HNF260-Exam1StudyGuide.pdf HNF 260
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This 14 page Study Guide was uploaded by Brittany Ballog on Sunday September 27, 2015. The Study Guide belongs to HNF 260 at Michigan State University taught by j. ekstrom in Spring 2014. Since its upload, it has received 29 views. For similar materials see Principles of Human Nutrition in Nursing and Health Sciences at Michigan State University.
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Date Created: 09/27/15
HNF 260 Exam 1 Study Guide Chapters 1 and 2 Disease and Mortality Leading causes of death in different age categories 0 Heart disease and then cancer 0 heart disease over 85 cancer under 85 0 Which of the major causes of death have a dietary component Heart disease 0 What of Americans are diabetic Prediabetic 0 Over 10 of adults are diabetic 0 Over 35 of adults are prediabetic What are the projected trends in diabetes 0 In 2050 1 in 3 people are projected to have diabetes if trends continue 0 How does diabetes affect cardiovascular risk 0 8 fold increase in rate of cardiovascular disease if you are diabetic Where do we spend more health care as a nation cancer or heart disease and stroke CDC study 14 of heart attack and stroke deaths are preventable 200000 per year 0 In last ten years Numbers of preventable deaths decreasing in people age 65 Medicare full health insurance Numbers of preventable deaths in people under 65 are stable not decreasing Nutrients How do we de ne essential nutrients o nutrient required for normal human body function that either cannot be synthesized by the body at all or cannot be synthesized in amounts adequate for good health and thus must be obtained from a dietary source 0 What are the six classes of nutrients o Carbs Fats Protein Vitamins Minerals Water 0 What are phytochemicals What are zoochemicals o Phytochemicals plant derived compounds that may provide signi cant health bene t 0 Zoochemicals food compononents that come from animal products 0 Which are macronutrients 0 Provide energy or calories 0 Which are micronutrients o Needed in small amounts for physiological purposes 0 Which nutrients supply energy 0 How much energy is supplied by a gram of carbohydrate 4 kcalg o How much energy is supplied by a gram of protein 4 kcalg o How much energy is supplied by a gram of lipid 9 kcalg AMDRs Acceptable Macronutrient Distribution Range 0 What is the recommended amount of carbohydrate as of daily kcal 4565 o What is the recommended amount of protein as of daily kcal 10 35 o What is the recommended amount of lipid as of daily kcal 2035 Carbohydrates What are simple carbohydrates 0 Monosaccharide glucose fructose galactose What are complex carbohydrates 0 Disaccharide sucrose lactose maltose What is starch What are some food sources of starches 0 form in which plants store carbs 0 potatoes wheat rice What is ber 0 a thread or lament from which a vegetable tissue mineral substance or textile is formed 0 barley oatmeal What is glycogen 0 form in which animals store carbs o stored in liver and in muscle 0 once this is built up then we store energy as fat When our glycogen stores are depleted our bodies can synthesize glucose by metabolizing which nutrient o from protein process is called gluconeogenesis Fats vs Oils water insoluble How do lipids behave in water What is the most common food lipid o A triglyceride glycerol and 3 fatty acids energy storage not water soluble What is a saturated fatty acid 0 Solid at room temp What is an unsaturated fatty acid 0 Liquid at room temp Monounsaturated one double bond Polyunsaturated two double bonds Which are the two types of essential fatty acids 0 N6 and n3 What are some food sources of omega 3 n3 fatty acids 0 Walnuts shrimp sardines salmon Proteins How many amino acids are there 0 20 How many are essential for adults o 9 What fraction of protein does an average person in the US get from animal sources Plant sources 0 In US we get 23 of our protein from animals meat eggs sh Vitamins Small amounts needed 13 total 9 watersoluble and 4 fatsoluble vitamins Name the 4 fatsoluble vitamins Needed by many enzymes Vitamin A high dose toxicity Possible partial loss during cooking by leaching into water or breaking down from heat We are commonly low in Vitamin D intake Minerals 0 Inorganic Needed by many enzymes 0 Not destroyed by processing 0 16 essential o gt 100 mgday 7 Ca P K S Na Cl