Midterm Flashcards
Study of Nutrition
Study of food, nutrients and other factors that interact to impact how our bodies process food and utilize nutrients
Benefits of food
Provides energy (in form of calories), nutrients, and other substances needed for growth and health
Calorie
Measure of the amount of energy transferred from food to energy
Nutrients
Chemical substances in food that are used by the body
Diet
Consumption of foods and thoughts that go in to what we consume on a daily basis
- tells us about one’s culture and traditions
Carbohydrates
Organic compounds consisting of C, H and O
Proteins
Organic compounds consisting of amino acids
Fats (lipids)
Organic compounds that consist of a glycerol molecule bound to three fatty acids
Vitamins
A group of organic compounds essential for proper nutrition and growth and required in limited amount in diet
Minerals
A group of inorganic compounds essential for proper nutrition and growth, and required in limited amounts in diet
Water
Essential component of our diet
- helps transport nutrients to cells
- lubricates us
Essential Nutrients
Nutrients we cannot make on our own but only obtain from our diet
- carbohydrates
- certain amino acids (9 essential)
- essential fatty acids
- vitamins and minerals
- water (can’t manufacture enough on our own)
Nonessential Nutrients
Present in foods and used by the body but not required in the diet since we can also synthesize them ourselves
- cholesterol
- glucose
Malnutriton
Lack of nutrition over extended period of time
- undernutrition
- over-nutrition
Deficiency
Inadequate nutrient intake - depletion of tissue reserves - decreased blood nutrient level - insufficient nutrient available to cells - impaired cellular functions - physical signs/symptoms of deficiency - long term impairment of health
Toxicity
Excessive nutrient intake - saturation of tissue reserves - increased blood nutrient level - excessive nutrient available to cells - impaired cellular function - physical signs/symptoms of toxicity - long term impairment of health
Dietary reference intakes
Nutrient intake standards for healthy members of population
- established jointly by scientists
- continually updated
- different categories exist for certain nutrients
- Specific to life stage/ages
RDA
Recommended dietary allowance
- Levels of essential nutrients adequate for ~98% of population
AI
Adequate intakes
- Tentative RDA’s used when scientific information is less conclusive
EAR
Estimated average requirements
- Estimated values to met requirements of half of healthy individuals in a population group
UL
Tolerable upper intake levels
- Upper limits of nutrients compatible with health (should not be exceeded)
Daily Values
Standards for daily intakes of nutrients
- based on needs for 2000 cal/day diet or eating pattern
- typically used on nutrition labels of foods
Factors that impact nutrient needs
- age
- body size
- gender
- genetic traits
- growth
- illness
- lifestyle habits
- medication
- pregnant (lactating)
Life cycle approach to nutrition and health
For certain population groups and life stages different people are more susceptible to deficiencies and diseases
WHO definition of health and extended definition
“Health is a state of complete physical, social and mental well being and not merely the absence of disease or infirmity.”
“…the extent to which an individual or group are able to realize aspirations and satisfy needs, and to change or cope with environment.”
Health promotion
Process of enabling people to increase control over determinants of health
Fundamental conditions and resources for health are:
- peace
- shelter
- education
- food
- income
- a stable eco-system
- sustainable resources
- social justice
- equity
Population/Public Health Approach
Our health and health behaviours are the result of numerous determinants from various sectors
- to improve health, action must be taken of the full range of health determinants and involve numerous sectors
Q: Define the term essential nutrients. Identify two essential nutrients and representative examples of foods that contain them
Nutrients that our body can’t make so you have to get them from food
- Carbohydrates (e.g. bread)
- Calcium (e.g. milk)
3 levels of prevention
- Primary (ALL)
- reduce new cases of problem behaviour - Secondary (SOME)
- improve health of people that already have problematic behaviour - Tertiary (FEW)
- help people with chronic or infections conditions manage their symptoms
Primary prevention
Health promotion activities aimed at a specific illness or disease
- precedes disease and is applied to generally healthy individuals
EX: immunizations, breast cancer screening, session on healthy eating to prevent cancer
Secondary prevention
Activities focused on early identification of health problems (identify and treat people who have asymptomatic/preclinical disease)
- people who pose risk factors for certain diseases
EX: breast self exam, screenings for genetic cancers, screening for specific illness
Tertiary prevention
Educating of an individual with a disease with the goal of returning them to optimum level of functioning
- targeting people that already have a certain condition
EX: referring a person who has stroke to rehab centre, educating person with type 2 diabetes how to identify and prevent complications
Health promotion (in CA) at federal level
- Public Health Agency of Canada
- Health Canada
- Canadian Food Inspection Agency
Health promotion (in ON) at provincial level
- Ministry of Health and Long Term Care
- Public Health Units
Health Canada
- Health care
- Education, food guide
- Development of food regulations (food labeling, the Food and Drugs Act, health claims)
Public Health Agency of Canada
- Health promotion
- Prevention and control of disease
- Disease Surveillance
- Public health emergencies (food borne illness outbreaks)
Canadian Food Inspection Agency
- Enforcement of food regulations set by Health Canada
- Inspection of facilities
- Identification and oversight of food recalls
Federal Minister of Health
Jane Philpott
PHAC Healthy Living Strategy targets
- Healthy eating, physical activity, and theirrelationsaip to health weights
- Tobacco, diabetes, chronic disease prevention, etc.
