Nutrition mark 2 Flashcards

1
Q

What are the 2015-2020 guidelines?

A
Encouraged:
F&V
Grains, more than 50% WG
Low fat dairy
A variety of protein foots (inc seafood, lean meat, egg, legumes, nuts)
Healthy oils
discouraged:
SF (<10%)
Sugar (<10%)
2300mg Na=
No trans fats
ETOH - 1/2 drinks a day (F/M)
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2
Q

Myplate, USDA nutrition

In a typical US diet how much diary calories are there?

A

30% grain, 40% veg, 10% fruit, 20% protein
+ dairy

10% of typical diet is dairy - 50% milk, 50% cheese

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3
Q

Benefits of diary:

On systemic disease?

On bone health?

On inflammation?

A

weak inverse relationship with stroke risk, CVD, DM2 (yoghurt), BP

Children bone health improves with dairy, and 1 cup decreases fracture risk by 5% in women, and fortified dairy increases BMD by 0.7-1.8% over 2 years

Yoghurt anti-inflame (OR 0.34), cheese pro-inflame

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4
Q

Eggs and health…

With 3+ eggs a weak what disease increases and what doesn’t?

Relationship with cholesterol?

A

DM2 increases, but CVD doesn’t

Eggs have 141-234mg cholesterols - 2/3rd pop mild rise in LDL (5.55 or 0.143) and HDL, 1/3rd bigger rise. HDL function improves too.

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5
Q

2015-2020 guidelines on cholesterol?

Compared to previous?

A

Eat as little as possible.

2010 said <300mg a day

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6
Q

Sat fat:
High (>8g)
Mod (4-7g)
Lower (1-3g)

A

High - fatty meats, processed meats, coconut products

Mod - full fat dairy, palm oil, lean meats

Low - avocado, healthy oils, egg, some fish, nuts and seeds

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7
Q

Where do calories come from in the US diet?

A

Great Britain’s Calorie Deficit Problem

Refined grain-based desserts
Non-whole grain breads
Chicken
Sweetened drinks
Pizza
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8
Q

Calcium:
High 20%:
Moderate 5-20%:

Low oxalate DG veg?

A

HIGH: Dairy, fortified non-dairy, chia/poppy/sesame, Tofu

MOD: Almonds, beans, low oxalate dark greens

Examples of low oxalate: Okra, Kale, bOK choy (OKOKOK)
30-40% of Ca2+ absorbed

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9
Q

Fibre:
High:

Moderate:

Soluble examples?
Insoluble examples?

A

HIGH:

1) Beans, split peas and lentils
2) Avocado
3) Bran cereals, some whole grains, wholewheat pasta
4) Pears, and dark berries
5) Dried fruits
6) Flax seeds

MOD:

1) Blueberries and strawberries (frozen mix from sainsbury’s)
2) most other F&V and grains and nuts and seeds (inc popcorn) and fungi
3) whole grain bread

Soluble - FLOwS - fruit, legumes, oats
Insoluble - Bran, veg

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10
Q

Magnesium:
High (20%)
Mod (5-20%)

A

HIGH: almonds and amaranth, brazil/cashew nuts, dark choc, edamame, pine nuts

(ABCDE)

MOD: potatoes, beans, tofu, spinach/dark green leafy, whole grains, and dairy/red/processed meat, fish

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11
Q

Potassium:
High (20%)
Mod (5-20%)

A
HIGH:
Large baked potato, yams, sweet potato, squash
Beans - soy, black turtle, lima beans
Red pepper
Plantain, passion fruit
Bamboo shoots
Avocado

(Bean stew on baked potatoe - made carribbean with pepper and plantain, made chinese with bamboo, or made mexican with guacamole)

MOD:
Dairy, fish, processed meat, poultry
Mushrooms, vegetable, nuts, legumes

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12
Q

Vitamin A:
High
Mod

A

HIGH:
sweet potato, red peppers, black-eyed peas, beef liver, raw carrot, spinach

Liver and bean stew (remember bean stew has red peppers in it)

MOD:
herring, tomato juice, dairy, hard-boiled eggs, fortified cereals
(all breakfast dishes)

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13
Q

Vitamin C:

A

HIGH:
All the Cs - citrus, cantaloupe, cruciferous (broccoli, cauliflower), cabbage and assoc (sprouts, asparagus), currants, (c) Kale (and Bok Choy)
Also red things tomatoes, red pepper, radishes, strawberries

MOD:
Most other F&V

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14
Q

Vitamin D:

A

HIGH: Oily fish, fortified dairy/non-diary and juices

MOD: dairy, egg, beef liver, fortified cereal and margarine

(high is one thing, plus fortified things)

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15
Q

Vitamin E:

A

HIGH: Sunflower seeds, safflower/sunflower oil, hazelnuts and almonds

MOD: Avocado, peanut butter, spinach/brocolli

(high is oils and milks - moderate is sides and spreads + DG leafy)

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16
Q

Vitamin K:

A

HIGH: Dark green leafy, prunes, sprouts (inc asparagus and broccoli), avocado, kiwi, oils

MOD: H&S

Spicy OK PADS (oil, kiwi, prune, avocado/asparagus, dark green leafy, sprouts)

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17
Q

What do these refer to?

