Principles of Dietetics Flashcards
Descriptive research
Generate hypothesis Change over time No causal relationship
Survey research
Population, describe and quantify characteristics
Correlation study
Frequency of events compared to nutrition intake
Hawthorne effect
Positive response due to attention Avoid with placebo
Analytical research
Test hypothesis. Cause and effect
Time series research design
Quasi-experimental Before and after measurements
Cohort study
Follow group through time to see if they get disease Incidence study
Cross-sectional study
Prevalence One point in time how many have disease?
Research author listed must have…
Contributed to design or analysis and interpretation
Validity
Does it measure what it is supposed to measure? Relevance
Reliability
Consistency of results Use test retest
Internal validity
Difference in two groups is real
External validity
Generalizability
ANOVA
Three or more groups Evaluates validity Differences anywhere amount groups??
Sensitivity
Proportion with disease who test positive
Specificity
Portion without disease who test negative
Measure of central tendency
Most typical data
Measure of dispersion
Range, standard deviation
Standard deviation
Degree of dispersion
Standard deviation facts
Mean to point of inflection = 1 sd Rule of 68 95 99.7 0 sd = mean
Coefficient r
Degree of linear relationship -1 to 1 Closer to 0 is more dispersed Close to 1/-1 strong relationship
Mortality
Rate of death
Morbidity
Rate of disease
Inferential statistics
Probability results apply to larger population
Pilot study evaluation method?
Formative
Focus groups: subjective or objective?
Subjective. Attitudes and beliefs
Histogram
Use to summarize data collected over time
Where to look for best available evidence for good nutrition care
Evidence analysis library
Crispness
Turgor, osmotic pressure
Ethylene gas
Ripens fruit
Controlled atmosphere
Delays aging in apples
Chlorophyll changes
Acid -> pheophytin, olive green Base -> chlorophyllin, bright green (mush)
Pigment least affected by pH
Carotenoids, yellow orange
Red color in tomatoes, watermelon, apricot
Lycopene, a carotenoid Antioxidants
Pigment most affected by pH
Anthocyanins Red blue purple Acid = red Base = blue
Flavones
White yellow pigment Base- yellow Aluminum Pan - yellow Use stainless steel
Canned fruit grading
USDA grade a b c
Fresh fruit grading
USDA fancy extra #1 combination #2
Starchy food in storage
Sweeter Cook darker Potatoes
Cook time for frozen veggies
Shorter Blanching and freezing make tender
Best way to cook cabbage
Short time Lots of water Lid off to let acids escape at first
10 cans
6/case 13 cups
300 cans
24/case 15 oz
Collagen vs elastin
Collagen - structure surround muscle, gel in heat, tender Elastin - resistant to heat, yellow
Amount of fat cover on a carcass
Finish
How to id cut of meat
Shape of bone
Pigment change in meat due to
Myoglobin break down in oxygen Red brown green
How to increase water holding capacity in meat
Acid salt
Sous vide
Anaerobic, extends storage, unfrozen
MAP
Modified atmospheric packaging Slows respiration Air replaced with nitrogen or co2
Round purple stamp
USDA inspection, mandatory
Meat grade shown on…
Shield Prime choice select standard
Tender cuts in order
Loin Chop Chuck Flank Brisket
Meat temperature
165 - poultry 160 - ground 145 - meat fish
High cook temp
More shrinkage
Slow roast
Less waste
Why are cured meats pink?
Nitrites inhibit botulism
Dry heat cooking methods
Fry Broil Grill Roast
Oil smoke points
Highest- safflower Lowest- butter
Rancidity
Oxygen into unsaturated fatty acid Soybean oil has more double bonds so more subscribe to rancidity than olive oil
Gluconeogenesis
Glucose made from non-cho sources (glycerol and amino acids)
Coenzymes used in energy production
Pantothenic acid, thiamin, riboflavin, niacin
Hormones come from
Endocrine glands
TEE =
BEE + EEPA + TEF (10%)
What age range has highest BMR?
0-2 year old Older adults have lower bmr
Protein bound iodine can be used to measure…
Activity of thyroid gland. High PBI means elevated BMR
BMR is higher during what stages of life?
Growth, pregnancy, lactation, fever, some diseases
How accurate is Mifflin?
Within 10% of indirect calorimetry
Use mifflin with:
Normal and overweight Always use actual body weight
What is the most practical way of measuring energy balance?
