HLTH 230 Midterm Flashcards
role of carbohydrates
-provide energy for the brain & NS
-help keep digestive system healthy
-within limits, keep body lean
Indigestible carbohydrates
yield little or no energy
carbohydrate rich foods
-whole grains
-plants
-legumes
-vegetables and fruits
-milk products are the only animal-derived foods that contain significant carbs (milk, yogurt, sour cream)
-concentrated sugars
categories of carbohydrates
simple and complex
simple carbohydrates
Monosaccharides - single sugar
Disaccharides -pairs of monosaccharides (one is usually glucose)
3 monosaccharides
glucose, fructose and galactose
*all have the same number & kind of atoms arranged in different ways
Glucose
-blood sugar
-monosaccharide
-mildly sweet
-essential energy source for body activities
-one of 2 sugars of every disaccharide
-polysaccharides are made almost exclusively of glucose
Complex carbohydrates
polysaccharides - chain of monosachharides
galactose
-component of milk sugar
-not sweet at all
-one of the two sugars in milk products
-found occasionally as a single sugar (fermented milk products)
Fructose
-very sweet
-naturally in fruit and honey
-often used in soft drinks, cereals and desserts
-
high fructose corn syrup
syrup made from cornstarch that has been treated with an enzyme tha converts some of the glucose to the sweeter fructose
3 disaccharides
lactose (glucose + galactose)
Maltose (glucose + glucose)
Sucrose (glucose + fructose)
**joined by cindensation rxns, split by hydrolysis rxns that release a water
Lactose
-milk sugar
-glucose and galactose
-principle carbohydrate in milk
-provides about 1/2 kcal in skim milk
maltose
-2 glucose
-prodcued duing starch breakdown
-occurs during process of alcohol fermentation
-only occurs in a few foods ex. barley
Sucrose
-glucose and fructose
-sweetest disaccharide
-naturally in fruit, vegetables and grains
-table sugar is sucrose refined from beets or sugarcane
Eating sugar
-monosaccharides are absorbed diretly into the blood
-disaccharides are digested before absorption (slit into monosaccharides)
-glucose is most used nutrient in the body
sugar on nutrition label
-cannot tell from % DV what sugar is natural or artificial
most energy in fruit and vegetables comes from
sugar
why are fruits different than purified sugars?
fruit contains fibre, phytochemicals, vitamins and minerals
polysaccharides
-starch
-glycogen
-fibre
**made up of many strands of glucose units
Starch
-storage form of glucose in plants
-long chains of glucose molecules linked together (branched-amylopectin and unbranched-amylose)
-starch is nutritive: we digest starch to glucose
rich food sources of starch
-grains
-tubers (yams and potatoes)
-legumes (peas and beans)
Glycogen
-storage form of carbs in animals
-highly branched glucose chains (this allows for rapid hydrolysis and surge of glucose)
-stored in muscle(2/3) and the liver (1/3)
**meat does not contain glycogen because it breaks down when animal is slaughtered
how long could you sustain energy on stored glycogen
about 1 hr
Fibre
-is a prebiotic
-retains water to protect seeds
-support plant structure
-most are polysaccharides
-humans cannot digest fibre therefore passes through without providing energy*
*digest to small degrees via fermentation
prebiotics
foods that are not digested but promote bacterial growth by acting as food for bacteria
Soluble fibre
-dissolve in water
-form gels (viscous)
-can be digested by bacteria in colon
-soften stool
-slow glucose absorption
-associtaed with low risk of chronic disease (decrease cholesterol)
-used as thickening agent
-gums, pectin, psyllium, some hemicelluloses
rich sources soluble fibers
barley, legumes, oats, apples, citrus fruit
Insoluble fibres
-do not dissolve in water
-speed passage of feces and allieve constipation
-outer layers of whole grains
-retain structure and texture
-easily fermented and do not form gels
examples insoluble fibres
cellulose, lignin, resisant starches, hemicelluloses, inulin
need for carbs
-provied energy
-cheaper than protein
-glucose is used as fuel by the brain and CNS
gluten is a
protein
Ketogenic diet
-used as therapy for epilepsy and seizure control
-low carb high fat diet
-use fat for fuel
why recommend fibre rich foods
-supply vitamins, minerals, & phytochemicals
-little or no fat (except nuts)
-soluble fibres have cholesterol effect
-maintain bodyweight
-maintain blood-glucose concentration
Low fibre diet and cholesterol
you absorb more cholesterol and therefore your cholesterol increases
high fibre diet and cholesterol
soluble fibre lowers blood cholesterol by binding with cholesterol containing bile and carrys it out in the feces
Blood Glucose control
-viscous fibres trap nutrients and delay their transit through the digestive tract
-glucose absorption slows and helps steady levels of blood glucose ans insulin and glycemic index
maintenence of digestive tract health
-fibre and fluid intake play a role in maintaining colon function and preventing constipation
-enlarge and soften stools
-speed passage
need for carbs: constipation
-fibre prevent constipation
-softens stools for preventing hemorrhoids
-prevent compaction (therefore appendicitis)
-stimulates gi tract muscles to retain strenght and resist bulging out (diverticula)
healthy weight management
-foods rich in complex carbs tend to be low in fat and added sugar: may promote weight loss by providing less energy
-fibre creates fullness and delays hunger
how do we get fibre
-pure fibre compounds usually not necessary
-most benefits come from food not compounds
-too much fibre without water can cause constipation
too much fibre?
