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HUNT141 > HUNT141 > Flashcards

HUNT141 Flashcards

1
Q

What is nutrition

A

“The sum of the processes by which an animal or plant takes in and utilises food substances foods that are necessary for human nutrition”

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2
Q

Six nutrients

A

Water
Carbs
Lipids
Protein
Vitamins
Minerals

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3
Q

Does water provide energy

A

No

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4
Q

Is alcohol considered a macronutrient

A

No

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5
Q

Does alcohol provide energy

A

Yes

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6
Q

What are nutrients

A

molecules found in food and beverages needed by the body for energy, growth, development, and reproduction

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7
Q

What is the double burned of disease?

A

Under and over nutrition

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8
Q

How many sustainability goals

A

17

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9
Q

DALY

A

Disability affected life year

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10
Q

Higher risk of NCD’S

A

High sodium, Low whole grains, Low fruit and veg

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11
Q

United States guidelines

A

Science based for health professionals
- Healthy diet pattern all ages
- Breast feed babies
- Customise diet for cultures and preferences
- Eat nutrient dense foods within caloric limit

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12
Q

Do the US follow guidelines

A

NO

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13
Q

US visual guideline

A

My Plate

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14
Q

Australia Guidelines

A

Maintain healthy weight
Eat variety of food
Limit sat fat, salt and sugar
Promote breastfeeding
Prepare and store food safely

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15
Q

NZ Guidelines

A

Variety nutritious foods
Limit sat fat, sodium sugar
Plain water 1st choice
NO alcohol pregnant or breastfeeding
Store and prep food safely
Encourage breastfeeding
Healthy body weight

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16
Q

Activity statements

A

2.5 hrs moderate
1.25 hrs high
Muscles strengthening 2x week
Some exercise better then none

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17
Q

NZ Visual guide

A

Healthy heart

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18
Q

Is dairy a food group in Canada

A

No

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19
Q

EAT LANCET Report main goals

A

Human and Planet Health

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20
Q

Scoring Systems

A

HEI
EAT LANCET

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21
Q

Micronutrients needed in … quantities

A

Small

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22
Q

Macronutrients needed in … quantities

A

Large

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23
Q

What are minerals

A

Inorganic elements

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24
Q

Why is all chemical energy in food eaten not available to the body ?

A

Can’t all be absorbed

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25
Q

How do we determine the energy in a food sample ?

A

Bomb Carolimeter

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26
Q

ATWATER Factors

A

Carbs - 17
Protein - 17
Fat - 37
Alcohol - 29

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27
Q

Equation for ATWATER

A

Macronutrient g x ATWATER factor

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28
Q

EAR

A

Estimated average requirement
- Meet 50% healthy individuals at life stage and gender

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29
Q

RDI

A

Recommended Daily Intake
Average daily intake level that is enough to meet the nutrients requirements for 97% - 98% healthy individuals at life stage and gender (EAR+2SD)

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30
Q

Al

A

Adequate intake
Observed or experimentally approximation or estimates of nutrient intake by a group when there isn’t enough info for EAR/RDI

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31
Q

AMDR

A

Acceptable Macronutrient Distribution Range
Protein - 15%-25%
Carbs - 45%-65%
Fat - 20%-35%

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32
Q

UL

A

Upper limit
Highest daily average a nutrient likely to pose no adverse health effects

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33
Q

SDT

A

Suggested Dietary Target
Amount of nutrient recommended to reduce the risks of NCD’s

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34
Q

Mouths job in digestion

A

Teeth break down
Salivary gland releases amylase
Tongue mixes food with saliva
Tongue pushes food to back of mouth

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35
Q

Oesophagus job in digestion

A

Saliva moistens and lubricates food
Swallowing reflex
GIT ringed with circular and longitudinal muscles
Peristalsis moves bolus of food down
Sphincter muscles control movement one section to the next

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36
Q

Stomachs job in digestion

A

Stomach = tennis ball size
Physical and chemical digestion
Food in stomach hormone gastric released
HCL and pectin break down protein
HCL also kills bacteria
Mucosa lines the stomach
Food and chyme

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37
Q

Small intestine job in digestion

A

Pyloric sphincter = stomach to small intestine
Majority of digestion and absorbtion occurs here

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38
Q

Where is amylase made

A

Salivary glands and pancreas

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39
Q

How are nutrients transported form the gut

A

Nutrients absorber by the epithelial cell and travel via hepatic portal vein to the liver

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40
Q

Coeliac disease

A

Reaction to dietary gluten
Cells lining small intestine damages and inflamed
Causes the flattening of villi this decreases the SA for absorption and can result in nutrient deficenecies

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41
Q

Probiotics

A

Yogurt, miso, kimchi, pickles

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42
Q

Prebiotics

A

Apples, artichokes, banana, onion

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43
Q

What are the 4 types of carbs

A

Starches
Sugars
Dietary Fibres
Glycogen

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44
Q

What are the monosaccharides

A

Glucose
Fructose
Galactose

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45
Q

What are the disaccharides and what are they made of ?

