1. The Six Classes of Nutrients
a. Carbohydrates (CHO)
i. Made up of Carbon, Hydrogen, and Oxygen.
ii. This is a key nutrient
iii. Body uses carbs as a source of energy
iv. There are:
1. Simple Sugars.
a. E.g. Cookies, Ice cream
2. Complex Carbohydrates.
a. E.g. Vegetables, Whole grain
b. Fats and Oils
i. Visible Lipids.
a. E.g. Olive Oil (mono saturated)
ii. Hidden Lipids.
a. E.g. Plain white bagel
i. Can be gathered from eating:
i. Water soluble Vitamins that can dissolve in water.
a. E.g. Ascorbic Acid (C), and B Vitamins (which get energy
from fat, alcohol, carbs, and protein).
2. Deficiency happens quicker since they don’t store very well.
3. Less toxic because the body can excrete these vitamins in high
doses (through urine).
4. Chance for Scurvy, if an individual lacks Vitamin C for too long
ii. Lipid soluble Vitamins that can dissolve in fat.
a. E.g. Vitamin A, D, E, K.
2. These vitamins are stored well. Hence, deficiency takes longer to
3. Can be more toxic. This toxicity happens due to excessive intake
of these substances.
i. Major Minerals
a. E.g. Calcium and Potassium
ii. Trace Minerals
a. E.g. Zinc and Copper
i. It is the indispensable nutrient!
2. Essential vs. Nonessential
a. Essential Nutrients: Nutrients that the body needs, but cannot make on its own.
b. Nonessential Nutrients: The body can make these nutrients (and they are not less important than the essential nutrients).
3. Energy released from nutrients
i. A gram has 4 k/call
i. A gram has 4 k/cal
i. A gram has 9 k/cal
d. Alcohol (not a nutrient, but still gives calories)
i. A gram has 7 k/cal
i. A gram has 7 k/cal
4. Nutrients that do NOT release energy Don't forget about the age old question of anatomy and physiology chapter 2 study guide
a. Since they provide no energy, they also do not provide calories.
b. Nutrients include:
5. Assessing Nutritional Status (ABCD’S)
a. Anthropometric Measurements
i. Height, weight, waist circumference (which can be an indicator to how prone someone is to heart disease).
ii. Body composition. E.g. Lean mass, body fat
b. Biochemical Indices
i. Blood and Urine.
c. Clinical examination
i. Medical history
ii. Physical exam
d. Dietary Assessment
i. Food records
ii. 24hour recall of what a patient ate.
6. What is One Serving?
i. 1 cup Raw or cooked vegetables, or vegetable juice.
ii. 2 cups Raw leafy green vegetables.
i. ½ a cup of Dried fruit.
ii. 1 cup Fruit or fruit juice. We also discuss several other topics like ucla math 31b
i. 1 cup Milk or Yogurt.
ii. 1.5 ounces of natural cheese.
i. 1 ounce A single slice of bread.
ii. 1 cup of dry cereal.
iii. ½ cup of cooked rice, pasta, or cereal.
7. Nutrition and its Density
a. Nutrient Dense
i. Many vitamins and minerals are nutrient dense.
1. E.g. spinach, pomegranates, whole grains, lean proteins, lean low
ii. Lower energy dense foods have a lot of fiber and water.
1. E.g. Carrots, broccoli, strawberries, fat free milk, broiled fish &
iii. Higher energy dense foods have a lot of fat and sugar.
1. E.g. peanuts, donut, bacon, mayonnaise, cookies, potato chips.
8. A brief history of Nutrition
a. Food deficiencies were very common in the 1700’s.
b. By the early 1900’s, food deficiencies became rare.
c. By 197090’s, there was nutrient excess, or rather over nutrition. This meant the intake of too much nutrition, led to a much higher intake of calories.
9. Organs that make up the Gastrointestinal Tract
i. Purpose: To chemically break down food with saliva, and also make food easier to swallow. We also discuss several other topics like suatro
ii. Chewing and mixing food with saliva begins digestion.
i. Purpose: To churn and mix food into a liquid mass.
