HLTH 230 Final (Weeks 6-12) Flashcards
1
Q
What is Hunger?
A
Unpleasant sensation that signals need for food
* Happens about 4 to 6 hours after eating.
* By this time, food has left the stomach, and most nutrients have been absorbed.
* Hunger is triggered by an empty stomach and small intestine.
* The stomach hormone ghrelin, produced between meals, along with signals from the brain, also plays a role.
* Other factors, like emotions and habits, can influence hunger too.
2
Q
What is Appetite?
A
- Appetite is the psychological desire to eat.
- You can feel appetite even if you’re not hungry.
- Seeing or smelling food can trigger brain chemicals (endorphins) that make you want to eat, even if your stomach is full.
- Stress or illness can reduce appetite in some people who need food, while others may feel hungrier under stress.
3
Q
What is Satiation?
A
- Typically determines how much food is eaten at one
sitting - Feeling full during a meal builds up until you’re satisfied enough to stop eating.
4
Q
What is Satiety?
A
- The feeling of fullness after a meal that keeps you from eating again until the next mealtime.
- Suppresses hunger
4
Q
What is Sensory Specific Satiety (SSS)
A
- SSS it is the concept that we tend to get bored of a food as we eat it.
- The more variety there is, the more likely it is that we will increase overall consumption.
4
Q
Which is stronger, Hunger or Satiety?
A
Hunger is stronger
5
Q
What is Leptin?
A
A Satiety Hormone
* An appetite suppressing hormone
* May also contribute to satiety
* Produced by adipose tissue and the stomach
* Travels to the brain
* Directly linked to appetite control & amount of body fat
6
Q
Is obesity primarily caused by genetics?
A
No, it is rarely caused by genetics alone.
7
Q
How do genes influence obesity?
A
Genes affect how the body stores and uses energy but don’t act alone.
7
Q
What is the likelihood of a child becoming obese if at least one parent is obese?
A
40-70%
7
Q
Are adopted children’s body weights more similar to their adoptive or biological parents?
A
Biological parents.
8
Q
How likely are identical twins to weigh the same compared to fraternal twins, even if raised apart?
A
Identical twins are twice as likely as fraternal twins to have the same weight.
8
Q
Why can’t genetics alone explain the rising obesity rates?
A
The gene pool hasn’t changed significantly, so environmental and lifestyle factors play a major role.
9
Q
Does genetics influence a person’s tendency to become obese?
A
Yes, but it’s not the only factor
10
Q
External Cues to Overeating
A
- Variety can make people eat even when they’re not hungry, like at a buffet or with a variety pack of snacks.
- Overeating can also happen due to emotions like loneliness, cravings, addiction, stress, depression, or even the time of day.
- Fast-food is acssible, cheap, highly adversited, & arguably delicious
11
Q
Physical Inactivity
A
- Reported intake often inaccurate (for everyone)
*
12
Q
What is E.A.T?
A
Physical activity is actually made up of “exercise related
activity thermogenesis (EAT)
13
Q
What is N.E.A.T?
A
non exercise activite
thermogenesis
* NEAT refers to the energy used in everyday activities like working, exercising, sitting, standing, walking, dancing, cleaning, and even small actions like toe tapping.
14
Q
HOW THE BODY LOSES AND GAINS WEIGHT
A
The balance between energy intake & energy output
determines whether you gain, lose, or maintain body fat
* A small or sudden change in body weight might not mean a change in body fat. It could be due to changes in:
Body fluids (drinking 2L will gain pounds)
Bone minerals
Muscle
Bladder or digestive contents
Weight changes often depend on the time of day.
14
Q
How do energy-yielding nutrients contribute to weight gain?
A
They can be stored as body fat.
15
Q
What contributes to Weight Gain?
A
Energy yielding nutrients contribute to body
fat stores
15
Q
What happens to excess amino acids from protein?
A
They are used for energy or converted to glucose or fat.
15
Q
How are fatty acids from fat used in the body?
A
They are either used for energy or stored as body fat efficiently.
16
Q
What happens to excess sugars from carbohydrates?
A
They are stored as glycogen, used for energy, or converted to fat and stored.
17
How does alcohol affect the body’s use of fat?
Alcohol slows down fat use by about 33% and increases fat storage, mostly as visceral fat.
18
What type of diet leads to large initial weight losses?
Low-carbohydrate, high-protein diets and “ketogenic” diets.
19
What are the DRI recommendations for carbohydrate intake?
Minimum of 130 grams/day (RDA for those over 1 year old).
45–65% of total energy intake is recommended for health.
20
What should nutrition recommendations for adults include?
* They should be personalized to meet individual values and preferences.
* Support a dietary approach that is safe, effective, nutritionally adequate, culturally acceptable, and affordable for long-term adherence.
* These principles also apply to weight loss.
21
How is obesity traditionally defined in weight loss intervention studies, and what is the limitation of this approach?
Obesity is traditionally defined using BMI classification, but this overlooks its true definition as a chronic, progressive, and relapsing disease characterized by excess adiposity that impairs health and social well-being.
22
22
What are the option for weight loss for those with obesity?
* Medical Nurition Therapy (MNT)
* Physical activity
* Psychological Intervention
* Pharmacological Therapy
* Bariaric Surgery
22
What should diets for weight management fall within?
The AMDRs (Acceptable Macronutrient Distribution Ranges).
23
What is the AMDR for carbohydrates in weight management?
45–65% of total calorie intake.
24
What is the AMDR for fat in weight management?
20–35% of total calorie intake.
25
What is the AMDR for protein in weight management?
10–35% of total calorie intake.
25
How should fats be chosen in a weight management diet?
Avoid trans fats.
Limit saturated fats.
Include enough healthy fats to provide satiety.
26
What is the goal of Intensive Lifestyle Intervention (ILI) programs for weight loss?
To achieve a weight loss of 5–15%.
27
What can Spot Reducing do?
Exercising a particular area cannot target fat from that area
27
What are the There are 3 pillars to support medical nutrition
therapy and physical activity?
* Psychological intervention
* Pharmacotherapy
* Obesity surgery
27
When is surgery an option for obesity management?
