FINAL EXAM Flashcards
Nutrition
The study of nutrients and other biologically active components in foods and in the body
Essential nutrients
Nutrients that the body cannot make or the body cannot make sufficient quantities of so we need to get those nutrients from food
Classes of nutrients
- Water
- Carbohydrate
- Fat
- Protein
- Vitamins
- Minerals.
Functional foods
Foods known to possess nutrients or non-nutrients that might lend protection against diseases. Ex oatmeal
Basic foods
Foods milk and milk products; meats and similar foods, such as fish and poultry; vegetables, including dried beans and peas; fruits; and grains
Fast foods
Restaurant foods that are available within minutes after customers order them
Natural foods
A term used to describe a product that has been isolated from food, often sold in pill form and believed to have medicinal effects
Organic foods
Understood to mean foods grown without synthetic pesticides or fertilizers
Partitioned foods
Composed of parts of whole foods, such as butter (from milk), sugar (from beets or cane), or corn oil (from corn)
Processed foods
Foods subjected to any process, such as milling, alteration of texture, addition of additives, cooking, or others. Depending on the starting material and the process, a processed food may or may not be nutritious
Staple foods
Foods used frequently or daily, for example, rice or potatoes
Enriched/fortified foods
Added nutrients
Characteristics of a nutritious diet
- Adequacy
- Balance
- Calorie control
- Moderation
- Variety
Adequacy
Dietary characteristic of providing all the essential nutrients, fibre and energy in amounts sufficient to maintain health and body weight
ex. consuming iron
Carbohydrate
4 kcal/g
Fat
9 kcal/g
Protein
4 kcal/g
Balance
Choices do not overemphasize one nutrient or food type at the expense of another (ex calcium)
Calorie control
Foods provide the amount of energy you need to maintain appropriate weight—not more, not less
Moderation
The foods do not provide excess fat, salt, sugar
Variety
Foods chosen differ from one day to the next
Ensure individuals are getting an array of different nutrients and by following this principle individuals are potentially diluting the amounts of potential toxins (pesticides, additives, etc.) they get in their diets
Influences on food choice
- Advertising
- Availability
- Economy
- Habit
- Emotional comfort
- Habit
- Personal preference and genetic inheritance
- Positive associations
- Region
- Social pressure
- Values/beliefs
- Weight
- Nutritional value
Dietary reference intakes (DRI)
Reports containing a set of five lists of values for measuring the nutrient intakes of healthy people in Canada and the United States
Five lists within the DRI
- Recommended dietary allowances (RDA)
- Adequate intakes (AI)
- Estimated average requirements (EAR)
- Tolerable upper intake levels (UL)
- Acceptable macronutrient distribution ranges (AMDR)
Daily values
Nutrient reference standards that are printed on food labels.
Based on nutrient and energy recommendations for a general 2,000-Calorie diet
RDA
Average daily nutrient intake level that meets the needs of nearly all (97% to 98%) healthy people in a particular life stage and gender group
AI
Nutrient intake goals for individuals are set whenever scientific data are insufficient to allow establishment of an RDA value
EAR
The average daily nutrient intake estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group
UL
The highest average daily nutrient intake level that is likely to pose no risk of toxicity to almost all healthy individuals of a particular life stage and gender group
Chronic disease risk reduction (CDRR)
Intakes of certain nutrients that will reduce your risk of chronic disease if followed
AMDR
Values for carbohydrate, fat, and protein expressed as percentages of total daily caloric intake; ranges of intakes set for the energy-yielding nutrients that are sufficient to provide adequate total energy and nutrients while reducing the risk of chronic diseases.
Recommended proportions of energy nutrients
- 45 to 65 percent from carbohydrate
- 20 to 35 percent from fat
- 10 to 35 percent from protein
Percent daily value (%DV)
Used to express the food’s content of macronutrients, fibre, and selected vitamins and minerals
Canada’s food guide
1/2 plate =fruits and veggies
1/4 plate =protein foods
1/4 plate= whole grains
Make water your drink of choice
Eat a healthy variety of foods each day
Discretionary calories allowance
The balance of Calories remaining in a person’s energy allowance after accounting for the number of Calories needed to meet recommended nutrient intakes through consumption of nutrient-dense foods
(ex. a person needing 2,000 Calories a day to maintain weight may need only 1,800 Calories or so of nutrient-dense foods to supply the day’s required nutrients so it is 200 in this case)
Nutrient function claims
Describe the well-established roles of energy or nutrients that are essential for the maintenance of good health or for normal development and growth; ex. carbohydrate supplies energy
Disease risk reduction claims
Highlight a relationship between consumption of a food or ingredient and a person’s health. For example, a healthy diet low in saturated and trans-fat may reduce the risk of heart disease.
Nutrient content claims
Using approved wording to describe the nutrient values of foods, such as a claim that a food is “high” in a desirable constituent or “low” in an undesirable one.
Function claims
Describe the roles of a food or food constituent has on the normal functions or biological activities of the body. For example: Consuming 7 grams of fibre from coarse wheat bran promotes regularity
Nutrition facts
Panel of nutrition information required to appear on almost every packaged food.
Parts of a food label
- common name
- name and address of manufacturer
- net contents (weight, measure, count)
- nutrient contents
- ingredients (predominance by weight)
- serving size
- servings per container
- cals
- nutrient amounts and %DV
- total, fat, cholesterol, sodium, carbs, protein
Other nutrients on nutrition labels
Daily values of…
- Vitamin A
- Vitamin C *no longer
- Calcium
- Iron
New food label
Has a %DV of sugar
Potassium will appear on the nutrition facts label
Vitamin C not required
Ghrelin
Hormone released by the stomach that signals the hypothalamus of the brain to stimulate eating, considered the “hunger hormone.”
Taste buds
Sweet, sour, bitter, and salty, umami
Mouth
Performs mechanical digestion
Involves saliva, taste buds, lysozyme, amylase
Stomach
In the stomach food is combined with secretions and undergoes a churning motion (mechanical digestion) which changes the consistency of the food into the consistency of a milkshake (called chyme)
Secretes gastric juice
Small intestine
Peristalsis, wavelike muscular squeezing, moves the chyme through the small intestine
Enzymatic digestion of carbohydrates, fats and proteins occurs in the small intestine, along with the absorption of most nutrients
Segmentation
Alternating forward and backward movement allowing for greater contact between the partially digested food and intestinal juices and enzymes
Sphincters
Circular muscles which contract or relax, allowing entry of food (or the products of digestion) into defined compartments in the body.