A

Maltose (2x glucose) germination and fermentation of seeds eg bread
Sucrose (glucose + fructose) refined sugar products eg sugar cane and beet
Lactose (glucose + galactose) milk and milk products

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46
Q

What is starch

A

Storage form of glucose in plants

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47
Q

What is starch found in

A

Grains, tubules and legumes

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48
Q

Glycogen

A

Multi branched polysaccharide of glucose
Provides glucose during fasting state of the body provides 60% brain

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49
Q

Dietary fibre

A

Fraction of the edible part of a plant and their extracts
Resistant to digestion and absorption in the small intestine usually completely or partially fermented in the large intestine
Promotes
Laxative
Reduces blood cholesterol
Modulation of blood glucose

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50
Q

Non starch polysaccharides

A

Not broken down by enzyme in small intestine
Due to …
Intrinsic factor
- physically inaccessible eg cant break down coating
- Starch granules eg cooking and cooling of potato’s

Extrinsic factors
- chewing time
- transit time

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51
Q

Carbs in NZ

A

Over 50g per day
45%-65% energy
Wheat number one
Bread bummer one

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52
Q

What are intrinsic sugars

A

Naturally occurring

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53
Q

What are extrinsic sugars

A

Extracted and concentrated refined form sources eg sugar cane

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54
Q

Recommended amount % of energy intake of sugar

A

Less than 10%

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55
Q

How could you reduce sugar intake

A

Sugar tax
Labelling
Non nutritive sweetners
Modify taste

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56
Q

Carbohydrate digestion

A

Amylase enzyme made by salivary glands and pancreatic glands (secretes to duodenum - first part of small intestine) lactase etc breaks down disacchaide into monosaccharides. Glucose galactose and fructose travel via the hepatic portal vein to the liver galactose gets converted to glucose

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57
Q

Lactose intolerance

A

Lactase persistence = ability to digest lactose
Expression of lactase starts to declining after weaning
With decrease amount of the lactase enzyme aren’t able to break down the lactose into glucose and galactose instead travels as lactose to the large intestine where the bacterial lactase breaks it down this causes osmotic shock which results in diarrhoea as well as the production of gas (methane) which could cause constipation + CO2 and H2 produce bloating and flatulence

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58
Q

Glycaemic index

A

Low GI carbs break down and released into blood stream slowly
Low (0-55)
Medium (55-69)
High (70-100)

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59
Q

Issues with glycaemic index

A

Different people respond to different foods different
Have to take into account the size etc

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60
Q

What decreases GI

A

High Fat and fibre

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61
Q

Sources of dietary fibre and Colon Cancer

A

Whole grains good
White bread remove the bran and the germ left with just endosperm
Colon cancer 2nd highest in NZ to lung
Consuming whole grains decreases risk

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62
Q

What is protein

A

Nitrogenous organic compounds composed of one or more chains of amino acids essential part of living organisms

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63
Q

Functions of protein

A

Contractile (actin and myosin)
Regulate gene expression (histones)
Facilitate biochemical reactions (enzymes eg sucrase)
Endocrine hormones (insulin)
Structural proteins (collagen in connective tissue)

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64
Q

Essential vs non essential amino acids

A

20 amino acids
Indespendible (essential) - 9
Dispensable (non essential) - 5
Conditionally indespendable - 6

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65
Q

Structure eg primary

A

Primary - order of amino acids
Secondary - eletrical interactions within polypeptides
Tertiary - twists and folds intricate shapes
Quaternary - interaction between multiple polypeptides

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66
Q

Quality of proteins

A

Eg high sat fat and impact on green house gasses
Scoring systems
Protein digestability corrected amino acid score
(Mg limiting amino acid/mg amino acid in reference x true fecal digestability)
Digestible Indispendible amino acid score
Mg limiting amino acid/amino acid in reference x ileal digestability
Protein efficiency ratio
Weight gain/intake of the food

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67
Q

Quantity

A

Amount
Proportional to body weight

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68
Q

Limiting amino acid

A

When an amino avoid is not provided in adequate amounts the diet protein synthesis is limited to that amino acid. Limited to the rate at which essential amino acids are available so essential amino acid becomes the limiting amino acid

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69
Q

Complementary proteins

A

Outmoded concept as the proteins we eat over a day more important than those eaten together in one meal

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70
Q

Protein digestion

A

Chewing
Peristalsis
In stomach HCL and pepsin
Proenzymes activated by enteropeptidase
Trypsinogen - trypsin
Chymotrypsinogen - chymotrypsin Procarboxypeptidase - carboxypeptidase Proelasases - elaprocollegenase - collegenase Peptidases - tripeptides, dipeptides aas

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71
Q

Protein metabolism

A

Peptides broken down into amino acids which are transported to the liver via the hepatic portal vein

Four fates of amino acids when joins the pool
- used to make dispensable amino acids
- oxidised for energy
- used to make a new protein
- Used to make other compounds eg purine and pyrimadine bases of nucleotides

