Final Flashcards
1
Q
Characteristics of water soluble vitamins
A
- Vitamins B and C
- Absorbed directly into the blood.
- Travel freely in watery fluids, most are not stored in the body.
- Readily excreted in the urine.
- Toxicities are unlikely but possible with high doses from supplements.
- Needed in frequent doses(perhaps 1 to 3 days) because the body does not store most of them to any extent.
2
Q
Vitamin A Retinoids(active)
A
Retinol-One of the active forms of vitamin A made from beta-carotene in animal and human bodies, an antioxidant nutrient. Other active forms are retinal and retinoic acid.
3
Q
Vitamin A Carotenoids(not active)
A
Beta-carotene-An orange pigment with antioxidant activity, a vitamin A precursor made by plants and stored in human fat tissue.
4
Q
Roles of Vitamin A
A
Vitamin A exerts considerable influence on body functions through its regulation of genes. Genes direct the synthesis of proteins.
The most familiar function of Vitamin A is to sustain normal eyesight. Two indispensable roles in the process of light perception at the retina and in the maintenance of a healthy, crystal clear outer window, the cornea.
5
Q
Vitamin A Dietary Sources(not toxic)
A
- Retinoids(vitamin A):animal sources
- Carotenoids:plant sources
6
Q
Vitamin A:Carotenoids and Disease
A
- Macular degeneration: The most common form of age-related blindness. The macula, a yellow spot of pigment at the focal center of the retina, loses integrity, impairing the most important field of vision, the central focus.
- Antioxidant: Beta carotene is one of many antioxidants present in foods. Dietary antioxidants are just one class of a complex array of constituents in whole foods that seem to benefit health synergistically.
7
Q
Vitamin A and beta carotene toxicity(due to excess supplementation)
A
- Bone weakness(vitamin A)
- Birth defects(vitamin A)
- Raise in risk of lung cancer in smokers(beta carotene)
8
Q
Vitamin D Two Forms
A
- Ergocalciferol(D2)
- Cholecalciferol(D3)
9
Q
Vitamin D Synthesis
A
Activation of Vitamin D, Liver: D3
10
Q
Influences on Vitamin D Synthesis
A
- weather, advanced age, skin color, geography, weight, homebound
- Warmer season bring more direct sun rays.
- Skin loses capacity to synthesize with age.
- Darker skin people synthesize less vitamin d per min than lighter skinned people.
- Locations south of 35 degrees(much of southern U.S) direct sun exposure is sufficient for vitamin D synthesis year round.
- weight
- Living indoors prevents sun exposure.
11
Q
Activation of Vitamin D
A
Skin to Liver to Kidneys
12
Q
Function of vitamin D
A
- Blood calcium concentration regulation, maintaining bone integrity.
- Low blood calcium
13
Q
Vitamin D Deficiency Disease(Children and Adults)
A
- Children: Rickets, abnormality of the bones, bowed legs, protruding belly.
- Adults: Osteomalacia, painful bone disease, bones become increasingly soft, flexible, brittle, and deformed.
14
Q
Vitamin D RDA(Recommendation)
A
- Infants, 400 IU
- 1-70 years, 600 IU
- Intake recommendation increases with age.
- Micrograms, 19-50 years/ 5 a day, 51-70 years/ 10 a day, over 70 years/ 15 a day.
15
Q
Vitamin E
A
- Alpha tocopherol: Active form
- Function: Antioxidant
16
Q
Vitamin K
A
- Function: Synthesis of blood clotting proteins.
- Deficiency(groups at risk): Deficiency causes uncontrolled bleeding. Newborns, Long term antibiotic use, fat malabsorption disease
- Sources(dietary and non dietary): Intestinal bacteria, non food source, leafy greens
17
Q
Water Soluble Vitamins
A
-Vitamins B and C
18
Q
Vitamin C
A
- Functions: Promotes healthy immune system.
- Deficiency: Scurvy, swollen and bleeding gums, livid spots on skin, disease that often killed as many as 2/3 of a ships crew on a long voyage.
- Food sources: Fruits and vegetables, easily destroyed by heat and oxygen
- How to store/prepare/cook to maximize Vitamin C content: Proper storage away from air, uncut skin, unopened can.