- Mental Health
- Injury prevention
Sodium reduction strategy for Canada
Particular strategy initiated in 2007: Reduction task force - researchers, industry, medical community, professional organizations, government Risks - elevated blood pressure - CVD - stroke - kidney disease Avg. intake among CA (3400 mg/day) Recommended intake (1500 mg/day) UL (2300 mg/day)
Who has highest intake of sodium?
Male teenagers
- sports drinks
- processed foods
- fast food availability
High sodium in common processed foods
- Kraft dinner
- Frozen pizza
- Pizza pockets
- Soy sauce
- Ketchup
- Pickles
Provincial Minister of Health
Dr. Eric Hoskins
Ministry of Health and Long Term Care
Healthy Eating and Active Living Action Plan
- access to healthy food for children
- help Ontarians access dieticians
- Active 2010
Healthy Change Ontario’s Action Plan
- provides action plan for Health Care
- keeping ontario healthy, faster access to stronger family health care, right care, right time, right place
What do Dietitians do in Public Health?
- Preparation of kits, educational material
- Liaise with policy makers to work on nutrition policy implementation and guidelines
- Public level screening
- Public level education
- Nutrition counselling (in person, telephone)
Define social determinant of health
Economic and social circumstances within which people live
- processes/mechanisms by which members of different socio-economic groups come to experience varying degrees of health and illness
12 Core Determinants of Health
- health services
- education
- physical environments
- social support networks
- health child development
- gender
- social environments
- personal health practices and coping skills
- culture
- biology and genetic endowment
- employment and working conditions
- income and social status
Socio-ecological Model
Individual - Interpersonal - Organizational - Community - Public Policy
SeM - INDIVIDUAL
Personal level factors
SeM - INTERPERSONAL
Factors relating to the influence of families, peers and partners, culture
SeM - ORGANIZATIONAL (institutional)
Practices and physical environment of an organization
SeM - COMMUNITY
Cultural values or norms unique to urban, rural and remote settings
SeM - PUBLIC POLICY
Broader guidelines at various levels of government
Where do food and nutrition fit into the SeM?
Individual: lactose intolerance impacting calcium status in individuals
Interpersonal: meal-time practices in the home – eating meals together
Organizational/institutional: time and space available to eat lunch at your workplace
Community: living in a food desert – few locations nearby to purchase healthy fresh foods
Public Policy: The former Conservative government replacing the federal Food Mail program which subsidized foods being shipped to the North, with Nutrition North, another federal program which subsidizes food retailers – none have been successful in establishing food security in remote northern regions of Canada!
Food security
All people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life
Food insecurity
The inability to acquire nutritionally adequate foods in culturally acceptable ways
Food availability
Daily energy, macronutrient, and micronutrient needs must be met
- food can be available for individuals or families living in a city or rural area
- sources of food locally such as farmer’s markets, grocery stores etc.
Food access
Individuals or households may not have access to available foods due to circumstances such as insufficient income or lack of transportation
Food supply and systems
Environmental impacts can lead to droughts, floods, sharp price increases
Traditional foods
Plants and animals harvested from the local environment
Tradition food systems
Include preferences at individual level
- physical, social and cultural environments
Determinants of traditional food choice
- no time to prepare
- lack of knowledge
- unhealthy
- no land access
- expensive
- no availability
Food as a social determinant of health
To achieve sustainable food systems, community members of all ages must identify a shared vision of food security and translate it into a locally controlled food system in order to ensure a vibrant healthy community
Emerging adult
Phase of the life span between adolescence and adulthood
- a period of time to explore possibilities and define one’s self
- not necessarily settled on career, house, partner
- theory coined by Jeffrey Arnett
Transitional period leading to adulthood
- moving from home
- paying bills
- own place to live
- buying/cooking food
- responsible for yourself (making appointments)
- completing education
- life partner
- starting family
How has this stage evolved?
Generally speaking…
- leaving home at older ages
- leaving school at older ages
- age of marriage is increasing
- age of parenthood increasing
Average age of first marriage in 1972 vs. today for men and women
Men: 25 vs. 31
Women: 22 vs. 29
Characteristics of emerging adult
- Don’t see themselves as adults
- Time of identity exploration
(work, love, worldview, lifestyle) - Experimentation
- High level of transition
(residential status, school attendance)
Human brain does not reach full maturity until?