Mg major minerals o lt 100 mgday 9 Fe Zn Cu Mn l Se Cr F Mo trace minerals Minerals we are commonly de cient in Ca K Fe Minerals we consume in excess Na Solvent temperature regulation 1115 cups per day intake Kilocalorie amount of heat required to raise the temp of 1000 grams of water one degree Celcius Composition of a typical human body understand this is body composition NOT intake needs 57 water 25 fat 13 protein muscle 5 minerals mostly in bone Less than 1 in sugar and carbohydrate Trace amounts of vitamins Food choices Hunger physiological need to eat Appetite psychological desire to eat ln uences hypotholamus Optimal nutrition the best desired Malnutrition Subclinical undernutrition early stage de ciency no overt signs or symptoms 0 More severe signs and symptoms become apparent Healthy People 2020 DHHS Understand goals objectives and scope Recognize the Nutritionrelated objectives from Healthy People 2020 Continuing Survey of Food Intakes by Individuals CSFII USDA Survey of food and nutrient intake consumed by the population as a whole 0 1 day food diary National Health amp Nutrition Exam Survey NHANES CDC 0 Interviews and Physical Exams medical and nutritional tests 0 Representative sample of people across the US 0 Data has been instrumental in the development and implementation of healthrelated guidelines and reforms and publicpolicy initiatives Nutritional Health Assessment 0 Done by health care professional History of Nut Sci 0 Iron anemia Scurvy vitamin C 0 Bomb calorimeter Calories in foods calorie needs of humans 0 Discovery of vitamins Scienti c method scienti c studies 0 Cause and effect vs correlations Simple and Complex relationships EpidemiogicaI studies 0 NHANES correlations Cohort studies Intervention studies 0 Controls 0 Types of bias 0 Understand the difference between singleblind and doubleblind studies 0 Placebo effect Reliability of Nutritional Claims How can we evaluate DSHEA Dietary Supplement Health and Education Act of 1994 Supplements do not require the rigorous testing and approval process that pharmaceutical drugs do 0 FDA has burden of proving that a supplement is unsafe before it can be restricted What are the rules on labeling 0 Nutrient claim 0 Structurefunction claim 0 disclaimers Recommendations for Healthy Eating Balance of food groups Dairy Proteinrich Veggies Fruits Grains Variety within each food group 0 Different classes of vegetables 0 Different colors 0 Look at table with plant sources of different phytochemicals Moderation portion size Nutrient density 0 For a given nutrient in a given food 0 Compare Contribution to nutrient needs 0 amount of nutrient in serving daily nutrient need Contribution to caloric needs Calories in that serving daily caloric need EED 0 Nutrient dense if contribution to nutrient needs gtgt contribution to caloric needs 0 Rich source of a nutrient one serving of a food provides 20 or more of the DV 0 Good source of a nutrient one serving of a food provides 10 or more of the DV Energy density aka caloric density Kcals per unit mass What foods have low medium and high energy density Impact of ber and water on energy density Impact of fat on energy density Satiety is related to bulk of food Low energy density foods for weight control High energy density foods to prevent wasting in people with poor appetites elderly chronic disease Daily Reference Intakes DRls First DRls in 1943 0 Frequently reviewed by the Food and Nutrition Board 5 years 0 under the Institute of Medicine National Academies of Science 0 reviewed and revised every few years 0 in 1993 increased nutrient amounts was at a lower level just enough to prevent de ciency diseases in 1993 raised to higher levels that help prevent chronic conditions 0 age and genderspeci c DRls know and understand all of these terms 0 EAR estimated need for the average person within a speci c agegender group 50 o RDA intake of a nutrient needed to meet with needs of nearly all individuals within an agegender group 9798 of the population 2 standard deviations above EAR 0 Al estimate of needs that is used when there is not enough info to establish an EAR and RDA for a nutrient o EER average calorie intake 0 UL max level of daily intake of a nutrient that is unlikely to cause adverse health effects to almost all people 9798 Food Labeling Nutrition Facts Label 0 FDA regulates food labels 0 Understand how the daily values DV on food labels are