highest median intakes in US populations where no evidence of deficiency
Why fatty acids requirements go down with age (in elderly)
As body weight goes down, then the requirement goes down
And their intake is lower ( caloric intake)
What is the rate fo glucose production in overnight fasted adults
2.8-3.6 g/kg/day from glycogen and gluconeogenesis
- ~ 210 to 270 g/d in a 70 kg man (without using ketoacids)
- ~50% from glycogenolysis & 50% from gluconeogenesis
Min CHO determined by
- by the brain’s requirement
- Uses glucose almost exclusively for its energy needs
- ~110-140 g/d in adults
What happens in subject with CHO metabolism in starvation
- In subjects fully adapted to starvation
- Ketoacid oxidation: ~ 80% of brain’s energy requirements
à only 22 to 28 g/d of glucose required
CHO EAR is based on and what assumptions it makes
- EAR based on amount that would provide the brain with adequate supply of glucose
- Without additional glucose production from protein or TG
- Without ↑ketones greater than observed after o/n fast
- This assumes:
- Energy sufficient diet with AMDR of CHO (45 – 65%)
- à glucose not limiting to the brain (no use of ketoacids)
Is there difference in oxidation between age and sex in CHO?
There is no proof
Amount of dietary CHO to decrease risk of chronic disease
Unknown
Definitions of fiber
•Nondigestible CHOs & lignin intrinsic & intact in plants
What is functional fiber and what is total fiber
- Functional fiber = isolated, nondigestible CHOs shown to have beneficial physiological effects in humans
- Total fiber = Dietary Fiber + Functional Fiber
What is resistant starch
Resistant starch- CHO rich source ( like pasta) part of the pasta is not broken down in upper digestion and it is the source of fermentation for bacteria in the colon
How can you cook potatoes ,so there will be more resistant starch
Cooked and then cooled
Benefits of fiber
Fiber- satiety, protection from obesity and weight gain (especially from cereal), in part because of satiety and in addition because they have a probiotic effect -> the greater the diversity, greater the protection
Cereal fiber increases bacterial diversity which is associated with a variety of health benefits and conversely a low bacterial diversity leading to unwanted weight gain or increased disease risk
- Ameliorate constipation & diverticular disease
- Fuel for colonic cells
- ↓ blood [glucose] and [lipids]
- Source of nutrient-rich low-energy foods à satiety & ↓risk of obesity
What is the best food to romote bacterial diversity
Wheat bran
A simple dietary modification to consume a daily bowl of a high fiber breakfast appears to have a positive impact on the gut microbiota for health adults which can be measured within the first 3 weeks
As little as 6 g of wheat fiber was shown to produce significant positive benefits to the gut microbiota,
How fiber can help with diverticulosis
Provide bulk and decrease the transition time
How fiber can be fuel for colonic cells if fiber is not digested
SCFAs from fermentation can be used as a fuel (butyrate) and it has been linked with decreased risk of colonic cancer
Why fiber requirements go down with age?
Due to decrease in caloric requirements
what kind of fiber has the greatest effect on CHD risk
Cereal fiber & proven Functional Fibers, including psyllium & pectin
-Certain kinds of fiber bind cholesterol & prevent absorption -> ↓CHD risk
Why there is a recommendation for fiber, but no EAR
- Strong data on relationship between dietary fiber intake and CHD risk -> use to set intake recommendation.
- Benefit of ↑Total Fiber intake: continuous across range of intakes à EAR cannot be made.
What nutrient is the largest constituent of the human body
Water
Water is essential for and what are the components for total water intake
- Essential for cellular homeostasis and life
- Total water intake = drinking water + water in beverages (80%) + water that is part of food (20%)
What happens if you take too much water and what happns to elderly with too little intake and what adivce can be given to avoid it
- Elderly population is less sensitive to thirst and thus can become dehydrated and pose risk to heart attack and platelet aggregation to blood clots
- A glass of water before bedtime can decrease the chance of stroke
- If too much: risk of edema and oxygen cannot rich the tissues
- With dehydration you have more risk of falling due to low pressure
Do we drink by thrist or something else and do we drink enough
Most healthy adults consume enough water and behavior daily fluid intake , not thirst
When you have thirst signals
- Thirst:
- ↓Body water (sensed as a low blood volume)
- ↑ [Na] (primarily sensed by cells of the brain)
What hormone plays a role in water levels in the body? what are the risks for chronic dehydration? How water, ADH and insulin resistance are connected
ADH plays a role in keeping water inside the body
One risks for chronic dehydration is decreased metabolic response to dehydration ( when high CHO intake->chronic water dehydration-> not enough vasopressin secreted -> insulin resistance
ADH acts on insulin receptors blunting the action
How water status is assessed
- Hydration status (assessed by plasma or serum osmolality) = primary indicator of water status
- Physical activity, environmental and dietary conditions: substantial influences on water needs
How dietary factors can influence water requirements
- Dietary factors also influence water requirements
- Osmotic load created by
- Metabolizing dietary protein & organic compounds
- Varying intakes of electrolytes
Is there a definite daily water requirenment for a given person?