1) Spicy OK PADS
2) oils and milks, sides and spreads
3) Everything in my cupboard
4) one thing + fortified, 2 fortified + 3 things)
5) All the Cs and red things
6) Liver and bean stew
7) All breakfast dishes
8) Potato and bean stew - mexican/carribean/chinese
9) ABCDE

A

1) vitamin K
2) Vitamin E
3) Fibre - remember that the things I like to buy most are highest in fibre
4) Vitamin D
5) Vitamin C
6) High vitamin A
7) Mod vitamin A
8) Potassium
9) Magnesium

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18
Q

Which are the helathies foods based on nutreints per calories?

A
Veg
Herbs
Fruits
Legumes
Whole grains
Nuts
Seeds

Very Happy Frogs like Whole Nuts and Seeds

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19
Q

Worst foods based on lack of nutrietns and potential disease promoting components per calories

A
Sugar-drink
Processed meat
Fried food
Processed snacks
Confections
High fat dairy
Red meat
Poultry
Eggs

Slightly purple frogs protect chickens having red purle eggs

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20
Q

Nutrition assessment:

Acronym? and parts:

A

Anthropometrics
Biochem
Clinical
Diet

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21
Q

Primary and secondary lab tests:

A

Primary: UsEs, FBC, BM/HbA1c, Cholesterol, albumin

Seconday - vit D, haematinics

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22
Q

Where do most calories come from in animal foods?

A

fat, no protein

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23
Q

Protein - the downlow:

Animal proteins are what, compared to plant proteins?

A

More readily digestible (95% ileal) and more concentrated, and have more sulfur-containing amino acids

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24
Q

Three levels of ilieal digestibility of plant-based proteins, and some examples:

A

90% - wheat and soy

80-90% - cereals and peas

50-80% - intact cell walls

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25
Q

Top plant protein sources and their protein per serving:

A
Soy beans - 18g
Tofu - 20.6g
Lentils - 17.9g
Pinto beans - 15.4g
Hmpseed - 15g
Whole wheat bagel - 11.6g
Pumpkin seeds - 9g
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26
Q

Recipe for plant based amino acid profile?

A

Unprocessed starch with combination of fruit and veg

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27
Q

Older people and protein - whats the increased need?

A

25% extra due to decreased absorption of protein

28
Q

Omega 3 sources:

A

flax, hemp, chia
oily fish - ‘healthy seafood sources’
walnuts, pecans, hazlenuts

29
Q

Monounsaturated sources:

A

CAPS - canola, avocado, peanut, saff/sun

plus avocado/olives

30
Q

Transfats - whats the risk?

A

Strokes and CHD

31
Q

AGEs in common foods:

A

Wholefoods 10-799 (carrots –> dried figs)

Processed 17-1522 (snickers –> French fries)

Animal 515 - 11905 (smoked salmon -> bacon fried)

Dairy 1 - 325 (heavy pasteurised cream)
Nuts and seeds 753 - 3363 (roasted pine nuts)

32
Q

Diet that lowers hyperlipidaemia includes:

A

limiting TF, SF

WFPB, complex carbs, PUFA/MUFA, fibre to 40-45g, nut intake, omega-3 intake, plant sterols/stanols

33
Q

Adventist 2 says:
Hyperlipidaemia (%s)
Hypertension (%s)
DM2

A

Hyerplipidaemia - <5% vs 15%
Hypertension 7% vs 23%
DM2 2.9% vs 7%

34
Q

Dietary associations in diabetes?
Fibre
Dietary fat
Corn syrup

A

fibre r=0.16
fat r=0.84
corn syrup r=0.83

35
Q

Diabetes diet/prescription:

A

Increase fibre and low GI foods

Decrease simple carb, high GI foods, processed grains, SF, TF and calories

36
Q

Anderson study in type 2 diabetes

intervention and findings and time

A

high fibre diet 65g/day, plant based, no weight los

16 days - 11 men stopped insulin, 9 reduced

37
Q

Small retrospective study of 13 patients showed 7 months of plant based high nutrient density diet did what to HbA1c?

A

8.2% to 5.8%

most meds stopped (4 down to 1)

38
Q

COPD and nutrition - 2 things in the book

A

100g of F%V reduced mortality from COPD by 24%

F&V improves lung function

39
Q

3 factors that worsen kidney disease

A

animal protein
animal fat
cholesterol

40
Q

Crohn’s and nutrition

A

semi-vegetarian diet - 80% remission rates

41
Q

Pneumonia vaccine and nutrition

A

higher F&V gets better response

42
Q

MS and nutrition

A

restricting saturated fat, no progression in 34 years

43
Q
Mean total cholesterol in different populations:
Uganda
China
USA
Vegans

How much higher is CAD mortality in USA men/women than Chinese?