Mechanical digestion
Chewing, mixing by the stomach, adding fluid, and moving the tract’s contents by peristalsis
Colon/Large intestine
Reabsorb the water donated earlier by digestive organs and to absorb minerals, leaving a paste of fibre and other undigested materials, the feces, suitable for excretion.
Chemical digestion and organs that secrete digestive juices
The digestive organs that release digestive juices are the salivary glands, the stomach, the pancreas, the liver, and the small intestine
Bacteria role in digestion
Ferment many indigestible fibres, producing short fatty acids that provide many colon cells with most of their needed energy
Break down any undigested protein or unabsorbed amino acids that reach the colon, producing ammonia and other compounds
Heartburn
Caused by overeating, to prevent eat smaller meals, drink liquids an hour before or after, but not during, meals
Constipation
Caused by slow dry hard bowel movements; prevent by defecate when it is time and choose foods high in fibre, drink water, be physically active
Diarrhea
Intestinal contents moving too quickly; treat w rest and drinking fluids, prevent by not changing diet too drastically or quickly
Irritable bowel syndrome (IBS)
Intermittent disturbance of bowel function; associated with diet, lack of physical activity or psychological stress
Ulcer
Erosion in lining
Hernia
Protrusion of organ through the wall of body chamber
Gastroesophageal reflux disease
Splashing of stomach acid and enzymes into the esophagus, throat, mouth or airway that causes inflammation or injury to those organs
Hiccups
spasms of the vocal cords and diaphragm causing periodic, audible, short, inhaled coughs; caused by irritation of the diaphragm, indigestion, eating or drinking too fast
Microbiota
Mix of the microbial species, such as the bacteria, fungi and viruses in the human digestive tract
Prebiotics
A substance that may not be digestible by the host, such as fibre, but serves as food for probiotic bacteria and thus promotes their growth
Probiotic
Contain live microorganisms found in sufficient numbers to alter the bacteria colonies of the body in ways believed to benefit health. Ex. kefir and many yogurts
Foodborne infection
Caused by eating foods contaminated with infectious microbes
Foodborne intoxications
Are caused by eating foods containing natural toxins, or microbes that produce toxins
Botulism
Cause: botulinum toxin produced by bacteria.
Food sources: foods in an anaerobic environment with low acidity (Ex. home canned foods like corn, peppers, green beans, meat, fish, chicken or garlic)
Symptoms: blurred or double vision, inability to swallow, difficulty speaking and progressive paralysis of the respiratory system which can become fatal.
Clostridiosis
Food sources: improperly cooked or cooled stews, meat and cooked beans
Symptoms: abdominal bloating, pain, cramp, watery diarrhea and muscle aches.
E.coli infection
Food sources: undercooked ground beef, unpasteurized milk, unpasteurized juice, raw produce like sprouts or romaine lettuce, person to person contact from unwashed hands.
Symptoms: severe bloody diarrhea, abdominal pain, vomiting, acute kidney failure; death
Hepatitis A
Food sources: are undercooked or raw shellfish; raw or lightly cooked produce, contaminated water, baked goods or other ready-to-eat foods contaminated by infected food handlers.
Symptoms: Inflammation of liver, fatigue, dark urine, headache, nausea, vomiting, jaundice, muscle pain
Listeriosis
Food sources: are raw meat and seafood, luncheon meats, hot dogs, unpasteurized milk, and soft cheeses.
Symptoms: mimic the flu but then can progress to meningitis, miscarriages of pregnancy, severe illness or death in newborns, blood or brain infection in the elderly
Salmonellosis
Food sources: sources raw or undercooked eggs, meats, poultry, unpasteurized milk products and juices, shrimp, pasta and raw produce.
Symptoms: fever, chills, diarrhea, nausea, vomiting, abdominal cramps, headache and can be fatal
Staphylococcal food poisoning
Toxin produce by bacteria in meat, poultry, egg products, tuna salad, macaroni salad, potato salad and cream filled pastry.
Symptoms include diarrhea, nausea, vomiting, abdominal cramps, fatigue and mimics flu
Cross-contamination
Contamination of food by bacteria from raw meat, chicken or seafood that comes in contact with other foods because of previously touched surfaces
Four principles of safe food prep
Clean, separate, chill, cook
Danger zone temp
(4-60 degrees Celsius)
Cooking temp for poultry
82 degrees celsius
Fridge temp
0-4C
Honey
Bad for infants due to botulism
Complex carbohydrates
Glycogen, starch and fibre
Simple carbohydrates
Disaccharides and monosaccharides
Roles of carbohydrates
Providing energy, feeding our brain and nervous system, helping to keep our digestive system functioning properly, and helping to keep the body lean when the body’s energy needs are not exceeded.
Monosaccharides
- Glucose: most imp; blood sugar; chief source of energy for brain
- Fructose: sweetest; fruit sugar; occurs naturally in fruit and honey and is added to soft drinks and processed cereals
- Galactose: least sweet; It rarely occurs free in nature but may be found in fermented milk products such as aged cheese or yogurt
Disaccharides
- Maltose: composed of two glucose molecules, and is generally formed as a result of starch breakdown; rare in foods but is found in barley and during fermentation when making alcohol
- Sucrose; table sugar
- Lactose: milk sugar; represents about 30-50% of milk’s energy depending on how much fat is in the milk.
Sugar absorption
Simple sugars are absorbed directly into the bloodstream while disaccharides need to be split into 2 monosaccharides by enzymes for absorption.
Polysaccharide
Complex carbohydrates
Starch
Storage form of carbohydrate in plants
Ex. starch-rich foods include wheat, bannock, corn, rice, tubers (e.g. potatoes), and legumes (beans, peas)
Glycogen
Storage form of carbohydrate in animals; found in the liver (approximately 1/3 of the body’s glycogen stores), and the majority is found in our muscle tissue (approximately the other 2/3rds).
Fibres
Considered a non-starch polysaccharide because it is mainly composed of chains of glucose but humans lack the enzymes to digest it
Ex. Cellulose, hemicellulose, pectin
Soluble fibres
Form gels (viscous), and are often digested by bacteria in the colon (fermentable), ex jam
ex. Gums, pectin, psyllium and some hemicelluloses
Insoluble fibres
Do not form gels (non-viscous) and are less readily fermented by bacteria in the colon
ex. cellulose, lignin, resistant starch, many hemicelluloses and inulin
Soluble fibre role in GI
Delays gastrointestinal transit
delays glucose absorption into the blood
lower blood cholesterol levels
Soluble fibre foods
Apples, citrus fruits, oats, barley, and legumes.
