Midterm #1 Flashcards
Hierarchy Of Nutrition Related Pathology
- Nutrition Plays Role - e.g. osteoporosis (related to Ca, exercise, etc.)
- Strong Nutritional Component - e.g. heart disease, stroke, diabetes, celiac
- Deficiencies/Toxicities - scury, iron deficiency, pellagra (b vitamin niacin)
Definition Of A Calorie
Heat Required To Raise Temp. Of 1 Kg Of Water 1 Degree Celsius.
Dietary Reference Intake (DRI) For Micronutrients - RDA
Recommended Dietary Allowance - first established when health care professionals were primarily concerned with deficiency disorders. Covers 97% of population from inadequacy.
Dietary Reference Intake (DRI) For Micronutrients - EAR
Estimated Average Requirement - meets requirement for 50% of the population. When enough data exists, an RDA is then established.
Dietary Reference Intake (DRI) For Micronutrients - AI
Adequate Intake - Used when RDA doesn’t exist; covers from estimated RDA at lower limit to 20% towards the upper limit.
Dietary Reference Intake (DRI) For Micronutrients - UL
Tolerable Upper Intake Level - the point where intake starts to show adverse effects. Begins at appropriately the AI maximum.
Dietary Reference Intake (DRI) For Macronutrients - EER
Estimated Energy Requirement - the average caloric intake to maintain energy balance for different populations.
Dietary Reference Intake (DRI) For Macronutrients - AMDR
Acceptable Macronutrient Distribution Ranges - range of intake for each macronutrient associated with reduced risk of chronic disease while still maintaining adequate intake of essential nutrients.
AMDR Recommendations
Carbohydrate - 45-65% of energy
Fat - 20-35% of energy
Protein - 10-35% of energy
Dietary Questionnaires
- Diet History - eating patterns, physical activity, frequency of eating out, etc.
- 24 Hour Recall - reliance on memory and estimation of portion size.
- FFQ (Food Frequency Questionnaire) - list of foods, patient records how often (s)he eats that food
- Diet Record - list over 3-7 days
Case-Control Study
More complex that epidemiological studies, but do not illustrate causation. Involve subjects from the same population (i.e. elderly men with high blood pressure.)
Clinical Trial
Level 1 - transfer from rats to humans; few people to prevent fatalities.
Level 2 - larger human subject pool; safe in humans now need larger pool to show not due to chance.
Level 3 - used to gauge dosages.
Malnutrition, Undernutrition, Overnutrition
Malnutrition - imbalance (too much of one nutrient without another)
Undernutrition - deficiency
Primary Deficiency - not enough
consumption of a nutrient.
Secondary Deficiency - cannot
absorb a nutrient.
Overnutrition - too much (i.e. obesity, toxicity)
Nutritional Assessment - ABCDE G
A - Anthropometric B - Biochemical C - Clinical D - Dietary E - Environment
G - Genetics
Nutritional Assessment - Anthropometric - General
- Percent Fat - Skinfold
- BMI
- Waist To Hip
Nutritional Assessment - Biochemical
- Urine - albumin and glucose
- Blood Glucose
- Insulin
- Others - cholesterol, triglycerides
- Homestatic Model (HOMA - IR)
- Triglyceride Index (TyG Index)
Nutritional Assessment - Clinical
Is the patient having headaches, nausea, hair falling out, etc.
Nutritional Assessment - Dietary
Usage of 24 hour recall, FFQ, diet record to determine dietary intake.
Nutritional Assessment - Envrionment
Water health, chemical plants, copper wiring, etc.
Nutritional Assessment - Genetics
Epigenetic affects on gene methylation, acetylation, phosphorylation, repression and activation, etc.
Caloric Equivalents For Macronutrients
Carbohydrate - 4 kcal/g; 5 kcal/L O2 Lipid - 9 kcal/g; 4.7 kcal/ L O2 Protein - 4 kcal/g; 4.5 kcal/ L O2 Alcohol - 7kcal/g Soluble Fiber - 1.5 - 2.5 kcal/g due to bacteria fermenting into SCFA
Components Of A Healthful Diet
- Adequate - enough energy, nutrients
- Moderation
- Balanced - many different food groups (meat, vegetables, fruits, etc.)
- Variety - different food from each food group (lettuce, peppers, kale, etc. among vegetables)
Components Of The Food Label
- Statement Of Identity - product name is prominently displayed.
- Net Contents - quantity of package
- Ingredients List - in order of weight
- Name/Address Of Manufacturer
- Nutrition Information
Nutrition Labels
- Serving Size - determine by FDA
- Calories and Calories From Fat
- Nutrient List - nutrients at top should be limited (fat, sat fat) while ones at bottom should be consumed more.
- Percent Daily Value - how much one serving contributes to the suggested overall daily intake of that nutrient.
- Footnote - if space, 2500 cal per day diet will also be included.
Manufacturer Claims - Regulated By FDA
- Nutrient Claims - based on daily values (i.e. low sodium means less that 140mg)
- Health Claims - related to health and disease.
Manufacturer Claims - Not Regulated By FDA
Structure-Function Claims - generic claims about the food’s impact on body (i.e. builds strong bones). Cannot be about a specific disease or symptom.
FDA Approved Nutrient-Related Terms And Definitions Relative Claims - Free/Without/Zero/No
None/trivial amount of that given nutrient.
FDA Approved Nutrient-Related Terms And Definitions Relative Claims - Light
- > 1/3 fewer kcal or >1/2 fat from regular food.