* For BMI ≥ 40.
* For BMI ≥ 35 with a coexisting disease (as per CPG).
* For BMI ≥ 30 with poorly controlled Type II diabetes or severe obesity-related diseases not responding to medical management.
27
What is Gastric Banding?
* Not in the top 3 for recommend
* Provides a **restrictive** method to weight loss
* An adjustable "band" is placed where the esophagus and the
stomach meet
28
What is Gastric Bypass?
* Most common
* Provides a** restrictive and malabsorptive** method to weight loss
* A small stomach pouch is created to hold only a few bites of food, and part of the intestines, including the duodenum and part of the jejunum, is bypassed.
28
What is Duodenal Switch?
* Provides a **restrictive and malabsorptive** method to weight
* The stomach reduction is less than the gastric bypass but more
of the small intestine is bypassed.
* Most common to see Vitamin and mineral defectiocy
29
Sleev e Gastrectomy (Gastric Sleeve)
* Provides a **restrictive** approach
* Uses staples
* stomach is cut into the shape of a banana
29
When is prescription medication recommended for obesity management?
* For individuals with:
* BMI ≥ 30, or
* BMI ≥ 27 with obesity-related complications or elevated disease risk, alongside diet and exercise.
30
What are all the drugs used for obesity?
* Xenical Orlistat
* Contrave naltrexone & bupropion
* Saxenda liraglutide
* Wegovy Semaglutide
30
What is Xenical Orlistat?
*How:
Stops some fat eaten from being absorbed by the body
30
What is Contrave naltrexone & bupropion?
* controls hunger and cravings
30
What is Saxenda liraglutide?
How: decreases appetite and and slow gastric emptying
Helps control amount eaten
31
What is Wegovy Semaglutide?
* AKA Ozempic
* Use for diebtes
* Decreases appetite and slows stomach emptying
Helps control amount eaten
32
Importance of Herbal Products?
*“Natural” does not mean safe: Belladonna, hemlock & sassafras all contain
toxins
33
Importance of Ephedrine/Ephedra?
Health Canada warns against unapproved products sold for:
* weight loss
* increased energy
* body building
* euphoria
34
NUTRITION MANAGEMENT FOR WEIGHT GAIN
* Physical Activity to Gain Muscle & Fat
* Diet alone can bring about weight gain fat
* Eat enough to support activity, to gain muscle and fat
* Choose Foods with High Energy Density
* Portion Size & Meal Spacing
* Weight Gain Supplements (Use ith phsyical actcity)
* Avoid Tobacco
35
What percentage of Canadian adults (18 to 79) were overweight or obese in 2019?
59.8%
35
What Category is < 18.5 for BMI
Underweight
36
What Cateogory is 18.5-24.9 for BMI
"Normal Weight"
37
What Cateogory is 25-29.9 for BMI
Overweight
37
What cateogory is 30 and over for BMI
Obese
37
What Cateogory is 30-34.9 for BMI?
Obese class 1
38
What Cateogory is 35-39.9 for BMI?
Obese class 2
39
What Cateogory is > or = 40 for BMI?
Obese class 3
40
What are the limitations of BMI (Body Mass Index)?
* Doesn't show how much weight is fat or where fat is located.
* Not suitable for athletes, pregnant or lactating women, or adults over 65.
* Needs more research on cutoffs for different races.
* Originally based on people under 65, mostly white Europeans and Americans.
40
What is the most practical indicator of fat distribution and abdominal fat
Waist circumference
40
What is the risk of the Waist circumference be for males and females?
* 102 cm for males
* 88 cm for females
41
how many stages does EDMONTON OBESITY STAGING SYSTEM have?
0,1,2,3,4
42
What is Stage 0 of E.O.S.S?
* No apparent risk factors
43
What is Stage 1 of E.O.S.S?
* Presence of obesity obesity-related subclinical risk factors
* (e.g., borderline hypertension, impaired fasting glucose levels, elevated levels of liver)
44
What is Stage 2 of E.O.S.S?
* * Presence of established obesity
* obesity-related chronic disease
* (e.g., hypertension, type 2 diabetes, sleep apnea, osteoarthritis),
* moderate limitations
45
What is Stage 3 of E.O.S.S?
* Established end-organ damage such as myocardial infarction, heart failure,
* stroke, significant psychopathology, significant functional limitations and/or
* impairment of well well-being
46
What is Stage 4 of E.O.S.S?
* Severe (potentially end-stage) disabilities from obesity obesity-related chronic
diseases, severe disabling psychopathology, severe functional limitations
47
What recommendations were made for healthcare providers regarding obesity care?
1. Assess personal attitudes and beliefs about obesity and how they may influence care.
2. Recognize that internalized weight bias in people with obesity can affect health outcomes.
3. Avoid using judgmental words, images, and practices when working with patients.
4. Avoid assuming that a patient’s ailment is related to their body weight.
47
What recommendations are given for healthcare providers working with Indigenous people living with obesity?
* Understand the patient’s social circumstances.
* Acknowledge the stress and disadvantages they face and explore ways to reduce stress to improve health.
* Advocate for access to affordable obesity management resources in public healthcare.
* Encourage patients to believe that good health is achievable and that they deserve it.
* Reflect on personal biases, including anti-Indigenous sentiment, and consider trauma or grief as factors affecting health.
* Explore how systemic racism may influence care.
47
What happens when more food energy is consumed than needed?
Excess fat accumulates in the fat cells of the body’s adipose tissue. 3500 kcal equals 1 pound of body fat.
47
Daily energy balance:
*
Change in energy stores = energy in energy out
48
How many kcal are in 1 gram of carbohydrate?
4 kcal.
49
How many kcal are in 1 gram of protein?
4 kcal.
50
How many kcal are in 1 gram of fat?
9 kcal.
51
How many kcal are in 1 gram of alcohol?
7 kcal.
51
What is the thermic effect of food for different macronutrients?
Fat: 0-5%
Carbohydrate: 5-10%
Protein: 20-30%
Alcohol: 15-20%
51
When is Basal Metabolic Rate (BMR) higher?