19
Q
B Vitamin Thiamin
A
- Functions: Part of Coenzyme in energy metabolism, required for nerve function.
- Deficiency(wet beriberi vs dry beriberi): Wet beriberi characterized by edema(fluid accumulation), dry beriberi, without edema. Wet beriberi allows things such as retaining imprint from touch. Beriberi, rice was 80 to 90 percent of total calories in East Asia, once the brown coat was removed, which contained the thiamin, beriberi became widespread.
20
Q
B Vitamin Niacin
A
- Function: Participated in the energy metabolism of every cell, its absence causes serious illness.
- Dietary Sources: Protein foods, animal>plant.
- Deficiency: Pellagra, disease, symptom are four d’s, diarrhea, dermatitis(skin darkens and flakes), dementia, and death.
21
Q
B Vitamin Folate
A
- Functions: Normal growth and development, RBC synthesis, nerve tissue, neural tube formation.
- Deficiency: Anemia, Neural Tube Defects(NTD):abnormalities of the brain and spinal cord apparent at birth, birth defects result when closure of neural tube is incomplete.
- Bioavailability(synthetic folic acid vs dietary folate): Synthetic folic acid, fortified foods and supplements, synthetic>dietary. Dietary folate(natural), dietary
22
Q
Vitamin B12
A
- Functions: RBC formation, maintain nerve cells, energy metabolism.
- Absorption(requires intrinsic factor): Dietary B12 protein bound, stomach acid frees B12, intrinsic factor, a compound made by the stomach with instructions from the genes, a gastric protein needed for B12 absorption. Intrinsic factor(free b12) attaches to the vitamin and the complex is absorbed into the bloodstream.
- Dietary Sources: B12 is present only in foods of animal origin, posing a deficiency threat to strict vegetarians.
- Deficiency: Low stomach acid, lack of IF(intrinsic factor). At risk for vegans and elderly.
23
Q
Vitamin Supplements
A
- Supplement Vs Medication: Supplement, not enough evidence to say whether it impacts health. Prescription medications, have passed rigorous tests for safety and effectiveness.
- Scientific evidence does not support a role for antioxidant supplements against chronic diseases
- Groups who may benefit from a supplement: Pregnant women:folic acid, iron. Newborn: Are routinely given a vitamin K dose. Elderly: B12, vitamin D. Vegan: B12, iron. Lactose Intolerant: Calcium. Habitual Dieters: Don’t get enough calories.
- USP(does not guarantee safety or effectiveness): Check supplement quality and purity, supplement contains nutrients stated on label, will dissolve in Gas Intestinal Tract(GIT).
24
Q
General characteristics of vitamins
A
Micronutrients, non caloric, essential, necessary for various body functions.
25
Minerals Calcium
- Functions: Structural, bone and teeth mineralization, physiological, nerve signaling, blood pressure, muscle contractions, blood clotting
- Regulation of low blood calcium: Parathyroid to PTH, kidneys, raise vitamin D activation, raise calcium absorption in small intestine, drop calcium excretion in urine, raise calcium released from bone.
- Regulation of high blood calcium: Parathyroid to a drop in PTH to a drop in active vitamin D. Thyroid to calcitonin, drop in calcium absorption in small intestine, raise in calcium excretion in urine, drop in calcium released from bone.
- Influences on bioavailability: Vitamin D. Oxalates. Phytates. Age.
- AI: 19-50 years, 1000 mg.
- Best dietary sources: Dairy products, sardines.
- Bioavailability of calcium carbonate vs. calcium citrate:
26
Minerals Magnesium
-Functions: Bone structure, calcium contracts, magnesium relaxes.
27
Minerals Potassium
- Functions: Fluid balance, heartbeat.
- Deficiency: Diarrhea and vomiting, diuretic(water pill)
- Dietary sources: Fresh, whole foods, unprocessed, fruits and vegetables.
28
Minerals Sodium
- Functions: Fluid balance, electrolyte balance.
- Regulation of Blood Sodium(hyponatremia and hypernatremia): Hyponatremia, sodium needed returns from urine back to the blood. Hypernatremia, adrenal glands, drop in aldosterone, kidneys excrete sodium.
- Deficiency: Infants and children, endurance sports.