-purified fibre can lead to a blocked intestine especially with too little water
-binders in some fibres act as chleating agents (carry minerals out of body)
-can contribute to dehydration because they remove water from the body
-too much can limit food intake and cause nutrient and energy deficencies
Bran
-outer part of a whole grain
-largely made of cellulose
-protects the grain
-removed in milling
3 parts os a whole grain
bran, endosperm, germ
Endosperm
-largely starch grains embedded ina protein matrix
-generally what is used in refined flour
germ
-part where new grain develops
-majority of fat in the grains are located here
-often left out of processing to avoid rancidity
Modern milling
-removed germ and bran (whiter, smoother texture increasing starch content and lowering fibre content)
-loss of nutrients
Modern milling laws in canada
1970: mandatory addition of riboflavin, thiamin, niacin and iron
1990: mandatory addition of folic acid (important for cell division)
digestion of carbs
-begins in mouth (salivary amylase)
-then becomes deactivated by stomach acid
-starch digestion resumes in small intestine
-pancreatic enzymes: split starch into smaller polysachharides and disaccharides
-intestinal ezymes split these into monosaccharides
starch found in refined grains
rapidly broken down into. glucose which is then absorbed
*sometimes digested slower and releases glucose later (cooked beans)
Resistant starch
-behaves like fibre
-found in raw potaties, unripe bananas, husks of seeds
-digested slowly
-most remain intact until bacteria of colon break it down
-sometimes classified as insoluble fibre
Sugars digestiona nd absorption
-digestible carbs are split into monisaccharides before absorption
-pancreatic amylase splits most starch to disaccharides
-small polysaccharides and disaccharides are split by enzymes atatched to cells lining the small intstine (lactase, sucrase and maltase)
Once in the bloodstream, sugars travel:
-to the liver
-fructose & galactose are converted to glucose or related products
-circulatory system transports the glucose and other products to the cells
-liver and muscle cells may store glucose as glycogen
-all cells may use glucose for energy
Digested fibre
-many fibres can be fermented by intestinal bacteria
-odourous gases are bi-product
-gas production can be minimized by small servings and gradually increasing
Lactose intolerance
-some people produce less lactase
-ability to produce lactase declines with age
-lactase deficency may be use to damage to villi
-intestinal bacteria ferment the undigested lactose producing gas and intestinal irritants
Milk allergy
-immune response
-allergic rxn to the protein in milk
-cannot tolerate any milk product
-calcium supplement
Using glucose
-glucose is basic carbohydrate unit that cells use for energy
-body keeps supply to use
what processes release energy from glucose
glycolysis and krebs
DRI carb reccomendation
-minimum intake to reduse ketosis is 130g/day (RDA=130g/day)
-45-65% kcalories/day of carbs
-more is reccomended to maintain health and glycogen stores
Glucose below healthy minimum
-body fat cannot be converted to glucose to feed the brain
-with carb defecit, body uses protein to make glucose via gluconeogenesis
-fat fragments usually combine with a compound derrived from glucose (or protein) before being used for energy
-
after10 days of eating less than RDA of carbs
-body would adjust to partly use keytones
adults with chronic ketosis may face:
-vitamin and mineral deficiencies
-loss of bone minerals