Track weight change
RQ
Respiratory quotient Used in indirect calorimetry
RQ = 1
Cho alone is being metabolized
RQ = 0.85
Mixed intake
To lower RQ
Increase fat
Monosaccharides
Glucose, fructose, galactose
Disaccharides
Maltose (gg) sucrose (gf) lactose (ggal)
Sorbitol
Alcohol from glucose Absorbed slowly Too much can cause diarrhea
Chemical makeup of protein
Carbon, hydrogen, oxygen, nitrogen(16%)
Essential amino acids (9)
Threonine Valine Tryptophan Isoleucine Leucine Lysine Phenylalanine Methionine Histidine
High biological value proteins
All essential amino acids to promote growth
Dietary protein requirement
0.8g/kg 10-15% intake
Soybeans are not a good source of
Methionine So are legumes and gelatin
Most unsaturated oil
Canola
Most poly unsaturated oil
Safflower
Essential fatty acids
Linoleic w6 - poor growth, eczema, petechiae, safflower
A-linolenic w3 - brain, fish oil, walnuts
A-lenolenic acid effect on fat
Decreased hepatic tag production Little effect on cholesterol
Naming fatty acid
Number of carbons, position and number of double bonds Name first double from methyl end (ch3)
Oil with most and least saturated fat
Most coconut Least canola
Oils with most and least monunstaurated fat
Most olive Least coconut
Oils with most/least polyunsaturated fat
Most safflower Least palm
Order of fatty acids for butter and margarine
Butter: sat, mufa, pufa Margarine is opposite
What nutrient delays gastric empty and increase satiety?
Fat.
Why does fat provide more energy?
More carbons for oxidation
Alcohol digestion
None needed. Directly absorbed by simple diffusion into bloodstream
How does alcohol affect fat?
Reduces beta oxidation and increase tag synthesis
Risk factor for head/neck cancers
Alcohol
Winterized oils
Corn soy and cottonseed. Not olive oil (Chill to 45, remove solids)
Vitamin A function and sources
Skin eyes Yellow orange fruit. Dark green leafy. Mango liver
Vitamin A deficiency
Night blindness (reversible) Xeropthalmia (not reversible) But it’s spots Dry scaly skin
Vitamin D properties
cholesterol is precursor. Get form UV light
Vitamin D deficiency
rickets in kids, osteomalacia in adults
Vitamin E properties
least toxic vitamin, tocopherol
Vitamin E function
antioxidant, resist hemolysis of RBC
Vitamin E sources
veggie oil, whole grain, green veggies, nuts
Vitamin K property
made by bacteria in intestinal tract, no toxicity
Vitamin K function
forms prothrombin, blood clotting
Vitamin K sources
spinach, kale, broccoli
Vitamin K deficiency
bleeding
Vitamin K alerts
mineral oil, anticoagulants, antibiotics
Thiamin properties and function
B1, lost in heat, stable in acid, CHO metabolism
Thiamin sources
pork, whole grain, wheat germ, liver
Thiamin deficiency
Beriberi, muscle weakness, memory, tachy. Check plasma pyruvate!
Riboflavin properties
B2, lost in light, protein metabolism
Riboflavin sources
liver, meat, milk
Riboflavin deficiency
poor growth, mouth probs (cheilosis, stomatitis, red tongue)
Niacin properties
B3, precursor is tryptophan, al cells need for ernergy
Niacin deficiency
pellagra (dermatitis, diarrhea, dementia), red tongue, rash
Folate function
B9, neural tube, DNA synthesis
Folate sources
fortified cereal, leafy greens, lentils!
Folate deficiency
megaloblastic macrocytic anemia, fatigue/irritability
Pyridoxine
B6, protein metabolism coenzyme
Cyanocobalamin
B12, cobalt, protein synthesis coenzyme
B12 deficiency
cause by GI resection since bound by intrinsic factor. macro, megalomaniac anemia pernicious anemia after resection
Pantothenic acid function
coenzyme A - fatty acid metabolism
Vitamin C properties
easily destroyed by heat/base/oxidation, needs acid pH,
What helps aid iron absorption?
Vitamin C
Vitamin C deficiency
Bleeding gums, scurvy, poor wound healing
Biotin properties
made by intestinal bacteria, needed for fatty acid synthesis
Most abundant mineral
calcium
How does calcitonin work?
inhibits bone resorption, lowering serum calcium
Tetany caused by?