Mid 20’s
Brain development in emerging adulthood
Frontal lobe
- largest of brain’s structures
- “prefrontal cortex” changes
Prefrontal cortex
Termed “Executive Suite” - Involves processing of tasks such as:
- calibration of risk and reward
- problem solving
- prioritizing
- long term planning
- self evaluation (awareness being less critical)
- regulation of emotion (not being so dramatic)
Changes to prefrontal cortex during emerging adult stage
“Melting of teenage brain”
Myelination
- more extensive myelination of nerves in this area of rain
Synaptic pruning
- nerve connections are pruned back = more efficient signal transmission among remaining nerves
Result of changes to prefrontal cortex
- More sophisticated learning and emotion regulation
- Executive suite functions are more efficient
Changes by the end of emerging adulthood
- More complex thinking (consider both present and future)
- Appreciation of diverse views
- Emotional regulation (weigh immediate rewards with future consequences)
- Risk taking and decision making (increased ability to modulate risk taking and make decisions about future)
Overall health and well-being of emerging adult
- self reported health is good to excellent
- rates of disease and stability are low
- peak in substance use, STI
- psychiatric disorders also peak (anxiety increases but depression decreases)
Window of opportunity for public health
Time of identity exploration during emerging adult stage
- incorporating health related behaviours is part of self-identity
- important indicator of lasting health-related behaviours
Nutrition in emerging adulthood
- Support active lifestyle
- Maintain physical status (healthy body weight, prevent type 2 diabetes)
- Special requirements for reproduction
- Otherwise nutrient requirements for adulthood
Trends in general dietary intake emerging adult
- Fast food intake is highest
- High consumption of sugar-sweetened and caffeinated beverages
- High salty snack foods
- Low intake of fruit and vegetables (only 13% of uni/college students have 5 or more servings per day)
- Low milk intake
Lifestyle influences emerging adult diet
Eating on the run is common
- sugar sweetened beverage
- fast food
- total fat and saturated fat
- fruits and veggies
True or false - students who live on campus have better diets than those who live off campus?
True - Compared to students living on campus those that lived with parents or in rented houses/apartments had:
- increased fast food intake
- decreased fruit, vegetable, and whole grain intake
Obesity and weight gain in emerging adults
- Large increase in prevalence of obesity among 18-29 year olds
- Transition to university (freshman 15)
BMI
Measure of obesity - weight relative to height (not a direct measure of body fat)
BMI = kg/m2
NOT ACCURATE FOR EVERYONE
BMI underweight
less than 18.5
BMI normal
18.5-24.9
BMI overweight
25.0 - 29.9
BMI obese I
30-34.9
BMI obese II
35.0 - 39.9
BMI obese III
greater than 40.0
Key considerations for using BMI
- 18+
- based on population level data
- only part of an individual’s risk assessment
- does not take into account bone density
- not to be used with pregnant/lactating women
- does not capture risk with weight change
Results of BMI less accurate for who?
- emerging or young adults
- muscular/lean individuals
- certain population groups
- adults older than 65
- dehydrated individuals
Q: BMI measure don’t accurately represent healthy weights for:
A. athletes with larger percentage of muscle B. individuals with little muscle mass C. individuals with large, dense bones D. dehydrated individuals E. all of the above
ALL OF THE ABOVE
Fertility
Ability to bear children
Infertility
Inability to bear children
(In)Fecundity
Biologic ability (inability) to bear children (uterus, ovaries - basically having proper parts)
Subfertility
Reduced level of fertility or early pregnancy losses
Infertility rates
- About 18% of couples are sub fertile (44% able to conceive with no intervention in 3 years)
- Healthy couples have a 20-25% chance of diagnosed pregnancy within a single menstrual cycle
Puberty
Period in which human become biologically capable of reproduction
Ova
Female reproductive cells that are produced and stored in ovaries
Follicle
Cellular structure in ovary where ova matures
Sperm
Male reproductive cells
Reproductive system develops…
within first months after conception and continue to grow and develop through puberty (course of 3-5 years)
Women born with how many ova?
Lifetime supply of approximately 7 million
- during fertile years about 400-500 ova will mature and be released
Menstrual cycle
4 week interval in which hormones direct buildup of blood and nutrient stores within uterus
- ova matures and is released
Follicular phase
First 14 days of cycle
- helping egg mature to eventually be released through ovulation
Luteal phase
Last 14 days of cycle
- lining of uterus build up (blood and nutrients)
- egg released
- ovulation occurs
- menstruation and fertilization takes place
Gonadotropin-releasing hormone
Released by hypothalamus
- stimulates the anterior pituitary gland to release FSH and LH
Follicle-stimulating hormone
- stimulates maturation of ovum (&sperm in men)
- stimulates production of estrogen
Lutenizing hormone
- stimulates secretion of progesterone
- surge in LH causes release of ovum
Estrogen
- stimulates further growth and maturation of follicle
- stimulates vascularity and storage of glycogen and other nutrients within uterus
- decrease in estrogen at the end of menstrual cycle stimulates release of GnRH