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kin 337 > midterm 1 > Flashcards

midterm 1 Flashcards

1
Q

nutrition

A

Interdisciplinary science that studies food and health with a focus on the nutrient and chemical properties of foods

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2
Q

How long can you survive without food

A

Weeks-month

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3
Q

How long can you survive without water

A

3 days

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4
Q

Food security

A

Access at all times to sufficient supply of safe nutritious foods (don’t have to scavenge or steal food)

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5
Q

Food insecurity

A

limited or uncertain availability of safe, nutritious foods-or ability to acquire them in non socially acceptable ways

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6
Q

What does food insecurity result in

A

-can lead to poor quality diet
-Greater risk of chronic disease ( due to less nutrious food)

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7
Q

What is food insecurity due to

A

-poverty
-absence of supermarkets
-access to inexpensive, high calorie (low nutrition) foods
-limited cooking facilities

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8
Q

Do you know where food insecurity is highest in Canada

A

Northern Canada, Nunavut, the more it costs to transport items the higher the price

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9
Q

What are calories

A

a unit of measure that represents of the amount of energy supplied by food, can be released and used by body)

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10
Q

nutrients

A

chemical substances used by the body help sustain growth and development

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11
Q

6 categories of nutrients and which ones are energy nutrients

A
  1. Carbohydrates
  2. Protein
  3. Fat
    4.vitamins
  4. Minerals
    6.water

First 3 are energy

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12
Q

Poor nutrition can result from

A

Inadequate and excessive nutrient intake

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13
Q

Vitamin A (inadequate intake)

A

-inadequate intake, reduced liver stores, blood levels, body will get rid of stores of vit A, so it moves to blood, increasing the levels in blood
-impaired ability to see in dim light
-long term:lead to loss of of vision
Blindness in developing countries

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14
Q

Vitamin A (high intake)

A

-hypervitaminosis A (500 000 IU or 50 000 IU)
-Nausea, irritability, blurred vision, headache
-liver damage
-birth defects
Too much vitamin A acts on developing fetus

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15
Q

RDA

A
  • Recommended dietary allowance RDA, average daily intake level estimated to be meet the needs of of nearly all people (97%-98%) in a certain group.
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16
Q

UL

A

The tolerable upper intake level (UL) is the highest average daily intake level likely to pose no health risks, do not exceed this amount on a daily basis

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17
Q

What are 3 nutritional deficiencies

A
  1. Under consumption; developing nations (because of food scarcity)
  2. Over consumption-typical western diet (contributes to obesity)

3.Under nutrition- from refined foods, lack of micronutrients, enough calories but processed fast foods, limited minerals

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18
Q

What groups of people are at higher risk of becomes malnourished than others

A
  1. Infants
  2. Pregnant
    3.elderly
  3. Recovering from illness
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19
Q

Poor nutrition can influence the development of certain chronic diseases -true or false

A

T

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20
Q

clean eating (orthorexia nervosa),

A

-unhealthy fixation with eating healthy
-can lead to nutritional deficits
-no specific category in DSM (diagnostics and statical manual) but falls under avoidant/restrictive food intake disorder (ARFID)
-do you feel in control when you stick to the correct diet
- cause psychological stress

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21
Q

how do we know what is inadequate or high intake

A

Referring to the dietary reference intakes (DRI), the RDA ( recommended dietary allowance, and UL ( upper limit) most used

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22
Q

Which dietary reference intakes are not used often

A

EAR ( estimated average requirement), average daily intake level to meet the needs of half the people in A CERTAIN GROUP

AI ( adequate intake)

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23
Q

malnutrition can result from

A

poor diets, disease, genetic factors or a combination of these factors

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24
Q

what foods must be labeled

A

-foods containing more than one ingredient (mostly processed foods)
- dietary supplements
-foods with claims of “low fat”, “low calorie” etc. must display nutritional information backing the claim

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25
Q

What are the specific guidelines for food labels with claims such as light, low sugar, reduced fat or calories and fat free

A

-light; no specific guidelines [light tasting]
-low sugar: no guidelines
-reduced fat or calories: 25% less than the original
-fat free <0.5g PER SERVING SIZE ( manipulated serving size)

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26
Q

foods that are not required to be labeled

A

-fresh fruits and vegetables
- raw, single-ingredient meat, poultry, fish and seafood
-very small packages, such as one bite candy
-items with insignificant calories and nutrients such a herbs and spices
-food sold t farmers markets
-food sold only in grocery stores where the product is prepared or packaged in store (bakery items and salads)
-alcoholic beverages

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27
Q

foods that are not required to be labeled

A

-fresh fruits and vegetables
- raw, single-ingredient meat, poultry, fish and seafood
-very small packages, such as one bite candy
-items with insignificant calories and nutrients such a herbs and spices
-food sold t farmers markets
-food sold only in grocery stores where the product is prepared or packaged in store (bakery items and salads)
-alcoholic beverages

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28
Q

Difference between nutritional labels in Canada

A

-in the newer nutritional label: calories is larger and stands out more with a bold line below
-mg amounts are stated for minerals and vitamins
-updated list of minerals of public health concern
-daily values are updated
-new % daily value for total sugars
-serving size stands out more and is more similar on similar foods
-new % daily value footnote