derived from but distinct from the DRls Nutrition Facts Labels are required on processed foods and meat since 2012 0 Nutrition Facts Labels are not required on fresh fruits and vegetables deli foods fresh seafood 0 Not required on alcohol 0 DV for nutrients on labels are based on 1968 DRI values 0 Reference Daily Intakes RDls 0 Daily Reference Values 0 Info on box selected to provide info to consumers 0 Minimal info on Nutrition Facts Label for ease of understanding 0 Standardized for a 2000 kcal diet nutrient DV based on highest need agegender group DVs are NOT age and genderspeci c Be able to list the info that is required to be present on the Nutrition Facts Label 0 Know the eight allergen groups that must be listed on the label Claims on food packaging Nutrient claims Table 23 low sodium reduced sugar etc strictly de ned 0 Health Claims 0 Signi cant scienti c agreement required 0 Must use quotmayquot or quotmightquot as quali ers in any health claim 0 Look up a few examples to understand the types of health claims refers to a disease 0 Quali ed health claims since 2002 0 Less conclusive scienti c evidence 0 Must have stronger disclaimer quotThis evidence is not conclusivequot StructureFunction claims of food packaging 0 describe the role of a nutrient or dietary ingredient intended to affect normal structure or function in humans quotcalcium builds strong bonesquot 0 may characterize the means by which a nutrient or dietary ingredient acts to maintain such structure or function quotfiber maintains bowel regularityquot quotantioxidants maintain cell integrityquot 0 FDA does not approve or authorize structurefunction claims 0 But must be truthful and not misleading Frontofpackage labeling Movement to standardize led by Grocery Manufacturer39s Association Dietary Guidelines Developed jointly by USDA and DHHS Foods and diets to promote health and reduce risk of chronic diseases Updated every 5 years Basis of Federal food and nutrition educationinformation programs Changes from previous version 0 Major focus on overweight and obesity 0 Use of evidencebased reviews and foodpattern modeling 0 Focus on nutrient density 0 Focus on broader environmental and societal aspects Major action steps 0 Reduce caloric intake and increase activity for weight management 0 Reduce SoFAS intake Solid Fats and Added Sugars 0 Increase consumption of nutrientdense foods shift towards a plant based diet 0 Build healthy eating patterns Physical activity recommendations 0 30 min 5x per week minimum 0 60 min 5x per week to maintain current weight 0 90 min 5 x per week to sustain a major weight loss Recommendations How we are meeting recommendations 0 lt 60 of recommended vegetables 0 lt 50 of recommended fruits o lt 60 of recommended dairy o lt 20 of recommended whole grains Sources of sodium processed foods Goal under 2300 mg SoFAS recommended to stay under 515 of total calories 35 current average in US diet Saturated fats under 10 of kcal MyPlate Communicates Dietary Guidelines to the public Focus on quotfoodsquot over nutrients Half the plate fruits and vegetables Half of grains should be whole grains quotProteinquot can be plant or animalbased Dairy for adults fatfree or lowfat milk 0 Table 210 Food sources of key nutrients Problem solving 0 Use AMDRs a stated EER Le 2000 2500 or 3000 kcal and the calories per gram of different nutrients to solve problems Chapter 4 Digestion and Absorption GI tract 0 lined with protective epithelial cells Mouth 0 Saliva amylase lysozyme lipase o Lubrication antibacterial starts starch digestion Esophagus o Peristalsis moves food down 0 Lower esophageal sphincter prevents stomach contents from re entering esophagus Stomach 0 Average 46 cup volume 0 Stays 14 hours 0 HCI Acidic environment know what the acid does and why this is important Protective mucous lining Pepsinogen gt pepsin protease Mixing of food and gastric juices into chyme Parietal cells chief cells gastric pits mucous Alcohol is absorbed here partially Pyloric sphincter retains contents releases them gradually to small intestine Liver o Produces bile Made of cholesterol and salts Emulsi es lipids Bile is stored in gall bladder Delivered through common bile duct into the duodenum 0 First organ to see most nutrients Villi to capillaries to portal vein to liver Exception fats Villi to lacteals to lymphatic system 0 Bile acids are reabsorbed in the SI and recycled Pancreas 0 Makes