* In younger people (because lean body mass declines with age).
* In taller people (due to larger surface area).
* In people who are growing (e.g., children, pregnant women).
* In people with more lean muscle mass (e.g., physically fit individuals).
52
When is Basal Metabolic Rate (BMR) lower?
* Older people people-lean body mass declines with age
* Fasting – body slows to preserve energy
* Malnutrition
* Hypothyroidism
52
What are some methods for measuring body composition and fat distribution?
* Anthropometry: Fatfold measures (caliper)
* Density: Underwater weighing or air displacement plethysmography
* Conductivity: Bioelectrical impedance
* Radiological techniques: DEXA
## Footnote
Lean tissue is denser than fat tissue
53
Toxicity and Alcohol?
Toxic in relatively small amounts which makes alcohol
dangerous
54
What is the equivalent of one standard drink in milliliters for different alcoholic beverages?
* 142 ml of wine (approx. 12%)
* 43 ml of hard liquor (approx. 40%)
* 341 ml of beer (approx. 5%)
| Values are sometimes written as 150ml, 45ml or 50 ml, and 350ml)
## Footnote
Distilled liquor is often stated in proof
* 80 proof refers to 40% alcohol
55
What type of substance requires no digestion and can diffuse through the stomach wall to reach the brain within a minute?
Alcohol
56
What is the role of the MEOS system in the liver?
* It metabolizes alcohol and some drugs.
* It handles about 10% of alcohol consumed.
* It becomes more efficient with higher alcohol concentrations or repeated exposure, resulting in better tolerance.
57
How does the MEOS system affect drug metabolism when alcohol and drugs are taken together?
* MEOS processes alcohol first, which can cause the drug to build up and its effects to be stronger.
* Heavy drinkers have more MEOS, helping to process drugs faster when not drinking.**
57
Brain centres on alcohol in a particular order:
* Frontal lobe– judgement and reasoning
* Midbrain– speech and vision centres become sedated
* Cerebellum – large muscle control is affected
* The conscious brain is completely subdued so the person passes out
* Deepest brain, medulla oblongata – respiration and heart rate
57
What is Fetal Alcohol Spectrum Disorder (FASD), and what support might individuals need?
* FASD refers to the impacts on the brain and body of someone exposed to alcohol in the womb.
* It’s a lifelong disability but can be prevented with proper support.
57
What factors influence the impact of alcohol on a developing fetus?
* How often alcohol was consumed
* How much alcohol was consumed
* When during the pregnancy the alcohol was consumed
58
Fetal Alcohol Spectrum Disorder (FASD)
Prevention
* Health care provider (doctor, midwife, community health nurse)
* Local health centres (friendship centre, public health unit, community health/resource centre)
* Provincial or territorial health services (ministry of health, health and social services)
* First Nations or Inuit communities (local health centre, nursing station, community health nurse)
58
What are the cancres that happen due to long use of alcohol
mouth, throat, esophagus, breast, stomach,
pancreas, liver, colorectal
58
What is the safest amount of alcohol to consume during pregnancy?
None, as no amount of alcohol is safe during pregnancy.
58
What are the benefits of not drinking alcohol at all?
Better health
Better sleep
No risk of alcohol-related consequences
58
What is the risk associated with drinking 2 or fewer standard drinks per week?
Likely to avoid alcohol-related consequences for yourself or others.
58
What is the risk of drinking 3-6 standard drinks per week
Increased risk of developing several types of cancer, including breast and colon cancer
59
What happens if you drink 7 or more standard drinks per week?
Increased risk of heart disease or stroke.
59
What is the risk associated with consuming more than 2 standard drinks per occasion?
Increased risk of harms to self and others, including injuries and violence.
59
What is the safest approach to alcohol consumption when pregnant or trying to get pregnant?
There is no known safe amount of alcohol use during pregnancy or when trying to get pregnant.
60
What are hemoglobin and myoglobin, and what is their role in the body?
* Hemoglobin: Oxygen-carrying protein in red blood cells.
* Myoglobin: Oxygen-holding protein in muscles
61
62
What are the main roles of iron in the body?
* Carries oxygen.
* Helps enzymes use oxygen.
* Needed to make new cells, amino acids, hormones, and neurotransmitters.
62
How does the body recycle iron?
* The liver creates red blood cells with iron from bone marrow.
* Red blood cells live for 3–4 months.
* The liver and spleen break down dead red blood cells and recycle their iron.
63
Why is iron considered an essential nutrient?
Iron is necessary for oxygen transport, enzyme function, and creating essential components like new cells, hormones, and neurotransmitters. Deficiency is a common problem.
63
What percentage of dietary iron is typically absorbed by the body?
Approximately 10–15%
64
When does the body increase iron absorption?
When iron levels are low or the body needs more iron.
64
When does the body decrease iron absorption?
When iron levels are abundant.
65
How is iron absorbed and stored in the body?
Iron is absorbed in the small intestine and stored by ferritin in mucosal cells.
66
What happens to iron if it is needed by the body?
If needed, iron is released from ferritin to transferrin and transported through the blood to the body.
66
What happens to iron if it is not needed by the body?
If not needed, iron is shed with intestinal cells, which are replaced every 3–5 days.
66
What happens in Stage 1 of iron deficiency?
Decreased iron stores.
67
What happens in Stage 2 of iron deficiency?
Depleted iron stores.
67
What is iron deficiency anemia?
A severe stage of iron deficiency where hemoglobin levels are low, resulting in anemia.
68
What are common causes of iron deficiency and anemia?
* Malnutrition and inadequate iron intake.
* Overconsumption of sugar and fats.
* Blood loss, especially during menstruation and GI bleeding.
68
How does blood loss contribute to iron deficiency?
* 80% of the body's iron is stored in blood.
* Blood loss reduces iron levels, leading to deficiency.
68
Who has increased iron needs?
* Women in reproductive years (due to menstruation).
* Infants, young children, adolescents, and pregnant women (due to growth).
68
What is the global impact of iron deficiency?
* Affects more than 1.2 billion people worldwide.
* Common in developing countries, especially in preschool children and pregnant women.