- AI: 19-50 years, 1500 mg. UL is 2300 mg. AI decreases with age, salt sensitivity.
- Salt and Water Weight: Raise in sodium intake triggers thirst, to ensure a person drinks to have an even sodium to water ratio, kidneys will excrete extra water and sodium. Control salt intake and drink more water to salt and water weight under control.
- High Blood Pressure:Risk Factors: Also known as hypertension, risk of heart disease, cerebral hemorrhage, and a stroke. Blood volume may damage blood vessels.
- DASH Diet: Increased fruits and vegetables, reduced sodium.
- Sodium sources in U.S diet: Unprocessed foods(10%), added salt(15%), Processed foods(75%).
29
Minerals Water
- Functions: Aids in maintaining body temperature. Solvent for minerals, vitamins, amino acids, glucose, and other small molecules. Transportation of nutrients, removes waste, lubricant(mucus) lungs, chemical reactions, shock absorber.
- Body's response to dehydration(brain:ADH;
kidneys: aldosterone): Low blood pressure and blood volume which are regulated by the brain and kidney.
30
Minerals Iron
- Functions: Iron containing hemoglobin in red blood cells carries oxygen from lungs to tissues throughout the body. Iron containing myoglobin holds and stores oxygen in the muscles for their use.
- Food sources(2 forms: heme(iron bound to heme) and nonheme): Heme, animal products. Nonheme, plant products, supplements and fortified foods.
- Absorption(heme vs nonheme (ferric/ferrous)):
- Enhancers/inhibitors of nonheme iron absorption: Enhancers,Vitamin C, Meat Factor-MFP. Inhibitors, phytates, tannins, calcium: dairy, supplements.
- Assessment of deficiency: Iron deficiency develops in stages, mildly iron deficient. Iron deficiency anemia, severely iron deficient. Iron deficiency: Ferritin low, hemoglobin normal. Iron deficiency anemia: Ferritin very low, hemoglobin low. Vegetarians and older adults at risk.
31
Minerals Iodine
- Food sources: Seafood, iodized salt.
- Regulation of iodine uptake by thyroid gland:
- Function: Essential component of thyroid hormone.
- Deficiency disorders(cretinism and goiter): Cretinism, fetal iodine deficiency, baby born to iodine deficient mother. Goiter, childhood and adult iodine deficiency.
32
Overweight and Obese Difference
- Overweight: Body weight above a healthy weight, BMI of 25-29.9.
- Obesity: Overfatness with adverse health effects, BMI greater than or equal to 30.
33
BMI Calculation and Interpretation
- BMI(Body Mass Index)
- Weight for height in people 20 and up.
- BMI=Weight(lb)/Height^2(in)X703
- Below 18.5 is considered underweight, 18.5-24.9 is considered healthy, 25.0-29.9 is overweight, 30 or higher is considered obese.
34
Visceral and Subcutaneous Fat Difference
- Visceral Fat: Fat that lies deep within the central abdominal area of the body.
- Subcutaneous Fat: Fat stored directly under the skin.
35
Central Obesity(waist circumference measurement: men and women)
Waist circumference reflects degree of visceral fatness in proportion to body fatness. Men greater than or equal to 40 in. Women greater than or equal to 35 in.
36
-Indicators to assess health risk from obesity
- BMI(Body Mass Index)
- Waist Circumference
- Disease risk profile
37
Energy balance
-Energy Balance,Positive Energy Balance,Negative Energy Balance: "Energy In" is measured by calories taken in each day in the form of foods and beverages. No easy method exists for determining the "energy out" side of a person's energy balance equation.
38
Energy Output Components
- Basal Metabolism: Involuntary activities needed to sustain life.
- Thermic Effect of Food
- Voluntary Activities
39
Factors influencing BMR(basal metabolic rate)
- Age: BMR declines with age.
- Physical Activity, Gender: Men activity with their muscle raises BMR
- Body Weight and Size
- Very Low Calorie Intake: Slows metabolic rate.
40
Hunger and Appetite Difference
- Hunger: Physical need for food.
| - Appetite: Desire for food, initiates eating and sometimes overeating.
41
Function of ghrelin and leptin
- Ghrelin: Hunger hormone, produced by stomach, signals brain to stimulate eating.