-altered blood lipids
-increase kidney stone risk
-constipation, nausea and vomitting
-glycogen stores that are too low to meet a metabolic emergency or support maximal high-intesity muscular work
blood glucose after eating
-BG increases
-insulin secreted from pancreas
insulin stimulates
-uptake of glucose into cells
-storage of glucose into glycogen
-excess glucose into fat
blood glucose after activity
-cells on body use glucose decreasing BG
-glucagon secreted from pancreas
glucagon stimulates
-breakdown of glycogen therefore glucose released into bloodstream
epinephrine
breaks down liver glycogen as part of the bodys defense mechanism in times of danger
to meet glucose needs
-foods rich in free sugars & sugary drinks are not good choices
-balanced meals, at the same times help the body maintain BG levels
Glycemic Index
-measure of the ability of a food to elevate BG & insulin levels
-scored against standard
-many influences
glycemic load
glycemic index multiplied by grams of carbohydrate
excess glucose
-stored as glycogen until muscle and liver are at full cap
-2/3 of te body total glycogen is stored in and used by muscle
-small store in liver and brain
if there is still excess:
-liver converts it into fats and stored in fat tissues
-fat cells may convert glucose to fat
-fat cells can store unlimited quantities of fat
diabetes
-impairs a persons ability to regulate BG
-type 1 and 2
T1D
-little or no pancreatic secretion of insulin
-diagnosed in childhood
-less common
-external source of insulin can be used
T2D
-develops insulin resistance (genetic component)
-as BG rises, so does blood insulin Drugs:
-stimulate secretion
-improve glucose uptake
-extenral insulin
T2D & obesity
-require more insulin
-consistent high BG can be considered prediabetic
-impaired glucose tolerance
reducing diabetes
-control lifestyle factors and diets
-regular PA hifhtens senstivity to insulin
-nutrition
-weightloss
-adequate:nutrients, fibre, protein
-moderate added sugar
-control total carbs
-low saturates fat
reccomended fibre intakes
AI: females 19-50= 25g/day
AI: females 51+=21g/day
AI: males 19-50: 38g/day
AI: males 51+ = 30g/day
fibre and colon cancer
-dilute and speed the removal of cancer causing agents from the colon
-promote bacterial reproduction binding nitrogen & carrying it out
2018 carb guidelines
-eating patterns; maintain regularity to optimize glycemic control
dietary appraches for those with T2D:
-medeterrainean style
-vegan/vegetarian
-DASH
-diet patterns
hypoglycemia
-low blood glucose
postprandial hypoglycemia
low blood glucose after a meal
(body releases too much insulin)
fasting hypoglycemia
too long between meals causes for low BG
causes of low blood suagr in people with diabetes
-more PA
-not eating on time
-eating less than you should have
-too much medication
-drinking alcohol
honey vs white sugar
from a chemical standpoint, they are the same (suagr contains fewer calories per serving)
carbs in proteins
-no carbs is fish or meat
Free sugars:
-added sugars as well as sugars naturally present in honey, syrups and fruit juices etc
-DO NOT include naturally occuring sources of sugars found in intact or cut fruit and vegetables
Added sugar:
all sugars added to food and beverage during processing or preparation. all added sugar are also free sugar.
Total Sugars
account for all sugars present in food and beverage regardless of the source. This includes added, free and naturally occurring sugars found in intact or cut fruit and veggies and unsweetened milk.
