Micronutrients: - Vitamins - Minerals - Essential amino acids - Essential fatty acids

Nutrition - Macronutrients and Energy Balance Flashcards by Charlie Woodward

Define nutrient.

Micronutrients:

Vitamins
Minerals
Essential amino acids
Essential fatty acids

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How are nutritional requirements calculated?

Take intake from:

Groups with no deficiency
Those with deficiency
Intake that cures clinical deficiency

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What is the Estimated Average Requirement (EAR)?

Notional mean requirement of a nutrient

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What is the Reference Nutrient Intake (RNI)?

Two standard deviations above the EAR, sufficient to meet the needs of most of the population.

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What is the Lower Reference Nutrient Intake (LRNI)?

Two standard deviations below the EAR, almost certainly inadequate for most individuals.

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What proportion of adults are overweight/obese?

2/3 of adults
22% men, 23% women
Obesity has tripled in the last 20 years.

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How does social class correlated to sugar consumption?

Sugar consumption increases from social class I to V.

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Give 5 risk factors for cardiovascular disease.

High blood cholesterol.
Hypertension
Smoking
Inactivity
Obesity

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What is the average salt intake in the UK, what is the the recommended amount?

Average = 9g/day
Recommended = 6g/day
High salt intake is associated with high blood pressure

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What ethnic group has a particularly high risk of high blood pressure?

British of South Asian origin - due to high salt diet

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What proportions of men and women die from coronary heart disease?

1/5 men
1/7 women
However deaths from CHD has decrease by 50% from 1990 to 2010

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What are the recommended proportions of your diet by the Department of Health?

Total fat = 30-33%
Protein = 10-15%
Sucrose = no more than 10%
Alcohol = no more than 5 %

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Give 5 ways of measuring body composition.

Body density
Body water - gives measurement of lean mass
Total body potassium
Methyl histidine or creatinine excretion - proportional to amount of muscle
Skin fold measurements

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What is the energy content in 1g of carbohydrate?

4.0kcal = 16.8kj

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What is the energy content in 1g of fat?

9.0kcal = 38.6kj

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What is the energy content in 1g of protein?

5.4kcal = 22.7kj

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What is the energy content in 1g of alcohol?

7.0 = 29.4kj

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How is oxygen consumption portional to energy expenditure?

1 litre O2 = 20kjoules

What is your Basal Metabolic Rate (BMR)?

Energy expenditure of doing nothing. (sleeping)

What is Diet Induced Thermogenesis?

Energy used during digestion - production of heat.

How are obesity and leptin related?

Leptin = hormone that controls appetite.
Obese people often have higher concentrations of leptin as they are leptin resistance.
Leptin infections will not help weight-loss.

Give some causes of obesity.

Genetic (very rare) - MC receptor deficiency (leptin receptor)
Socio-economic/cultural - higher obesity in lower socio-economic groups in the UK. In some countries it is seen as a status symbol.
Endocrinological - adrenal hyperactivity, hypothyroidism
Lack of physical activity/over eating

Conditions associated with obesity.

Cardiovascular disease
Diabetes mellitus type 2
Respiratory problems
Hypertension
Reduced fertility in men
Gall bladder stones

What are 4 pharmacological therapies for obesity? Are they used or not?

Thyroid hormone treatment - dangerous so is not used
Sibutramine - increases concentration of serotonin which reduces appetite. Not used as causes depression
Orlistat - currently in use. Decreases fat absorption. Must be used with low fat diet to reduce side effects.
Leptin therapy - modest effect but obese people have leptin resistance.

Name 4 types of surgical treatment for obesity.

Liposuction Resection of the intestine Stomach stapling Stomach banding

What is the average UK intake of fat?

88g/day | 40% total energy intake

What is the importance of essential fatty acids?

Major constituent of membrane phospholipid. | Precursors of eicosanoids (prostaglandins, thromboxanes, prostacyclins)

What is the requirement for essential fatty acids?

2-5g/day | In UK diet average = 8-15g/day so deficiency is rare

How is diet linked to cardiovascular disease?

Increased saturated fatty acids leads to increased LDL and total cholesterol. Cholesterol levels can be lowered by increased intake of polyunsaturated fatty acids.

What are the average intakes of carbohydrate in the diets in affluent compared to poorer countries?

``` Affluent = 40% of daily energy intake Poorer = 80-90% of daily energy intake ```

Is carbohydrate necessary in the diet?

Not necessary but has a protein sparing effect and low carb diets lead to fat utilisation and ketosis.

Name four different types of monosaccharide and their sources.

Glucose - small amounts in fruit Fructose - small amounts in fruit Sorbitol - commercially prepared for diabetic foods Inositol - in fibre as hexaphosphate

How many grams of sucrose/day will likely lead to zero dental carries? How does this compare to the UK average intake?

``` <60g = no dental carries 105g/day = average UK intake ```

What proportion of diet is made up of protein?

10-15% of total energy intake 14% = US/UK 10% = developing countries

What is the daily protein recommendation?

0.75g/kg/day | No more than 1.5g/kg/day

What are the 10 essential amino acids?

PVT TIM HALL Phenylalanine Valine Threonine Tryptophan Isoleucine Methionine Histidine Arginine Leucine Lysine

What protein sources are high/low quality?

Animal origin = high quality as they have higher utilisation and less waste. Plant proteins are often lacking in certain amino acids hence are low quality

What occurs in excess protein consumption?

May lead to bone demineralisation or deterioration of renal function

Name the 4 pathological conditions caused by protein-energy malnutrition.

Growth failure Marasmus Kwashiorkor Marasmic kwashiorkor

What is the prevalence of PEM?

Globally, 20-75% of children under 5 have suffered from malnutrition in developing countries.

Outline BMI boudaries in children.

Acceptable = 18.5-25 Moderate PEM = 17-18.4 Moderately severe PEM = 16-17 Severe PEM = <16

What is Marasmus?

``` Protein-energy malnutrition. <60% expected weight for age. Caused by chronic shortage of food in developing countries. Extreme emaciation Muscle wasting Loss of protein from vital organs Impaired immune response and GI tract ```

What is Kwashiorkor?

``` Severe protein-energy malnutrition. Same as marasmus but with severe OEDEMA. Enlarged fatty liver. Dermatitis/change in hair colour/texture Can lead to permanent mental retardation ```

How are PEM conditions treated?

Fluid and electrolytes balanced first. Dextrose solution Dilute milk Solid foods when tolerated.