Insoluble fibres role in GI
Accelerates GI transit (promoting bowel movements), and delays glucose absorption.
Insoluble fibres in food
Wheat bran, corn bran, whole grains and vegetables and fruit such as cabbage, carrots and cherries.
Fibre intake
- Daily intake of 21-38 g
- AI for fibre for females age 19-50: 25 g
- AI for fibre for males age 19-50: 38 g
Benefits of fibre rich food
Promotion of normal blood cholesterol concentration, Blunting blood glucose fluctuations and reduced risk of diabetes, Maintenance of healthy bowel function/healthy digestive tract, Promotion of a healthy body weight
Excess fibre
Constipation and - in some cases, a blocked intestine
Speed transit time leading to decreased absorption of some minerals
Too much fibre can cause one to feel full and lead to inadequate intake of energy, protein, vitamins, and minerals
Total sugars
Account for all sugars present in foods and beverages regardless of the source; includes added, free, and naturally occurring sugars
Free sugars
Added sugars as well as sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrates; added by manufacturer, cook or consumer; not including natural sugars
Added sugars
All sugars added to foods and beverages during processing or preparation. All added sugars are also free sugars.
Carbohydrate digestion in mouth
Enzymatic digestion of starch begins in the mouth, where amylase is present in saliva. Amylase starts a small amount of digestion, breaking down polysaccharides (chains of glucose) into smaller polysaccharides and disaccharides
Mechanical digestion of fibre, crushing and chewing, occurs in the mouth, but no enzymatic digestion of fibre occurs.
Carbohydrate digestion in stomach
Enzymatic digestion of starch stops as salivary amylase is denatured, and products of starch digestion and fibre are mixed with stomach acid.
Carbohydrate digestion in small intestine
Pancreatic amylase enters the small intestine and breaks polysaccharides into shorter glucose chains and disaccharides.
Disaccharidases
Cleave disaccharides into monosaccharides
How are monosaccharides absorbed?
By intestinal cells
Maltase
Cleaves maltose into two molecules of glucose, which are then absorbed
Sucrase
Cleaves sucrose into glucose and fructose, which are then absorbed
Lactase
Cleaves lactose into glucose and galactose, which are then absorbed.
Carbohydrate digestion in large intestine
Undigested fibre continues its journey to the large intestine where bacteria initiate some fibre breakdown into acetic acid, propionic acid and butyric acid
Fructose and galactose
Converted to glucose or glycolysis intermediates
Glucose
Stored as glycogen or will be sent back into the blood stream to be brought to other tissues for energy.
Lactose intolerance
Undigested lactose attracts water into the intestine and is a source of food for bacteria. This lactose can therefore lead to bloating, gas, diarrhea and pain.
Celiac disease
Medical condition where the body has an autoimmune response caused by ingestion of a protein called gluten; The absorptive surface of the small intestine becomes damaged and therefore can affect the body’s ability to absorb nutrients
Ketone bodies
A breakdown product of fat which can be used for energy in the absence of glucose.
Regulation of blood glucose
When blood glucose levels increase with a meal, insulin, secreted from the pancreas, binds to the insulin receptors on body cells and allows those cells to take up glucose from the blood
When blood glucose levels fall because a person has not eaten, the pancreas secretes glucagon. Glucagon stimulates glycogen breakdown, gluconeogenesis and fat breakdown
Hypoglycemia
When blood glucose falls below normal range
Symptoms: weakness, rapid heart rate, sweating, anxiety, hunger, and trembling
Type I diabetes
Insulin-dependent form, where that person’s pancreas is unable to produce sufficient amounts of insulin to allow for adequate cellular glucose uptake
Type I diabetes
Insulin-dependent form, where that person’s pancreas is unable to produce sufficient amounts of insulin to allow for adequate cellular glucose uptake
Type II diabetes
Cells are generally less responsive to the insulin therefore glucose uptake is limited; primary risk factor is obesity
The glycemic response
The extent to which blood glucose concentration is raised by a food, and the extent to which it elicits an insulin response
Refined sugars
Contain no other nutrients—proteins, vitamins, minerals, or fibre—and thus qualify as foods of low nutrient density
Alternative sweeteners
Calorie free and taste sweet without promoting dental decay
ex. Saccharin, aspartame, acesulfame-potassium, sucralose, cyclamate and tagatose
Natural ones such as stevia and monk fruit extract (luo han guo extract)
Three classes of lipids
Triglycerides
Phospholipids
Sterols
Roles of fat
- Shock absorber for vital organs
- Insulates body
- Form cell membrane
- Contain essential fatty acids that are required by the body
- Other essential nutrients, like the fat soluble vitamins (A, D, E and K) are mainly found in foods that contain fat
Triglycerides
Further classified into saturated, monounsaturated and polyunsaturated fats depending on the majority of fatty acids that make up the triglycerides
Composed of 3 fatty acids joined to a glycerol backbone
Phospholipids
Phospholipids play a role in maintaining cell membranes.
Ex. Lecithin
Sterols
Involved in cell membrane structure as well as the synthesis of hormones and vitamin D.
Ex. Cholesterol
Saturated fat
Fat that contains primarily saturated fatty acids, is generally firm at room temperature (e.g. butter)
Unsaturated fats
Generally liquids at room temperature (e.g. safflower oil or sunflower oil)
Two families of polyunsaturated fatty acids: omega-3 and omega-6 fatty acids
Fatty acids in foods
- Olive oil: rich in monounsaturated
- Cheese: rich in saturated
- Sunflower oil: rich in omega 6
- Fish oil: rich in omega 3
Short chain fatty acids
Softer at room temperature (e.g. coconut oil)
Sources of cholesterol
Shrimp, egg yolks, cheese and fatty meats.
Hydrophobic
Water fearing
Lipids
Hydrophilic
Water loving
Enzymes that digest lipids
Fat digestion in the mouth
Little enzymatic digestion of fats occurs.
Lingual lipase, present in the saliva, accounts for the small amount of enzymatic digestion; digests short and medium chain fatty acids in milk
Fat digestion stomach
Fats are mixed with acid and water, while gastric lipase hydrolyzes a very small amount of fat
Fat digestion in small intestine
Lipase enzymes from both the pancreas and the small intestine (pancreatic lipase, intestinal lipase) fully digest the fats
Phospholipids are also dismantled while most sterols are absorbed as they are.