The stomach adds acids, enzymes, and fluid to promote digestion.
c. Small Intestine
i. Purpose: It is the major site of absorption into the blood system.
This intestine is small in diameter and long in length. There is also a lot of surface area to maximize absorption.
d. Large Intestine
i. Purpose: Allows the passage of waste and water, and also absorbs water and minerals.
∙ The gallbladder, liver, and pancreas are Accessory Organs. Meaning that all three organs produces substances, and release them to the top part of the small intestine.
i. Purpose: To store bile, and release it into the small intestine
i. Purpose: To make and produce bile. Bile is what is needed for digesting fat.
i. Purpose: To create digestive enzymes that will be secreted into the small intestine. We also discuss several other topics like new jersy plan
SUGGESTION: Look up image of the Gastrointestinal Tract to see the organs involved. 10. Important Hormones
i. It comes from the stomach.
ii. It is stimulated by food, alcohol, caffeine, spices, and proteins.
iii. What this hormone does, is stimulates acid.
b. Cholecystokinin (CCK)
i. It comes from the small intestine.
ii. It is stimulated by fat and protein.
iii. What this hormone does, is stimulate the release of enzymes and bile from the gallbladder.
i. It comes from the small intestine.
ii. It is stimulated by acid from the stomach, in the small intestine.
iii. What this hormone does, is stimulate the secretion of bicarbonate from the pancreas.
11. Food Absorption
a. Absorption refers to the small molecules that are nutrients, moving through the Gastrointestinal Tract, especially from the intestines, and into the bloodstream. b. Where it happens:
i. Absorption mostly takes place in the small intestine.
ii. Water and limited amounts of alcohol can be absorbed inside the mouth and stomach.
1. Passive Transport
a. Little to no energy is required for digestion
i. E.g. Fatty acids and fructose
2. Active Transport
a. Energy is required for digestion
i. E.g. Amino acids, glucose, and some vitamins
12. Gastrointestinal Tract disorders
i. Ulcers are when the protective layer of the duodenum or stomach erodes. ii. Ulcers ARE caused by the bacteria H. pylori Don't forget about the age old question of astroten study
iii. Stress is NOT the cause of ulcers, but it does worsen them.
iv. Suggested treatment is taking antibiotics and antacids until the erosion has healed.
i. When stomach acid flows back up through the esophageal sphincter. ii. Heartburn can occur through the use/consumption of alcohol, nicotine, and coffee.
iii. People who are prone to heartburn:
1. Overweight individuals
3. Pregnant women
iv. Suggested treatment includes not laying down after eating (remaining upright), quit smoking, avoiding foods that cause it, and losing weight.
i. When digestive fluids become solid, and block the duct in which bile travels from.
1. Lack of bile, results in minimal and difficult ability for the body to digest fat.
ii. Treatment can be removing the gallbladder, eating a lowfat diet, and taking certain medications for cholesterol.
d. Lactose Intolerance
i. When an individual lacks the enzyme, lactase, which is used to help digest dairy products.
ii. Lactose intolerance occurs mostly in adults.
iii. Inability to digest, causes the large intestine to ferment the food into waste, resulting in diarrhea and bloating.
iv. Treatment includes avoiding dairy, and taking a lactase supplement before eating a dairy product.
i. When bowel movements become difficult to make.
ii. Eating more fiber can help bowel movement occur.
i. When the veins around the anus and rectum are swollen. Don't forget about the age old question of richard knight drexel
ii. Causes usually include the lack of fiber.
i. Loss of water which is apparent in stools.
ii. The lack of fiber is a contributing cause in diarrhea.
h. Celiac Disease
i. The immune system’s reaction in some individuals, when gluten is cannot be absorbed in the small intestine.
ii. Treatment includes a gluten free diet.
i. When small pouches grow inside the colon wall, causing further
inflammation from bacteria.
ii. This does not happen often in people that have a lot of fiber in their diet iii. Can be prevented through higher fiber intake AFTER the colon has healed (and introducing the fiber gradually), and taking antibiotics can help treat it.