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29
Q

What happens when companies use the organic label inappropriately

A

Financial penalties

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30
Q

Organic foods should be lower in

A

-hormones, antibiotics and pesticide and herbicide residues

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31
Q

Overview on organic plants

A

-must be grown i soils not treated with synthetic fertilizers, pesticides, herbicides for at least three years
-cannot be fertilized with sewer sludge
-cannot be treated by irradiation
-cannot be grown from genetically modified seeds or contain genetically modified ingredients

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32
Q

overview on organic animal products

A

-cannot be raised in factory like confinement conditions
-cannot be given antibiotics or hormones to prevent disease or promote growth
-must be given feed products that are 100% organic

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33
Q

on,y products with organic content of —— can be labeled as organic

A

GREATER THAN 95%

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34
Q

Organically grown, organically raised or organically produced all mean the same as organic TRUE or FALSE

A

True

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35
Q

If a multi-ingredient product has 70 to less than 95% organic content

A

-must declare the percentage of organic content on the label
-may not use the organic logo nor the claim organic
-if less than 70% organic content, can on,y indicate which ingredients are organic in the ingredient list

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36
Q

Is organic food always healthier than non organic

A

nutrient wise (protein/ vitamins etc) are similar. One difference is that organic fruits and vegetables can have higher antioxidant content, organic diets do lead to less pesticide exposure.

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37
Q

which foods do you have less of an advantage buying organic

A

avocados , cantaloupe, pineapple, broccoli, cabbage and corn, have low levels of pesticides so less advantage to buying organic

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38
Q

Which foods do you have a greater advantage buying organic

A

Strawberries, spinach, grapes, apples, tomato’s and celery have higher levels of pesticide residue

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39
Q

What do nutritionists say about organic foods

A

Given the cost of organic foods, it may not be feasible for many Canadians ( expensiveee) we should encourage Canadians to eat more fruits and vegetables closing the gap would be equally or more important for health

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40
Q

When a product only indicates which ingredients are organic in the ingredient list, What is the organic content?

A

organic content is less than 70%

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41
Q

Can companies put health claims onto their products

A

Yes there are 13 approved health claims, they can put them on their product,

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42
Q

health claims on food and oats?

A

Health Canada has determined that the eligible sources of beta-glucan (giving a cholesterol lower effect)j so the claim is “oatmeal helps reduce cholesterol” oat fibre; such as oat bran, rolled oats (oatmeal) and whole oat flour

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43
Q

What is increased by enrichment and fortification

A

Vitamin and mineral content of food

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44
Q

Enrichment

A

Pertains only to refined grain products where thiamine, riboflavin, niacin and iron lost in milling are added back in (whole wheat flour -> white flour), producers of bread, cornmeal, pasta and crackers from refined grains must use enriched flours ( enriched means vitamins/minerals that were originally there is placed back in after stripping the grain)

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45
Q

Parts of a whole grain

A

Bran- fibre rich outer layer that protects the seeed and contains B vitamins and trace minerals

Endosperm- middle layer that contains carbohydrates and proteins

Germ- small nutrient rich core that contains antioxidants, vitamin E, B vitamins and healthy fats

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46
Q

What 2 parts of whole grain are lost and remaining when converting whole grain to white flour

A

Bran and germ are lost and endo sperm is left

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47
Q

Fortification

A

-the addition of a vitamin or mineral not normally found in the food

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48
Q

Example of fortification

A

Added calcium in orange juice

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49
Q

Ingredient labels

A

All ingredients must be listed in descending order of amount present (by weight) heaviest —> lightest
Ingredients causing allergic (peanuts, tree nuts, milk, eggs, fish, shellfish, wheat , soy, sesame, and sulphites must also be listed on the ingredient label

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50
Q

Food additives must must be listed TRUE OR FALSE

A

True

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51
Q

What are Food additives

A

3000 chemicals are added to food to enhance its flavour, colour, texture, cooking properties, shelf life or nutrient content

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52
Q

Food additives with GRAS can be used

A

Without pre-approval (generally recognized as safe),

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53
Q

Food additives with GRAS examples

A

Sodium chloride, sucrose, corn starch, many vitamins/ minerals

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54
Q

Should new additives approved by health Canada

A

Yes

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55
Q

Irradiated foods must contain what?

A

Must contain radura symbol

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56
Q

Irradiated foods (3)

A

Put it through machines with high levels of radiation, food doesn’t retain radiation passes through food and kills what it needs to.

Foods do not retain radioactive particles

Doses 10-20x higher than lethal dose in humans

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57
Q

Irradiated foods uses

A
  1. Prevent sprouting
  2. Delay ripening (import vegetables)
  3. Kill insects/ mold/ bacteria
  4. potatoes, onions, wheat, flour, spices, ground beef, reduces E. coli)
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58
Q

Dietary supplement

A

Dietary supplement must be labeled, cannot claim the products,treat, cure, or prevent disease
not classified as a drug so no vigorous testing

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59
Q

Are dietary supplements classified as drugs

A

No, it’s considered as natural health products

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60
Q

For natural health products to be sold they need

A

Must have a product license and displayed natural product number

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61
Q

To get product and site licenses what must happen?