The end components are absorbed in the small intestine
Fat digestion in large intestine
Cholesterol and bile trapped in fibre, will not be absorbed in the small intestine and instead travels to the large intestine and then exits the body in feces
Absorption of glycerol, short and medium chain fatty acids
Glycerol, short chain fatty acids and medium chain fatty acids are absorbed into the intestinal cells and pass directly into the blood
Absorption of monoglycerides and long chain fatty acids
Reformed into triglycerides in the intestinal cells and are then packaged with protein into chylomicrons which are released into the lymphatic system (lacteal) and then eventually gain entry to the blood stream.
Lipoproteins
Clusters of lipids associated with proteins that serve as transport vehicles for lipids in the lymph and blood
Chylomicrons
Transport of diet-derived lipids from the intestine to the rest of the body
Very low density lipoproteins (VLDL)
Ship triglycerides, cholesterol and fatty acids to other parts of the body; shrinks becoming more dense and the remaining product is the cholesterol-rich lipoprotein, LDL.
Low density lipoproteins (LDL)
Deposited in artery walls which plays a role in the development of fatty, atherosclerotic plaques, increasing one’s risk of heart disease and stroke
Bad cholesterol
High density lipoproteins (HDL)
Package cholesterol, lipids, etc. and to bring them back from cells to the liver for dismantling, disposal and recycling
Good cholesterol
Guideline for fat
Limit saturated fat intake to less than 10% of kcalories and trans fats should be eliminated from the diet
Increase HDL cholesterol and decrease LDL cholesterol
The Mediterranean diet
Emphasizes unprocessed plant foods such as vegetables, fruit and whole grains. Nuts and fish are emphasized while sweets and meat (particularly red meat and processed meats) are greatly limited.
The added fat recommended is olive oil
High in fibre, low in saturated fat and trans fat and rich in omega 3 fatty acids.
DASH diet
Recommends vegetables, fruit, whole grains, low fat dairy and fish while limiting fatty meat, high fat dairy products, refined foods and sweets
Portfolio diet
Vegetarian way of eating that emphasizes nuts, soy protein, plant sterols and fibre and again leaves little room for processed foods.
Essential fatty acids
Serve as raw materials from which the body makes substances known as eicosanoids that act somewhat like hormones, affecting a wide range of diverse body functions, such as muscle relaxation and contraction; blood vessel dilation and constriction etc.
Omega 6-fatty acid
A polyunsaturated fatty acid with its endmost double bond six carbons from the methyl end of the carbon chain.
ex. linoleic acid
Omega-3 fatty acid
a polyunsaturated fatty acid with its endmost double bond three carbons from the methyl end of the carbon chain. Ex. Linolenic, EPA and DHA (from fish)
Food sources of linoleic acid
Leafy vegetables
Seeds
Nuts
Grains
Vegetable oils
Linolenic acid food sources
Canola oil
Flaxseed oil
Soybean oil
Walnut oil
Food sources of EPA and DHA
Human milk
fatty cold-water fish (salmon, herring etc.)
Omega-3 eggs
Hydrogenation
The process of adding hydrogen to unsaturated fatty acids to make fat more solid and resistant to the chemical change of oxidation; makes them stay fresher longer and also changes their physical properties.
Fat replacers
Dextrin, maltodextrins, modified food starch, gums, microparticulated protein, artificial fats and even water.
Artificial Fats, such as olestra (Olean®), are synthesized to mimic the qualities of naturally occurring fats
Trans fatty acids
Fatty acids with unusual shapes that can arise when polyunsaturated oils are hydrogenated (act as saturated fats)
Added fats
A dollop of dessert topping, a spread of butter on bread, oil or shortening in a recipe, dressing on a salad
Fat in meat
Large proportion of the hidden fat and saturated fat in many people’s diets
Fat in milk-based foods
Cream and butter are fats, as are whipped cream, sour cream, and cream cheese, so they are grouped together with the solid fats
Fat in grain foods
Grain foods in their natural state are very low in fat, but fat, including saturated fat and trans fat, may be added during manufacturing, processing, or cooking
Essential amino acids
Amino acids that either cannot be synthesized at all by the body or cannot be synthesized in amounts sufficient to meet physiological need
Nonessential amino acids
Amino acids that the body can synthesized in sufficient amounts to meet its need.
Amino acid structure
An amino group
An acid group
A central carbon
A side group (side chain)
Protein digestion in mouth
Mechanical digestion
No enzymatic digestion
Protein digestion in stomach
Mixed with hydrochloric acid and denaturation occurs
HCl activates the pepsinogen by converting it to pepsin
Pepsin
Important enzyme necessary for digestion of proteins into smaller polypeptides and some free amino acids
Denaturation
Results in a change in shape, and therefore the loss of function, of that protein
Protein digestion in small intestine
Intestinal enzymes and pancreatic enzymes facilitate further digestion of polypeptides into tripeptides, dipeptides, and amino acids.
These enzymes include trypsin, chymotrypsin, elastase, collagenase, and carboxypeptidases
Roles of protein
- growth an maintenance of tissues
- tissue repair
- act as enzymes
- transport of nutrients, hormones etc.
High quality protein
Dietary proteins containing all essential amino acids in relatively the same amounts as what humans require
ex. fish, wild game, beef, poultry, eggs, and milk.
Plant protein
Considered to be of lower quality not only because of their lower digestibility but because they lack some of the essential amino acids
Complementary proteins
Two or more proteins whose amino acid assortments complement each other in such a way that the essential amino acids missing from one are supplied by the other
ex. Black beans and rice, Peanut butter and whole grain bread, Stir-fried broccoli, peppers, cashews, and rice
Nitrogen balance
Comparison of the amount of protein eaten (nitrogen consumption), compared to the amount of protein catabolism (nitrogen excretion), in a given period of time
Positive nitrogen balance
If nitrogen intake exceeds nitrogen excretion
Building more proteins than they are degrading
Ex pregnant woman
Negative nitrogen balance
Nitrogen intake is less than nitrogen excretion
Indicating that the body is degrading more than it is synthesizing
Ex those who are starving
Mutual supplementation
The strategy of combining two incomplete protein sources so that the amino acids in one food make up for those lacking in the other food. Such protein combinations are sometimes called complementary proteins
Recommended protein intake
0.8 gram for each kilogram (or 2.2 pounds) of body weight
10-35% of total energy intake
Limiting amino acid
An essential amino acid that is present in dietary protein in an insufficient amount, thereby limiting the body’s ability to build protein
Protein-energy undernutition
The world’s most widespread malnutrition problem, including both marasmus and kwashiorkor and states in which they overlap; also called protein-Calorie malnutrition (PCM).