68
What non-nutritional causes contribute to iron deficiency anemia?
* Blood loss from conditions like GI bleeding.
* Parasitic infections or digestive tract ulcers in developing countries causing daily blood loss.
69
What happens if a person takes in too much iron?
Iron is toxic in large amounts and difficult to excrete. The body controls absorption to prevent overload. Hepcidin, a hormone, limits iron absorption.
69
How does the body protect against iron overload?
The small intestine traps excess iron, holding it until the intestinal cells are shed. When iron stores are full, less iron is absorbed.
69
What is hemochromatosis?
Hemochromatosis is an inherited disease where the body absorbs too much iron, most commonly in Caucasian men.
69
What are the early symptoms of hemochromatosis?
Early symptoms include fatigue, mental depression, and abdominal pain.
69
What are the later symptoms of hemochromatosis?
Later symptoms include liver failure, abnormal heartbeats, type II diabetes, and infections due to bacteria thriving on iron-rich blood.
70
Do pregnant women need iron supplements?
Yes, pregnant women need iron supplements to meet their iron needs.
70
What is the best source of iron?
Food is the best source of iron, as it is better absorbed than iron supplements.
70
Why are vegetarians advised to consume more iron?
Vegetarians are advised to consume 1.8 times the recommended daily amount (RDA) of iron, as plant-based iron is not well absorbed.
70
Do adult men usually experience iron deficiency anemia?
No, adult men rarely experience iron deficiency anemia, but may have low iron due to unknown bleeding
70
What is the role of vitamin C in iron absorption?
Vitamin C enhances the absorption of iron.
71
Do iron-fortified foods pose a risk to healthy people?
No, iron-fortified foods pose no risk for healthy people.
71
What is heme iron?
Heme iron is the iron-containing part of hemoglobin and myoglobin found in meat, poultry, and fish.
71
What is nonheme iron?
Nonheme iron is found in plant-based foods and in meat, poultry, and fish.
71
How is heme iron absorbed compared to nonheme iron?
Heme iron is absorbed better than nonheme iron. Healthy people absorb heme iron at a rate of about 23%, while nonheme iron is absorbed at rates of 2% to 20%, depending on dietary factors and iron stores.
72
What is the MFP factor and how does it affect iron absorption?
The MFP (meat, fish, poultry) factor promotes the absorption of nonheme iron from other foods eaten at the same time.
73
What dietary factors impair iron absorption?
Tannins (found in tea and coffee), calcium and phosphorus (found in milk), and phytates (found in lightly processed legumes and whole grains) can impair iron absorption.
74
Why is black tea known to reduce iron absorption?
Black tea is especially efficient in reducing iron absorption, making it advisable for individuals with iron overload.
74
Soucres of Iron in food?
* Red meats, fish, poultry,
* shellfish, eggs
* Legumes, green leafy
* vegetables, dried fruit
* Cooking in an iron pan
* adds iron to food
74
What is the role of iodine in the body?
Iodine is an integral part of thyroxine, a hormone made by the thyroid gland that regulates basal metabolic rate.
74
What are the symptoms of iodine deficiency?
* Symptoms of iodine deficiency include an enlarged thyroid (goiter),
* sluggishness
* weight gain
* and, in severe cases during pregnancy, congenital hypothyroidism leading to extreme developmental delays.
74
What are goitrogens, and which foods contain them?
* Goitrogens are substances that inhibit iodine uptake by the thyroid.
* Foods that contain goitrogens include collards, kale, and brussels sprouts.
74
What can result from iodine toxicity?
Iodine toxicity can lead to an enlarged thyroid gland and, in very large amounts, can be deadly.
74
What are the best dietary sources of iodine?
Best sources of iodine include seafood, iodized salt, milk, and bakery products that use iodine-containing dough conditioners.
74
Does sea salt contain iodine?
No, sea salt contains little iodine compared to iodized salt
74
How much iodine is in 250 mL (1 cup) of milk?
250 mL (1 cup) of milk provides nearly half of the daily recommended iodine intake.
75
What is the role of zinc in the body?
* Assists in immune function
* Taste perception
* Wound healing
* Sperm production
* Fetal development
* Growth & development in children
76
What does zinc help produce in the body?
* Zinc helps produce parts of the cell’s genetic material
* heme in hemoglobin,
* vitamin A from storage,
* and plays a role in the active form of vitamin A in visual pigments.
76
What are some symptoms of zinc deficiency?
Symptoms include poor growth, digestive issues (diarrhea), weakened immunity, increased infections, impaired taste, poor wound healing, and abnormal vision in the dark.
76
What can excessive zinc intake cause?
* Excessive zinc intake can reduce HDL levels
* inhibit copper absorption
* lower copper content
* and interfere with iron absorption.
77
How does zinc absorption vary in the body?
Zinc absorption ranges from 15% to 40% and decreases with increased intake. It is also limited by phytates.
77
What are major food sources of zinc?
Major sources include meats, shellfish, poultry, milk, and milk products. Plant sources like legumes and whole grains are not absorbed as well as animal sources
78
Why is zinc deficiency often misdiagnosed as general malnutrition?
Zinc deficiency has widespread symptoms, including growth problems, digestive issues, and impaired immunity, which are common in malnutrition.
79
What is the role of selenium in the body?
activating thyroid hormone
79
What are the consequences of selenium deficiency?
Selenium deficiency is linked to cancer, particularly prostate cancer, and heart disease, such as Keshan disease, which involves heart enlargement and insufficiency.
80
What is Keshan disease, and how is it related to selenium deficiency?
Keshan disease is heart enlargement and insufficiency caused by a virus, but selenium deficiency may make people more susceptible to it. It was first discovered in regions with sodium-deficient soil.
81
What are good dietary sources of selenium?
Good sources of selenium include meats, shellfish, vegetables, and grains grown in selenium-rich soils. The selenium content of soils varies by region.
81
Is there a benefit to taking selenium supplements?
NO
82
Is fluoride essential to life?
No, fluoride is not essential to life but it is beneficial for dental and bone health.
83
What are the primary sources of fluoride?