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72
Q

Food adversion

A

Physcologicaly based
Usually conditioned responce
No reaction if the food is disguised

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73
Q

Food intolerance

A

Reproducible abnormal non psycologically based reaction to food eg lactose intollerance etc

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74
Q

Food allergy

A

Group of disorders characterised by abnormal or exaggerated reproduvable responces to specific food proteins

Ige mediates - in ige antibodies
Rapid onset
Seconds, minutes, hours
Involves skin, GIT and respiratory

Non Ige mediated reaction
Does not involve antibodies
Symptoms hours or days
Difficult to access clinically

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75
Q

Lacto-ovo-vegeterian

A

No meat eats dairy and eggs

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76
Q

Lacto-vegeterian

A

No meat no eggs eats dairy

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77
Q

Vegan

A

No meat or animal products
Honey maybe
Other animal non food items may also be restricted eg leather

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78
Q

How common veges and vegans in nz

A

Veges - 5%
Vegans - 1%

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79
Q

Health benefits of vege/vegan

A

Decreased risk of…
Ischemic heart disease, diabetes and some cancers

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80
Q

Risks of veges/vegans

A

Low
- Vitb12
- iron
-zinc
- homocysteine

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81
Q

Lipids

A

Class of organic compounds that are fatty acids and their derivatives

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82
Q

Lipid functions

A

Energy
Structural - cell membranes
Signalling - hormones
Provide insulation
Cushion internal organs

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83
Q

Types of lipids

A

Triglycerides
Fatty acids
Phospholipids
Shingolipids and prostaglandins
Sterols eg sex hormones cholesterol etc
Fat soluble vitamins DEKA

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84
Q

Triacylglycerides

A

90% dietary lipids
Energy storage
Fatty acid storage
Structural component of lipoproteins
3 fatty acids bound to a glycerol

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85
Q

Fatty acids

A

Chains of carbon molecules with a methyl group at one end and a carboxyl group at the other

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86
Q

Length of fatty acid chains

A

2-6 carbon short
8-12 medium
14+ long
22+ very long
Position of the first double bond from the methyl end in naming

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87
Q

Cis v trans bond

A

Trans bad act like SFA

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88
Q

Saturated

A

Saturated - high melting point eg palmitic acid
Monounsaturated - low melting point eg oleic
Polyunsaturated - even lower linoleic

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89
Q

Essential fatty acids

A

Humans are able to make double bonds with the first 6 carbons from methyl end

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90
Q

Essential fatty acid deficency

A

Growth retardation
Reproductive failure
Skin lesions
Kidney and liver disorders
Neurological and visual problems

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91
Q

Bad vs good fats

A

Animal and tropical oil fats mostly saturated - bad
Vege oils and canola - monounsaturated
Other vege oils polyunsaturated

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92
Q

Phospholipids

A

Chemical structures
Unique role in body
Glycerol backbone + fatty acid + phosphate group
Phosphate - hydrophilic
Fatty acid - hydrophobic

Roles
- cell membrane
- plasma lipoprotein
5-10% dietary lipids

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93
Q

Shingolipids

A

Brain and nervous

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94
Q

Prostaglandins

A

Signalling
Vasoconstriction and dilation
Platelet alregation
Uterine contraction
Bronchoconstriction

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95
Q

Sterols

A

Multi ring structure
Plants and animals
Starting material for bile acids sex hormones adrenal hormones etc
Cholesterol
Plants lower cholesterol

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96
Q

Lipid digestion

A

Chewing, heat (body temp)
Peristalsis
Formation of fat globules
Lingual lipase in mouth
Bile acids released from gall bladder emulsify fat
Pancreatic and intestinalipases break down fat to
Monoglyceride
Glycerol
Fatty acid

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97
Q

Lipoprotein

A

Transport hydrophilic lipid molecules in the blood complex structure with alipoproteins
Contain cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids and alipoproyeins that facilitate lipoprotein formation and function

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98
Q

Blood cholesterol

A

10% VLDL - bad
65% LDL - bad
25 % HDL - good

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99
Q

Lipid metabolism

A

Energy (daily and or stored)
Structure
Signalling

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100
Q

CVD

A

Disorders of the heart and blood vessels including coronary heart disease rehuemtaic heart disease. 4/5 deaths due to heart attack or stroke

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101
Q

Top 3 CVD deaths

A

1- Ischemic heart disease
2- stroke
3- copd

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102
Q

Why do we need fats

A

Brain development
Structural parts of cell
Healthy heart and blood vessels
Source of energy

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103
Q

Best place to get oils

A

Nuts and seeds (unprocessed foods)

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104
Q

How fats negatively effect our health

A

Sat fat - increased ldl increased risk of heart disease
Trans - negatively effect blood lipids increases heart disease more than sat fat

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105
Q

Function of ketones

A

Energy source
Cross blood brain barrier
Spares glucose in the brain

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106
Q

Who was the ketogenic diet originally made for

A

Those with epilepsy

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107
Q

How do you produce ketones

A

Through carb restriction induces a metabolic rate similar to starving and fasting

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108
Q

Alcoholic ketosis

A

Ketone levels are increased through alcohol consumption

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109
Q

Issues with the ketogenic diet

A

Dyslipidemia - imbalance of lipids
Low intakes of fibre low in other vitamins
Compliance

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110
Q

What is alcohol?

