Nutrient specifics Flashcards
Vitamin A
Large amounts in: Beef liver, spinach, carrots (raw), squash/sweet potato
Lesser amounts in: Boiled egg, dairy, herring, fortified cereal
Vitamin K
Large amounts in: Oils (e.g. sunflower/safflower oils) and their seeds, dark green leafy veg + broccoli and sprouts, dried prunes
Lesser amounts in: Herbs and spices
Spicy PODS
Prunes, Oils, Dark, Sprouts
H&S
Hyperlipidaemia prescription…
What studies underpin the evidence?
Increase:
Portfolio diet - almonds, sterols/stanols, viscous fibre
Fibre (40-45g)
Beneficial MUFA (canola, peanut, avocado, olive, nuts) and PUFAs (omega 3s - found in oily fish, flax/chia/hemp) in place of SF/TF
Decrease:
Saturated fat - AHA/ACA guidelines 5-6% total calories
Trans fats - eliminate
Free fats
Studies:
Portfolio diet - Jenkins 2003
Orlich - Lifestyle heart trial, sorta
Adventist 2 - stepwise decrease in lipids in different diets
Iron sources (plant based)
What aids apsorption?
High sources - lentils/chickpeas/beans/quinoa, tofu, cashew/chia/pumpkin, dried apricots/figs/raisins, dark green leafy veg - kale/spinach
Vit C aids absorption
Easy way to remember - all the dried whole foods in my cupboard (fruit and legumes)
Vitamin C
High sources (all the Cs) - citrus, cantaloupe (and tropical fruit), cabbage and associated (sprouts, broccoli, boy chow), cauliflower
Less high sources - other fruit and veg
Calcium
Special considerations
High sources - dairy, calcium fortified juices and plant based milks, TOFU, CHIA
Less high sources -almonds, low oxalate dark green veg
High oxalate veg such as spinach, chard and beet greens limits calcium absorption
Vitamin D
High sources - fortified milks etc, oily fish
Less high sources - dairy, fortified marg, egg, fortified cereal, beef liver
Magnesium
High sources - dark chocolate, brazil nuts, cashews, almonds
Less high sources - Tofu, beans, wholegrain, meat and dairy
Vitamin E
High sources - Sunflower/safflower, almonds and hazelnuts (seed oils and nut milks)
Less high sources - peanuts, avocado, and spinach/brocolli (dark leafy greens) (spreads and sides - guacamole)
Potassium
High sources - potato, sweet potato, squash, banana, plantains, beans/peas
Less high sources - diary, fish, poultry, veg in general
(Carribean stew - with a healthy protein and veg)
4 types of saturated fat:
What are the two most common?
What are their sources?
What are their effects?
Lauric acid
- mainly coconuts, also palm kernel (not palm) oil, a little in dairy
- raises HDL and LDL
- may cause heart disease
Steric acid (second most common)
- animal fats, dark chocolate
- Lowers LDL
- Increases colorectal cancer and endothelial damage
Palmitic acid (most common)
- palm oils, as well as meats and dairy
- harmful, increases LDL
- heart disease
Mystiric acid
- palm oil, coconut oil, dairy
- biggest raiser of cholesterol, also raises trigs, possibly HDL
- increased heart disease
Where does sugar come from?
Fizzy drinks 47%
Snacks and sweets 31%
Desserts
Where does saturated fat come from?
One source : Cheese and pizza
Other source : Burgers 19% Snacks 18% Protein foods 15% Dairy 13% Condiments 7%
Where does sodium come from?
Mixed meals 44% Protein foods 11% Grains 11% Tomatoes/potatoes 11% Sweets 8%
Where do transfats come from?
Grain based processed foods 40%
Animal products 21%
Margerine 17%
Where does cholesterol come from?
Eggs 24.6% Chicken 12.5% Beef 11% Cheese 4.2% Pork 3.9%
All the major proteins
Fibre - guideline amounts?