13.The Types of Carbohydrates
i. Monosaccharides does not require digestion, because it is easily absorbed into the body.
ii. Types of Monosaccharides
a. We all have a certain amount of glucose in our blood
because it is essential for our survival.
b. Starches are long chains of glucose that are bonded
c. Glucose is the major form of CHO that our cells use for
a. Fructose is naturally contained in fruits, that is why it is
cheap (because of its abundance).
b. The United States has an abundance of corn, which
promotes the production of High fructose corn syrup,
which is intensely sweet.
a. It is found in lactose, therefore being found in milk and
other dairy food products.
b. After digestion, it becomes a monosaccharide in the small
14. These are the simplest forms of carbohydrates.
i. Types of Disaccharides
Disaccharides are two saccharides bonded together.
These types of carbohydrates require digestion
a. Sucrose is the product of glucose bonded to fructose.
b. Sucrase is an enzyme that digests sucrose.
c. Digestion of sucrose occurs in the small intestine.
d. It is absorbed as glucose and fructose once the bond is
a. Dairy is a source of carbohydrates.
b. Lactase is the enzyme that digests lactose.
c. Lactose is the product of glucose bonded to galactase.
d. Adults are most likely to be lactose intolerant compared to
a. Maltose is the product of two glucoses bonded together.
b. Maltase is the enzyme that digests maltose.
c. Once the bond is broken, one glucose is absorbed.
1. Poly means many, and in the case of polysaccharides, it means at
least ten monosaccharides are bonded together. Therefore, they
are long CHO chains.
2. Many carbohydrates have polysaccharides, and are considered as
3. Three major types of polysaccharides include:
4. Fiber is a polysaccharide that we cannot fully digest.
15. Digesting Carbohydrates
i. Amylase is an enzyme found in saliva, that helps break down food in the chewing process. It is what chops up large polysaccharides.
ii. Amylase also breaks down amylose, so glucose, maltose, and other oligosaccharides are what remains.
i. Not a lot of chemical digestion occurs in the stomach. Acts as a mixing bowl, with stomach acid and the food products.
ii. This acid prevents amylase in the mouth from doing work.
i. The pancreas pours more amylase into the small intestine. So, amylase is active in the small intestine, and continues to break down carbs.
d. Small Intestine
i. Most of food digestion occurs here. This organ makes sucrose, maltase, and sometimes lactase. These listed enzymes break apart disaccharides into monosaccharides.
ii. The goal of digestion is to break the food down to the monosaccharides. e. Large Intestine
i. Some materials make its way to the large intestine (e.g. fiber, sometimes lactose).
ii. It is then fermented with bacteria, which is a beneficial process (if it’s fiber).
16. How Carbohydrates Function
∙ These carbs end up going to the liver, to be turned into glucose, and then is sent back into the blood system. It does not matter where you get your carbohydrates from, as long as it digests as a monosaccharide.
∙ All carbs have the same amount of energy.
a. Glucose is the body’s main provider of energy (ATP), after its been metabolized. i. Oxygen is required for ATP to happen.
b. Glycogen is the stored form of glucose.
i. This is stored in the liver and in the muscle tissue.
1. The liver will share its glucose with any cells.
2. Muscle cells will use the glucose for muscles only.
ii. Glucose is supplied through glycogenolysis (lysis= break down).
iii. Vitamin B6 helps us get energy from breaking down glycogen.
c. Appropriate carbohydrate consumption is less than 20 grams daily. i. When there is not enough carb intake:
1. Blood glucose levels drop, and we need glucose in our blood to
2. Glycogen is then used, in order to maintain an individual’s blood
glucose levels, but this can be depleted in a day.
3. Muscle tissue begins to break down, so that way the amino acids
can be used to make glucose and go to the brain. A low carb diet
could result in muscle loss
∙ Fatty acids begin to break down, and ketones are formed. Ketones form when the body breaks down fat without the use of carbohydrates, and it is very acidic. It ends up being excreted through the breath.