A

Colourless flammable liquid produced by the natural fermentation of sugars and is the intoxicating constituent of wine, beer, spirits and other drinks

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111
Q

Does alcohol have a function

A

No

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112
Q

Atwater factor of alcohol

A

29

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113
Q

Digestion of alcohol

A

Alcohol does not require digestion

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114
Q

Alcohol absorption

A

20% in stomach
80% in small intestine
Easily moves between cells as is a small molecule

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115
Q

Glucose to alcohol steps

A

Glucose —> pyruvate—> acetaldehyde—-> ethanol

Pyruvate ——> Acetaldehyde (pyruvate decarboxylase)
Acetaldehyde ——-> ethanol (alcohol dehydrogenase)

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116
Q

How many standard drinks for men (long term health effects)

A

3

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117
Q

How many standard drinks for women (long term health risks)

A

2 standards

118
Q

How many standards men (risk of injury)

A

5

119
Q

How many standards women (risk of injury)

A

4

120
Q

Pregnant women standards

A

0

121
Q

Metabolism of alcohol

A

Small amount in stomach
Most in liver

122
Q

Unmetabolised alcohol

A

Urine
Breath
Breast milk

123
Q

Alcohol dehydrogenase (ADH)

A

Stomach, liver, pancreas, brain
Pathway in majority of people
ADH rate limiting step

124
Q

Microsomal ethanol oxidising system (MEOS)

A

Activated in long term heavy drinkers

125
Q

Catalase, presence of hydrogen peroxide

A

Converts ethanol to acetylaldehyde
Less than 2% ethanol metabolism

126
Q

Factors that affect alcohol metabolism

A

Quantity consumed
Male/female
Size
Genetics (Chinese, Korean and Japanese different variant of ADH build up of acetylaldehyde causes flushing and headaches)

127
Q

Effects of acetalaldehyde

A

Short lived but toxic effect - cell damage (Liver, GIT, Brain, pancreas)
Long term - chorrhosis of liver, cancers

128
Q

Elevated NADH/NAD+ Ratio

A

NAD not available for key energy production pathways eg glycolysis
Accumulation of H+ affects acid base balance
Increased lipid synthesis (Fatty liver)
Increased fatty acid oxidation (elevated TG’S)

129
Q

Induced metabolic tolerance

A

MEOS produces many toxic metabolites

130
Q

G/dl blood alcohol and their effects

A

0.05 - well being - relaxed - talk lots
0.05 - 0.09 - risky state - judgement and finer moments effected
0.08 - 0.15 - dangerous state - slow speech, balance effected, blurry eye sight, sleepy, vomiting, help to walk
0.2-0.4 - drunker stupor - no bladder control, heavy breathing, unconscious
0.45-0.6 - death - shock and death

131
Q

Energy balance

A

Energy cant be created or destroyed but can be transformed
Energy = in - out
In = what we wat
Out = excreted, heat loss etc

132
Q

BMR

A

Energy expended at rest
Used to fulfil life sustaining functions
Strict conditions
- relaxed physically and mentally
- 12 hour fasted
- well rested

133
Q

Percents of basal metabolic rate

A

Muscles - 20
Liver - 19
Brain - 17
Miscellaneous - 16
Digestion - 10
Heart - 8
Kidneys - 7
Fat - 3

134
Q

REE

A

Resting energy expenditure
No strict conditions

135
Q

DEE

A

Diet endured energy expenditure
Diet endured thermogenesis (DIT)
Energy needed for digestion and processing of food
10% energy
Varied with diet consumption
Pro>CHO>Fat

136
Q

AIEE

A

Activity induced energy expenditure

137
Q

Positive energy balance

A

Growth
Weight gain

138
Q

Negative energy balance

A

Weight loss
Stunting (in children)

139
Q

Obesity

A

Overweight defined as abnormal excessive fat accumulation that prevents a risk to health
BMI 30+

140
Q

Obesity

A

Cluster of non communicable disease
Chronic

141
Q

BMI equation

A

Wt/ht2

142
Q

Under weight

A

Below 18.5

143
Q

Normal weight

A

18.5 - 25

144
Q

Overweight

A

25-30

145
Q

Obese

A

30+

146
Q

Why use BMI

A

Can make meaningful comparisons of weight status between populations
Possible to identify groups with increased risk of mortality and morbidity
Priorities for intervention and individual and community levels

147
Q

Prevalence of overweight and obesity in NZ

A

66.2% 2019/2020
68.1% 2020/2021

148
Q

Percent of overweight or obese children

A

30%

149
Q

Health concequences of obesity

A

Cardiovascular disease - mainly heart disease and stroke
Diabetes
Muscoskeletal disorders including osteoarthritis they are highly disabling degenerative disease of joints
Some cancers eg breast, ovarian, liver, gallbladder, kidney and colon

