Nutrition

Question 1

define EER

Answer 1

• Estimated Energy Requirement
  
  • the average daily dietary energy intake to maintain an energy balance

Question 2

how much energy from major food components?

Answer 2

• carbs and proteins = 4 kcal/g
• fats = 9 kcal/g
• alcohol is not a nutrient but generates 7 kcal/g

Question 3

what are the 3 components of TTE (total energy expenditure)?

Answer 3

• Resting metabolic rate (RMR)
• Diet Induced Thermogenesis (DIT)
• Energy cost of physical activity

Question 4

how many grams of nutrients are needed for an individual with TEE requirement of 2000 kcal/day?

Answer 4

• The diet consists of 50% carbs, 30% fat and 20% protein
  
  • carb: 50%
    
    • .5 x 2000kcal = 1000kcal/4kcal/g = 250 g
  • fats: 30%
    
    • .3 x 2000 kcal = 666 kcal/9kcal/g = 74 g
  • protein: 20%
    
    • .2 x 2000kcal = 400 kcal/4kcal/g = 100 g

Question 5

describe the RMR

Answer 5

• the energy expended in a resting postabsorptive state
• approximately 10% higher than the BMR
• increased in hyperthyroidism (weight loss)
• decreased in hypothyroidism (weight gain)

Question 6

describe diet induced thermogenesis (aka SDA or TEF)

Answer 6

• DIT is the energy required to digest, absorb, transport and store food
• DIT is different for each nutrient:
  
  • fat: 0-3%
  • carb: 5-10%
  • protein: 20-30%
  • alcohol: 10-30%

Question 7

describe physical activity and exercise

Answer 7

• high active individual may require 100% or more calories above the RMR

Question 8

how is daily total energy expenditure (TEE) calculated

Answer 8

• it is assumed that the BMR for young individuals is 24 kcal/day/kg body weight
• BMR for 60 kg person:
  
  • 24 kcal x 60 = 1440 kcal/day
• RMR = BMR + 0.1 BMR
  
  • 1,440 + 144 kcal/day = 1584 kcal/day
• When RM

Question 9

define the respiratory quotient (RQ)

Answer 9

• allows the determination of the relative rate of utilization of carbohydrates and fats
• the RQ is the ratio of CO2 output to O2 usage
  
  • the RQ for carbs = 1
  • the RQ for fat = .7

Question 10

why is DHA important

Answer 10

• DHA is needed for brain structure and functions
  
  • it is found in breast milk and can cross the blood-brain barrier in infants

Question 11

describe the glycemic response and index

Answer 11

• a dietary carbohydrate leads to an increased blood glucose level which is seen as a glycemic response
• the glycemic index (GI) is a relative ranking of carbohydrates in foods to how they affect blood glucose levels

Question 12

describe foods with low glycemic index

Answer 12

• slowly increase blood glucose
• have a low max. effect
• sustain blood glucose levels longer
• cause less fluctuation of insulin release
• a diet with low glycemic index:
  
  • improves blood glucose control in diabetic patients
  • increases satiety and may help to limit caloric intake in overweight or obese individuals
• dietary fiber reduces the glycemic response

Question 13

what are the actions of dietary fiber

Answer 13

• adds bulk to food, absorbs water and increases bowel motility
• soluble fiber:
  
  • resistant to human digestion but is fermented by bacteria in the large intestine
  • delays gastric emptying = sensation of fullness
• insoluble fiber
  
  • passes through digestive tract largely intact
• too much fiber = interferes with vitamin and mineral uptake

Question 14

name the dietary essential amino acids

Answer 14

• adults:
  
  • lysine
  • branched-chain amino acids
  • threonine
  • tryptophan
  • phenylalanine
  • methionine
  • histidine
• children and pregnant women:
  
  • arginine and histidine
  • always have positive nitrogen balance = growth

Question 15

define nitrogen output

Answer 15

• Nitrogen balance (NB) = intake - output
• Nitrogen output = UUN + 4g
  
  • UUN = Urinary Urea Nitrogen
  • 4g = other sources of nitrogen output (sweat, skin and feces)
  • nitrogen balance = adults
  • positive nitrogen balance = children and preg. women

Question 16

name the 2 short term signals that influence appetite and satiety

Answer 16

• Gherlin
  
  • peptide hormone produced by the stomach (fasting)
  • stimulates appetite
  • drives hunger and food intake
• Cholecystokinin (CCK)
  
  • peptide hormone produced by small intestine
  • stimulates satiety

Question 17

name the 2 long-term signals that influence appetite

Answer 17

• Leptin
  
  • peptide hormone produced by adipose tissue
  • secreted in proportion depending on the size of fat stores
  • decreases appetite
  • increases energy expenditure
• Insulin
  
  • peptide hormone produced by B-cells of pancreas

Question 18

describe protein energy malnutrition in children

Answer 18

• Kawshiokor: “the disease of the displaced child”
  
  • a child with kawshiokor is often older than a child with marasmus because no longer being breast fed
  • deficiency of dietary protein and dietary essential amino acids. the diet consists mainly of carbs
  • decreased blood albumin
    
    • often have infections, albumin level drops more
  • edema found in the abdomen and legs

Question 19

define marasmus

Answer 19

• marasmus is due to severe undernourishment with deficiency in: carbs, lipids, proteins and other nutrienets
• marasmus can result also from other diseases
• typical symptoms:
  
  • arrested growth, anemia
  • extreme tissue and muscle wasting
  • loss of subcutaneous fat (emaciation)
  • loss skin folds hanging over buttocks and thighs

Question 20

describe the ranges of BMI

Answer 20

• BMI
  
  • (weight in kg)/(height in meters)²
• underweight: BMI < 18.5
• healthy: BMI between 18.5 and 24.9
• overweight: BMI of 25 - 29.9
• obese: BMI > 30, severe when > 40

Question 21

describe the apple shape and pear shape

Answer 21

• wasit to hip ratio
• > .8 for women or > 1 for men is defined as android (apple-shaped) or upper body obesity
  
  • more fat deposition in trunk
• < .8 for women or < 1 for men is defined as gynoid (pear shaped) or lower body obesity
  
  • more fat deposition in hips and thigh