The primary source of fluoride is fluoridated drinking water, but it can also be found in tea and seafood.
83
What happens when fluoride is deficient?
Where fluoride is missing, the incidence of dental decay is very high.
84
What is fluoride toxicity, and what are its symptoms?
Fluoride toxicity leads to fluorosis, which is characterized by discoloration and pitting of tooth enamel caused by excess fluoride during tooth development. It is irreversible.
85
What is the role of chromium in the body?
Chromium works closely with insulin to regulate and release energy from glucose.
86
What happens in the body when there is chromium deficiency?
Chromium deficiency impairs insulin action, leading to a diabetes-like condition with high blood glucose. This can resolve with chromium supplementation.
86
Can chromium supplements cure diabetes?
No, chromium supplements cannot cure the common forms of diabetes, but they may help in the management of type 2 diabetes.
86
What is Wilson’s disease?
* Wilson’s disease is a genetic disorder where copper accumulates in the liver and brain, potentially leading to toxicity.
* signs, a ring of copper around the eye
* comes from cropper
86
What is Menkes disease?
Intestinal cells absorb copper but can’t release it into the circulation causing deficiency
* What is Menkes disease?
87
OTHER TRACE MINERALS
*
* Molybdenum - Functions as a part of several metal containing enzymes
* Manganese - enzymes
* Boron - enzymes
* Cobalt- in B12
* Nickel - health and tissue
* Silicon - Bone calcification in animals
* Arsenic - a know poisn but still helps
* High amounts is toxic
88
How does water's incompressibility benefit the body?
Water acts as a lubricant and cushion for joints, cushions sensitive tissues like the spinal cord and fetus, and maintains optimal pressure in the eye.
89
How does water function as a lubricant in the body?
Water lubricates the digestive tract, respiratory tract, and tissues moistened with mucus.
89
What role does water play in thermoregulation?
* Sweat cools the body through evaporation,
* and blood routed through skin capillaries releases excess heat.
* The cooled blood flows back to the body's core.
89
Why is water considered a nearly universal solvent in the body?
Water dissolves amino acids, glucose, and minerals for transport and helps package fatty substances with water-soluble proteins for transport in the blood and lymph.
89
How does water serve as the body’s cleansing agent?
Nitrogen wastes dissolve in blood, and the kidneys filter these wastes, mix them with water, and excrete them as urine.
89
What is the progression of symptoms for dehydration?
Thirst → Weakness → Exhaustion & Delirium → Death.
90
What is the AI (Adequate Intake) for total water per day for females?
2.7 liters/day
90
What is the AI (Adequate Intake) for total water per day for males?
3.7 liters/day
91
What is hard water?
Water with high calcium and magnesium concentrations.
91
What is soft water?
Water with high sodium content.
92
Why might soft water be less healthy for some people?
It may aggravate hypertension and heart disease.
92
How are minerals classified?
Minerals are classified into major minerals and trace minerals based on the amounts required in the body.
92
What are major minerals?
Major minerals are essential nutrients with amounts exceeding 5 grams in the body.
92
What are trace minerals?
Trace minerals are essential nutrients with amounts less than 5 grams in the body.
93
According to the DRI committee, what is included in total water intake?
Both caffeinated and non-caffeinated beverages.
Food.
93
What percentage of total water intake comes from liquids?
About 80%.
93
What is the most abundant mineral in the body?
Calcium
94
Where is 99% of calcium stored in the body?
Bones and teeth.
95
What are the two major roles of calcium in bones?
Integral part of bone structure.
Acts as a calcium reserve.
95
What is fluorapatite, and how is it formed?
Fluoride can replace part of hydroxyapatite in bones and teeth, forming fluorapatite, which resists bone dismantling and hardens teeth.
95
What percentage of dietary calcium is absorbed in different life stages?
* Infants and children: ≈60%
* Pregnant women: ≈50%
* Adults: ≈25%
96
How does the body maintain constant blood calcium levels?
Through hormonal regulation, not daily calcium intake.
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What happens when calcium intake is inadequate?
Blood calcium levels are maintained at the expense of bone calcium.
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What nutrient helps increase calcium absorption?
Vitmin D.
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How does the body adjust calcium absorption when dietary intake is low?
The percentage of calcium absorbed increases, and calcium loss via the kidneys is reduced.
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When does peak bone mass occur?
By the late 20s (10 years after reaching adult height).
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At what age does bone density begin to decrease?
Around 40 years of age.
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How can bone loss be slowed?
Diet rich in calcium.
Regular physical activity.
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What is a consequence of a calcium-poor diet during growing years?
Reduced peak bone mass and increased risk of osteoporosis later in life.
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What is osteoporosis?
A condition where bones become brittle and fragile due to loss of bone calcium.
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What percentage of calcium is found in body fluids?
1%.
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What are good sources of calcium?
* Milk and milk products
* Fortified soy beverages and other milk alternatives
* Fish with bones (e.g., canned salmon, sardines)
* Calcium-set tofu
* Broccoli, some leafy greens, and legumes
* Fortified juices
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Are Canadians meeting recommended calcium intakes?
No, on average, Canadians are not meeting recommended intakes.
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What are the effects of calcium deficiency?
Adult bone loss (osteoporosis).
Stunted growth and weak bones in children.
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What dietary trends contribute to calcium deficiency?
Decline in milk consumption.
Increased consumption of soft drinks.
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What are potential effects of excessive calcium intake (toxicity)?
* Constipation.
* Kidney stones.
* Interference with absorption of other minerals.
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Why might people avoid milk, and how does it affect calcium intake?
* Reasons: Lactose intolerance, preference, dislike, or allergy.
* Effect: Lower calcium intakes and poorer bone health, especially in children.
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What are alternatives for people who don’t consume milk?
Fortified milk alternatives, calcium-rich vegetables, legumes, and fortified juices.
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Which vegetables are good sources of calcium?
Rutabaga, broccoli, beet greens, collards, and kale, dark green veges
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Which vegetables are poor calcium sources and why?
Spinach, Swiss chard, and rhubarb because binders inhibit calcium absorption.
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How does age affect osteoporosis risk?
