Test 1 - Nutrition Flashcards
1
Q
nutrition
A
science of food and it’s relationship with health
2
Q
nutrients - role
A
body growth
development
maintenance
3
Q
nutrient/ food factor
A
specific dietary constituent
4
Q
dietetics
A
planning of meal for:
well
sick
5
Q
good nutrition:
A
maintain nutritional status - enable
growth
good health
6
Q
five sections of nutrition
A
dietary constituents nutritional requirement assessment of nutritional status nutritional problems in public health nutritional programme in india
7
Q
vitamins and essential amino acids discovered by
A
1950
8
Q
roots of nutrition
A
physiology
biochemistry
9
Q
international activities in field of nutrition initiated by
A
League of nations
FAO
WHO
UNICEF
10
Q
nutrition is associated with
A
infection immunity fertility maternal health family health
11
Q
science of nutrition
A
laboratory testing
epidemiology
12
Q
concepts of nutrition epidemiology
A
- epidemiological assessment of nutritional status of communities
- nutritional surveys
- dietary surveys
- nutritional surveillance
- nutritional and growth monitoring
- nutritional rehabilitation
- nutritional indicators
- nutritional intervention
13
Q
use of epidemiological factors in
A
- elucidation of disease
- aetiology
- identification of risk factors for disease
planning and evaluation of nutritional programmes
14
Q
cornerstone of socio-economic development
A
nutrition
15
Q
nutritional factors affects
A
- education
- demography
- agriculture
- rural development
16
Q
how to tackle nutritional problems
A
intersectoral and integrated approach of sectors of development
17
Q
8 elements of primary health care (HEALTH FOR ALL)
A
- food supply and promotion of proper nutrition
- education about prevailing health problems and how to control and prevent them
- adequate supply of water and basic sanitation
- maternal and child health and family planning
- immunization against infectious disease
- prevention and control of endemic disease
- treatment of common infections
- essential drugs
18
Q
HEALTH FOR ALL
A
monitored by nutritional indicators
19
Q
how to promote health and nutritional status of families and communities
A
- integrate nutrition in primary health care systems
2. formulate national dietary goals
20
Q
classification of foods - ways
A
- by origin
- by chemical composition
- predominant function
- nutritive values
21
Q
classification of food by origin
A
- animal origin
2. plant origin
22
Q
classification of food by chemical composition
A
- proteins
- carbohydrates
- minerals
- fats
- vitamins
23
Q
classifications of food by predominant function
A
- body building foods
- energy giving food
- protective food
24
Q
body building food
A
- milk
- meat
- poultry
- fish
- eggs
- pulses
- nuts
- oil seeds
25
energy giving foods
1. cereals
2. sugars
3. roots and tubers
4. fats
5. oils
26
protective food
1. vegetable
2. fruits
3. milk
27
classification by nutritive values
1. cereals and millets
2. pulses (legumes)
3. vegetables
4. nuts and oilseeds
5. fruits
6. animal foods
7. fats and oils
8. sugar and jaggery
9. condiments and spices
10. miscellaneous foods
28
nutrients
organic and inorganic complexes in the food - have specific function
29
number of nutrients
about 50
30
types of nutrients
1. macronutrients
| 2. micronutrients
31
macronutrients are also called
proximate principles (because they form the bulk of food)
32
examples of macronutrients
proteins, carbohydrates and fats
33
In india - contribution of protein in total energy intake
10-15 per cent
34
In india - contribution of fats in total energy intake
15- 30 per cent
35
In india - contribution of carbohydrate in total energy intake
50-80 percent
36
Micronutrients
vitamins and minerals
37
Micronutrients- etymology
because these are required in small amounts (fraction of a milligram to several grams)
38
Protein - derivation
that which is of first importance
39
proteins - chemical structure
complex, organic, nitrogenous (carbon, hydrogen, nitrogen (16%), oxygen and sulphur- phosphorus, iron, etc)
40
protein % of body
20%
41
Amino acids