canadas food guide sugar reccomendations
-prepare meals and snakcs using ingridents that have little to no added sodium, sugar or saturated fat
replacing sugar:
-energy-yieling sugar alcohols (nutritive sweetners)
-no energy artificial sweetners (nonutritive sweetners)
Sugar alcohols
-do not contain ethanol or any other intoxicant
-are polyols
-naturally found in small amounts in fruit and veg
-manufactured from common sugar
-provide energy
-produce low glycemic response: body absorbs them slowly
-gas, abdominal discomfort & diarhea from large amounts
-do not contribute to tooth decay
artificial/alternative sweetner
-make food taste sweet
-do not promote tooth decay
-provide ver little food energy
-can be toxic in high doses
Aspartame
-4kcal/g (same as sugar)
-not heat stable
-made of phenylalanine and aspartic acid and a methyl group
-sweeter so we use less
-in powder form, mixed with lactose
-in GI tract, the fragments are split, absorbed & metabolized just as would be any protein fragment
-byproducts are not toxic at the levels generated (formaldehyde, methyl alcohol…)
***NOT SAFE FOR PPL WITH PKU
Stevia
-naturally sweet herb
-natural sweetner
-approved as non medical and medical ingrident
-300x sweeter than sucrose
strgeties for artificial sweetner
-moderation is key
-does not lower energy intake
-safer for teeth
what is nutrition?
the study of nutrients and other biologically active compounds in foods and in the body; sometimes also the study of human behaviours related to food
what does diet mean?
the foods (including beverages) that a person usually eats and drinks
Malnutrition
any condition caused by excess or deficient food energy or imbalance of nutrients
Includes: undernutrition OR overnutrition
Undernutrition
nutrient or energy deficiencies
Overnutrition
nutrient or energy excess
the only two lifestyle habits that have more influence on long-term health than diet:
-smoking/tobacco
-alcohol consumption
what are the 4 leading causes of death in Canada (2018) and which are influenced by nutrition?
- Cancer
- Heart Disease
- Cerebrovascular Disease
- Acciedents
1,2,3 are influenced by nutrition
what are the 4 leading causes of death in canada in 2022
- Cancer
- Heart Disease
- COVID
- Accidents
nutrition and chronic diseases
genetics and lifestyle together with diet can influence the risk of getting chronic diseases such as: heart disease, diabetes, dental, bone loss and some types of cancer
genetics, individuality and nutrition
-some diseases are purely hereditary (sickle cell) but some can be influenced by diet (diabetes)
-some diseases are purely diet (vitamin deficiency)
-some are influenced by both genetics and nutrition (hypertension)
what is nutritional genomics? aka molecular nutrition or nutrigenomics
-the science of how nutrients affect the activity of genes & how genes affect the activity of nutrients
purpose of nutritional genomics
-helping to determine an individuals specific nutrient needs for heath and fighting disease
lifestyle choices affecting health
-smoking
-alcohol
-PA
-sleep
-stress
-air & water quality
What is energy
-the capacity to do work
where does the energy the fuels the human body come from
indirectly from the sun via plants and animals that eat plants
food energy is measured in
Calories (kcalories)
What are calories?
-unit measuring energy
-1kilocalorie is the amount of heat necessary to raise the temperature of 1kg of water by 1 degree celcius
1000calories = 1kilocaorie =1 Calorie
6 classes of nutrients
- carbohydrate
- Lipid (fat)
- Protein
- Vitamins
- Minerals
- Water
Macronutrients
-required in relatively large amounts per day (g/day)
-carbohydrates, protein, fat, water
Water
does not provide energy, need this in larger amount than any other nutrient
Micronutrients
-required in small amounts per day (mg/day)
-vitamins and minerals
Essential Nutrients
nutrients a person must obtain from food because sufficent amounts cannot be made from the body
Vitamin D
not essential in other countries because they recieve sun year round, but essential in Canada because we have seasons
Inorganic Nutrients
-nutrients that contain no carbon
-ex. water, iron, calcium & other minerals
Organic Nutrients
-carbon containing
-ex. carbs, proteins, lipids and vitamins
Energy Yielding Nutrients
-nutrients that can be broken down to provide energy to the body
-carbohydrates, lipids, potein
List the 4 macronutrients
carbs, protein, water & lipids
list the 2 micronutrients
vitmains & minerals
list the 2 inorganic nutrients
minerals & water
list the 4 organic nutrients
carbs, protein, lipids & vitamins
list the 3 non-energy yielding nutirents
minerals, water, vitamins
list the 3 energy yielding nutrients
carbs, protein, lipids
Vitmains & minerals
regulators that asssit in all body processes, such as digesting food & healing wounds
alcohol
not a nutrient but is energy yielding
carbohydrate energy from food
4kcal/g
protein energy from food
4 kcal/g
fat energy from food
9 kcal/g
alcohol energy yielding
7 kcal/g
Elemental Diets
Diets composed of purified ingredients can supply all the nutrients to people who cannot eat food
Can we live on supplements only
yes - but not superior to real food
what happens to digestive organs if they are not being used
they atrophy
nonnutrients
compounds other than the 6 classes of nutrients present in food that have biological activity in the body
Phytochemical
-type of nonnutrient
-found in plant-derived foods and have biological activity in the body
-contrivute to colour, taste etc
enriched and fortified foods
-foods that have nutrients added
are enriched/fortified foods good or bad
-if the starting material is a whole food it may be a nutritious food
-if the starting material is high in fat/sugar, the result may be less nutritious
what are functional foods?