Advancing age increases the risk of osteoporosis.
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Which sex is at higher risk of osteoporosis?
Females are at higher risk.
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How do lifestyle factors like alcohol consumption impact osteoporosis risk?
Heavy drinking increases the risk of osteoporosis.
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What medical conditions or treatments increase osteoporosis risk?
* Chronic steroid use.
* Rheumatoid arthritis.
* Removal of ovaries or testes.
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How does body weight affect osteoporosis risk?
Being underweight or experiencing significant weight loss increases the risk.
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What genetic and racial factors are linked to osteoporosis?
* Family history increases risk.
* White people are at higher risk.
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What is the risk of osteoporotic fractures for women in Canada?
1 in 3 women will experience an osteoporotic fracture.
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What is the risk of osteoporotic fractures for men in Canada?
1 in 5 men will experience an osteoporotic fracture.
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How does osteoporosis risk differ by race?
* Black women have far fewer hip fractures than white women.
* Black women have denser bones and lose bone density more slowly than white women.
* Black race is considered protective against osteoporosis.
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How does being underweight or losing weight affect bones?
Being underweight or losing weight increases the risk of osteoporosis.
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How does excessive dietary protein affect calcium?
Excess protein causes the body to excrete more calcium in urine.
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How does caffeine consumption impact bone health?
Heavy caffeine consumption may be linked to bone loss.
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What is the second most abundant mineral in the body?
Phosphorus
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What are the main roles of phosphorus in the body?
* Helps maintain acid-base balance (buffers).
* Part of DNA and RNA.
* Part of phospholipids.
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What can phosphorus toxicity lead to?
Calcification of soft tissues.
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What are the best sources of phosphorus?
Animal protien
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Where else can phosphorus be found?
In cola drinks.
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What are the primary roles of magnesium in the body?
* Works with calcium for muscle function:
* Calcium promotes contraction.
* Magnesium helps muscles relax afterwards.
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Where is most of the body’s magnesium located?
* Half in the bones.
* The rest in muscles, heart, liver, and other soft tissues.
* Only 1% in body fluids.
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Do most Canadians meet their magnesium needs?
Most Canadians meet the EAR (Estimated Average Requirement) but are below the RDA (Recommended Dietary Allowance).
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What can cause magnesium deficiency?
* Inadequate intake.
* Vomiting or diarrhea.
* Alcoholism and malnutrition.
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What can cause magnesium toxicity?
High intakes of magnesium from non-food sources (e.g., supplements or magnesium salts), especially in large amounts.
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What percentage of the weight of sodium chloride is sodium?
40%.
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What are the primary roles of sodium in the body?
Fluid and electrolyte balance
Acid base balance
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Is sodium deficiency common
No, it’s unlikely because most people consume more salt than needed.
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What can cause sodium deficiency?
Very strict low sodium diets for conditions like hypertension, kidney disease, or congestive heart failure.
Vomiting, diarrhea, or heavy sweating.
Endurance athletes who lose too much salt and drink too much water (hyponatremia).
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What is the adequate intake of sodium for individuals aged 14 and up?
1500 mg/day.
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What is the Chronic Disease Risk Reduction (CDRR) level of sodium intake for individuals aged 14 and up?
2300 mg/day.
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What was the previous daily value for sodium on food labels?
2400 mg
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What is the current daily value for sodium on food labels?
2300 mg
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What is the average sodium intake for females aged 19-30?
2270 mg/day.
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What is the average sodium intake for males aged 19-30?
3420 mg/day.
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What is the mean daily sodium intake for Canadians (based on CCHS 2015 data
2760 mg/day.
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What is the main benefit of the DASH diet?
It may help both salt-sensitive and non-salt-sensitive people lower their blood pressure, often more effectively than sodium restriction alone.
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What foods are emphasized in the DASH diet?
Increased intake of vegetables and fruits.
Adequate amounts of nuts, fish, whole grains, and low-fat dairy.
Occasional small portions of red meat, butter, and sweets.
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What are the main food sources in the DASH diet?
Whole grains, fruits, vegetables, seeds, nuts, and legumes.
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What happens when the DASH diet includes more magnesium, potassium, calcium, protein, and fiber?
Blood pressure drops even lower at each level of sodium intake.
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How does low potassium intake affect blood pressure?
Low potassium intake is found to raise blood pressure.
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How does high potassium intake affect blood pressure?
High potassium intake helps prevent and correct hypertension.
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How does physical activity affect blood pressure?
Physical activity helps lower blood pressure.
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How much sodium is in 1 teaspoon of salt?
2300 mg of sodium.
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What are the main sources of chloride?
Salt, both added and naturally occurring.
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Is chloride deficiency common?
No, there is no known diet that lacks chloride.
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How does low potassium intake affect hypertension?
Low potassium intake makes hypertension worse.
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Does a typical diet provide enough potassium for healthy people?
Yes, a reasonable diet provides enough potassium to prevent dangerously low blood potassium levels.
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What are the main roles of potassium in the body?
* Maintenance of fluid balance.
* Maintenance of electrolyte balance.
* Maintenance of heartbeat.
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What is one of the main roles of sulfur in the body?
Sulfur is required for the synthesis of many important sulfur-containing compounds.
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What are the fat-soluble vitamins?
Vitamins A, D, E, and K.
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Can fat-soluble vitamins be toxic?
Yes, they may be toxic in excess
125
What are the water-soluble vitamins?
The B vitamins and vitamin C
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What are the three active forms of Vitamin A in the body?
Retinol
Retinal
Retinoic acid
125
What is the plant-derived precursor of Vitamin A?
Beta-carotene (corrots)
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What are the main roles of Vitamin A in the body?
* Vision
* Maintenance of body linings and skin
* Growth of bones and the bodya
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What happens if there is a Vitamin A deficiency in terms of eyesight?
* Keratin accumulation (keratinization) of the cornea can occur.
* This leads to xerosis (drying) and eventually xerophthalmia (dryness and thickening of the cornea), causing permanent blindness.
* Early detection can reverse the damage with Vitamin A supplementation or consumption of vegetables and fruits.