150
Q

Causes of obesity

A

Energy imbalance (poor nutrition and lack of exercise)
Multifactorial eg environmental and genetic factors

151
Q

Obesity prevention

A

Government goals and policies
Food industry changes
Health Profesionals

Education and knowledge
Networks and support

152
Q

Roles of water

A

Lubricator, insulator, excretion, body temp, communication

153
Q

Percentage of male body water

A

60

154
Q

Percentage of female body water

A

55

155
Q

Input of water

A

Beverages - 550-1500mL
Foods - 500 - 1000mL
Endogenous 200-300mL
Total - 1400 - 2800mL

156
Q

Output of water

A

Urine - 500-1400mL
Faeces - 150mL
Insensible losses (sweat/breath) - 450 - 900mL
Total 1450 - 28–mL

157
Q

Water benefits

A

Weight loss/control
Kidney disease
Kidney stone formation
UTI Bladder infections (less contact with the bacteria)

158
Q

Thirst

A

Conscious desire to drink

159
Q

Mild dehydration

A

2-5% body weight loss
Symptoms - lethargic, alert, restless, don’t feel well, thirsty

160
Q

Moderate dehydration

A

5-10% loss body weight
Symptoms - lethargic, rapid pulse, low blood pressure, dry mouth and eyes, shrunken fontanelle, skin retracts slowly, conc unrine

161
Q

Severe dehydration

A

10% + loss in body weight
Symptoms - drowsy, limp, feeble, no urine, death in children within 24 hours

162
Q

How to treat mild dehydration

A

Drink water, increase intake fluids, eat

163
Q

Moderate to severe

A

Depends on circumstances
Access to health care - IV (Intravenous solution)
NO access - ORS (Oral rehydration salts (clean water, sodium and glucose, potassium, chlorine and citrate) + zinc

164
Q

3 clinical types of diarrhoea

A

Actuate watery - several hours or days
Acute bloody - also called dysentery
Persistent - 14 + days

165
Q

Sick child in NZ

A

Drink water or pedialyte
Good access to medical care IV

166
Q

Sick child in rural Africa

A

ORS +Zinc

167
Q

Blood glucose regulation

A

Glucose enters blood stream
Pancreas excretes insulin in responce
Insulin tells muscle tissues to put a glucose transporter on outside
Glucose flows from blood stream into tissues

168
Q

Insulin resistance (Type 2 diabetes)

A

Insulin responders stop responding appropriately to insulin
Pancreas excretes increased amount of insulin to try and overcome this
Blood glucose still remains higher for much longer (too much glucose can damage the blood vessels)
Hepatic glucose occurs in response to defective insulin
Fasting glucose levels risk
Glucose travels to the kidneys
Causes osmosic diuresis and polyuria
Lots of peeing and lots of drinking to try and dilute blood
Can lead to dehydration - polydispsia lots of drinking and polyphagia - lots of eating
Eventually beta cells slow insulin production as the pancreas gets worn out having to produce lots of insulin
Type 2 diabetics eventually have to take insulin

169
Q

HbA1c mol/mol

A

50+ indicative of diabetes
41-49 pre diabetes
40 - diabetes unlikely
5-7% pop have type 2 diabetes

170
Q

Health concequences of type 2 diabetes

A

Stroke
Blindness
Heart attack
Kidney failure
Amputation

171
Q

Risk Factors for type 2 diabetes

A

High BMI
Family history
Long term real corticosteroids
Gestational diabetes
Severe mental illness (long term use of anti physcotics)
CVD
PSOS

172
Q

Life style changes to reduce risk diabetes

A

Reduced energy intake
Increased physical activity
Increased fibre intake
Reduce sat fat intake

173
Q

Mineral and trace elements

A

Essential non organic elements
Small amounts required
Minerals - Na, K, Mg, Cl
Trace elements - Fe, Zn, I, Fe, Se, Cr

174
Q

Sodium in diet

A

10% inherent
15% discretionary eg salt to cooking at table
75% processing - salt during processing

175
Q

Sodium contributing foods

A

Grains
Chicken
Eggs
Fish
Diry

176
Q

Sodium absorption

A

Well absorbed not regulated
PLasma levels controlled by kidneys

177
Q

Sodium function

A

Principal cation in ECF
Primary regulator of ECF volume
Maintain acid/base balance
Nerve impulse transmission
Muscle contraction

178
Q

Sodium excretion

A

Urine 90%
Sweat 10%

179
Q

Deficency

A

Rare from diet
Depletion from losses (sweat, diarrhoea, vomiting)

180
Q

Sodium Toxicity

A

Acute = rare
Chronic = common

181
Q

Kidneys excreting sodium

A

Ability to excrete sodium declines with age

182
Q

Factors that affect hypertension

A

Genetics
Ag
Weight
Smoking
Exercise
Stress
Diet

183
Q

DASH 1

A

Clinical intervention trial
3 groups
1- controlled
2- fruit and vege
3– fruit and vege + low fat dairy