A

specific labeling and packaging requirements must be met, good manufacturing practices must be followed and proper safety and efficacy evidence must be provided

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62
Q

Do we generally seek out nutrients we are deficient in?

A

No, nothing innate in us/ biological that we consume nutrients we need, select food on food preferences, culture, nutrition knowledge and beliefs, cost, hunger, availability, convenience. Humans and most animals will seek water and food, but not generally the best foods, unless they have learned how to eat a well-balanced diet

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63
Q

How do we decide when and how much to eat

A

-hunger, satiety and thirst centres are located in the “primitive” brain, hypothalamus- appetite centre

-inborn attraction to sweet and salty tasting foods, dislike of bitter and sour foods

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64
Q

Infants prefer

A

Sweet liquids to plain water, sweeter the liquid the higher the consumption

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65
Q

What makes us “like” or “dislike”

A

the strongest influence is food preference, a learned behaviour

We reject foods us that bring us discomfort, guilt and unpleasant memories (eating something that gave us food poisoning; as a child having to eat vegetables before leaving the table

Food preference is shaped by memory and memories are based on culture and the pleasure associated with the memory

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66
Q

Food marketing can influence food choices?

A

-create food trends; vegan, keto, carnivore
-encourage you to buy certain foods or drinks, buy foods in order to get promotional items such as loyalty points, tickets to movies or sports events, coupons for future food purchases
-create links between certain foods or brands and a particular lifestyle
-build brand loyalty so you will continue to purchase from a particular store or products with a brand name

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67
Q

Why do companies use red in products

A

companies use unique colour evoke emotion, red=enhance appetite, increased heart-rate

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68
Q

Why do companies use green in their products

A

Makes you think it’s healthy, natural, eco friendly

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69
Q

Why do companies use white

A

Evoke the thought that is reduced calories

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70
Q

Why do companies use yellow

A

associated with happiness, youthfulness, brain processes yellow very rapidly

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71
Q

Orange

A

Evoke that it’s good value, stimulates appetite and conversation

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72
Q

Why do companies use brown

A

Evoke rich flavour

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73
Q

Why do companies use blue

A

Directed to kids, blue suppresses appetite most unappetizing colour

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74
Q

conditions that contribute to death among adults under 75

A

-health care (10%)
-environmental exposures (20%)
-lifestyles (51%)
-genetic makeup (19%)

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75
Q

risk factors

A

condition or behaviour associated with an increased frequency of disease but not proved to be casual

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76
Q

Risk factors

A

1.dietary
2.genetics
3. age
4. sedentary lifestyle
5.smoking and tobacco use
6. Stress
7. Environmental contaminants

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77
Q

Western diets promote

A

Chronic diseases

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78
Q

Characteristics of western diets

A

-diets high in salt, refined grains, processed meats, refined sugars
-diets low in fruits, vegetables and fiber

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79
Q

top causes of death

A

Nutrition related diseases, heart diseases, cancers, strokes, obstructive lung disease

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80
Q

BMI

A

kg/m^2
<18.5 at risk
18.5-24.9= healthy
25-29.9 =overweight
>30 obesity

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81
Q

Prevalence in Canadians

A

Adult-36.3% have overweight +26.8% have obesity = 63.1% unhealthy weight
The greatest recent increase in obesity is in 20 to 39 year olds

Children- 17% overweight 9% obese 26% unhealthy weight

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82
Q

Obesity

A

Complex, multi factorial chronic disease calorie intake is just one contributor

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83
Q

Calorie dense foods

A

Foods with high calorie example burger, not much nutritional value

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84
Q

Are ancient diets the best

A

Claim; healthiest during paleolithic era 10 000 years ago
Paleo diet restricts what you eat to foods the hunter-gatherers of the Stone Age ate
Would overeat when food available to protect them during famine
Common cycle through periods of feasting and famine

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85
Q

Feast and famine then

A

Root vegetables (high in fibre) nuts seeds and wild game

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86
Q

Feast and famine now

A

Too much choice contributing to overeating

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87
Q

What are the biological processes in the body that make it hard to stay healthy

A

-we get hungry every 4-6 hours even in the presence of excess body fat stores (consuming more calories than what we burn)
-our bodies conserve sodium-historically diets were low in sodium and there was lots of vigorous activity sweating and diarrhea, so it was advantageous to conserve sodium for survival (high sodium salt diet leads to high bp)

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88
Q

We naturally prefer what kinds of foods

A

fatty and sweet tasting foods

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89
Q

What do we associate sweet taste with

A

Calories and nutrients that are safe for human consumption, help orient our behaviour to seek out and consume these foods

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90
Q

What is bitter associated with

A

Toxic products (lots of vegetables taste bitter therefore people consume less)

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91
Q

Today we over consume what and eat fewer what

A

Over consume- sugary foods and eat fewer vegetables

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92
Q

Was the Stone Age healthier

A

No, many died of starvation, vitamin deficiencies and food poisoning, died younger so less degenerative diseases (died younger)

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93
Q

Should we eat like they did in the past

A

No, meats differing (leaner back then)
Fruits and vegetables differ (different types causing nutrient level to vary)
Environment is different more pollution, sedentary behaviour etc

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94
Q

So instead of focusing on attempting to implement ancient diets

A

Exercise more and integrate wholesome foods into diet

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95
Q

Sources of nutritional information

A

Celebrities, influencers, media

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96
Q

Typical problems from nutritional information

A

Tight deadlines (rushed inconclusive not thorough)
Limited understanding
Single study
Report scientific findings prematurely
Half truths and hype are common in books, magazines, media internet, etc ( but what they are doing is not necessarily legal,y wrong because of our right of free speech

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97
Q

Nutrition in media (what is unlawful?)