Hypocalcemia
Second most abundant mineral?
Phosphorus, from animal protein
What aids Iron absorption
gastric juice and vitamin c
Iron deficiency
spoon nails, pale conjunctivae
Zinc
animal protein taste acuity poor wound healing
Copper deficiency
Wilson’s disease good source: oysters
Copper function
hemoglobin synthesis iron absorption
Chromium function
aids insulin action glucose metabolism
How much insensible water loss in a day?
0.8 - 1.2 liters
Electrolyte concentration equation
mEq = mg/atomic wt x valence
Sodium atomic weight and valence
23, 1
Potassium atomic weight and valence
39, 1
Calcium atomic weight and valence
40, 2
Normal saline
0.9% NaCl (40% sodium)
Intracellular electrolytes
K, Mg, P
Extracellular electrolytes
Na, Ca, Cl, HCO3
Sources of potassium
meat, fruit, veggies (banana, orange, tomato, potato, cantaloup)
Sources low in potassium
apple, cranberry, blueberry, carrot, corn
Aldosterone affect on Na and K
keeps sodium, excretes potassium
Na normal range
136 - 145 mEq
K normal range
3.5 - 5 mEq
Ca normal range
4.5 - 5.5 mEq
What does the formula for Urine Specific Gravity use?
weight and volume
Osmosis
fluid movement to area of higher concentration
Diffuision
particle movement to lower concentration area
Anasarca
extreme, generalized edema. heart, liver, renal, and pro/kcal malnut.
Best assessment parameter for fluid status
sodium lab
Major acid base buffer
carbonic acid (controlled at lungs) and sodium bicarb (controlled at kidneys), maintains pH 7.4
Emphysema may show what acid/base imbalance?
respiratory acidosis due to hypoventilation lung keeps acid, kidney comps by absorbing more bicarb
Acid/base normals
pH 7.4 HCO3 24 - 28 pCO2 35 - 45
Weight gain in pregnancy by BMI categories
lower limits: (achieve lower limit!) underweight 28 lb normal. 25 lb overt. 15 lb obese 11 lb
High risk pregnancy
adolescents and those who do not gain 4lb/month in last half of pregnancy
How much linolenic acid in pregnancy?
1.4 g/day for fetal nervous system
What vitamin to avoid excess in pregnancy?
A
Normal birth wt?
2500 - 4000 grams (5.5 lb lower limit)
Baby calorie needs
0-6 months: 108 kcal/kg 7-12 months: 98 kcal/kg
Which has more protein: egg yolk or white?
Yolk, by weight
How are eggs graded?
candling
What does a fresh egg do in water?
sinks. has dull, rough shell
What is syneresis
liquid released from coagulated product, tough watery product
When do you see syneresis?
cooked at too high temp too low temp for long time
Acid effect on egg white?
Tenderizes protein, extended more easily, stiffen foam
Whipping egg whites
room temp due to lower surface tension. cold egg whites have high tension and will collapse
Egg yolk or white for an emulsion?
Yolk, more protein, stiffer foam
Frozen egg additive?
10% salt or sugar by wt of yolk
Egg substitutes are higher in?
sodium (lower in fat, cholesterol, and kcal)
Breastmilk kcal/oz?
20
Prolactin vs. oxytocin
prolactin production, oxytocin moves milk
Breastfeeding recommendations
exclusive through 6 months, then add complementary foods. at least 12 months
How do you know if breastmilk supply is good?
growth, frequent stools, 6-8 wets daily
Baby friendly hospital initiative
increase breastfeeding incidence and duration (measurable outcomes)
How much formula does infant need?
1.5 oz/lb/day
What should be fortified in infant formula?
Iron
Hyperbilirubinemia reccommendations
feeding 9-12 times a day to increase hydration and GI motility.
When to start solids and what to use?
extrusion stops, sitting posture, use iron-fortified rice cereal
When to add teething biscuits?
6-8 months, with palmar grasp
When to add small finger foods?
9-12 months, with pincer grasp
Infant cannot tolerate cow’s milk or soy. Use what?
Product with casein hydrolysate (pregestimil) no lactose
Sunken fontanel may mean?
dehydration or protein malnut
How much fruit juice for kids?
4 oz max under age 6
PA in kids?
60 minutes daily
Adolescent protein recommendations
Male: 52 g Female: 46 g
What can detect short term change in nutrition status in children?