make up protein (required for synthesis of tissue protein)
42
number of amino acids needed by the body
20
43
essential amino acids -number
9
44
essential amino acids- definition
amino acids that the body cannot synthesize in amounts corresponding to its needs and therefore they are obtained from the dietary proteins
45
essential amino acids - names
leucine, isoleucine, methionine, lysine, phenylalanine, threonine, vaine, tryptphan, histidine (PVT TIM HALL)
46
non essential amino acids
alanine, arginine, asparagine, glutamic acid, cysteine, aspartic acid, glutamine, glycine, proline, serine
47
arginine
essential during development stage
48
tryptophan
forms niacin
49
methionine
methyl group donor- synthesis of
1. choline
2. folates
3. nucleic acids
50
amino acids essential for premature babies
cysteine and tyrosine
51
biologically complete protein
those which contain all the essential amino acids in amounts corresponding to human needs
52
quality of proteins depend on
pattern of amino acid
(pattern of amino acids of milk and egg are considered most suitable for humans and therefore these proteins are of superior quality)
53
functions of proteins
1. repair and maintenance of body tissue
2. body building (especially in infants and small children)
3. maintenance of osmotic pressure
4. synthesis of certain substances like antibodies, plasma proteins, coagulation factors, hormones, enzymes, hemoglobin
5. supply energy when calorie intake is inadequate - 4 kcal per gram
54
protein energy malnutriton - features
CMI and bactericidal activity of leucocytes is lowered
55
dietary source of proteins
1. animal source (complete proteins)
| 2. vegetable source
56
best food protein
egg protein
- high biological value
- high digestibility
57
reference protein- in nutritional studies
egg protein
58
main source of proteins in india
cereals and pulses - because they are cheap and easily available
59
cereal proteins are deficient in
lysine and threonine
60
pulse proteins are deficient in
methionine
61
limiting amino acids
if a diet is inadequate in any essential amino acids, the protein synthesis cannot proceed beyond the rate at which that amino acid is available. that amino acid is called the limiting amino acid
62
supplementary action of proteins
combination of food eaten together (example rice and dhal)
- their protein content supplement each other
- provide nutrition comparable to animal proteins (in respect of essential amino acids)
63
advantages of supplementary action of proteins - for vegetarians
he can get
- high grade proteins
- at low cost
64
protein metabolism
-not stored like fats
- replaced everyday
- break down and utilization occurs
turnover rate varies from tissues to tissues
- 1-2% of body protein replacement per day
- pattern of specific protein and amount of protein - maintained constant
65
evaluation of proteins
- amount of amino acids
- digestibility
- suitability
66
parameters for evaluation of proteins
- estimation of biological value
- digestibility coefficient
- protein efficiency ratio
- net protein utilization
67
net protein utilization
product of biological value and digestibility coefficient divided by 100
68
net protein utilization - definition
it is the
- proportion of ingested protein
- that is retained in the body
- under specified condition
- for the maintenance and growth of the body tissue
69
essentiality of nutrient is measured by the -
growth
70
tests to assess state of protein nutrition
1. arm muscle circumference
2. creatinine height index
3. serum albumin and tranferrin
4. total body nitrogen
71
best measure of state of protein nutrition
serum albumin concentration
72
liver's ability to sythesise protein measured by
serum albumin and serum transferrin levels
73
indian medical council of medical research
recommends the daily requirement of nutrients
74
Fats - solid at
20 degrees celsius
75
oils -
liquid at 20 degrees C
76
Fats and oils -
concentrated source of energy
77
classification of fats
1. simple lipids (triglycerides)
2. compounds (phospholipids)
3. derived (cholesterols)
78
fats that can be synthesised endogenously
triglyceride