And

Is it rare to see these laws enforced

A

Unlawful to state false claims on a product label or in an ad

Unlawful yo use US or Canadian mail systems to send fraudulent products or receive payments for fraudulent products

Yes, penalties are minimal

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98
Q

What is the primary reason for nutrition misinformation

A

-profit

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99
Q

Why are fraudulent products very profitable

A

When people think there is a quick and easy way to lose weight, build muscle, slow aging and reduce stress, it results in a huge profit market for nutrition products and services

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Not at all
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3
4
5
Perfectly
100
Q

How much is the world market for vitamins

A

3 billion

101
Q

What certifications does a registered dietitian need

A

BS in nutrition
Internship
National licensing exam
Registration (college of dietitians of Alberta)
RD

102
Q

In September 2016 were people describing themselves as nutritionists without certification

A

Yes

103
Q

What happened after September 2016

A

The title nutritionist can only be used by members of the college of dieticians if alberta

104
Q

What are titles that need certifications

A

Registered dietitian
RD
Nutritionist
Dietician
Registered nutritionists

105
Q

Sources of reliable nutrition info

A

Health organizations ( heart and stroke foundation, Canadian diabetes association)
Scientific organizations (Canadian nutritional society )
Professional organizations (dieticians of canada)
Government publications (health Canada)
Registered, licensed or certified dietitians
Nutrition textbooks (not diet books)

106
Q

Importance of research in nutrition

A

Facts and evidence provided by scientific studies used to develop nutrition information and guidelines that affect public health
Peer reviewed papers published in scientific journals
pubmed

107
Q

Nutrition deception

A

1.Too good to be true or a quick fix
2. Testimonial (before and after pictures)
3.Make you suspicious of food supply
4.fake credentials
5.elimination of whole food groups
6.use of the word, natural
7.supplements needed by all, megadoses

108
Q

What are 8 concepts that serve as a foundation for our understanding of nutrition

A
  1. Food is a basic need for human
  2. Food provides energy nutrients and other substances required for health
  3. Poor nutrition can result from both inadequate and excessive nutrient intake
  4. Malnutrition can be a result of poor diets, disease, genetic factors or a combination of these factors
  5. Some groups of people are at a higher risk of becoming malnourished than others
  6. Poor nutrition can influence the development of certain chronic diseases
  7. Adequacy, variety,balance are key points if a healthful diet
  8. There are no good or bad foods
109
Q

What are healthy diets characterized by

A

Adequacy, and balance

110
Q

Adequate diets

A

Diet with a variety of foods that provide sufficient level of calories and essential nutrients, contains all nutrients necessary for long term survival but it may not be necessarily be optimal or have any variety

111
Q

Balanced diet

A

Provide calories, nutrients and other components in the right proportions, a balanced diet has the six classes of nutrients in good proportion

112
Q

2 types nutrients and examples of each

A

Essential- nutrients the body produce or produce in sufficient amounts, must be obtained in the diet example- iron, calcium

Nonessential- nutrients the body can manufacture in sufficient quantities example cholesterol

113
Q

Recommended nutrient intake for carbohydrates

A

45%-65%

114
Q

What is the recommended amount of fat?

A

20-35%

115
Q

Recommended protein intake

A

10%-35%

116
Q

Recommend fibre intake

A

25g-38g

117
Q

Western diets are overloaded with and low in

A

-refined sugars
-refined grain
-salt
- saturated fats

Low in
-essential fatty acids
-vegetables and fruits
-fibre

118
Q

High intakes of fat (saturated fats and trans fat) are risks for

A

Heart disease and metabolic syndrome

119
Q

Low intake of dairy product and vitamin D are risks of what?

A

Osteoporosis

120
Q

What adults regularly consume broccoli, dark leafy greens,

A

6%

121
Q

What are dark leafy greens associated with

A

Reduced cancer risk

122
Q

Most commonly consumed vegetable in Canada

A

Potato in the form of fried

123
Q

Whole grains reduce the risk of what diseases

A

-cancer
-type 2 diabetes
-heart disease

124
Q

What % of Canadian do not consume any whole grains

A

50% Canadian children 54% Canadian adults

125
Q

Guides to healthy diets

A

-Canada food guide
- My Plate (USDA)
- Mediterranean food pyramid

126
Q

The previous food guide focused 4 groups

A
  1. Grain products
  2. Vegetables and fruits
  3. Milk products
  4. Meat and alternative
127
Q

Canada food guide reccomendations NEW

A

Plate instead of rainbow, the new food guide focuses on broader statements and no longer uses the food group categories