Marasmus
Severe and chronic deprivation of protein and energy, along with vitamins and minerals. It commonly affects children less than 2 years old and results in severe weight loss, muscle wasting, and changes to the skin and hair. (develops slowly; chronic PEU)
Kawashiorkor
a sudden (or acute) protein deficiency or a rapid deprivation of food, and generally affects 1-3 year-old children; often develops when a child is weaned off breastfeeding because a second child is born. (rapid onset; acute PEU)
Lacto-vegetarian
Excludes meat, poultry, seafood, and eggs, includes dairy
Ovo-vegetarian
Excludes all animal based foods but eggs
Pesco-vegetarian (pescatarian)
Excludes all meat but fish
Vegan
Pure vegetarians, strict vegetarians;
includes only food from plant sources: vegetables, grains, legumes, fruits, seeds, and nuts
Fruitarian
only raw or dried fruits, seeds and nuts
Protein-sparing
The body’s ability to make sure that the proteins that the body acquires through food are not converted into energy molecules.
Vitamins
Essential micronutrients required for their roles in energy metabolism, physiological functioning and deficiency disease prevention.
Water-soluble vitamins
Absorbed into the blood, and they circulate freely in water-filled parts of the body until the kidneys filter them during urine production; required in frequent doses, due to our inability to store them.
Fat-soluble vitamins
Absorbed into the lymph, travel through the blood via protein carriers and they are stored in fat deposits and in the liver. They are less readily excreted and tend to remain in fat-storage sites; needed in periodic doses
Vitamin A
First fat soluble vitamin to be discovered and retinol, retinal, and retinoic acid are the 3 active forms in the body.
Function of vitamin A
Involved in vision and maintaining mucous membranes, skin, bone and tooth development and growth, as well as reproduction, gene regulation and immune functions.
Sources of carotenoids involved in vitamin A
Carrots, sweet potatoes, pumpkin, and spinach
Sources of vitamin A
Liver, milk products, eggs, and fortified foods are good sources of vitamin A
Vitamin A deficiency
Blindness, keratinization decreased goblet cells, damages the cells of the intestine decreasing digestion and absorption of nutrients, worsening malnutritionq
Vitamin A toxicity
Dry and itchy skin, loss of menstruation, jaundice, bone weakening and birth defects
Vitamin A toxicity
Dry and itchy skin, loss of menstruation, jaundice, bone weakening and birth defects
Vitamin D
Primarily found in animal foods, rather than plant foods, but it can also be synthesized in the body, using cholesterol as a precursor
Considered the only non-essential vitamin because it can be made from the body with the help of sunshine
Function of vitamin D
Bone maintenance and growth, and raising blood levels of calcium and phosphorus
Vitamin D deficiency
Rickets in children; results in inadequate bone mineralization and subsequent bowing of the legs
Vitamin D toxicity
High blood calcium and the calcification of tissues such as blood vessels, kidneys, heart, lungs and joints
Vitamin D toxicity
High blood calcium and the calcification of tissues such as blood vessels, kidneys, heart, lungs and joints
Functions of Vitamin E
Acts as an antioxidant; significantly decrease the adverse effects of oxidation on living tissues
Helps to protect a variety of tissues and molecules, including polyunsaturated fatty acids (pufa) and low density lipoproteins (LDL).
Sources of vitamin E
Vegetable oils, margarine, salad dressing, nuts, seeds, whole grains, eggs and leafy green vegetables in your diet regularly
Vitamin E deficiency
Rare in adults
Most common in premature infants because they may be born before vitamin E transfer from the mother which occurs near the end of a full-term pregnancy
Vitamin E toxicity
Could impair blood clotting and enhance effects of anti-clotting medications
Vitamin K function
Helps with blood clotting and the synthesis of bone proteins
Sources of vitamin K
Dark green leafy green vegetables (such as kale, collards, spinach, and beet greens), cabbage, liver and milk.
Vitamin K deficiency
Can occur due to inadequate intake, as a result of hindered fat absorption, or as a result of medications that may kill vitamin K-producing bacteria in the gut.
Vitamin K toxicity
Causes the liver to release bilirubin into the blood, leading to jaundice and potentially brain damage in infants
Vitamin C functions
Collagen formation, producing carnitine which is involved in transporting fatty acids.
Iron absorption can also be helped by dietary vitamin C.
Sources of vitamin C
Many fruits and vegetables, especially red peppers, kiwi, mango, broccoli, and oranges
Vitamin C deficiency
Scurvy and deficiency symptoms include pinpoint hemorrhages, bleeding gums, joint pain, poor wound healing and frequent infections
Vitamin C toxicity
Nausea, abdominal cramps, diarrhea, and fatigue.
The B vitamins
Thiamin
Riboflavin
Niacin
Folate
Vitamin B12
Vitamin B6
Biotin
Pantothenic acid
Function of the B vitamins
Act as coenzymes which facilitate enzymatic reactions by binding to specific enzymes and forming a recognizable active site for the substrate(s)
Function of Thiamin
Energy metabolism and nerve processes
pyruvate dehydrogenase
Sources of thiamin
Include pork, whole grains, legumes and sunflower seeds.
Thiamin deficiency
Dry beriberi or wet beriberi
Dry berberi
Nerve damage, and muscle weakness in the legs and arms
Wet berberi
Damage to the cardiovascular system which results in edema
Riboflavin function
Involved in energy metabolism of all cells
Sources of riboflavin
Milk products, eggs and meats, liver
Riboflavin deficiency
Ariboflavinosis: cracked corners of the mouth, smooth purplish tongue, inflamed eyelids, light sensitivity, painful, sore, and inflamed skin
**Rare
Niacin function
Energy metabolism
Sources of Niacin
Meat, fish, whole grains and fortified foods (bread, cereal), beans, and milk.
Niacin deficiency
Pellagra; bilateral symmetrical rash on areas exposed to light, symptoms are the 4D’s= diarrhea, dementia, dermatitis, and even death
Niacin toxicity
Niacin flush’ which is a tingling of the skin that can be painful
Function of folate
Coenzyme used in DNA synthesis, production of new cells (blood cells, gastrointestinal cells, hair, skin, nails)
Sources of folate
Legumes (pinto beans and chickpeas), fortified foods (bread, cereal, orange juice), and green leafy vegetables
Folate deficiency
Results in a large-cell type anemia called macrocytic or megaloblastic anemia
RDA of folate
The RDA for the average healthy adult is 400 mcg DFE (dietary folate equivalents) per day
Vitamin B12 function
Cell synthesis and maintenance of nerve cells, activation of folate
Sources of B12
Meat, fish, poultry, milk and milk products, eggs and fortified foods
Vitamin B12 deficiency
Large-cell type anemia (macrocytic anemia) like a folate deficiency, and of largest consequence, degeneration of peripheral nerves resulting in paralysis.