No, single requirement
Dehydration will lead to
- >Impaired heat dissipation
- >↑Body core temperature
- >↑ strain on CV system
Is there an evidence of water intake and chronic diseases
Decreased intake might have an association, but no sufficient evidence
Is there an UL for water and what can happen if you drink more than needed
- XS fluid consumption -> hyponatremia. Rare occurrence -> no UL
- Acute water toxicity: fluid consumption > kidney’s max excretion rate (0.7-1.0 L/h)
Is Ca a risk nutrient for elderly?
Most elderly do not consume 100% of the recommendation.
-↑ risk of osteoporosis, HTN, colon cancer
What is an RDA for calcium and how it was determined
- Relies on Ca balance studies
- -> Intakes to achieve small gains in BMC
- RDA = 1000 mg (25 mmol)/day in adult males and females ages 19 – 50 years
- Based on clinical trial data showing an ↑ in bone mineral density in women provided with intakes of 1000 mg/d
Why phosphorus is important and how it is found in our body
- Occurs as PO4
- Essential constituent
- 85% of adult body P is in bone
- Occurs as phospholipids, nucleotides & nucleic acids
- Buffers acid or alkali XS to maintain normal pH
- Temporary storage & transfer of energy derived from metabolic fuels
- Required for phosphorylation, the activation of many catalytic proteins
Requirements for P is set according to and do we consume enough
- EAR based on the lower end of the normal adult [Pi] range
- 0.87 mmol/liter [2.7 mg/dl]
- -> ingested intake value of ~580 mg (~19 mmol/d)
Absorption efficiency of phosphorus
60-65% on mixed diets
What are dashed lines and curves
- Dashed horizontal lines = upper & lower limits of the normal range
- Dashed curves = relationship between serum Pi and ingested intake for absorption efficiencies ~15% higher and lower than average
why do we need magnesium
- 50 – 60 % in bone
- 1/3 skeletal Mg exchangeable as reservoir for maintaining normal extracellular [Mg]
- Required cofactor for over 300 enzyme systems
EAR for Mg is based on
Balance studies, maintenance of total body Mg
Why requirement for Mg rise with age
- With age, ↑ diets high in fiber (interactions with phytates)
- Renal function declines with age -> ↑EAR
Where we cna find iron in the body and why it is important
- Component of a number of proteins (e.g. enzymes, Hb)
- Almost 2/3 in Hb (erythrocytes)
- 15% in myoglobin in muscle
- Variety of enzymes necessary for oxidative metabolism and many other critical functions
How requirement for iron was set
- The components of Fe requirement used as factors include
- Basal iron losses (obligatory loss in feces, urine, sweat, skin cells)
- Menstrual losses
- Fetal requirements in pregnancy
- Growth: expansion of blood volume, and/or ↑ tissue and storage iron
EAR for iron is based on
-Body Fe store regulates absorption (% absorbed inversely proportional to serum [ferritin])
•Based on the need to maintain a normal, functional [Fe]
-Maintenance of minimal Fe store (serum [ferritin] cutoff = 15 ug/L)
- EAR: set by modeling the components of Fe requirements,-> because iron requirements are skew, so not normally distributed, simple addition cannot be done-> factorial modelling
- Estimating req’t for absorbed Fe at 50th percentile,
- Upper limit of 18% absorption
Major factor for iron asbsorption is
Bioavailability
Where you can find heme and nonheme iron and how they are absorbed
- Heme iron
- Meat, poultry, and fish
- Always well absorbed, slightly influenced by dietary factors
- Nonheme iron
- Present in all foods
- Strongly influenced by solubility & interaction with other meal components
What is the typical mixed diet and what iron bioavailability their
18%
2/3 heme, 1/3 non heme
For men and women EAR is based on
- Men: Basal Fe losses
- Women: Basal iron losses + menstrual losses
Why K intake is important
- Adequate potassium intake important in:
- Lowering blood pressure
- Blunting the adverse blood-pressure effects of salt intake
- Reducing the risk of kidney stones
- Potentially reducing bone loss
Is K AI or EAR
The committee concludes that none of the reviewed indicators for potassium requirements offer sufficient evidence to establish Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA) values. Given the lack of evidence of potassium deficiency in the population, median intakes observed in an apparently healthy group of people are appropriate for establishing the potassium Adequate Intake (AI) values.
Is there a UL for K
No
How much sodium usual det provide, where usually Na is excreted
- Diet providing an average of ~1.5 g/day
- Can meet recommended intakes for other nutrients in a Western-type diet.
- Allows for XS Na loss in sweat by unacclimatized persons exposed to high temperatures or who are moderately physically active
- Wide variation in daily Na needs
- Especially athletes, workers, soldiers
- Sedentary individuals: primary route of loss = urine
- Kidneys can conserve or excrete Na as needed
1.5 g/day is how much salt? and is there an UL? and special recommendations for physically active adults
Sedentary : UL- 2.3g/day
1.5 g/day-3.8 g of salt
Athletes excrete more due to sweat loss, no UL
How Ul and AI is set for Na
In the absence of a specific indicator of sodium adequacy, the sodium AI for adults is based on the lowest levels of sodium intakes evaluated in randomized controlled trials for which there was no evidence of deficiency and also drew on evidence from the best-designed balance study.
There is sufficient evidence to characterize the relationship between sodium intake and risk of chronic disease. The CDRR is established using evidence of the beneficial effect of reducing sodium intake on cardiovascular disease risk