Make your drink of choice water
Eat protein foods (1/4 of plate)
Eat whole grain foods (1/4)
Have plenty of fruits and vegetables (1/2)

128
Q

Healthy food choices ( choose foods with blank instead of blank)

A

Healthy fats over saturated

129
Q

USDA MY plate

A

Grains- 1/4 plate grains and at least half should be whole grains
Protein- vary your protein
Vegetables and fruits, more veg than fruit (focus on whole fruit)
Dairy; move to low fat or fat fee dairy milk or yogurt

130
Q

Mediterranean diet pyramid

A

WHO, developed guide in 1994 to help popularize a diet associated with reduced risk of heart disease and cancer
-emphasizes olive oil, bread, whole grain cereals, nuts,fish dried beans, vegetables and fruits and wine in moderation
- intake of red meats limited to monthly and sweets and poultry to weekly intake

131
Q

Mediterranean diet pyramid Key features

A

Rich in plant foods, olive oil, limited red meat

132
Q

Our bodies are in a continuous state of what

A

State of renewal

133
Q

Materials used to renew body tissues come from the food we eat in the form of nutrients T or F

A

T

134
Q

Digestive system is made up of the following ( main organs )

A
  • mouth
    -pharynx
    -epiglottis
    -esophagus
    -stomach
    -small intestine
    -large intestine
  • rectum
    -anus
135
Q

Digestive system accessory organs

A

-liver
- galbladder
-pancreas

136
Q

What does the gut do

A

Approximately 92-99% of the protein, fat and carbs that we. Consume is digested and absorbed here

137
Q

Dietary fibre is not digested by humans True or false

A

True most is fermented by bacteria

138
Q

When did we discover bacteria can cause infections

A

-late 1800s

139
Q

What is higher levels of antibiotic use coincided with

A

Higher levels of childhood asthma and obesity

140
Q

Types of microbiota

A

-viruses
-bacteria
- fungi
- protozoan

141
Q

Types of microbiota

A

-viruses
-bacteria
- fungi
- protozoan

142
Q

The body part with the most densely colonized ecosystem

A

Gut

143
Q

Baseline gut bacteria is associated with

A

-Predicting weight loss in response to diet intervention
-response to chemotherapy and immunotherapy (influence of the effectiveness of this treatment)
-responder/ non responder to artificial sweeteners Artificial sweeteners like aspartame and saccharin can alter the gut microbiota, which may lead to metabolic changes. Some individuals are “non-responders” because their microbiota composition isn’t significantly altered by sweeteners, while others may experience negative metabolic effects like insulin resistance.

144
Q

Why is age 3 significant in a infants microbiota

A

Starts to resemble the diversity and stability of an adults

145
Q

Why is the gut microbiota important

A

-train immune system
-harvest energy from fiber
-intestinal barrier and motility
-produce vitamins such as vitamin K

146
Q

What causes dysbiosis

A

Microbiota (helpful bacteria and microorganisms living in the gut) can become imbalanced
-A low-fiber, high-sugar, high-fat diet disrupts gut microbiota by killing helpful bacteria and promoting harmful ones. This damages the gut lining, allowing harmful bacteria and LPS (lipopolysaccharides) to leak into the bloodstream. LBP (lipopolysaccharide-binding protein) binds to LPS, triggering an immune response that causes chronic inflammation. This affects the liver and brain (via the gut-brain axis), leading to neuroinflammation linked to anxiety, and also causes inflammation in fat tissue, contributing to insulin resistance.

147
Q

Fecal microbiota transplant

A

Profile in gut can cause disease
(Rat-rat and interspecies tests from humans to rats ran)
-when doing a FMT with a rat that is obese onto a regular rat, body fat in recipient mouse increased
-FMT associated with patients with colorectal cancer increased tumour incidence
-FMT from patients with depression induces depressive live behaviours in recipient mice

148
Q

What is a major modifier of the gut microbiota

A

Diet
-promote symbiosis (mutualistic relationship with gut bacteria and us)

149
Q

How do we promote symbiosis with our gut

A

-High fiber diet
-include whole natural foods

150
Q

Without fibre

A

The thick mucous layer that protects are intestinal cells from bacteria get eaten by pathogens/harmful bacteria and carbohydrates and proteins are in direct contact with intestinal cells 9disrupting digestion and causing inflammation)

151
Q

Dysbiosis can be caused by

A
  1. High fat high sugar foods
  2. Artificial sweeteners
    3.dietary emulsifiers polysorbate 80 and carbosymethocellulose
  3. Ultra processed foods
152
Q

Mechanical digestion

A

Physical breakdown of food,
Chewing, grinding and mixing food either mouth,tongue and teeth

153
Q

Chemical breakdown of food

A

Use enzyme, bile and hydrochloric acid
Over 100 enzymes that are secreted by the digestive system

154
Q

Stomach ——- chyme into ——-

A

Percolates chyme into the small intestine

155
Q

Stomach ——- chyme into ——-

A

Percolates chyme into the small intestine

156
Q

Solid foods stay in stomach for —-and liquids pass through in —-

A

Hours, 20 minutes

157
Q

Amount of solid food passed to small intestine at a time

A

1-2 teaspoons

158
Q

How long is the small intestine and parts

A

6 meters long composed of jejenum, duodenum and ileum

159
Q

Surface area of small intestine

A

675 square feet

160
Q

Intestinal cells turn over every

A

4-5 days due to high nutrient needs

161
Q

Where are the end products of digestion taken by

A

Blood vessels (carbohydrates and protein breakdown products) are taken up for distribution to the body