Primary deficiency
caused by inadequate intake of a nutrient
Secondary nutrient deficiency
Occurs when the body’s ability to absorb nutrients is limited by a medical condition or illness like celiac disease, cystic fibrosis, lactose intolerance, pancreatic insufficiency and pernicious anemia
Vitamin B6 function
Part of a coenzyme needed in amino acid and fatty acid metabolism; helps convert tryptophan to niacin and to serotonin; helps make hemoglobin for red blood cells
Vitamin B6 deficiency
Weakness, depression, and irritability
Symptoms include microcytic anemia and a characteristic greasy scaly dermatitis
Vitamin B6 toxicity
Depression, fatigue, and most notably, paralysis.
Sources of vitamin B6
Protein rich foods like meats, fish and poultry. Some plant foods are also good sources such as watermelon, bananas, fortified foods (cereal, bread), and potatoes
Where is vitamin B6 stored?
Muscle tissue
What are the water-soluble vitamins?
B vitamins
Vitamin C
What are the fat-soluble vitamins?
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K
Biotin
Imp in energy metabolism
Panthothenic acid
Imp in energy metabolism, synthesis of fats, neurotransmitters and steroid hormones
B5
Panthothenic acid deficiency
Failure of all body systems, fatigue and gastrointestinal problems
Bioavailability
How much of the nutrient can be absorbed and used and stored when it is eaten
ex. The dietary fibre in folate rich foods, like leafy green vegetables for example, can reduce the bioavailability of folate.
Roles of water
- Transport waste and nutrients
- Maintain structures of large molecules such as glycogen and proteins
- Act as a substrate in chemical reactions
- Lubricant for joints and cushion around joints, spinal cord, eyes and organs
- Regulating body temp
- Maintaining blood volume and pressure
Mild dehydration
A loss of body water less than 5%
Symptoms: thirst, low blood pressure, lack of energy, decreased mental functioning, muscular work, and athletic performance.
Severe dehydration
Loss of body water greater than 5%
Symptoms: Exhaustion, confusion and disorientation, weak, irregular pulse, thickening of blood and eventually death if water is not replaced
How much should I drink?
Females ages 19 and older is 2.7 L per day and for males 19 and older is 3.7 L per day.
Water intoxication
Rare condition where there is “a dangerous dilution of the body’s fluids resulting from excess ingestion of plain water”
Symptoms: lack of concentration, poor memory, loss of appetite, and in extreme cases, potentially death
Hard water
High in calcium and magnesium
Soft water
High in sodium
Can aggravate hypertension and heart disease because of the sodium present and it can dissolve toxic metals like lead and cadmium from old pipes
Major minerals
Calcium, chloride, magnesium, phosphorus, potassium, sodium, and sulfur
Calcium function
Mineralization of bones and teeth; muscle contraction and relaxation, nerve functioning, blood clotting
Most abundant mineral
Calcium deficiency
Stunted growth and weak bones in children; bone loss (osteoporosis) in adults
Calcium toxicity
Constipation; interference with absorption of other minerals; increased risk of kidney stone formation
Calcium food sources
Milk, cheese, soy milk, yogurt, tofu
Calcium absorption
Adults absorb approximately 25% of ingested calcium, whereas children and pregnant women absorb more (50-60%)
Enhanced by stomach acid and vitamin D
Phosphorus functions
Mineralization of bones and teeth; part of phospholipids, important in genetic material, energy metabolism, and buffering systems
85% is found combined w calcium in the crystals of the bones and teeth
Phosphorus deficiency
Muscular weakness, bone pain (rare)
Phosphorus toxicity
Calcification of soft tissues, particularly the kidneys
Food sources of phosphorus
Most foods in milk and meat groups
Magnesium function
Regulating muscle and nerve function, blood sugar levels, and blood pressure and making protein, bone, and DNA
Magnesium deficiency
Weakness, confusion; if extreme, convulsions, uncontrollable muscle contractions, hallucinations, and difficulty in swallowing; in children, growth failure
Magnesium toxicity
From nonfood sources only; diarrhea, pH imbalance, dehydration (rare but can be fatal)
Sources of magnesium
Pumpkin seeds, cereal, spinach
Sodium intake
Limited to 2000 mg/d
Sodium functions
Maintains fluid and electrolyte balance, maintains acid-base balance, muscle contraction, nerve transmission
Sodium deficiency
not known
Sodium toxicity
Hypertension, CVD, cerebral hemorrhage, hypertension-related stroke
Potassium function
Maintains normal fluid and electrolyte balance; facilitates chemical reactions; supports cell integrity; assists in nerve functioning and muscle contractions
Potassium deficiency
Muscle weakness, paralysis, confusion
Potassium toxicity
Muscle weakness; vomiting; for an infant given supplements, or when injected into a vein in an adult, potassium can stop the heart
Food sources of potassium
Bananas, oranges, potatoes, spinach, cantaloupe, and almonds
Chloride function
Maintain the crucial fluid balances (acid–base and electrolyte balances), responsible for stomach acidity
Sulphate function
Synthesis of many important sulphur-containing compounds (skin, hair, nails proteins)
Sulphate function
Synthesis of many important sulphur-containing compounds (skin, hair, nails proteins)
Sulphate toxicity
Diarrhea and may damage the colon
Trace minerals
Iodine
Iron
Zinc
Selenium
Fluoride
Chromium
Copper
Trace minerals
Iodine
Iron
Zinc
Selenium
Fluoride
Chromium
Copper
Iodine function
Iodine is a part of thyroxine, the hormone made by the thyroid gland that is responsible for regulating the basal metabolic rate
Iodine deficiency
The cells of the thyroid gland enlarge in an attempt to trap as many particles of iodine as possible. Sometimes the gland enlarges until it makes a visible lump in the neck, a goitre as well as cretinism; symptoms= sluggish, weight gain
Sources of iodine
Seafood, fast food (iodine salt), additive in milk and bakery products, foods grown on land that was once covered by oceans
Iodine toxicity
Enlargement of thyroid gland
Iron function
Carries oxygen as part of hemoglobin in blood or myoglobin in muscles; required for cellular energy metabolism
Iron deficiency
Anemia, weakness, fatigue, headaches, impaired mental and physical work performance, impaired immunity, pale skin, nail beds, and mucous membranes, concave nails chills, pica
Pica
Craving for nonfood substances (ice, clay, paste, soil)
Anemia
Severe depletion of iron stores resulting in low blood hemoglobin
Iron toxicity
GI distress; with chronic iron overload, infections, fatigue, joint pain, skin pigmentation, organ damage
Iron food sources
Meats, legumes, grain products
Iron food sources
Meats, legumes, grain products
Zinc function
Activates many enzymes; associated with hormones; synthesis of genetic material and proteins, transport of vitamin A, taste perception, wound healing, reproduction
Zinc deficiency
Growth retardation, delayed sexual maturation, impaired immune function, hair loss, eye and skin lesions, loss of appetite, infections
Zinc toxicity
Loss of appetite, impaired immunity, reduced copper and iron absorption, low HDL cholesterol (a risk factor for heart disease)
Zinc food sources
Meats, shellfish, poultry, milk and milk products, legumes, whole grains
Selenium function
Protects vulnerable body chemicals against oxidative destruction
Activates thyroid hormone which regulates body’s rate of metabolism
Selenium deficiency
Development of some forms of cancers, especially prostate cancer in men, heart disease
Food sources of selenium
Shellfish, vegetables, grains grown on selenium rich soil
Selenium toxicity
Hair loss, diarrhea, and nerve abnormalities
Fluoride function
Inhibits the ability of dental caries by promoting the remineralization of early lesions of the enamel that might otherwise progress to form caries.
