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FTM Exam 2 > Lecture 51: Nutrition in Health and Disease > Flashcards

Lecture 51: Nutrition in Health and Disease Flashcards

1
Q

Dietary Reference Intake (DRI)

A

Includes:

1) Estimated Avg requirements (EAR)-risk inadequacy = 50%
2) Recommended Dietary Allowance (RDA)- risk inadequacy = 2-3%
3) Adequate Intake (AI)
4) Tolerable Upper Intake Level (UL)

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2
Q

Vitamins:

Water soluble

Lipid soluble

A

1) Water Soluble
- Synthesize coenzymes

2) Lipid Soluble
- Vitamin A = growth/vision
- Vitamin D = calcium/bones
- Vitamin E = radical scavenging
- Vitamin K = Blood clotting

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3
Q

Minerals:

Macromineral >100mg/day

Microminerals 1-100mg/day

Microminerals >1mg/day

A

Macromineral >100mg/day

1) Calcium
2) Chloride
3) Magnesium
4) Phosphorus
5) Potassium
6) Sodium

Microminerals 1-100mg/day

1) Chromium
2) Copper
3) Fluoride
4) Iron
5) Manganese
6) Zinc

Microminerals >1mg/day

1) Iodine
2) Molybdenum
3) Selenium

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4
Q

Estimated Energy Requirement (EER)

A

-The avg daily dietary INTAKE to maintain an energy balance

Depends on genetics, body composition, metabolism, age, gender

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5
Q

Weight Gain

Weight Loss

A

Weight Gain:

  • More calories in than out
  • Increased fat stores
  • Can lead to heart disease or diabetes

Weight Loss:

  • More calories out than in
  • Decreased fat stores
  • Can lead to less capacity to fight infections, pneumonia, or diarrhea
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6
Q

Total Energy Expenditure (TEE)

A
  • How much energy is used per day
    1) Resting Metabolic Rate (RMR) to carry out normal body functions
    2) Diet-induced thermogenesis (DIT) –> heat generated from food intake
    3) Energy cost of physical activity

Males:
-1 kcal/kg/hr = 24 a day

Females:
-0.9 kcal/kg/hr

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7
Q

Resting Metabolic Rate (RMR)

A

1) Energy used in resting
2) >Basal metabolic rate (BMR)
3) Affected by age, gender, body temp, environmental temp, thyroid function, pregnancy, lactation

4) Increased in Hyperthyroidism (Weight loss)
Decreased in Hypothyroidism (Weight gain)

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8
Q

Resting Metabolic Rate (RMR) varies w diff tissue

A

1) High energy expenditure
- Heart, lungs, kidneys, brain, liver

2) Organs > muscles
3) Muscles > Fat

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9
Q

Acceptable Macronutrient Distribution Ranges (AMDRs)

A

-Intake connected to reduced risk of chronic disease while providing adequate amounts of essential nutrients

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10
Q

Dietary Carbohydrates

A

1) Monosaccharides
- Glucose, fructose (Fruit)

2) Disaccharides
- Sucrose (Glucose + Fructose)
- Lactose (Glucose + Galactose)
- Maltose (Glucose + glucose)

3) Polysaccharides
- Starch (in plants)
- Glycogen (in animals, muscle, liver)

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11
Q

Diet and Disease:

Cause death from diet or alch

A

Death caused by diet:

  • Heart disease (Recommended serum cholesterol >200mg/dL)
  • Malignant neoplasms
  • Stroke
  • Diabetes mellitus

Death caused by alch:
-Untentional injuries

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12
Q

Recommended dietary cholesterol intake

A

Healthy: < 300mg/day

Diabetes/heart disease:
< 200mg/day

-Dietary cholesterol has little influence on fasting plasma LDL cholesterol levels in healthy ppl

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13
Q

Trans-Fatty acids

A

1) formed during hydrogenation of vegetable oil
2) In margarine
3) Increase the risk of cardiovascular disease and diabetes

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14
Q

Macronutrients

Micronutrients

A

Macronutrients

  • Provides energy, calories, essential nutrients
  • Carbs, fats, proteins

Micronutrients
-Vitamins, minerals

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15
Q

How much energy is available and how much

Carbs
Proteins
Fats
Alch

A

Carbs –> 4kcal/g –> need 40% = 200g
Proteins –> 4kcals/g –> need 30% = 67g
Fats –> 9 kcal/g –> need 30% = 150g
Alch –> 7 kcal/g

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16
Q

Dietary lipids

A
  • Energy metabolism
  • Storage of fat

1) Lipid soluble-vitamins

2) Essential fatty acids
- Brain fluidity
- Eicosanoids –> blood brain barrier (20Cs)
- Def = scaly dermatitis

3) Cholesterol
- Synthesis of bile acid, steroid hormones, vitmain D

17
Q

Omega Fatty Acids

A

Omega 6’s:
-Linoleic acid (18:2) Omega 6 –> Arachidonic Acid (20:4) Omega 6 Eicosanoids

Omega 3’s:
-Alpha-Linolenic acid (18:3) Omega 3 –>EPA (20:5) Omega 3 Eicosanoids –> DHA (22:6) Omega 3 (Brain vision)

Omega 3 Intake Reduces:

1) Arrhythmia
2) HR
3) BP

18
Q

Mediterranean Diet vs Western Diet

A

-Med had more monosaturated fatty acids (Oleic acid 18:1) = less saturated fats = lowers cardiovascular risk factors

More:
-Olive oil, fish oils/nuts (omega 3), fiber

Less:
-Low saturated foods/red meat

19
Q

Carbohydrates and Concerns:

High sugar

A

High sugar (HFCS 55)–> obesity, diabetes, caries

20
Q

Glycemic index

A

-Area under the positive blood glucose response curve

Levels:

1) High = >70
- (Elevates blood sugar glucose = elevated serum insulin)

2) Low = <55
- (Whole wheat, veggies, legumes, fruit)
- slowly incr. blood glucose level
- less fluctuation of insulin release

Affected by:

1) Carbohydrate digestibility
2) Fibers
3) Fat content

21
Q

Dietary Fiber

A
  • Fiber absorbs water in the intestines
  • Increases bowel movements

Soluble fiber = fermented by bacteria
-Fruit/nuts

Insoluble fiber = passes through digestive tract
-Veggies/whole grain

22
Q

Dietary essential amino acids

A

-PVT TIM HALL

1) Phenylalanine
2) Valine
3) Tryptophan
4) Threonine
5) Isoleucine
6) Methionine
7) Histidine
8) Arginine (Not essential anymore)
9) Lysine
10) Leucine

23
Q

How can one obtain optimal score of dietary amino acids?

A

-Mixture of plant foods eaten at the same time
(Ex: Beans and wheat)

(Beans = high lysine/low methionine)

24
Q

Nitrogen metabolism

Balanced
Positive
Negative

A

-Healthy Individual: Nitrogen in = nitrogen out

Positive nitrogen balance (More in than out):

  • Children/pregnant women
  • Dietary amino acids used for protein synthesis = less urea formed (muscle growth)

Negative nitrogen balance: (More out than in)

  • Inadequate dietary protein = lack of essential amino acids
  • Inscr. protein degradation (muscle)
  • Physio stress: burns, illness, etc
25
Q

Respiratory Quotient (RQ)

A
  • Tells you if carbs or fats are metabolized
  • Ratio of oxygen usage to carbon dioxide output
  • RQ Carbs = 1.0
  • RG fats = .7

-During fasting: fatty acids metabolized, RQ = .7

26
Q

Control of food intake and regulation of energy balance

Ghrelin
Cholecystokinin (CCK) and PYY
Leptin
Insulin

A

Ghrelin:

  • stomach
  • Stims appetite, inc desire to eat
  • Sleep deprivation = inscr ghrelin

Cholecystokinin (CCK) and PYY:

  • Intestine
  • (duodenum and jejunum = CCK)
  • (Ileum and colon = PYY)
  • Stims Satiety

Leptin:

  • Adipose tissue
  • Secreted depending on fat stores
  • Stims metabolic rate/inc energy expenditure
  • Overeating = leptin resistance/obesity

Insulin
-Produced by B-cells in pancreas

27
Q

Protein Energy Malnutrition (PEM)

A

Usually found in:

  • Hospitalized pt’s from a trauma/illness
  • Elderly PEM = metabolic changes
  • Depression pt’s = less food intake
  • Starving children in 3rd world countries
    1) Kwashiorkor Def proteins (Bloated)
    2) Marasmus Def calories (Skinny)

Symptoms:

  • Decreased appetite
  • Altered digestion/absorption

Treatment:

  • Intravenous fluids
  • Total parenteral nutrition (TPN)
28
Q

BMI

A

-Body mass index (Weight (kg)/Height (M)^2

Underweight = >18.5
Healthy = 18.5-24.9
Overweight = 25-29.9
Obese= >30, severe >40
29
Q

Measuring muscle mass vs adipose tissue

1) Triceps Skinfolds (TSF)
2) Mid-arm muscle circumference
3) Bioelectric Impedance Analysis (BAI)
4) DEXA scan

A

1) Triceps skinfolds (TSF)
- Measures body fat

2) Mid-arm muscle circumference
- Measures muscle mass

3) Bioelectric Impedance Analysis (BAI)
- Measures body fat %

4) DEXA scan
- Measures body fat/density

30
Q

Fat deposition in men and women

Waist to hip ratio

A

Apple-Shaped:

  • Upper body obesity
  • More fat deposition in the trunk
  • High amounts of visceral fat
    1) Women: > 0.8
    2) Men: > 1
Pear-shaped:
-Lower body obesity
-Fat deposition in hips and thighs
Women: < 0.8 
Men: < 1
31
Q

Differences in abdominal fat depositions:

1) Subcutaneous Fat Depots
2) Visceral Fat depots

A

1) Subcutaneous Fat Depots (80-90% body fat)
- just under the skin
- upper abdominal/gluteal-femoral regions
- Fatty acids released enter general circulation

2) Visceral Fat depots (10-20% body fat)
- Abdominal cavity in close association w digestive tract
- Fatty acids released into portal vein = higher VLVL formation with risk of coronary heart disease

32
Q

Deficient of proteins

A

Leads to a low serum album level

33
Q

Fasting or starving

A

-Increase in serum free fatty acids released from fat cells

Also found in pt’s with insulin resistance

FTM Exam 2 (25 decks)

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