Lymphatic vessels (fatty acids from fat breakdown) this empties into the subclavian veins which feed back to the heart

162
Q

The large intestine

A

Water, sodium and some of the end products of bacterial digestion are absorbed from the large intestine
Bacteria digest fibre and complex carbohydrates that we can’t digest
These bacteria excrete gas and short chain fatty acids that can be absorbed in large intestine
Substances that cannot be absorbed are excreted as feces

163
Q

Pancreas

A

The enzymes produced by the pancreas act to breakdown all of the major energy nutrients

164
Q

Enzymes and their associated macronutrients produced by the pancreas

A

Carbohydrates- amylases
Proteins- proteases
Fats- lipases

When broken down these small molecules are transported into cell lining the small intestine

165
Q

Heartburn

A

Caused by excessive stomach acid or defective lower esophageal sphincter- causes burning sensation in the esophagus

166
Q

Acid reflux

A

Common medical condition that can range in severity from mild to serious/ Gastrophagael reflux disease GERD is the chronic, more severe form of acid reflux. Heartburn is a symptom of acid reflux and GERD

167
Q

What is factors involved in heartburn

A

Stress, anxiety, frequent, use of aspirin and other anti inflammatory medicines, fatty foods, spicy foods coffee, alcohol, citrus fruits, soft drinks and other foods are involved

168
Q

What increases the symptoms of heartburn

A

Weight gain and eating within 3 hours prior to going to bed increase symptoms, , weight gain of 10-20 pounds associated with a 3 fold increase in heartburn symptoms

169
Q

What protects against development of heartburn

A

High fibre diets

170
Q

Treatments include (heartburn)

A

Stress reduction
Elimination of offending foods (spicy)
Eating small and frequent meals
Mild occasional heartburn can use over the- the counter antacids but with persistent symptoms (prescription medications may be needed (proton pump inhibitor)

171
Q

When do ulcers develop

A

develop when protective stomach or duodenum lining is damaged. HCLs lowers the pH of the stomach to about 1.5-2 stomach acid and digestive enzymes erode the lining and cause an ulcer
Duodenal ulcers are closely associated with heavy NSAID use and or the presence of H pylori bacteria
Rates of H pylori infection are highest in countries with poor sanitary conditions
Classified as Class I carcinogen- stomach cancer

172
Q

Class 1 carcinogens

A
  1. Alcoholic beverage
    2.Asbestos
  2. Cadmium
  3. Engine exhaust, diesel
    5.epstein bar virus
  4. HPV
  5. Radiation
  6. Paint fumes
  7. Tobacco smoke, secondhand, smokeless
  8. Radon
173
Q

Constipation, hemorrhoids

A

-Constipation and hemorrhoids are due to diets with too little fibre
-adults need fibre intakes of 25g/day females to 38 (males) g/day plus plenty of fluids
- this regimen will help prevent constipation and hemorrhoids in healthy people

174
Q

Diarrhea

A

-severe diarrhea leads to dehydration, heart and kidney, malfunction and death
-most due to bacterial- or viral-contaminated food or water, lack of immunizations aganist infectious diseases and deficiencies
3.5 million deaths from diarrhea occur annually in children five years old or less

175
Q

Most foods contain a mixture of…

A

-energy nutrients and other substances

176
Q

Kilocalorie

A

The amount of heat required to raise the temperature of 2kg of water 1 degree

177
Q

Carbohydrates and proteins are how many calories per gram

A

4kcal/gram

178
Q

How many calories per gram of alcohol

A

7 cal/gram

179
Q

How many calories come from fat

A

9kcal/gram

180
Q

How much energy do we need

A

-Thermal effect of food 10% of basal and physical activity
-physical activity (20%)
-basal metabolism (60-75%)

181
Q

Factors that affect basal metabolic rate

A
  1. Age (increased age reduced metabolic rate)
  2. Height ( increased height increased metabolic rate
  3. Growth= increased metabolic rate
    4.Body composition= increased lean mass= increased BMR
    5.Fever= increased metabolic rate every 1 degree= 7%increase in BMR
    6.Stress= increased stress increased BMR
    7.environment temperature increased BMR
    8.fasting/starvation lower BMR
  4. Malnutrition decreased BMR
  5. Thyroxine increased BMR
182
Q

Basal metabolism

A

Men= body weight (lbs) x 11kcal
Women= body weight x 10kcal

183
Q

Physical activity

A

-activity tables; sum of all activity for the day),
-activity factors
Inactive= basal metabolism x 1.3
Average= basal metabolism x 1.5
Active= basal metabolism x 1.75
Dietary thermogenesis total ( Basal + PA) x 0.1 add this to the sum of basal and PA and this is the total calorie need

184
Q

Physiological influences for hunger

A

Empty stomach, gastric contractions, absence of nutrients, GI hormones ( elevated gherlin), endorphins (brain pleasure compounds)