Wt/lg
What can detect chronic nutrition problem in children?
Lg/age
When to use CDC vs WHO?
0-2 years - WHO 2-20 years - CDC
Age to stop measuring head circumference?
3 years
When to use Down syndrome growth charts?
never
When to use special needs growth charts?
alongside CDC and WHO, not alone
FTT may be caused by
lack of fiber, constipation and reduced intake.
Symptoms of lead poisoning?
irritable, leathery, anorexia, vomiting
Adult RDA protein?
Male: 56 g Female: 46 g
Macronutrient distribution
CHO 45-65% Fat 20-35% Pro 10-35%
How much fluid do adults need?
35ml/kg
Categories of elderly?
young old 65 aged 75 oldest old 85
Protein needs in elderly
remain the same even when kcal need decreases. 1g/kg
Nutrients of concern in elderly
iron and calcium, decreased absorption due to decreased HCL
Nutrients to encourage/supplement in elderly
folate, B6, B12
Water for athletes
16 oz/1 lb body weight lost
CHO loading, glycogen loading
stores 2-3 times normal amount of muscle glycogen Weakness, bloating, sore
Fuel source in rest and normal activity?
fat is primary
Fuel source needed in prolonged activity
CHO is needed to provide pyruvate for lipid oxidation
Should runner use creatine supplements?
No, they do not enhance endurance
Botanicals to avoid with Warfarin
garlic, ginger, ginkgo biloba, ginseng, St. John’s wort
Hormone gastrin
gastric secretion and motility
Hormone CCK
from duodenum in presence of fat, makes gallbladder release bile, stimulates pancreas
Hormone secretin
stimulates pancreatic juice (bicarb) into duodenum, inhibit gastric acid
GLP-1 and GIP
released in intestine in presence of cho and fat. stimulate insulin release
Which vitamins are made by bacteria in large intestine?
thiamine, riboflavin, B12, K
Colonic salvage definition
anaerobic fermentation and absorption of end-products of cho, fiber, and aa breakdown
In large intestine, what happens to malabsorbed CHO and fiber?
converted to SCMFA for energy
How much of ingested portion becomes glucose?
58%, from amino acids
Which amino acid is most gluconeogenic?
Alanine
How much of ingested fat becomes glucose?
10%, from glycerol
End products of metabolism
energy, CO2, water
Where does glycolysis happen?
cytoplasm
What is the end product of aerobic glycolysis?
Pyruvate for kern’s cycle
What is the end product of anaerobic glycolysis?
Lactate, Citric acid cycle
Kreb’s cycle requires what main substrate?
pyruvate
What micronutrients are required for metabolism?
thiamin, pantothenic acid, niacin, riboflavin, magnesium
What is the intermediate breakdown product of CHO, fat, and protein metabolism?
acetyl CoA
What vitamin is needed for amino acid transport?
pyridoxine
Branched chain amino acids?
valine, leucine, isoleucine
Nitrogen balance equation
N g/6.25. - UUN+4
First step in catabolism of protein catabolism
deamination of NH2 by hydrolysis in liver
What happens with N in protein catabolism?
NH2 - NH3(ammonia/toxic) - urea - excretion
Most active site of lypogenesis
adipose tissue
How is fat storage avoided in liver?
Choline, lipotropin factor, makes lipoproteins to move fat out of liver
What is needed for complete fat metabolism?
CHO.
What are the ketone bodies?
acetoacetic acid, acetone, and beta-hydroxybutyrate
What happens when not enough CHO in fat metabolism?
ketones build up.
Situations with inadequate cho for metabolism
starvation, uncontrolled diabetes. lead to high ketones
Active transport
needs energy from ATP, sodium pump, most nutrients
passive diffusion
carrier facilitated, higher to lower concentration
What is vitamin D pathway?
hydroxylated in liver, then in kidney. needs bile, accompanies Ca absorption
Folate needs what for absorption?
zinc to cleave the glutamic acids
Neurotransmitters that affect hunger/satiety
controlled by hypothalamus serotonin - low makes crave cho gremlin - hunger leptin - from fat, satiety
genome
sum of genetic material
Nutrition genomics
study of diet and lifestyle-related disorders resulting from interaction of genome and environment
What food aids micornutrient absorption in keto diet?
spinach (folate, B6)
What increases and reduces risk of breast cancer?
increase - alcohol
reduce - indoles
High Vitamin E may antagonize?
Vitamin K