Potassium goes up with fruit intake
Group 3 greatest decrease in diastolic and systolic blood pressure

184
Q

DASH 2

A

Two different diet groups 3 levels sodium intake
1- control diet
2- dash diet

At each level DASH diet best
Lower sodium = lower diastolic and systolic blood pressure

185
Q

Potassium main foods

A

Fruity and veges

186
Q

Potassium function

A

Main cation in cells
Fluid and electrolytes balance
Facilitates many reactions
Nerve and muscle contractions

Increased potassium decreased risk of cvd

187
Q

Reductionist approach

A

Looking at individual nutrients
Supplements
Pharmological model

188
Q

Calcium main foods

A

Milk, bread, non alcoholic drinks, cheese

189
Q

Calcium absorbtion

A

20-35% absorbed from diet
Rest excreted
Calcium and VIt D work together
Especially needed for pregnancy
Low bioavailability

190
Q

Calcium absorption

A

Regulates by dietary intake and the bodies need
Brush border calcium channels
Calcium binding proteins
Diffusion across cytoplasm
Secretion into ECF ca-ATPase pump

191
Q

Promoters of calcium absorption

A

Protein and amino acids
Lactose
Acidic gut

192
Q

Inhibitors of calcium absorption

A

Oxalate
Phosphorus
Phylate

193
Q

Calcium excretion

A

Can’t store as water soluble
Main route urine

194
Q

Calcium uses

A

Plasma ca is biologically active tightly controlled at expense of bone
47% bound to proteins 47% free or ionised 6% bound to anions

195
Q

Functions of calcium

A

Intra cellular messenger 1%
Nerve transmission
Muscle contraction
Hormone secretion
Cell membrane function

Bone 99%
Structural role - skeleton
Physiological role - reservoir of essential minerals

196
Q

Cortical bone - teeth

A

Compact and dense
Slow turn over
80% bone mass

197
Q

Trabecular bone

A

Looks spongy
Day to day withdrawals blood hormones
20% bone mass

198
Q

Bone remodelling

A

Remain bone integrity
Reshape and accomodate for mechanical loads
3 types pf cells
Osteoblasts - build bone
Osteoclasts - breakdown bone
Osteocytes - sensors

199
Q

Peak bone mass

A

Continues past linear growth
Determinants
- genetics
- environment eg exercise, smoking, medication, nutrition

200
Q

Calcium deficency

A

Children - decreased bone growth and mass
Adults - decreased bone mass

201
Q

Iron sources

A

Liver, red meat, beans and lentil, seafood

202
Q

Haem vs Non Haem

A

Haem absorption - 25-30%
Non Haem absorption - 5% - 15%

203
Q

Hemoglobin

A

67% body iron
Transports O2 in RBC’S

204
Q

Concequences of iron deficency

A

Decreased growth
Behaviours disturbances
Decreased cognitive function
Fatigue
Spoon shaped nails

205
Q

Groups at risk for iron deficency

A

Pregnant
Menstators
Vege/Vegans

206
Q

Iron overload

A

Acute toxicity
Hereditary hemochromatosis
African iron overload

207
Q

Zinc main sources

A

Dairy, shellfish, liver, meat, legumes

208
Q

Bioavailability zinc enhancers and inhibitors

A

Enhancers - meat and dairy
Inhibitors - iron, copper and calcium supplements
Whole grains, seeds and legumes

209
Q

Function of zinc

A

200 enzymes due it as a cofactor
Needed for growth
Immune function
Vit a metabolism
Reproduction
Appetite

210
Q

Zinc deficency

A

First cases 1960s Middle East
Male adolescent dwarfs
Clinical features
- stunting
- little/no secondary sexual development
Diet
- unleavend wheat bread
- low intake animal food
- geophagia (eating soil)

211
Q

Zinc deficency effects

A

Poor weight gain and growth of children
Imparted immune competence
Increased morbidity
Diarrhoea
Pneumonia
Increased mortality

212
Q

Who’s at risk for zinc deficency

A

Infants and young children
Adolescents
Preganant and lactating women
Elderly
Vegeterians
Vegans
Low socioeconomic
Those who have diarrhoea

213
Q

Zinc toxicity

A

Extremely high more than 1g a day
Metallic taste in mouth
Nausea
Gastric distress
May be fatal

214
Q

NZ soils are low in …

A

Flouride, selenium, iodine

215
Q

Strategies to increase intake of nutrients

A

Fortification
Supplementation
Dietary diversification

216
Q

Sources of selenium

A

Grains
Some plants accumulate it eg Brazil nuts, mushrooms and garlic
Fish
Organ meat
Muscle meat
Dairy

217
Q

Function of selenium

A

Diverse number of enzymes and proteins
Glutathione peroxidases
Preventative oxidation damage to phosphopilids abd cell membranes
Antioxidant nutrient
Thyroid hormone