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What are the key roles of Vitamin A in the body?
1. Gene Expression: Retinoic acid activates or deactivates certain genes, affecting protein production.
1. Immunity: Vitamin A regulates genes that produce immune system proteins. A deficiency can lead to a cycle of malnutrition and infection.
1. Growth: Vitamin A assists in the growth of bones and teeth, particularly in the dismantling of old bone structure.
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What are the symptoms of Vitamin A toxicity?
* weaken bones
* abdominal pain, stunted growth
* , liver damage
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What is the risk of Vitamin A toxicity in pregnant women?
*
* Excessive Vitamin A intake, especially in the form of supplements exceeding the recommended dose, can cause fetal malformation (teratogenic effects).
* A single large dose (100x the need) or chronic supplement use can pose risks.
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How does Vitamin D help when more calcium is needed in the body?
* Promotes calcium absorption from the intestines.
* Promotes calcium retention by the kidneys, reducing calcium loss in urine.
* Draws calcium from bones to maintain blood calcium levels.
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What is Rickets and how is it related to Vitamin D deficiency?
* Rickets is a Vitamin D deficiency disease in children, leading to abnormal bone growth.
* Symptoms include bowed legs, outward-bowed chest, and knobs on ribs.
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What are the risks for bone loss due to Vitamin D deficiency in adolescents and older adults?
* Adolescents who consume beverages without Vitamin D (e.g., non-fortified drinks) or prefer indoor activities may face bone loss risks.
* Older adults may experience painful joints and muscles due to low Vitamin D levels.
* Osteomalacia, the adult form of rickets, is common in women with low calcium intake, little sun exposure, and frequent pregnancies
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What are the symptoms and dangers of Vitamin D toxicity?
* Vitamin D is the most toxic of all vitamins in excess.
* Symptoms include appetite loss, nausea, vomiting, increased urination and thirst, severe psychological depression.
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Q: Does skin synthesis of vitamin D pose a risk of toxicity?
No, skin synthesis of vitamin D poses no risk of toxicity. The body naturally regulates vitamin D production from sunlight to prevent excessive levels.
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What is the gold standard for vitamin E activity?
Alpha-tocopherol is the gold standard for vitamin E activity.
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What causes vitamin E deficiency, and how is it affected by food processing
Infants born before the transfer of vitamin E from mother to infant may experience deficiency, leading to erythrocyte hemolysis (rupturing of red blood cells), which results in anemia.
Adults can also be affected, though it's less common
## Footnote
Vitamin E is destroyed by food processing and heating.
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What are some good food sources of vitamin E?
* Vegetable oils (including salad dressing and shortening)
* Avocados
* Wheat germ
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What are the main functions of vitamin K?
* Synthesis of blood clotting proteins
* Synthesis of normal form of bone proteins that bind minerals to bone
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Why are newborns given a dose of vitamin K?
* Newborns have a sterile GI tract at birth.
* Vitamin K-producing bacteria will establish themselves in the gut after birth.
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What food sources are richest in vitamin K?
Leafy green vegetables, particularly dark green ones (e.g., kale, spinach, collard greens).
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What are the general characteristics of Vitamin C and B vitamins?
* Easily absorbed
* Excess is readily excreted in urine
* Cooking and washing with water leaches them out of food
* General advice: Choose foods rich in water-soluble vitamins daily to meet recommended intakes.
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What are the symptoms of Vitamin C deficiency?
* Loose teeth
* Bleeding gums
* Pinpoint hemorrhages
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How can scurvy be cured?
Cured with 100 milligrams of Vitamin C per day for 5 days
Easily achieved through food
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Does Vitamin C prevent colds?
* Inconsistent results for preventing colds.
* High doses (1 gram) at the onset of a cold may reduce duration by half a day and reduce symptom severity by 40%.
* 2 grams per day for 2 weeks may reduce blood histamine, acting like a weak antihistamine.
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Can too much Vitamin C be harmful?
* Vitamin C from food is safe.
* Adverse effects from high doses include digestive issues: nausea, cramps, diarrhea.
* Massive doses may interfere with blood-clotting medications and can be dangerous for those with iron overload.
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How does smoking affect Vitamin C levels?
* Smoking introduces oxidants that deplete Vitamin C in the body.
* The RDA for Vitamin C is set 35 mg higher for smokers to compensate for the increased depletion.
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What are some good food sources of Vitamin C, and how should they be stored and prepared?
Food Sources:
* Citrus fruits, dark green vegetables (bell peppers, broccoli), cabbage-type vegetables, strawberries, cantaloupe, lettuce, tomato, papaya, mangoes, red bell pepper.
* Potatoes also contain Vitamin C.
* Historical note: Scurvy became evident in Ireland during the potato famine
Preservation:
* Vitamin C in fruits & vegetables is prone to destruction by heat and oxygen.
* To preserve Vitamin C:
* Consume fresh, raw, and quickly cooked foods.
* Store properly and consume promptly
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What is beriberi and how was it first observed?
Beriberi is a deficiency of thiamine (vitamin B1), first observed in Asia when rice was polished, removing the outer layers rich in thiamine.
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What are the symptoms of beriberi?
Symptoms of beriberi include loss of sensation in the hands and feet, muscular weakness, advancing paralysis, and abnormal heart action.
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How does alcohol affect thiamine levels and what disorder can result from this?
* Alcohol displaces food in the diet.
* Impairs thiamine absorption.
* Promotes thiamine excretion in the urine.
* Leads to thiamine deficiency.
* Can cause Wernicke-Korsakoff Syndrome (neurological disorder).
* Thiamine is widespread in healthy foods, but alcohol interferes with its utilization.
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What is riboflavin’s role, deficiency symptoms, and sources?
* Role: Important for energy metabolism in all cells.
* Deficiency:
* Often with other vitamin deficiencies (especially thiamine).
* Symptoms: Inflammation in the mouth, skin, eyes, GI tract, and a smooth, purplish-red tongue.
* Common in children lacking milk and meat.
* Sources: Milk, leafy greens, whole grains, enriched grains, meats, and eggs.
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What is Pellagra and what are the 4 Ds?