185
Q

What is the process of hunger

A

Hunger—> Seek food—> continue meal —>satiation—> meal ends—-> satiety

186
Q

Why do we stop eating

A

-presence of food triggers stretch receptors
-nutrients in intestine elicit satiety hormones
GLP-1
CCk both are released

187
Q

Why do we not start eating yet

A

-nutrients in blood signal brain
-as nutrients diminish, satiety diminishes and hunger develops
-hunger hormones increase ghrelin

188
Q

Fat % in body , importance of body composition

A

-essential fat: men 3% women 12%
Bone marrow, central nervous system, internal organs
-Acceptable % body fat
Men 18-25% (> 26% classified as obesity)
Women 25-31% (>32% classified as obesity)
Fitness % body fat
(Men 14-17%)
(Women 21-24%)

189
Q

Below certain threshold of fat% may experience

A

Infertility, develop depression,abnormal hunger regulation and unable to keep warm

190
Q

Apple shaped body compostion

A

Excess fat in the chest and stomach areas , visceral/central and abdominal fat) causes a higher risk for diabetes, heart disease and hypertension than pear shaped bodies apple shape most likely place to gain weight in men

191
Q

Pear shaped body composition

A

Excess fat i the hips, thighs and buttocks =, subcutaneous fat most likely place to gain weight in women

192
Q

When are men at risk when waist size is..

A

102cm

193
Q

What waist size are women at risk for

A

88

194
Q

Metabolic syndrome exist in the presence of 3 of the following

A

-abdominal obesity; waist circumference greater than 102 cm in men or greater than 88cm for women
-elevated levels of triglycerides (1.7mmol/L)
-Low levels of HDL (<1.0 mmol/l for men and 1.3 mmol/L in women)
-high blood pressure/hypertension (>130/85)
-impaired fasting glucose (>6.1mmol/L) pre diabetic state

195
Q

What are the measurements. Of body composition

A

Fat fold measure, DXA, underwater weighing, bioelectrical impedance

196
Q

Fat fold measure

A

Use caliper to gauge thickness of a fold of skin on tricep,sub scapular, chest, abdomen or thigh

197
Q

Underwater weighing

A

measure body density by weighing person first on land then submerged in water amount of water displaced and and the known density of fat mass, and lean mass. By volume, fat weighs less than muscle and and muscle each have a constant mass and displace a specific amount of water

198
Q

Bioelectrical impedance

A

Use low intensity electrical current. Lean tissue conduct more current, fat, more resistant to current (when current passes through fat mass, fat mass is resistant) a limitation is the calibration of the machine

199
Q

DXA

A

Use low dose x ray absorption to measure lean and fat mass and bone density

200
Q

Lean mass heavier than

A

Heavier than fat mass

201
Q

Limitation of BMI

A

These men have the same BMI but different health risk

202
Q

Underweight in the US usually results from

A

Genetics or from poverty, lines or voluntary restriction of food

203
Q

Fad diets

A
  • short because people can’t stick to it example raw food diet, juice cleanse, paleo
204
Q

Greatest weight loss

A

During 1st week of dieting

205
Q

What do you lose in the first week of dieting

A

-CHO, H20, (70% H20, 25% fat 5% lean mass)
Lose primarily glycogen 1 gram glycogen 3G h20
Water weight

206
Q

True or false rapid weight regain when you resume normal eating after 1 week

A

True

207
Q

In 2nd week of dieting

A

20% h20
Fat and lean mass

208
Q

In 3rd week of dieting

A

Minimal h20 loss
Fat and lean mass

209
Q

Why does weight loss becomes increasingly difficult

A

You need to fewer kcal to maintain new lower body weight (basal energy needs are tied to body weight) and they go down as the body weight goes down

210
Q

How do we gain adipose tissue

A

-fat cell development
Hyperplasia ( increase in number of fat cells)
Hypertrophy (increase in the size of fat cells)
Critical periods for fat cell increase
- late childhood
-puberty

211
Q

Critical enzyme affecting fat storage

A

LPL promote fat storage in adipose and muscle
People with high LPL store fat very efficiently
-individuals with obesity have more LPL activity per fat cell and more fat cells even modest excess in energy intake has more dramatic effect in an individual with obesity versus lean (easier for them to gain weight)

212
Q

LPL as a gender specific hormones

A

In women, fat cells in breasts, hip and thighs produce more LPL and in men cells in the abdomen produce more LPL (where there is LPL is where excess energy will go gain fat in specific area)

213
Q

After weight loss what happens to LPL

A

LPL increases

214
Q

Why do we lose weight and regain it easily

A

LPL increases after weight loss

215
Q

Leptin

A

Made in adipose cells

216
Q

An increase in leptin

A

Negative energy balance

217
Q

Decrease in leptin

A

Positive energy balance

218
Q

What happens in increase in leptin

A

-gain of body fat
-blood leptin increases
-hypothalamus responds to diminishing

Food intake decreases and energy expenditure increases

219
Q

Result of an increase in leptin

A

Negative energy balance
When leptin levels are high the hypothalamus produces proteins called melanocortins which dampen appetite