218
Q

Metabolism of selenium

A

80% no regulation

219
Q

Selenium deficency

A

White muscle disease in sheep
Stillborn die first days
Undeady gait arched back

Keshan disease in china
Cardiomyopathy in pregnant women

220
Q

Selenium toxicity

A

Rare from diet
Exception parts of china and Venezuela
Irritability, indigestion and giddiness

221
Q

Flouride sources

A

In order
Dental treatments
Toothpaste
Tea
Fish
Fluoridated water

222
Q

Flouride absorption and excretion

A

100% absorbed
Excreted in urine via kidneys

223
Q

Fluoridation

A

Evidence for decreased dental carries
Tooth enamel outer surface of tooth closely packed mineral crystals

224
Q

Dietary factors that affect Flouride

A

Eating freq
Cho foods
Sequence if foos eaten
Clearance time of food
Acidity of food

225
Q

Flouride roles

A

Inhibits bacteria
Inhibits demineralisation
Enchanced remineralisation

226
Q

Iodine sources

A

Good sources
Fish and seafood
Iodised salt

Moderate sources
Eggs, milk, fortified bread

Poor sources
Fruit and veges

227
Q

Function of iodine

A

Integral in thyroid hormone t3 and t4
Needed for body’s metabolic rate
Needed for growth and development (CNS and Brain)

228
Q

Goitre (iodine)

A

If you don’t get enough t4 tells the thyroid gland through TSH that is needs to make more thyroid hormone to maintain BMR if dint have enough can cause goitre as the thyroid gland swells to try be more efficient at capturing iodine

229
Q

Absorption of iodine

A

100% absorbed

230
Q

Excretion of iodine

A

90% in urine

231
Q

Iodine stores

A

No iodine stores thyroid hormone lasts 3 months

232
Q

Goitre % in population

A

Want to keep less than 5%

233
Q

Iodine deficency and those at risk

A

Cretinism - due to iodine severely stunted mental and physical growth

Pregnant women at risk

234
Q

Why iodine is re-emerging

A

1- increase in people using non iodised eg Himalayan salt
2- people are trying to decrease salt intake to reduce hypertension

235
Q

Increasing iodine intake in NZ

A

Dietary diversification - already diverse and hard to change behaviour
Supplementation- recommended for preganant and lactating women
Fortification - mandatory use of iodised salt in bread making

236
Q

Iodine toxicity

A

Thyrotoxicitis - excess thyroid hormone
Hyperactivity increased BMR

237
Q

Group 1 foods

A

Fresh and minimally processed
Dried / fresh fruit and veg
Tea/coffe
Flour
Pasta
Milk
Yoghurt

238
Q

Type 2 foods

A

Processed culinary ingredients
Oils
Sugar
Butter
Starches
Salt

239
Q

Group 3 foods

A

Processed food
Fresh cheese
Fresh bread
Canned fruit and vege
Tomato paste
Meat/fish cured salted dried
Alcohol
Coconut fat

240
Q

Group 4 foods

A

Ultra processed foods
Snack
Lollies
Biscuits
Fizzy

241
Q

SHAKE

A

S- SURVAILLANCE
H- HARNESS INDUSTRY
A - ADOPT STANDARDS
K - WARNING LABELS
E - ENVIRONMENTAL SUPPORT

242
Q

Vit B1

A

Thiamin
Energy metabolism
Nerve processes

243
Q

Vit B2

A

Riboflavin
Energy metabolism

244
Q

Riboflavin deficency

A

Generalised symptoms …
Inflamed eyelids
Sensitivity to light
Redding of cornea
Sore throat
Cracked sides of mouth
Painful smooth purpilish tongue

245
Q

Vit B3

A

Niacin

246
Q

Niacin deficency

A

Pellagra
1900s USA Corn diet (leucine interferes with tryptophan conversion)
4 D’s
Diarrhoea
Dementia
Dermatitis
Death

Rash when exposed to sunlight

247
Q

Vit B5

A

Panthoneic acid
Energy metabolism
Part of COa
Needed for RBC synthesis, neuron activity, antibody production

248
Q

Vit B6

A

Pyridoxine
Energy metabolism

249
Q

Vit B7

A

Folate
Folic avid supplements recommended for pregnancy to reduce neural tube defects

250
Q

Vit B12

A

Cobalamin
Deficency …
Low levels in diet or intrinsic factor
Comes from…
Meat, fish ,eggs, beer, milk

251
Q

Vitamin c source

A

Citric fruit

252
Q

Scurvy study thing

A

1974 James Lind
12 patients 6 dietary treatments
- cider
- vinegar
- elixir of vitriol
- seawater
- pastes and spices
- oranges and limes
(Oranges and limes worked)

253
Q

Symptoms of Vit c deficency

A

Weak
Bleeding gums
Loss of teeth
Foul breath
Painful legs
Haemorrhages eg around skin follicles and internal
Larger muscle bruises

254
Q

Vit C function

A

Converts ferric iron to ferrous iron
Synthesis of collagen
Dopamine to noradrenaline
Activation of neuropeptides
Conversion of lysine to carnitine in fatty acids, conversion of cholesterol to bile acids