Soluble:
Insoluble sources:
25/38g, better 40/45g
Fruit Legumes Oats Soluble (FLOwS)
Veg Seeds Wheat Insoluble Bran (Very SWIB)
What did the EPIC study show about diabetes?
EPIC study: each 5% calories from animal protein gives 30% increased diabetes risk
What did the combined NHS1/2 and HPFUS show about diets and diabetes?
What other outcome did they look at?
(regarding healthy and unhelath PB diets)
A health plant based diet reduces diabetes risk by 34%, whilst unhealthy PB increases by 16%
(are these the same numbers as the Pan et al substitution studies?)
CAD: 0.92 overall, 0.75 healthy, 1.32 unhealthy
DM2: 0.67 healthy, 1.16 unhealthy
What did the NIH study into nutrition in diabetes show?
What did it compare?
Broad outcomes?
It compared a plant based diet with the ADA advised diet
Plant based diets gave 3 x reduction in HbA1c, 2 x reduction in LDL, decreased weight and meds
4 findings, 3/2/1/1
aka 4/3/2/1/1
Mechanisms of endothelial injury? (3)
What is TMAO?
What outcomes does TMAO associate with?
Diminished nitric oxide
Diminished progenitor cells
Increased TMAO
TMAO produced by bacterial metabolism of choline (internet) and lectin/pectin (book).
These bacteria are more present in regular meat eaters.
TMAO levels associated with all-cause mortality and cardiovascular disease/atherosclerosis
The mixed evidence on dairy…
What benefits are there to dairy?
What about yoghurt?
What about plant based milks?
In who does milk help bone health? by how much?
Dairy weakly helps CVA and heart disease…
Yoghurt helps DM
Plant based alternatives probably much better
Milk improves bone health in children and women.
Bone mineral density increases of 0.7-1.3%
Breast cancer - obesity and lifestyle…
You can be obese or non-obese - same mortality if physically active and getting your fruit and veg!
180 minutes and 5 F&V
Weight and diet:
What difference do calories make?
Whole food plant based diets, do they cause weight loss?
Do adults or children having sugary drinks result in weight change?
If the calories are the same, no evidence that weight will change.
Yes they do!
Adults yes, children no
The EPIC study:
Population number
Follow up length
BP findings (3)
Bone health (2)
Cancer (3)
All-cause (1)
Heart disease (1)
4 behaviours and how much years of life?
500000 European adults
>10 years
Blood pressure:
Low sodium and high potassium, fruit and veg
Bone health and bone fractures
Physical activity with high impact activity
Cancer:
Obesity - increases a number of cancers
Fibre - reduces colorectal
Sex hormone and fat intake - increases breast cancer
All cause death
Increases in eating fruit and vegetables
Heart disease
High blood sugar levels
14 years of life gained from 4 behaviours: not smoking being physically active moderate alcohol intake five fruit and vegetable servings a day
The exercise tolerance tests…
If <30%
If >70%
In between?
<30% - symptom limited ECG
> 70% - angiography
in between either MRI or 12 minute tolerance test
Epidemiology of diabetes:
How many diagnosed in US, how many undiagnosed?
How many pre-diabetes?
Whats the costs - direct and indirect?
WW prevalence and US prevalence?
23 million diagnosed, 7 million undiagnosed
80 million pre-diabetes
Costs: total 300bn 230bn + 90bn
8.5 and 9.3%
Ways to remember:
Costs overall the same as smoking (300bn with 150/130 split)
30ml and 300mil
23 diagnosed and 230 direct
7mil undiagnosed, 80pre-d, 90 indirect costs
Positive psychology - the 5 pillars
Positive emotions Engagement Relationships Meaning Accomplishments
Sleep restriction study and food seeking behaviours:
What did they do?
What did they seek - calories and type?
4 hours for 5 nights
300 calories, saturated fats
Obesity counselling:
4 important CBT techniques:
4 techniques:
- self monitor
- goal set
- normalise healthy diet
- problem solve
MNOP Monitor Normalise gOal set Problem solve