17. Regulating Blood Glucose
a. Blood glucose levels should range from 80100 mg/dl.
b. Body tries to avoid levels too low or too high, because it can be dangerous. i. Hyperglycemia is highglucose bloodstream.
ii. Hypoglycemia is lowglucosebloodstream. This ranges to 2030 mg/dl 1. When blood glucose levels are below normal (for a nondiabetic
individual), symptoms are: being impatient/ irritable, hungry,
nervous, shaky, cold, or confused.
a. E.g. Think of someone who is ‘hangry’
2. Treatment: To not go a long time without eating. Sugary/ simple
carb foods is not helpful for someone with hypoglycemia, in
comparison to them eating complex carbohydrates instead.
3. Fasting (a day without eating, for a nondiabetic)
a. What happens while fasting is:
i. Blood glucose levels begin to fall.
ii. Glucagon is released.
iii. Glycogen is used to maintain one’s blood glucose
b. After a Meal (for nondiabetics)
i. What happens after eating is:
1. A rise in blood glucose levels
2. Secretion of insulin.
3. Glucose enters the cells, to be used for
4. Glycogen is made.
5. The body can store excess glucose as fat,
and fat storage is unlimited. Glycogen is not.
Once glucose becomes fat, you cannot convert it back to glucose.
iii. Early Starvation (for nondiabetics)
1. Similar to fasting
2. Protein is broken down into amino acids, so it can make glucose.
3. Glucose is what’s used to help metabolize fatty acids.
iv. Prolonged Starvation (for nondiabetics)
1. Protein is used to maintain the essential levels of glucose.
2. Ketones are produced, since fatty acids are used for energy.
c. Hormones Regulate Blood Glucose
i. Insulin is a protein and a hormone, that is released from the pancreas right after a meal is consumed and after blood glucose is high.
1. Glucose is trapped until insulin comes around. Insulin acts like a
key, because it is what allows glucose to go into the cells. This
decreases blood glucose.
ii. Glucagon is a hormone and protein that is released from the pancreas when there is low blood sugar.
1. Glucagon will break down glycogen to allow glucose into the
bloodstream. This will cause an increase in blood glucose.
iii. Epinephrine (a.k.a Adrenaline)
1. When adrenaline goes into the bloodstream, it provides an instant
surge of energy.
2. It can be released from the adrenal gland during times of stress
(response of “Fight or Flight”)
3. This causes glycogenolysis, which leads to a blood glucose
increase, and allows for triglycerides to break down to be
a. People with diabetes, generally have high glucose levels, and have problems with their insulin since there is the inability of regulating one’s own blood glucose levels.
b. Lack of control over blood glucose can result in either abnormally high or low glucose levels.
i. Diabetes: Type I
1. The pancreas stops making insulin.
2. The body attacks those cells, and destroys them. This happens
quickly, hence an individual can get sick quickly.
3. The body can still absorb glucose and digest carbohydrates, but it
gets trapped in the blood system.
4. Glucose cannot go into the cell because there is no insulin, and the body can’t absorb that energy from the glucose. So, the body just
gets the energy from fat. This results in fat being lost rapidly,
because the cells are starving for energy.
5. Now that fat is being lost without the use of carbs, ketones are
6. There is a genetic link of Type 1 Diabetes. Only 5% of the cases
in the U.S. have patients experience ketosis as a result this type of
diabetes, and it is potentially deadly. Ketosis happens when
someone has uncontrolled diabetes or are on a low carb diet.
7. Dangers/ Long term side effects: Coma, amputation (because of
the nerve damage), blindness, heart attack, kidney failure, fertility
issues with men and women. All of these dangers are preventable.
8. Symptoms: Unexpected weight loss, thirst, excessive hunger, very frequent urination, and fatigue and dizziness.
9. Currently, there is no cure for Type 1 Diabetes. The most helpful
treatment option is taking shots of insulin (since the beta cells are
inactive), balancing carb and fat intake. Food that is high in fiber
is good for diabetics because this carbohydrate digests slower.
ii. Diabetes: Type 2
1. Typically occurs in older people, but lately it is happening more in children because of obesity in children. Overweight kids face a
risk to Type 2 Diabetes.
2. Type 2 Diabetes can also be genetic.
3. The pancreas still secretes insulin, but there may be actually too
much of it. The cells potentially do not respond to the insulin,
preventing glucose to entering the cell.