| cholesterol
79
fat storage
99% in adipose tissues as triglyceride
80
adipose tissue - % of body weight
10-15%
81
1 kg of adipose tissue =
7700 kcal of energy
82
fatty acids + glycerol
formed by fat hydrolysis
83
types of fatty acid
1. saturated (hydrogenated)
| 2. unsaturated - have double bonds
84
saturated fatty acids
in animal fats
| lauric, palmitic, stearic acids
85
unsaturated fatty acids
1. monounsaturated
| 2. polyunsaturated
86
monounsaturated fatty acids
oleic acid
87
polyunsatured fatty acids
in vegetable oils
| alpha-linolenic, linoleic acids
88
essential fatty acids
1. linoleic acid- most important
2. linolenic
3. arachidonic acid
89
coconut and plam oils
saturated fatty acids
90
fish oils -
poly and mono unsaturated fatty acids
91
high medium chain SFA -
coconut, palm kernels, butter ghee
92
high SFA
palmolein
93
high MUFA and moderate LA
ground nut, rice bran, sesame
94
high LA
cotton seed, corn, safflower, sunflower
95
LA and ALA
soyabean, canola, mustard, flax seed
96
high TFA -
vanaspati
97
linoleic acid-
vegetable oils
1. safflower
2. corn oil
3. sunflower
4. soyabean
5. sesame
6. groundnut
7. mustard
8. palm
9. cocunut
98
arachidonic acid
meat, eggs, milk
99
linolenic acid
soyabean oils
| leafy greens
100
eichosapentaenoic acid
fish oils
101
essential fatty acids -
linoleic, linolenic, arachidonic, eichosapentaenoic acid
102
animal fats
saturated - ghee, butter, cheese, eggs, fat of meat and fish
103
cord liver oil and sardine - sat/unsat?
Saturated
104
vegetable fats
```
plant seeds
ground nut
mustard
sesame
coconut
```
105
other sources - invisible fats
cereals
pulses
nuts
vegetables
106
invisible fats
not visible to naked eye (in cereals and pulses)
| - contribute to the major portion of fat intake
107
visible fats
separated from their natural sources- ghee (from milk), cooking oil (from seeds)
108
visible fat - measurement
easy to estimate the daily intake
109
good source of unsaturated fatty acids
edible plant products
110
cereals, millets and oil seeds
linoleic
111
soyabean, mustard, flaxseeed
| pulses, legumes, green leafy
linoleic and ALA
112
cholesterol source
animal foods like butter, ghee, whole milk cream, fatty cheese, fatty meats
113
high saturated fatty acid source
animal foods like butter, ghee, whole milk cream, fatty cheese, fatty meat
114
trans fatty acid - natural source
animal foods like, butter, ghee, whole milk cream, fatty cheese, and fatty meat
115
long chain PUFA
lean meat, poultry meat
116
eggs - fat content
1. cholesterol
2. LA
3. ALA
4. DHA (docosahexanoic acid)
117
fish - fat content
PUFA
118
visible fats
vegetable oils
ghee
vanaspati
119
commercial food is prepared in which fats?
vanaspati - PHVO
120
fats - function - calorie needs
1. high energy foods
2. 9 kcal per gram
3. protein sparer
4. vehicle for fat soluble vitamins
5. support viscera
6. insulation against cold
7. palatability
121
fats -non calorie roles
1. body growth
2. structural integrity of cell membrane
3. reduce platelet adhesiveness
4. reduce serum cholesterol and LDL
5. PUFA- forms prostaglandins
6. cholesterol - component of membrane and nervous tissue, form steroid hormones and bile acids
122
hydrogenation of vegetable oils
1. under optimum temperature
2. under optimum pressure
3. presence of catalyst
4. VANASPATI is formed (semi solid - solid fat)
5. unsaturated fatty acids are converted into saturated fatty acids
6. EFA is reduced
123
vanaspati - fortification
vit D -175 IU per 100 gm
| vit A - 2500 IU per 100 gm
124
advantage vanaspati
1. ghee like consistency
| 2. keeping quality good even in humid climate
125
trans fatty acids
1. formed by partial hydrogenation of polyunsaturated fatty acids - also remove the critical double bonds of EFA - hence harmful
2. geometrical isomers of cis unsaturated fatty acids with saturated fatty acid like configuration
126
trans fatty acids - shelf life
increased
127
trans fatty acid - pathogenic potential
1. atherogenic
2. risk of CAD increased
3. increase LDL
4. decrease HDL
128
trans fatty acid- elimination
years
129
refining of oils
treatment with steam, alkali etc.