- > 1/2 sodium from regular food
- Lighter in color or texture
FDA Approved Nutrient-Related Terms And Definitions Relative Claims - Reduced/Less/Fewer
> 25% less nutrient or kcal than regular food.
FDA Approved Nutrient-Related Terms And Definitions Relative Claims -More/Added/Extra
> 10% of DV compared to regular food. Only used for vitamins, minerals, protein, fiber, potassium.
FDA Approved Nutrient-Related Terms And Definitions Relative Claims - Good Source Of/Contains/Provides
10-19% of DV per serving, not used for carbohydrate.
FDA Approved Nutrient-Related Terms And Definitions Relative Claims - High/Rich In/Excellent Source Of
> 20% of DV per serving (protein, vitamin, mineral, fiber, potassium, not carbohydrate).
Percent Daily Values - Total Fat, Sat. Fat, Total Carbohydrate, Fiber
Total Fat - 30%
Saturated Fat - 10%
Total Carbohydrate - 60%
Fiber - 25g
*Based on 2000 kcal/day diet
Food Pyramid
Grains Vegetables Fruits Oil Dairy Meat and Beans
Quantity Estimates - Golf Ball, Tennis Ball, Deck Of Cards, Baseball
Golf Ball - 2 tbsp
Tennis Ball - 1/2 cup
Deck Of Cards - 3 oz
Baseball - 1 cup
Layers Of GI Wall
- Mucosal - epithelial/endocrine cells
- Submucosal - connective tissue; glands, nerves, vessels
- Muscular - circular, longitudinal, oblique (oblique only in stomach)
- Serosa - connective tissue, protection
Miscellaneous Anatomy - Pharynx
Throat, passageway between mouth and esophagus. Soft palate prevents bolus from entering the nasal pharynx.
Miscellaneous Anatomy - Superior and Inferior Mesenteric Arteries
Arise from the abdominal aorta. Superior supplies SI and pancreas. Inferior supplies colon.
Miscellaneous Anatomy - Superior and Inferior Mesenteric Veins
Drain blood from GI to the liver via the portal vein. Superior drains SI. Inferior drains colon and meets superior as it meets the portal vein.
Miscellaneous Anatomy - Omentum
Sheet of fatty connective tissue that protects and holds organs in place. It is highly vascularized. This is where abdominal fat accumulates.
Miscellaneous Anatomy - Celiac Trunk Artery
One of 3 branches from the aorta (the others being super and inferior mesenteric arteries). Supplies the liver, stomach, esophagus, and superior duodenum and pancreas.
Miscellaneous Anatomy - Hepatic Artery
Branches from celiac trunk artery and supplies liver, pylorus (part of the stomach that connects to SI), and pancreas.
Miscellaneous Anatomy - Lacteals
Digestion of longer chain fatty acids collected in lacteals and enter lymph which ends at thoracic duct and is dumped into heart. SCFA enter portal vein with carbohydrate.
Digestion. Mouth. Salivary Glands
Parotid - largest, back of the mouth
Sublingual - smallest, under tongue in from of submandibular
Submandibular - middle sized, beneath jaw, between parotid and sublingual
Digestion. Mouth. Chewing and Swallowing
Chewing: epiglottis is open, breathing
Swallowing: epiglottis covers trachea, esophageal sphincter releases to open trachea.
Digestion. Mouth. Secretions. Saliva
Water Amylase - Starch to maltose Lingual Lipase - Milk, lost at age 5-6 Ca and P - Preserve ionic gradient Lysozyme - kill bacteria and viruses Antibodies - " Bicarbonate - Buffer acidity
Digestion. Esophagus. Sphincters
Upper esophageal sphincter
Lower esophageal sphincter
Digestion. Stomach. Sphincters
Pyloric sphincter empties chyme into SI in small amounts
Digestion. Stomach. Cell Types and Locations
Gastric Gland - bottom of the invaginations created by rugae, at the gastric pit.
Parietal Cells - bottom of gastric pit
Chief Cells - bottom of gastric pit
Mucus Neck cells - halfway up the gastric pit.
Mucus Surface Cells - top of rugae
G Cells - “
Digestion. Stomach. Secretions. Mucus Neck and Surface Cells
Secretion: Mucus
Stimulus: Irritation
Function: Forma bolus, lubrication, barrier between chyme and epithelial cells, some weak buffering capacity.
Digestion. Stomach. Secretions. Parietal Cells
Secretion. HCl and Intrinsic Factor
Stimulus. Chewing, smell, sight, distension, gastrin, histamine, acetylcholine, peptides
Function.
HCl denatures protein, kills bacteria and virus, converts pepsinogen to pepsin and inactivates amylase
Intrinsic Factor complexes with B12 to allow absorption.
Digestion. Stomach. Secretions. Chief Cells
Secretion. Pepsinogen and Gastric Lipase
Stimulus. Pepsinogen stimulated by ach, peptides, acidity,
Gastric Lipase stimulated by gastrin
Function.
Pepsinogen converts to pepsin in the presence of HCl and digests polypeptides to smaller polypeptides.
Gastric Lipase digests SCFA and MCFA, though minimal lipid digestion in stomach.
Digestion. Stomach. Secretions. G Cells
Secretion. Gastrin. HORMONE
Stimulus. Ach, peptides, amino acids, distention
Function. Stimulates HCl, pepsinogen, and gastrin secretion. Induces pancreatic and gallbladder secretion. Constricts pyloric sphincter, slowed gastric emptying. Stimulates peristaltic waves.
Absorption. Stomach
Water, fluoride, some lipids, some lipid-soluble drugs (aspirin and alcohol)