4. Some glucose manages to enter the cell and help provide energy
5. Symptoms are the same as Type 1, but are not as severe.
6. People with Type 2, typically have high glucose levels.
7. 90% of diabetes cases correlates with someone who is obese or
8. The goal is to normalize blood glucose levels. So, the best
treatments are to lose weight, exercise, reduce carb intake, have
consistent meal times, lessen fat intake, decrease intake of empty
calories/ simple carbohydrates, increase high fiber carbs (to slow
down digestion), and medication.
∙ Know the differences between Type 1 and Type 2 Diabetes.
a. Major sources of added sugars:
i. Sweetened/ Sugary beverages
1. E.g. Sodas, juices, energy drinks, and sports drinks.
ii. ‘Junk food’
1. E.g. Candy, Cake, Cookies, etc.
b. Direct Health Risks
i. Blood lipids
1. LDL levels increase, and HDL levels decrease.
2. Heightens risk factors for heart disease.
ii. Diabetes and Obesity
1. Excess sugar= excess calories= weight gain= obesity
2. There is an association between Type 2 Diabetes and obesity. iii. Hyperactivity
1. There is no significant evidence for long term effects.
2. Caffeine is more likely (than sugar) to cause a noticeable effect. 3. Chocolate and sodas causes high amounts of hyperactivity.
iv. Dental Decay
1. Increase in acid production by bacteria in the mouth.
2. The tooth enamel can erode.
c. Indirect Health Risks
i. Empty calories are associated with refined sugars.
1. E.g. It is very easy to take in empty calories by drinking soda. ii. Weight gain occurs
1. E.g. Obesity
iii. It is recommended that simple sugar intake happens in moderation. 1. If you read your food label, make sure there is no added sugar. d. Soda
i. Soda alone is a major contributor to a higher calorie intake in people’s diets.
a. 12 ounces of soda has about 10 teaspoons of sugar, making
it about 140 calories.
b. 64 ounces of soda has about 53 teaspoons of sugar, making
it about 742 calories.
e. Alternative Sweeteners
i. It is recommended that alternative sweeteners are used lightly because they are super sweet.
ii. Alternative sweeteners do not usually cause tooth decay also! iii. Aspartame (NutraSweet)
1. It is 180x sweeter than sucrose.
1. It is 500x sweeter than sucrose.
2. Some people can’t consume it.
v. Sugar alcohols
1. Can be found in products like gum, and breath mints.
2. Eating/ chewing too much can cause GI complications.
vi. Acesulfame Potassium
1. It is 200x sweeter than sucrose and is heat stable
vii. Sucralose (Splenda)
1. It is heat stable, and made from sucrose.
2. There are no studies that suggest it is unsafe.
1. It has no calories, and is found from a plant.
2. It is 200300x sweeter than sugar.
3. It is also recognized as safe.
f. Why bother using these sugars?
i. So that way people can still eat foods that are not inherently good, but can make it lower in calories.
a. Fiber is typically a polysaccharide deriving from nature. It is the parts of the foods/ plants that we eat, and that our body lacks the enzymes to absorb it. b. Dietary fiber refers to the parts of plants that are indigestible
c. Functional fiber refers to the fiber that is added into foods or supplements. d. Consuming fiber, prolongs nutrient absorption in the intestine.
e. Insoluble fiber
i. Cannot dissolve in water.
ii. Leads to larger feces, and happens sooner.
iii. The best example of an insoluble fiber is corn.
f. Insoluble fiber
i. Can dissolve in water.
ii. Slows down the rate of nutrient absorption.
iii. Blood glucose levels are controlled, and slows down how fast glucose is absorbed.
iv. Lowers blood cholesterol
g. Recommendations for fiber intake
i. 2535 g/day
1. For children: at least 5g/day + age.
ii. Unrefined/ not purified forms of fiber are preferred.
iii. The U.S. diet usually does not contain enough fiber.
h. Health risks for too much fiber
i. There aren’t many chronic health risks, but a lot of GI issues can happen. ii. Having too much fiber can bind a lot of the nutrients, which prevents those nutrients from being absorbed.
iii. Energy dilution is a possibility. Energy dilution is when you feel full, but can’t get any energy from the food.