insulin and glucagon endocrine 0 Makes bicarbonate know what this does and why it39s critical 0 Makes several different enzymes exocrine Lipase proteases amylase nucleases o Delivered through pancreatic duct 0 Common bile duct and pancreatic duct ow together into the duodenum SI at the Sphincter of Oddi Small intestine O O CO 00000 200 sq meters of surface area about 10 feet long Sections of SI know order and function of each Duodenum Jejunum lleum Villi microvilli glycocalyx Villi absorptive cells originate from stem cells in the crypt and live only 36 days Most nutrients absorbed in SI most H20 also absorbed here Some additional digestive enzymes are made by small intestine cells Food remains in SI 310 hours Peristalsis and segmentation Longitudinal and circular muscle Enterocytes Four types of transport of nutrients across the intestinal epithelial membrane Passive diffusion Facilitated diffusion Active absorption Endocytosis Colon large intestine O O O O 35 feet long Ascending transverse descending sigmoid lleocecal valve keeps contents of large intestine from reentering small intestine Appendix appendicitis Importance of rapid treatment bursting can cause serious infection Bacterial ora Vast numbers Diverse set of bacteria Most are bene cal or mutualistic Ferment some undigested matter produce shortchain fatty acids mbiotics Example in yogurt Bacteria we can ingest that may be bene cial biotics Carbohydrates that we don39t digest well that will provide food to and support bene cial micro ora o lnulin and resistant starch 0 Found in vegetables beans 0 Hormonal signals OOOO Gastrin regulates release of HCI and pepsinogen CCK stimulates release of pancreatic enzymes and bile Secretin stimulates release of bicorbonate Gastic inhibitory peptide slows release of gastric juices slows stomach motility Disorders Diarrhea 0 Major cause of childhood death in developing countries 0 Rotavirus food borne illness unclean water 0 Treated by hydration and electrolyte replacement Ulcers o Degraded mucous layer less protection acid damages epithelial cells 0 NOT due to stress or spicy food common knowledge is incorrect o Heliobacterpyori Nobel Prize for linking this to ulcer formation prori can live in the acid stomach environment 0 Aspirin and prostaglandin suppression can cause ulcers 0 Treatment antibiotics for prori antiacid medications Heartburn GERD 0 Acid chyme backs up into esophagus 0 Pregnancy or obesity make this more likely 0 Alcohol can play a role 0 If chronic can get ulceration and bleeding in the esophagus o Ups risk of adenocarcinoma of the esophagusa poor prognosis cancer In ammatory bowel diseases immune attack 0 Crohn s disease primarily ileum o Ulcerative Colitis Colon 0 Serious Damages cells may require removal of sections of intestine o Increases risk of colon cancer 0 Can reduce absorptive capability of the intestines Irritable bowel disease 0 1015 of population has this 0 Pain bloating 0 Stress is a component 0 Common 0 Smaller meals diet modi cation can help Food allergies 0 Know the eight Food intolerances o Lactose intolerance low production of lactase Milk protein travels to Large intestine gets consumed by bacteria which produce gas Discomfort Celiac disease 0 Severe reaction to gluten protein 0 Immune disorder with a genetic component 0 Immune cells cause damage to intestinal cells attening of villi Malabsorption as a result 0 Must avoid wheat rye and barley Constipation Hemorrhoids DiverticulosisDiverticulitis o Outpouching of colon wall infection or in ammation due to trapped bacteria and food Gallstones Crystals of cholesterol and bike salts in gall bladder Can be painful Small ones may be passed Large ones may require gallbladder removal Triggers fasting low ber diet high insulin overweight advanced age OOOOO Chapter 5 Carbohydrates Metabolism from lecture notes Anabolic pathways build new molecules require energy Catabolic pathways break down molecules release energy 0 ATP highenergy bonds provide energy to drive molecular reactions rapid recycling of ATP pool Carbohydrate metabolism 0 Glycolysis o Glucose to pyruvate through multiple steps Occurs in the cytosol No 02 needed Small amount of ATP produced Anaerobic exercise insuf cient 02 pyruvate to lactic acid gives shortterm energy that does not require 02 0 Red Blood Cells no organelles no mitochondria Glycolysis is only way for RBC to get energy Citric Acid Cycle TCA cycle