A

147
127
203
Vegans - 141

16.7/5.6 fold increase

44
Q

Research in South African Bantu showed…

Then research comparing Ugandan and Americans showed?

And expanded research in Uganda showed?

A

1328 autopsies, 5 years, 7 cases of coronary thrombosis or MI
Another study in Ugandans and Americans - n=632, age and gender matched
- 1 MI in Black Ugandan
136 MI in Caucasian Americans

Further in Uganda to 1427 Ugandans >40 years, 1 healed MI

45
Q

75% of USA MI patients have what?

A

‘normal’ LDL cholesterol

46
Q

What does plant based do to HDL and LDL?

A

decreases both, but more LDL

47
Q

What percentage have type 1 diabetes?

A

5%

48
Q

DM prevalence in different pops

A

15.1% American Indian/Alaskan native
12.7% black
12.1% Hispanic
8% Asian
7.4% white

49
Q

How many will have DM2 by 2050?

A

100million

50
Q

Diabets personal medical costs:

A

2.3x higher, 16750 a year, 9600 attributed to DM

51
Q

Global diabetes prevalence 1980 and 2014

A

4.7% to 8.5%

108 milioin and 422 million in absolute numbers

52
Q

Insulin resistance in the liver does what?

A

increases glucose in the blood
increases FAs which are TAG in the liver and pancreas and muscles

TAGs damage beta cells

53
Q

PAthway to healing in type 2 diabetes: 3 factors/interventions

A
  • diet key
    exercise can help improve weight control, insulin resistance, lower perecentage of fat in muscles and liver
    Stress management reduces cortisol
54
Q

Adiponectin - 5 things

A

DETTH (death)

clears trigs
protects endothelium
reduces TNFa
hippocampal growth
decreases depression

It is decreased by inflammation and FFA

55
Q

Lipolysis and lipotoxicity - 4 things that associate with IR

A

DAG
TAG
Ceramide
Sphingosine

56
Q

Leptin

A
  • resistance can develop
  • pro-angiogenic
    I think they also say apoptosis of B cells occurs
57
Q

NFkB - what activates it (3), and what does it activate (5)?
What is it associated with?

What down regulates NFkB?

A

Free radicals and inflammation from radiation, food, toxins

activates telomerase, cytokines, adhesion molecules, VEGF and TNF

Associated with atherosclerosis, cancer, DM, asthma, allergies, aging, colitis, GI disease, autoimmune disease, Alzheimer’s, arthritis

Diet through phytonutrients and antioxidants - pharmaceuticals have not been shown to be able to do this

58
Q

Bariatric surgery and type 2 diabetes:

  • with weight loss how much do Hb!1c, mortality and medication reduce by?
  • what’s the remission rates of diabetes?
A

wit hweight loos there is reduction in HbA1c, mortality and medication from 8.7-31.8%

at 18-24 months 39-93% remission, 30% at 5 years (STAMPEDE) and at 15 years (Swedish)

59
Q

Mediterannean diet and type 2 DM

What improvements (2)

A

A1C - 0.3-0.47% better

20-30% reduced DM2

60
Q

Vegan diet vs ADA diet - effect on meds and A1c?

NIH study 3/2/2/2

A

48% vs 23% reduced meds
1.23% vs 0.38% HbA1c improvement in those not changing meds
Weight 6.5kg vs 3kg
LDL 21.2% vs 9.3%

61
Q

Diabetes and eggs:

A

1 a day doubles risk compared to <1 a week
5 a week increased risk
Carnitine nd choline in milkd and eggs –> inflamm

62
Q

Vegetarian vs ADA diet - a 24 week RCT, 74 people

findings?

A

Reduction in meds, weight, improved IS
Increased adiponectin, vitamin C, and SOD
decreased leptin

63
Q

DM2 in three large cohorts… % of diabetes risk reduction

Plant based diets

A

NHS, NHS2, HPFUS

plant foods 20% lower risk of DM
Healthy 34% lower
Unhelathy 16% higher

64
Q

Nf-kB p65 is affected by what?

A

hyperglycaemia - leading to infallamation, endothelial damage, vascular disease

65
Q

Butyrate is produced how?

And does what 5 things?

A
Produced by the microbiome
Enhances insulin sensitivity
Enhances mineral absorption
Decreases hepatic glycolysis
Increases satiety
Decreses cholesterol and trigs

CHIMS

66
Q

WFPB and neuropathic pain

A

after 4-16 days 81% reported improved symptoms
At 4 years 71% remained on the diet and exercise program and all but one continued to have relief

(same adherence as reported by ornish)