130
refined and deodourized oil - advantage
1. improves taste and quality
2. remove free fatty acid
3. remove rancid materials
131
diseases of disturbances of fat metabolism
1. obesity
2. phrenoderma
3. CAD
4. cancer
5. others like kwashiorkor
132
obesity (fat and disease)
30% increase in adipose tissue
133
phrenoderma- pathology- (fat and disease)
EFA deficiency
1. rough dry skin
2. horny papular erruptions- posterior, lateral aspects of limbs and back, buttocks
134
phrenoderma - treatment
linseed, safflower oil along with B complex
135
CAD - (fat and disease)
>40% fats in the diet
| especially saturated fats
136
cancer- (fat and disease)
colon cancer
| breast cancer
137
kwashiorkor ? (fat and disease)?
skin lesions like in EFA deficiency
138
WHO/FAO expert group pf diet, nutrition and prevention of chronic diseases - endorse
qualitative composition of fats in diet - significant role in CVD pathogenesis
139
WHO/FAO expert consultation of fats and fatty acids on 2008 Geneva, Switzerlands
reviewed
1. scientific evidence on nutrient intake values for total fats and fatty acids
2. assessed the risk to adequate growth, development and maintenance of health
3. provided recommendations to different groups
140
WHO/FAO expert consultation of fats and fatty acids- consultations and recommendations
1. energy balance is critical to maintain healthy body weight and ensuring optimal nutrient intake
2. 6% PUFA recommendation - lower LDL, cholesterol, and CHD risk; increasing HDL
3. n-3 PUFA - prevent CHD- other degenerative diseases of aging
4. no need to recommend specific n-6- n-3 ratio or LA to ALA ratio - consdiering both of them are in recommended doses
5. attention for - replacement of TFA
141
replacing SFA with PUFA/MUFA
decrease LDL
decrease total/ HDL ratio
decrease CHD risk
142
replacing SFA with carbohydrate
decrease LDL, HDL
143
replacing SFA with TFA
decrease HDL
| increase total/HDL ratio
144
replacing carbohydrates with MUFA
increases HDL
145
minimum intake levels of LA
2.5% E
146
minimum intake levels of of ALA
0.5 % E
147
choice of cooking oil
1. limit butter/ghee use
2. avoid PHVO/ use its replacment
3. correct combination of oils
148
oil containing LA + oil containing both LA and ALA
1. groundnut/sesame/rice bran/cottonseeds +mustard/rapeseed
2. groundnut/sesame/rice bran/cottonseeds + canola
3. groundnut/sesame/rice bran/cottonseeds + soyabean palmolein + soyabean
4. safflower/sunflower + palm oil/ palmolein + mustard/rapeseeds
149
oil containing high LA + oil containing moderate to low LA
1. sunflower/safflower + palmolein/palm oil/olive
| 2. sunflower/safflower + ground nut/sesame/rice bran/ cotton seeds
150
frying oil - home- single
high thermal stability - palm oil/palmolein, sesame, rice bran, cotton seeds
151
frying oil- commerical - blends
palm oil/palmolein, sesame, rice bran, cotton seeds
152
RDA fats - takes in account
1. total fat
2. individual fatty acids
3. health promoting non glyceride components
4. age group and condition like foetus, pregancy, lactation, energy deficiency and non communicable diseases
153
main source of energy
carbohydrate (4 kcal per gram)
154
functions of carbohydrate
1. source of energy
2. oxidation of fats
3. aa synthesis
155
sources of carbohydrate
sugar, starch, cellulose
156
starch source
1. cereals
2. roots
3. tubers
157
sugars - types
monosacchride
| disaccharide
158
carbohydrate reserve
500g
159
sources other than carb reserve for glucose homeostasis
protein, glycerol
160
glycaemic index
AUC - area under two hour blood glucose response curve following 50 g test carbohydrate as a % of AUC of the standard (white bread/glucose)
161
sugar
soluble
| easily assimilate