possess nutrients or nonnutrients that might lend protection against diseases ex organge juice with added calcium
“Natural Foods”
-can label anything as natural, no legal definition
“Super Foods”
no such thing
“Processed Foods”
-not always bad
-foods subject to any milling, alteration in texture, additives, cooking or others
Nutracutical
a product that has been isolated from food and often sold in pill form
“staple foods”
foods used frequently or daily
5 characteristics for planning a healthy diet
- Adequacy
- Balance
- Calorie-control
- Moderation
- Variety
Adequacy
providing all essential nutrients, fibre and energy in sufficent amounts to maintain health and body weight
Balance
providing foods of a number of different types in proportion to each other, such that foods rich in some nutrients do not replace foods that are rich in other nutrients
Calorie-control
-coltrol of energy intake
-nutrient dense NOT calorie dense
Nutrient density
-a measure of the nutrients provided per kcalorie of food
-the more nutrients and the fewer calories, the higher the nutrient density
Moderation
providing constituents within set limits, not to excess (sugar, fat, salt)
Variety
providing a wide selction of foods
-increases adequacy
-limit toxins by limiting exposure
-make diet interesting
Why people chose foods (cultural/social)
-symbolism of sharing ethnic foods
-omnivore
-traditional cuisine & foodways
-vegetarian/vegan/ pescitarian
foodways
the sum of a cultures habits, customs, beliefs, & preferences concerning food
factors that drive food choices.
-convienence
-advertising
-economy
-emotional comfort
-availability
-habit
-personal preference
-positive associations
-regions of country
-social pressure
-values/beliefs
-weight
-nutritional value
nutrition is a young science that inclues:
-clinical nutrition
-community nutrition
-public health
-food policy
-food science
reasons why not to trust media
-report ideas before fully tested
-misunderstanding of complex principles
-scientists report findings before subject to scruitny
what to look for when reading about nutrition
-published in a peer reviewed journal
-state purpose & describe methods
-note limitations
-define subjects
-describe previous research & put current research into proper context
-common sense?
thinking about if post/article is reliable
-who is responsible
-do names appear
-editorial board?
-updated?
-selling product?
-sponsored?
Regestered Dietitian vs Nurtitionist
dietitians must meet practice standards while anyone can claim to be a nutritionist (not a protected title in ontario)
Nutrition Assessment
-individual assessment is vital
-generally includes: health & diet history, anthropometric measures, lab test, socioecomomic/social info
“eating well” in theory
-supply appropriate amount of nutrients, fibre, phytochemicals & energy
-dont exceed reccomendations for sugar, salt and fat
Primary deficiency
caused by inadequate dietary intake of a nutrient
Secondary Deficiency
NOT caused by inadequate intake but by something else such as a disease condition or drug interaction that reduces absorption
Dietary Reference Intake (DRI)
-used for reccomendations in canada and US
-set of 6 lists of values of nutrient intake values for healthy people
Estimated Average Requirement (EAR)
- th average daily nutrient requirement intake estimated to meet the requirement of half of the healthy individuals in a particular life stage and sex group
-basis for an RDA
types of DRIs
-estimated average requirements
-reccomended dietary allowances
-adequate intakes
-tolerable upper intake levels
-chronic disease risk redution
-acceptable macronutrient density ranges
if you dont know EAR;
you cant come up with an RDA, therefore you have an AI
**cant have both an EAR and AI
Reccomended dietary allowance (RDA)
-average daily nutrient intake level that meets the needs of nearly all (97-98%) healthy people in a particular life stage and sex group
-derived from EAR
-nutrient intake goal
Adequate Intakes (AI)
-reccomended daily nutrient intake level based on intakes of healthy people (observed or experimentally derived) in a particular life stage and sex group and assumed to be adequate
-used when insufficent evidence for EAR, therefore RDA
which is better AI or RDA
RDA would be used if possible, if not then AI is fine
Tolerable Upper Intake Levels
-highest average daily nutrient intake level that is likely to pose no risk of toxicity to almost all healthy individuals in a particular life stage and sex group
-intake above level may pose nutrient toxicity
-imp for people taking supplemets
-some nutrients dont have UL values
Chronic Disease Risk Reduction (CDRR)
-a new RDI category based on chronic disease risk
-only nutrient with this is sodium
Acceptable Macronutrient Distribution Ranges (AMDR)
-values for carb, protein and fat expressed as % 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 risk of chronic diseases
AMDR protein, fat & carbs
Carbs: 45-65%
Protein: 10-35%
Fats: 20-35%
people that have separate DRI reccomendations
-pregnancy
-lactation
-infants
-children
-sex
-specific age ranges
who do RDAs apply to ?