- Leptin: Satiety hormone, appetite suppressing hormone produced in fat cells. Conveys information about body fatness to the brain.
42
Physical Activity
Spot reducing
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-Body's Response To Fasting
– Nervous system unable to use fat as fuel – only glucose
– After glycogen reserves depleted, body starts breaking down protein (which can be metabolized to glucose in order to provide nervous system with fuel)
– After a few days, to spare protein loses, body converts fat to ketone bodies for use by the nervous system
44
Body's Response To Feasting(Overeating)
– How the body uses and stores excess intake of the energy-yielding
macronutrients: Carbohydrate, protein, and fat.
- Carbohydrate, broken down to glucose and ends up as liver and muscle glycogen stores, body fat stores.
- Protein, broken down to amino acids(first used to replace body proteins), and ends up as nitrogen lost in urine, body fat stores.
- Fat, broken down into fatty acids, and ends up as body fat stores.
45
Weight Loss Surgery
– Roux-en-Y Gastric Bypass(RYGB): Restrictive, malabsorptive, nonreversible
– Adjustable Gastric Banding (AGB): Restrictive, not malabsorptive, reversible
46
Eating Disorders
– Continuum of eating concerns and disorders: Body dissatisfaction causes dieting behaviors which cause disordered eating which cause clinically significant eating disorder.
– Anorexia nervosa (diagnostic criteria & outcome goal): Diagnostic Criteria, refusal to maintain normal weight for height and age, extreme self starvation, key:distorted body image. Outcome goal, weight gain-KEY.
– Bulimia nervosa (diagnostic criteria & outcome goal): Diagnostic Criteria, recurrent episodes of binge eating, lack of control over binges, recurrent inappropriate compensatory behavior to prevent weight gain, over concern with body shape and weight. Outcome goal, weight maintenance, no weight fluctuations.
– Binge eating disorder (diagnostic criteria): Diagnostic criteria, recurrent episodes on binge eating, differs from BN by excluding purging or other compensatory behaviors.
47
Prepregnancy Nutrition Concerns
– Underweight/overweight: These women have a greater risk of giving birth to infants with heart defects and other abnormalities.
– Alcohol (fetal alcohol syndrome): Cluster of symptoms including brain damage, growth retardation, mental retardation, and facial abnormalities seen in an infant or child whose mother consumed alcohol during her pregnancy.
– Diabetes (consequences of poorly controlled gestational diabetes): Gestational diabetes, abnormal glucose tolerance during pregnancy, is likely in obese women, may also suffer hypertension, complications during and infections after birth.
48
Characteristics of fat soluble vitamins
- Vitamins A,D,E and K
- Absorb like fats, into lymph first then blood.
- Must travel with protein carriers in watery body fluids, stored in the liver or fatty tissues.
- Not readily excreted, tend to build up in the tissues.
- Toxicities are likely from supplements, but occur rarely from food.
- Needed in periodic doses(perhaps weeks or months) because the body can draw on its stores.
49
Placenta(3 functions)
Performs the nutritive, respiratory, and excretory functions that the fetus's digestive system, lungs, and kidneys will provide after birth.
50
Pregnancy Nutrient Requirements
Energy, carbohydrates, protein, and fat. No extra energy needed in first trimester. Additional 340 daily calories during the second trimester, an extra 450 calories each day during the third trimester. They have an increased need for iron and must take iron supplements during the second and third trimesters.
-Diet that includes more nutrient dense food from the five food groups, folate, vitamin B12, vitamin D, calcium, and zinc all in greater demand during pregnancy.
51
Motor Development Order
-Formation and closure of neural tube in early weeks of pregnancy, that will later develop to form the brain and spinal cord.
52
Satter Feeding Dynamics(fdSatter)
-Division of responsibility in feeding.
53
First Foods
-4 to 6 months (provide iron and vitamin C)
54
Feeding Pressure Backfires
A child needs variety, not pressure to eat specific things. Do family friendly feeding, always provide bread or some other starch, include high and low fat food.
55
Eating Competency Model(ecSatter)
1. Context management (contextual skills)
2. Eating attitudes
3. Food acceptance
4. Internal regulation
56
Women of THIN
- Shelly,25
- Polly,29
- Brittany,15
- Alisa,30