162
high glycaemic foods
readily digestible
| absorbable sugar
163
low glycaemic foods
foods favouring slow release and absorption of sugar in small intestine (reduced peak, prolonged action)
164
low GI- 55 and less
```
most fruits and vegetables
whole grains
pasta
beans
lentils
```
165
medium GI -
56-69
sucrose
basmati rice
brown rice
166
high GI
```
70 or more
corn flakes
jasmine rice
baked potatoes
white bread
candy bars
syrupy foods
```
167
dietary fibers
- remnants
- of edible parts of plants
- and analogous carbohydrates
- that are resistant to digestion and absorption in the human small intestine
- with complete or partial fermentation in the human large intestine
168
dietary fibers - examples
1. oligosaccharides
2. polysacchrides
3. lignin
4. organic acid (butyric acid)
5. polyols (sorbitol)
169
dietary fibers- function
- laxative - softening, increased bulk, frequency, regularity
- blood cholesterol and glucose attenuation
- promotes interactions between nutrients
- changes pattern of bacterial colonies and thus, the fermentative products
- favours satiety
- increses transient time in the gut
- substrate for organic acids and nutraceuticals in gut
170
dietary fibers - classification
source - cereal, vegetable, fruits
| solubility in water- soluble (partially/ fully), insoluble
171
part of energy from resistance starch made available by
bacterial fermentation
172
digestibility of dietary fibers depend on
- physiochemical and structural properties of the fiber
- process used for digestion
- enzymes
173
dietary/ crude fiber - old concept
all that was insoluble in boiling water, dilute acid and alkali
- has digestibility
- can hold water
174
dietary fibers - advantages
- decrease CAD (bind to bile salt- decrease its reabsorption - decrease cholesterol)
- pectin and gum - reduce post prandial glucose in blood
175
most effective gum
fenugreek seed - 40% gum - reduce cholesterol and glucose
176
disadvantage of fibers
may decrease vitamin and mineral (Ca, Mg, Iron, Zn) absorption
177
vitamins
essential nutrients
- fat soluble- A, D, E, K
- water soluble
178
vitamin A- constitute of
retinol pre-formed v
| beta carotene - pro-v - converted to retinol in intestinal mucosa
179
retinol term introduced in (for vitamin A-1 - crystalline form)
1960
180
international units for vitamin A
0. 3 micro gram of retinol
| 0. 55 micro gram of retinol palmitate
181
1mcg of retinol
1 Retinol equivalent
182
1 mcg of beta carotene
0.167 mcg of Retinol equivalent
183
1 mcg of other carotenoids
0.084 mcg of Retinol equivalent
184
1 Retinol equivalent =
3.333 IU of vitamin A
185
functions of vitamin A
- retinal pigment- vision in dim light
- glands and epithelial tissue functioning
- growth esp. skeletal
- anti-infective
- may protect from bronchial cancer
186
vitamin A - sources
animal- retinol
| palnt - carotene
187
retinol in
- liver
- eggs
- butter
- cheese
- whole milk
- fish
- meat
- FISH LIVER OILS (used as supplement - richest source)
188
carotene
- spinach
- amaranth
- green, yellow fruits
- carrots
189
conversion of carotene to retinol
hindered in malnourishment and diarrheal diseases
190
storage of vitamin A -
retinol palmitate - in liver - reserve 6-9 months
191
retinol is toxic - how is it transported in blood
by binding to a retinol binding protein (produced by liver)
192
vitamin A deficiency causes -
xeropthalmia - dry eye
- night blindness
- conjunctival xerosis
- bitot's spot
- corneal xerosis
- keretomalacia
193
night blindness
failure to dark adaptation
194
conjunctival xerosis
- conjuctiva - dry, non wettable, muddy, wrinkled (normal is smooth and shiny)
EMERGING LIKE SAND BANKS AT RECEDING TIDES when child ceases to cry