healthy people
Purpose of DRIs
-shown to help prevent the development of chronic diseases and include generous safety margin
what are DRIs designed for
helping healthy people maintain health not to restore depletion
Estimated Energy Requirements (EER)
average dietary energy intake predicted to maintain energy balance in a healthy adult of a certain age, sex, weight, height & level of PA consistent with good health
why is the value for EER not generous
no UL for energy; small excess amounts of energy consumed day after day cause weight gain & associated disease
PA DRI recommendations
60m moderate activity each day for weight control & health benefit
what does canadas physical activity guide suggest for adults aged 18-64
-150m moderate-vigourous PA/ week in bouts of 10 mins or more
-muscle/bone strenthening activity 2 days per week
-more PA= greater health benefit
benefits of PA
-more restful sleep
-better nutrition
-improved bone density
-enhanced immunity
-lower risk of cancer
-lower risk of CVD
-strong circulation & lung function
-lower type II diabetes risk
-stronger self image
-reduce gallbladder disease (women)
-lower MH problems
what foods are most nutrient dense?
vegetables (non-starchy), also rich in phytochemicals
Canadas food guide
-provides daily healthy eating pattern including a variety of healthy foods from 3 food categories
-helps reduce development of chronic disease
Recent revisions of canadas food guide
-did not meet with representatives from food and beverage industry
-open consultations to all stakeholders
-
Canadas fod guide reccomendations
-be mindful of eating habits
-cook more often
-enjoy food
-eat with others
-eat plenty of fruits and vegetables, whole grain and protein foods
-chose protein foods that come from plants more often
-make water drink of choice
-use food labels
-beware of marketing
which canadian population has separate food guide
first nations, inuit and metis
Image and recommendations on Food Guide help ensure:
Adequate: micro and macronutrients
Balance: ensuring one type of food is not eaten in excess and others not eaten
Variety: many choices in each group
Discretionary Calorie Allowance
the difference between the calories needed to maintain weight & those needed to supply nutrients
2 types of daily values
- Intake goal to strive for, ex fibre, fat, protein, vitamins & most minerals
- healthy daily maximums such as cholesterol, total fat, sum of saturated fat, trans fat & sodium
Daily values
are based on recommended daily intakes for vitamins and minerals or reference standards for carbs, protein, fats, fibre, sodium
Nutrition facts table present information in 2 ways:
- Absolute quantities
- Percent of standards
% daily values
-calaculations to determine are based on 2000 calorie diet
-5% is a little 15% is a lot
2 types of nutrition claims
Nutrient content claims: may highlight a nutrition featureof a food such as “light, low, less, free”
Health claims: include 2 types: disease reduction and functional
health claims: nutrient function claims
subset of function claims
Nutrient content claims
-meet criteria for specific claims defined by Canadas Food and Drug Regulations
ex. “cholesterol-free” or “source of fibre”
Disease Reduction Claims
-highlight relationship between consumption of food or ingrident and a persons health
-quite restricted
Function Claims
-describe the roles of a food or food consitiuent has on the normal functions or biological actvities of the body