Stabilizes bones
Sources of fluoride
Drinking water
Fluoride toxicity
Discoloration of teeth (fluorosis), large doses toxic
Chromium function
Works closely with the hormone insulin to regulate and release energy from glucose
Chromium deficiency
Insulin action is impaired, resulting in a diabetes-like condition of high blood glucose
Sources of chromium
Liver, whole grains, nuts, cheeses
Copper function
Helps form hemoglobin and collagen
Enzymes depend on copper for its oxygen-handling ability
Plays roles in the body’s handling of iron and, like iron, assists in reactions leading to the release of energy
Copper deficiency
Disturb growth and metabolism, and in adults, it can impair immunity and blood flow through the arteries, may contribute to heart disease (RARE)
Copper toxicity
Unlikely but can be caused by supplements
Sources of copper
Protein foods, such as organ meats, seafood, nuts, and seeds, water
Molybedenum
Functions as part of several metal containing enzymes, some of which are giant proteins
Manganese
Works with dozens of different enzymes that facilitate body processes
Boron
Influences the activity of many enzymes, and research suggests that a low intake of boron may enhance susceptibility to osteoporosis by way of its effects on calcium metabolism
Food sources: noncitrus fruits, leafy vegetables, nuts, and legumes
Cobalt
Mineral in vitamin B12
Nickel
- Imp for health of body tissues
- Deficiencies harm liver and organs
Silicon
Bone calcification of animals
Binge drinking
As consuming five drinks or more in a row for a man and four drinks or more in a row for a woman
Ethanol in Beer
4-7% ethanol
Ethanol in wine
8-12% ethanol
Spirits
Rum, rye, gin, vodka
40-50% ethanol
Spirits
Rum, rye, gin, vodka
40-50% ethanol
Proof
Ethanol content
Ex.A spirit containing 40% ethanol is also described as 80 proof
Standard drink
15ml of pure ethanol
341 ml (12 oz) bottle of beer
142 mL (5 oz) glass of wine
43 mL (1.5 oz) shot of spirits.
Effects of alcohol
Judgement can be impaired with a blood alcohol concentration as low as 0.02%
Driving skills can be significantly affected beginning at 0.04%
0.30% leads to becoming unconscious
0.40% to 0.50% can cause death
Order that alcohol affects the brain
- Frontal lobe – judgement and reasoning are affected
- Speech and vision centres become sedated
- Large muscle control is affected
- Conscious brain is completely subdued so person passes out
- Deepest brain – respiration and heart rate are affected potentially leading to death.
Alcohol absorption
Absorbed directly into bloodstream as ethanol
A small percentage of alcohol consumed on an empty stomach can be absorbed through the stomach and can reach the brain within 1 minute of ingestion
Effects on the brain
Atrophy (a shrinking of the brain), memory problems, abnormal eye movements, dementia, balance problems, and gait disorders.
Effects on liver
Fibrosis and eventually cirrhosis, wherein the normal liver cells become irreversibly damaged and are replaced with scar tissue.
Cirrhosis
Can lead to liver failure
Jaundice (a yellowing of the skin and eyes), ascites (the presence of fluid in the abdomen), and bleeding problems
Effects on heart and cardiorespiratory system
Increased blood pressure, dilated cardiomyopathy
Other effects of alcohol on the body
Cancer, joint, weakens muscles, bone deterioration etc.
Malnutrition and alcohol
In heavy drinkers alcohol is often consumed rather than food (“substituted” energy), which replace kcals from more nutritious sources
Can put an individual at risk of many vitamin and mineral deficiencies from inadequate food intake.
Two imp nutrients that may be deficient in heavy alcohol users
- Folate
- Thiamin
Folate and alcohol
In the presence of alcohol, the liver is unable to retain folate, and the kidneys increase the excretion of folate
Causes homocysteine levels to build up and play a role in the development of heart disease
Causes a lack of methionine which impairs the production of rapidly dividing cells
Thiamin and alcohol
Deficiency develops due to decreased dietary intake in chronic alcoholics and increased urinary excretion
May contribute to Wernicke Korsakoff syndrome
2023 Canada’s guidelines on alcohol and health
o 0 drinks per week — Not drinking has benefits, such as better health, and better sleep.
o 2 standard drinks or less per week — You are likely to avoid alcohol-related consequences for yourself or others at this level.
o 3–6 standard drinks per week — Your risk of developing several types of cancer, including breast and colon cancer, increases at this level.
o 7 standard drinks or more per week — Your risk of heart disease or stroke increases significantly at this level.
o Each additional standard drink radically increases the risk of alcohol-related consequences.
Hypertension and alcohol guidelines
2 drinks per day or less is recommended to prevent hypertension.
More than 2 drinks per day, a reduction in alcohol intake is associated with decreased BP and is recommended.