195
bitot's spots
- triangular
- pearly white or yellowish, foamy, either side of cornea
- bilateral
196
corneal xerosis
cornea - dry, dull, non wettable, eventually opaque
| ulceration, corneal scar
197
keratomalacia
liquefaction of cornea
| - cornea is soft - may brust
198
extra ocular manifestation of vitamin A deficiency
- child mortality
- infections
- follicular hyperkeratosis
- anorexia
- growth retardation
199
treatment - vitamin A deficiency
200,000 IU or 110 mg of vitamin A orally on two successive days
- vitamin A given to children with corneal ulcers (regardless of vit A deficiency diagnosis)
200
prevention of vitamin A deficiency
- nutrition education
- improving diet
- reducing frequency and severity of associated conditions
201
National institute of nutrition at hyderabad - intervention against nutritional blindness (immunisation against xeropthalmia)
100,000 IU to children between the age of 6 months to 1 year -
200,000 IU 6 monthly to children between the age of 1 - 6 years -
202
Assessment of vitamin A deficiency
- population survey (6 months to 6 years - special risk groups)
- clinical and biochemical criteria
203
criteria for assessing xeropthalmia
```
night blindness
bitot's spots
corneal xerosis/ corneal ulceration/ keratomalacia
corneal ulcer
serum retinol less than 10 mcg/dl
```
204
prevalence of xeropthalmia features in preschool and children upto 6 years
```
night blindness - >1 %
bitot's spots- > 0.5%
corneal xerosis/ corneal ulceration/ keratomalacia - > 0.01%
corneal ulcer - > 0.05%
serum retinol less than 10 mcg/dl- >5%
```
205
RDA of vitamin A
adults- 600 mcg
| > 50% from animal sources
206
conversion ratio of carotene to retinol
1:8 - current
| older - 1:4
207
RDA - retinol - man
600 mcg
208
RDA - retinol - woman
600 mcg
209
RDA - retinol - pregnancy
800 mcg
210
RDA - retinol- lactation
950 mcg
211
RDA - retinol - infant
350 mcg
212
RDA - retinol 1-6 years
400 mcg
213
RDA - retinol - 7-9 years
600 mcg
214
RDA - retinol - 10- 17 years
600 mcg
215
Vitamin A (retinol) toxicity
- nausea
- vomiting
- anorexia
- sleep disorders
- skin desquamation
- enlarged liver
- papillar edema
- teratogenic
216
Vitamin D forms
- calciferol (ergosterol from plants)
| - cholecalciferol (animal, fish, liver oils) - also made by body (UV lights - five mins per day)
217
Vitamin D storage
in fat deposits
| liver
218
vitamin D - active metabolites
25 HCC
1,25 DHCC
bound to proteins
219
target tissue of vitamin D
bone
| intestine
220
vitamin D
kidney hormone
| - not required in diet
221
vitamin D function
- promotes Ca and phosphorous gut absorption
- reabsorbs phosphates from kidney
- variable effect on Ca (kidney)
- bone mineralisation, reabsorption, collagen maturation
- growth
222
sources
```
sunlight (UV light act on 7DHC of skin)
foods- liver, egg yolk, butter, cheese, some fish, fish liver oil
human milk
- fortified
milk
margarine
vanaspati
infant food
```
223
deficiency
1. rickets
| 2. osteomalacia
224
prevention
1. nutritional education
2. sunlight exposure
3. prophylaxis with vitamin D
4. fortification
225
daily requirement
ICMR
| 400 IU or 10 mcg - in case of minimal exposure
226
toxicity - due to hypercalcemia
```
nausea
vomiting
anorexia
thirst
drowsiness
cardiac arrhythmias
renal failure
coma
```
227
rickets
```
vitamin D deficiency
6 months - 2 years - affected age group
- hypocalcemia
1. growth failure
2. bone deformity- curved legs, deformed chest, harrison's sulcus, rickety rosary, kyphoscoliosis
3. muscular hypotonia
4. tetany
5. convulsions
- elevated ALP
- milestones like walking and teething - delayed
```
228
osteomalacia
vitamin D deficiency
in women
esp pregnant or lactating