Antioxidant nutrient
Regenerates vit e and protects lipids

255
Q

Vit C toxicity

A

Consumptions of large doses common
Generally not toxic
Large doses may cause
- diarrhoea
- rebound survey
- red eye
- inflammation

256
Q

What is vitamin A

A

General term to describe retinal and related structure and the pro vitamin A carotenoids

257
Q

Retinoids

A

Include retinol, retinal and retinoids acids

258
Q

Caretnoids

A

Plant pigments
Yellow, orange, red
Help plant absorb light enrgy for photosynthesis
Act as antioxidants

259
Q

Functions vit A

A

Maintaining healthy corneas, epithelial cells and muscles membrane in eyes
Reproduction
Health of epithelial tissues and skin through its role in protein synthesis
Immunity

260
Q

2 roles in vision of Vit A

A

Key component of visual cycle
1- Retinal component of the chromosphere found in 2 types of light receptor cells

Rod cells - part of chromosphere in rhodopsin
Conce cells - part of chromosphere are idoposin

2- health of epithelial cell
Keep eye moist
First sign of deficency = dry eys
Bitots spot

261
Q

R

A
262
Q

Top 3 micronutrient deficiencies

A

Iron
Vit A
Iodine

263
Q

Vit A and sight

A

Night blindness - unable to see dim light
Effects 1% kids 6month to 6 yrs

264
Q

Sources of VIt A + good source caretnoids

A

Liver
Milk butter cheese egg yolk fatty fish

Caretnoids
Dark leafy veg
Yellow orange vege and fruit
Golden rice

265
Q

Vitamin A toxicity

A

Vit a and bet carotine can occur in conc amount of ore formed vit a

Symptoms
Birth defects(tetragoen)
Discolouration of skin from beta Carotine

266
Q

Vitamin K sources

A

Green leafy vege, broccoli, canola oil, fermented stuff
Smaller amounts in
Some fruit and vege
Cereal, dairy products eggs, meat

267
Q

Vit K functions

A

Blood clotting
Bone metabolism
Inflammation
Prevents oxidative damage to brain
Sphingoilipid synthesis

268
Q

Vit K deficency

A

Rare

269
Q

Vitamin E sources

A

Polyunsaturated plant oils
Green leafy vege
Wheat germ
Whole grains
Liver and egg yolk
Nuts and seeds

270
Q

Vitamin e function

A

Powerful fat soluble antioxidant
Stabalises cell membrane
Protracts plasma lipoproteins from oxidative damage

271
Q

Changes likely to have mist significant and immediate impact on more sustainable life - health environment economic and social factors likely to complement each other

A

Reducing meat and dairy
Reduce consumption ultra processed food
Reduce food waste

272
Q

Changes likely to have a significant positive impact, but where gains in one area may negatively impact in other areas

A

Increasing consumption of fruit and vege field grown
Consuming only fish from sustainable stocks

273
Q

Changes likely to have a significant positive impact, but where grains in one area may negatively impact in other areas

A

Reduce input of shopping over foot - internet and cooking and storing food sustainably
Drink tap water instead of bottled

274
Q

Avoidable waste

A

Bread

275
Q

Potentionally unavoidable waste

A

Apple and potato peel

276
Q

Unavoidable waste

A

Banana skin

277
Q

Ways at judging sustainability

A

Blue dot and eat lancet

278
Q

EAT LANCET goals

A

Change eating habits
Improve food production
Reduce food waste

279
Q

Blue dot

A

Decrease meat and dairy
Buy locally to limit air freighted pre packaged food
Decrease high sugar salt foods
Shop sustainably
Eat whole grains
Eat beans and lentils
Drink water first
Recycle

280
Q

Climate change

A

Green house gasses
Co2, methane, nitrous gasses

Causes
Dairy Cattle
Road transport
Industrial soils (fertiliser use)
Refrigerator and air cons

281
Q

Percent of emmisons from food

A

25% of this 58% animals 30% of this meat and red meat the worst

282
Q

Emission trading scheme

A

Financial incentive to reduce emissions

283
Q

Paris agreement

A

2050 zero carbon bill

284
Q

Climate change amendment act 2019

A
285
Q

Climate change effects on health

A

Extreme weather events
Food production
Pressure on rural economy
Poor air quality

286
Q

Factors that effect food choice

A

Biological - hunger, apetite, taste
Economic - income availability
Social - culture, family
Physical - access , cooking skill

287
Q

Indigenous people

A

Important for worlds land management keep worlds food systems diverse and sustainable
5% population but
25% worlds land surface

288
Q

Food security

A

Ability or individuals, house holds and communities to acquire appropriate and nutritious foods on regular basis

289
Q

Food sovereignty

A

Right of people to healthy and cultural appropriate food produced through ecologically sounds and sustainable methods and the right to define their own food and agricultural systems

290
Q

Access of nutritional status methods

A

Clinical - clear eyes, goitre, weight
Anthropometric - height and weight
Biomedical - height and weight
Diet/food - 24 hr recall etc

HUNT141 (1 decks)

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