220
Q

What happens when there is a decrease in leptin

A

Loss of body fat—> blood leptin decreases—> hypothalamus responds stimulating appetite
Food intake increases and energy expenditure decreases

221
Q

Result of positive energy balance

A

When leptin levels are low the hypothalamus produces a protein called neuropeptide Y which stimulates appetite and slows energy expenditure leptin inhibits neuropeptide production

222
Q

Four prescription medication are available for the treatment of overweight and obesity

A

-xenical (orlistat)
-semiaglutide, wegovy, ozempic
-linaglutide; saxenda
-contrave (naltrexone x bupropion)

223
Q

How does xenical work

A

Block fat absorption in the testing so that you absorb fewer calories,capsule taken after or during every meal (results in diarrhea, fatty stool)

224
Q

Contrave

A

Low dose naltrexone used for addiction and bupropion used for depression, work on two separate areas of the brain to control hunger and cravings
Oral tablet

225
Q

Semaglutide

A

Wegovy and ozempic,
-GLP-1 glucagon like peptide-1 is a satiety hormone found naturally in the body acts by decreasing appetite
- pre-filled pen self inject once a week

226
Q

Liraglutide

A

Saxenda
-GLP 1 receptor agonist
-pre-filled pen that you self inject daily
Long acting

227
Q

Why is semaglutide and liraglutide super effective weight loss drugs

A

They overcome appetite signals levels of ghrelin and PYY

228
Q

Is ozempic a long term drug

A

Yes because it manages obesity not treats it

229
Q

Organized weight loss programs

A
  • weight watchers
    Works as a point system cook their own food

-Jenny Craig
Helps people to track their food with proportioned, pre established serving sizes and meals

230
Q

Why are diets unsuccessful

A

-hard to follow
-different than what we are accustomed to
-easy to slip off and “cheat”
-people want a quick and easy fix
-persistent obesity changes the biology of the body

231
Q

What does it mean by persistent obesity changes the biology of the body?

A
  • the body makes metabolic changes hard to go back to old weight
232
Q

Full year after significant weight loss

A

-ghrelin was 20% higher
-PYY 20% lower
-body acted as if starving “post dieting syndrome”
- appetite hormones are not reaching equilibrium, metabolic adaptation persist over a longtime

233
Q

Is willpower enough to overcome biological signals

A

NO

234
Q

Post weight loss

A

-muscle biopsy- burns 20-25% less energy during low intensity exercise and activities of daily living (after weight loss we burn less calories)
-skeletal muscle work efficiency increased

235
Q

Following calorie restriction

A

-functional MRI activation in the attention and reward regions in response to food ( which areas of the brain will light up in response)
-caloric deprivation increased the reward value of high calorie foods increase cravings and can result in a binge ED

236
Q

More invasive and drastic measures of weight loss

A
  1. Prolonged fasting
  2. Bariatric surgery
    3.Liposuction

Each of these carries risk and the last 2 are expensive af

237
Q

Prolonged fasting

A

Causes intestinal starvation
- 50-80% of intestinal nutrients are provided by the food we eat
-mucous and cells are lost from GI tract lining
-

238
Q

Difference of prolonged fasting and intermittent fasting

A

-caloric restriction and intermittent fasting result in similar degrees of weight loss and improvement in insulin sensitivity

239
Q

Surgery available which clinical population

A

-over 28years old
-bmi over 40
-bmi less than 35 plus 1 or more (high bp, high cholesterol, diabetes, sleep apnea)
-have tried different ways of trying to lose weight

240
Q

Surgery can reduce weight by ——- and most can maintain ———

A

50% maintain the weight loss

241
Q

Limitation

A

Risk and complications during and after surgery
-expensive

242
Q

Bariatric surgery 3 types

A

-adjustable gastric band
-gastric bypass
-vertical sleeve gastrectomy

243
Q

What is gastric band

A
  • safest type of Bariatric surgery requires follow up for band adjustments (removable)
244
Q

Gastric bypass

A

-greatest weight loss
- reduce stomach size from football to egg bypass first section of small intestine stomach contents automatically move directly to duodenum

245
Q

Vertical sleeve gastrocteomy

A

About 2/3 of stomach removed leaving a sleeve/tube behind, ghrelin removed giving a metabolic response

246
Q

Liposuction

A

Max amount of fat removed=5L (4.5kg)
- purely cosmetic not intended for WL
- risk include bumpy skin, due to uneven fat removal, poor skin elasticity and unusual healing, changes may be permanent
-liposuction removes fat cells for targeted areas of the body, so if you gain weight the fat will be stored in different parts of the body

247
Q

Maintainers of weight loss

A

-exercise regularly
-make small;; and comfortable changes in diet and PA
-eat breakfast (contribute to appetite regulation throughout the day)
-choose low fat options
-keep track of their weight, dietary intake, PA level

248
Q

Regainers of weight

A

-exercise little
-use fad diets
-make drastic and unpleasant changes in diet and PA levels
-take diet supplements
-cope with problems by stress eating

249
Q

National weight loss registry

A

Largest observational study of weight maintenance and includes individuals who have maintained a weight loss of at least 30 lbs for at least 1 years
-identifies behaviours associated with long term weight loss success

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