In adults with hypertension who drink 6 or more drinks per day, a reduction in alcohol intake to 2 or fewer drinks per day is associated with decreased BP and is recommended
Health risks of being underweight
- Undernutrition
- Osteoporosis
- Infertility
- Impaired immunocompetence
Health risks of being overweight
- Type 2 diabetes
- Dyslipidemia
- Hypertension
- CHD
- Gallbladder disease
- Obstructive sleep apnea
- Cancer
Measurements of body fat
Fatfold
Hydrodensitometry measurements
Bioelectrical impedance
Dual energy X-ray absorptiometry
Fat distribution and health risk
More fat around abdomen=more dangerous
What measure of waist circumference is associated w increased risk?
Above 94 cm for males and 80 cm for females
Substantially increased = 102 and 88
Prevalence of obesity
- 35.5% were overweight
- 24.3% were obese
- 59.8% overweight or obese
Weight bias
Negative attitudes and views about obesity and about people with obesity
Weight stigma
Social stereotypes and misconceptions about obesity. Ex. people w obesity are lazy, awkward, sloppy, non-compliant, unintelligent, unsuccessful and lacking self-discipline or self-control
Weight discrimination
This is when we enact our personal biases and the social stereotypes about obesity and treat people with obesity unfairly
Energy balance
There must be a 3500 kcal deficit between kcalories taken in and kcalories expended in order to lose 1 pound of body fat
Sensory specific satiety
Tendency to get bored of a food as we eat it
Satiation
Our ability to sense fullness during a meal
Satiety
Sensation of fullness following a meal
Energy output
- Basal metabolism
- Physical activity
- Thermic effect of food
- Adaptive thermogenesis
Basal metabolism
Number of kcalories used to support chemical reactions, and physiological functioning of the resting body.; Basal metabolic rate: amount of kcalories used per unit time.
Thermic effect of food
The number of kcalories used to digest, absorb and transport food in the body; protein has highest thermic effect
Adaptive thermogenesis
Adjustments in energy expenditure related to changes in the environment such as extreme cold, or physiological changes such as overfeeding.
Appetite
“I’m full from dinner, but I want to eat the chocolate cake”
Hunger
“I am eating this burger because I haven’t eaten in 6 hours and went for a run this morning”
Hormones that impact on obesity
Ghrelin and leptin
Ghrelin
A hormone which is secreted mainly by stomach cells and acts mainly in the hypothalamus; It increases appetite and decreases energy usage
Leptin
Promotes a negative energy balance by suppressing appetite and increasing energy expenditure; Without leptin there is little appetite control therefore one is constantly hungry
Theories of metabolic causes of obesity
- Enzyme theory
- Fat cell number theory
- Set-point theory
- Thermogenesis I
- Thermogenesis II
- Thermogenesis III
Fad diets
High protein, low carb
Ketogenic
Herbal products
The high-protein, low carb diet
A starvation diet bc without enough carbohydrates in the diet, the body believes it is starving and resorts to other modes of accessing glucose
The ketogenic diet
An extremely high fat diet which is exceptionally low in carbohydrate and often low in protein
- Constipation, vitamin and mineral deficiencies, gallstones, kidney stones, high cholesterol, fatigue, and even ketoacidosis are all possible consequences of the diet if not properly monitored
Weight loss from a starvation diet
Weight loss on a starvation diet comes from 50% fat and 50% lean muscle tissue and water.
Over the long term, engaging in a non-starvation, adequate weight loss plan will result in weight loss from 75% fat and 25% lean tissue.
Herbal products diet
Ephedra/Ephedrine once showed promise for weight loss but consequences from diet preparations included cardiac arrest, strokes, seizures, and even death
Weight loss drugs
- Meridia® (sibutramine)
- Xenical® (orlistat)
Sibutramine
Suppresses appetite by inhibiting serotonin reuptake; taken off market
Orlistat
Forms a bond w pancreatic lipases and gastric lipases, thereby inhibiting the lipases; lipases are unable to hydrolyze dietary fats into absorbable free fatty acids and monoglycerides so the undigested fats are not absorbed resulting in a potential caloric deficit
Other weight loss drugs
- Liraglutide (Saxenda®): injection which helps control appetite by working like a hormone in the brain that regulates appetite
- Naltrexone/Buproprion (Contrave®): Combination medication; Naltrexone has been used to treat alcohol and opioid addiction for many years and Bupropion is an antidepressant
When should you receive drug therapy for weight management?
Those with a BMI of 30 or greater or those w a BMI of 27 or greater if the individual has comorbidities associated with excess body fat such as hypertension, dyslipidemia, or excess body fat
Types of weight loss surgery
- Gastric bypass
- Gastric banding
- Gastric sleeve
Gastric bypass
Creation of a mini stomach, limiting intake and limiting absorption of vitamins and energy yielding nutrients * malabsorptive and restrictive method of weight loss
Gastric banding
An adjustable band is placed at the top of the stomach creating a small pouch *restrictive method
Gastric sleeve
Most of the stomach is removed leaving the person with a banana-sized stomach *restrictive method
What is considered underweight?
A BMI of less than 18.5
Eating disorders
Disturbance in eating behaviour that jeopardizes a person’s physical or psychological health
- Anorexia nervosa, bulimia nervosa, and binge eating disorder
Amenorrhea
Loss of menstruation; results from kcal deprivation, starvation and loss of body fat
Who is affected by anorexia nervosa
Mostly women, have a distorted body image, pressures and stresses to starve themselves
Physical consequences of anorexia nervosa
Moodiness and disinterest in social events, amenorrhea, low body temp, increased growth of body hair
Bulimia nervosa
- Repeating episodes of binge eating, purging, and starvation
Purging
Vomiting, abusing laxatives and diuretics, exercising excessively, or engaging in a mix of these behaviors
Binging
Anxiety, and rushed, uncontrollable eating
Physical consequences of bulimia nervosa
Abnormal heart rhythms, as a result of electrolyte imbalances; esophageal injury, as a result of the vomiting; cavities, as a result of excessive enamel destruction from exposure to stomach acid; and death
Binge eating disorder
Binge eating disorder
No purging
Usually in overweight people
Orthorexia
- Eating only foods regarded as healthy
- Relying only on “natural” products to treat an illness.
- Finding more pleasure in eating “correctly” rather than enjoying the tastes and textures of a variety of foods
- Experience emotional satisfaction when they stick to their goals, but intense despair when they fail to do so
Antioxidants
Vitamin C
Selenium
Vitamin A
Vitamin E
Kcals/g of alcohol
7 kcals/g
Normal weight
BMI: 18.5 - 24.9
Overweight
BMI: 25-29.9
Obese class I
BMI: 30-34.9
Obese class II
BMI: 35-39.9
Obese class III
BMI: >40