Krebs cycle 0 Occurs in mitochondria 0 Makes NADH which goes to electron transport chain 0 Electron transport chain 0 Occurs in mitochondria o Requires 02 o Produces lots of ATP 0000 AMDR for carbohydrates 4565 of calories RDA for carbohydrates 130 gramsday for brain CNS needs Energy 4kcalgram DRI for ber 14 g dietary ber per 1000 kcal intake Total diet sugars should stay under 25 of total calories Goal of lt6 of energy from added sugars Monosaccharides Glucose blood sugar D primary fuel for red blood cells also called dextrose Fructose in fruits HFCS Galactose no free galactose in foods we get galactose by digesting lactose Disaccharides Maltose 2 glucose units 0 Maltose not found naturally in foods We create maltose in the gut by digesting starches o Digested by maltase Sucrose 1 glucose 1 fructose 0 Table sugar 0 Digested by sucrase Lactose 1 glucose 1 gaactose 0 Milk sugar 0 Digested by lactase 0 Many people have poor ability to digest lactosenot much lactase produced by body Only monosaccharides are absorbed in the SI Disaccharides are digested by maltase sucrase or lactase to form absorbable monosaccharides 0 These three enzymes are produced by intestinal absorptive cells 0 These enzymes are attached to glycocalyx at the surface of the microvilli Oligosaccharides 310 monosaccharide units linked together Plant foods legumes whole wheat some veggies lnulin raf nose stachyose Linked by betaglycosidic bonds We do not have enzymes that can digest these Bene cial bacteria in our colon ferment oligosaccharides bi dobacteria 0 Produce some gas shortchain fatty acids some Bvitamins Polysaccha rides Some digestible Some indigestible o Digestible polysaccharides Starches Amylose Long linear chain of sugar units 0 In plants only Amylopectin Branched chain of sugar units 0 More rapidly digested than amylose In plants only Glycogen Storage form of carbohydrate in our bodies Liver muscle Branched chain of sugar units 0 Undigestible polysaccharides Fiber DRI for ber 14 g dietary ber per 1000 kcal intake Sugar units connected by betaglycosidic bonds we can39t digest these Insoluble ber vs Soluble ber 0 Know which parts of foods give ber soluble and insoluble Soluble ber Pectins Gums Mucilages o Dissolves in water 0 Fermented by gut bacteria Bene cial bacteria produce shortchain fatty acids that are good for the health of the colon cells 0 Adds viscosity slows gastric emptying Inhibits bile reabsorption D helps body rid itself of excess cholesterol 0 Slows glucose absorption helps moderate glycemic load Helps with weight control diabetes Insoluble ber Cellulose hemicelluloses 0 Does not dissolve in water 0 Not fermented by gut bacteria 0 Provides bulk to diet helps movement through GI tract Lignin o Insoluble but not technically a carbohydrate or polysaccharide 0 Not digestible o Fibrous matter in celery stems and other plants Carbohydrate digestion Amylase in mouth 0 Begins to break down starch o Inactivated by stomach acid 0 Small intestine pancreatic amylase breaks down starch o Maltase sucrose lactase from intestinal cells breaks disaccharides into monosaccharides Uptake of monosaccharides in small intestine o Glucose and Galactose uptake needs ATP active transport both are brought in by the same transport mechanismreceptor o Fructose Facilitated diffusion o Monosaccharides go to liver via portal vein D converted to glucose 0 Large intestine fermentation of some soluble ber by bene cial gut bacteria More on carbohydrates Proteinsparing o If blood glucose is low and glycogen stores are depleted protein from muscle will be broken down to create glucose gluconeogenesis Ketosis use of fatty acids to make ketone bodies Energy source for brain when glucose and glycogen are depleted Glycemic index 0 Measure of how quickly the carbohydrate in a food gets into your blood as glucose Spikes in glucose lead to increases in insulin UNDERSTAND the regulation of blood sugar by insulin and glucagon Figure 515 UNDERSTAND the response to a glucose spike in healthy patients and in diabetes Figure 514 0 Metabolic syndrome Insulin resistance or glucose intolerance High blood glucose Abdominal obesity High blood triglycerides High LDL cholesterol Low HDL cholesterol Increased in ammatory proteins 0 Alternative sweeteners Sugar alcohols sorbitol xylitol mannitol Aspartame and PKU metabolic defect metabolism of phenylalanine
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