Pellagra is a deficiency of Vitamin B3 (Niacin).
The 4 Ds of Pellagra are:
* Diarrhea
* Dermatitis
* Dementia
* Death (if untreated)
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How is Niacin (B3) measured using Niacin Equivalents (NE)?
* 1 milligram of niacin is made from 60 milligrams of tryptophan.
* Example: If a food contains 1 mg of niacin and 60 mg of tryptophan, it would provide 2 mg NE (Niacin Equivalents).
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What are Neural Tube Defects (NTDs), and how are they related to folate intake?
* Neural Tube Defects (NTDs) are birth defects affecting the spinal cord and brain, which may lead to mental delays, severely diminished brain size, or even death shortly after birth.
* These defects typically arise in the first few days or weeks of pregnancy, during the critical period of neural tube development.
* Folate deficiency is a major cause of NTDs, as most women do not consume enough fruits and vegetables to meet the folate needs for proper fetal development.
* Adequate folate intake before and during pregnancy significantly reduces the risk of NTDs.
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The bioavailability of folate ranges from approximately 50% to 100%
* 50% when obtained from food sources.
* 100% when taken in supplement form on an empty stomach, as supplements are more easily absorbed by the body.
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What are the primary sources of folate, and what is the recommended daily allowance (RDA) for healthy adults and pregnant women?
* Sources: Folate is found in leafy green vegetables (e.g., spinach, kale), legumes, and fortified foods.
* RDA for Healthy Adults: 400 mcg DFE/day
* RDA for Pregnant Women: 600 mcg DFE/day
135
Why are fortified foods and supplements considered more bioavailable sources of folate?
Fortified foods and supplements are 1.7 times more bioavailable than natural food sources, meaning they provide extra credit when calculating dietary folate equivalents (DFE).
135
What are the primary roles of Vitamin B12 in the body?
* Works closely with folate to activate both vitamins.
* Maintains the sheaths surrounding and protecting nerve fibers.
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What are the symptoms of Vitamin B12 deficiency?
* Damaged nerve sheaths, leading to creeping paralysis and general nerve/muscle malfunction.
* Failure of folate to produce red blood cells, resulting in macrocytic (megaloblastic) anemia.
135
Why is it important to provide Vitamin B12 when treating folate deficiency symptoms?
Folate can clear up the anemia caused by Vitamin B12 deficiency, masking the underlying issue. If untreated, nerve damage from Vitamin B12 deficiency will persist.
135
Who is at higher risk for Vitamin B12 deficiency?
* Elderly (due to decreased stomach acidity or intrinsic factor).
* Those with atrophic gastritis or a genetic defect affecting intrinsic factor production.
* Vegans and strict vegetarians (symptoms may take years due to stored reserves of B12).
135
How can vegans prevent Vitamin B12 deficiency?
Consume B12-fortified products or take B12 supplements regularly.
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How is Vitamin B12 absorbed in the body?
* Intrinsic factor (a compound made by the stomach) is required for Vitamin B12 absorption.
* The stomach acid liberates Vitamin B12 from food, and intrinsic factor binds to it.
* The Vitamin B12-intrinsic factor complex is absorbed in the small intestine into the blood.
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What are the best food sources of Vitamin B12?
* Animal-based sources (e.g., meat, fish, eggs, dairy).
* Milk and fish have the highest bioavailability.
* Fortified plant foods (e.g., soy beverage) can provide B12 for those following a plant-based diet.
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What is Pernicious Anemia?
* It is a Vitamin B12 deficiency disease caused by a lack of intrinsic factor.
* It is characterized by the presence of large, immature red blood cells.
* Treatment involves B12 injections.
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What are the roles of Vitamin B6 in the body?
* Aids in protein synthesis by converting one amino acid to another.
* Converts tryptophan to niacin (vitamin B3).
* Supports neurotransmitter synthesis, including the conversion of tryptophan to serotonin.
* Involved in hemoglobin synthesis.
* Alot of things its involve in
137
What are the symptoms of Vitamin B6 deficiency?
* General symptoms:
* Weakness
* Psychological depression
* Confusion
* Irritability
* Insomnia
* Other symptoms:
* Anemia
* Greasy dermatitis
* alot of things its invole in
138
What are the toxicity symptoms of Vitamin B6?
* Seen in individuals taking 2+ grams/day for 2+ months.
* Symptoms include:
* Numbness in feet
* Loss of sensation in hands
* Inability to walk or work
* Recovery occurred after stopping the supplementation
138
where do we store B6
Musule tissue
138
What are the main food sources of Vitamin B6?
* The main sources of Vitamin B6 include:
*
* Protein-rich foods: meats, fish, poultry
* Legumes & peanut butter
* Potatoes
* Leafy green vegetables
* Some fruits
138
How is elevated homocysteine related to cardiovascular disease (CVD)?
Elevated homocysteine levels may be an indicator of CVD risk. Deficiencies of folate, vitamin B12, or vitamin B6 can lead to an excess of homocysteine in the blood.
138
What is the role of biotin, and how does a deficiency occur?
* Biotin plays a crucial role in energy metabolism. A deficiency can occur if a person consumes excessive raw egg whites daily, as they contain a protein called avidin that binds biotin, preventing its absorption.
* Cooking eggs denatures this protein, making the biotin available for absorption.
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What are the roles of pantothenic acid, and what can cause its deficiency?
* Pantothenic acid is essential for energy metabolism, acting as a coenzyme involved in the release of energy from nutrients.
* It plays a role in over 100 steps related to the synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin.
* Deficiency is rare but may occur in certain rare diseases. It is widely found in many foods.
138
Who may likely need supplements?
* People with nutrient deficiencies
* Habitual dieters
* Vegans or individuals with atrophic gastritis
* Those with lactose intolerance or milk allergy
* Infants (need iron), newborns (vitamin K), and women who could become pregnant (folate)
* Pregnant women (need iron and folate)
* Elderly individuals (need B12 and vitamin D)
* People with injuries or infections that impair nutrient intake, absorption, excretion, or metabolism
* Individuals taking medications that interfere with nutrient absorption
