Nutr 303 Final Exam Study Guide
Nutr 303 Final Exam Study Guide NUTR 303
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This 17 page Study Guide was uploaded by Maggie Cunningham on Monday January 26, 2015. The Study Guide belongs to NUTR 303 at a university taught by Burgess in Fall. Since its upload, it has received 266 views.
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Date Created: 01/26/15
PA RT 2 Chapter 13 Physical activity any movement produced by muscles increasing energy expenditure Physical Fitness ability to perform moderate to vigorous activity without undue fatigue Physical Activity helps heart function lessens injuries and improves sleep habits and body composition Physical activity can also reduce stress and positively affect blood pressure blood cholesterol blood glucose regulation and immune fuction Physical activity aids in weight control Both by raising resting energy expenditure for a short time after exercise and by increasing overall energy expenditure Immediate source of energy for body Required for muscles to contract 0 ATP Energy to do work ADP Pi Formed from glucose or tridlvceride breakdown 0 Uses energy from food ADP Energy from food Pi ATP Phosphocreatine PCr o If no resupply of ATP muscle store 24 sec 0 Phosphocreatine resupplies ATP 0 Replenishes ATP for sprinting jumping etc o Anaerobic 0 Only enough stored in muscle for about 1 min PCr ADP ATP Cr Carbohydrates 0 Used in Highintensity exercise especially lasting 30 seconds to 2 minutes 0 Preferred fuel especially as intensity increases Fat oxidation cannot supply ATP rapidly enough at high intensities o Perception of fatigue parallels declining muscle glycogen stores 0 Need to consume 60 of total kcal from CH0 0 Recommended 5 10 g CHOkg body weight 0 Endurance activities require more CH0 0 Length of time exercise can be performed is dependent on preexercise muscle glycogen content Diet Muscle glycogen Time to exhaustion at 34 maximal effort Low Carb 38 mmolkg 60 min Mixed 106 mmolkg 115 mins High Carb 204 mmolkg 170 mins Fat 0 Exercise lasting more than a few minutes greater amounts are used to lower exercise intensities Moderateintensity aerobic physical activity Activity that increases a person s heart rate and breathing to some extent 5 6 on RPE o Brisk Walking dancing swimming or bicycling on level terrain Vigorous Intensity aerobic physical activity Aerobic activity that greatly increases a person s heart rate and breathing 78 on RPE 0 Examples Jogging singles tennis swimming continuous laps or bicycling Calorie Needs Varying amount of calories depending on each body size body composition and the type of training or competition being considered An estimate of the calories required sustaining moderate activity to 5 to 8 kcal per minute The calories required for sports training or competition then have to added to those used to carry on normal activities 0 Hour of bowling requires to sustain normal daily living 0 12hour endurance bicycle race over mountains can require an additional 4000 kcal per day Therefore some athletes may need as much as 7000 kcal or more daily to maintain body weight while training whereas others may need 1700 kcal or less If an athlete experiences daily fatigue the rst consideration should be whether he or she is consuming enough food Estimating daily intake f 0 Food Diary 0 Skinfold Measurements 0 Bioelectrical Impendence 0 Underwater weighing C arboh ydra tes Anyone who exercises vigorously especially for more than1 hour perday on a regular basis needs to consume a diet that includes moderate to high amounts of carbohydrates Numerous servings of grains starchy vegetables and fruits provide enough carbohydrates to maintain adequate liver and muscle glycogen stores especially for replacing glycogen losses from workouts on the previous day Relatively lowcarbohydratehighprotein diets such as the Zone Diet is not recommended Carbohydrate content of this diet is only 40 of calories rather than 60 or more typical Carbohydrate intakes should be at least 5 grams per kilogram body weight If working out more than 60 minutes a day as much as 7 grams per kilogram per body weight If Exercise duration is several hours the carbohydrate recommendation increases to up to 10 grams per kilogram Fat Needs A diet obtaining up to 35 of calories from fat is generally recommended for athletes Rich sources of monounsaturated fat such as canola oil should be emphasized Saturated Fat and Trans fat intake should be limited Protein Needs American College of Sports Medicine American Dietetic Association and Dietitians of Canada recommend protein intake within the range of 8 to 17 grams of protein per kilogram of body weight This advice is considerably higher than the RDA of 8 grams per kilogram body weight for nonathletic recommended by the food and Nutrition Board for all adults including athletes Athletes usually have high calorie intakes so they tend to consume plenty og vitamins and minerals An expectation is athletes consuming lowcalorie diets 0 Athletes needs for antioxidants such as vitamin E and vitamin C may be somewhat greater because of the potential protection these nutrients provide this effect could be especially important in the face of high oxygen use by muscles 0 The use of large does of vitamin E and C require more study and is not currently an accepted part of the dietary guidance for athletes 0 Foods rich in antioxidants such as fruits veggies wholegrain breads and cereals 0 Iron is involved in red blood cell production oxygen transport and energy production so a de ciency of this mineral can noticeably detract from optimal athletic performance 0 Distance runners should pay special attention to iron intake because their intense workouts may lead to gastrointestinal bleeding 0 Another concern is sports anemia which occurs because exercise cause blood plasma value to expand particularly at the start of a training regimen before the synthesis of red blood cells increase This results in dilution of the blood 0 Sports anemia is not detrimental to performance but it is hard to differentiate between sports anemia and true anemia 0 Athletes especially women try to loose weight by restricting their intake of dairy products can have marginal or low dietary intake of calcium 0 The negative impacts of low dietary calcium intake and irregular menses in female athletes outweigh the bene ts of weight bearing exercise on bone density 0 Increasing energy intake to restore body weight and body fat stores is important to correct hormonal imbalances and prevent further bone loss 0 Body uid loss negatively affects 0 HR and cardiovascular system 0 Cooling system and body temperature Dehydration is strongly related to fatigue Loss of 23 of body weight 1015 performance decrement 0 Regularly scheduled intake is necessary because the thirst mechanism is inadequate Adequate amount CHO sports drink 124 improved performance 0 Pre exercise 0 14 22 oz 2 hours prior 0 710 02 10 20 minutes prior 0 During exercise 0 6 to 12 oz every 15 to 20 minutes 0 Post exercise 0 24 oz per lb Body weight lost 0 Fluids need for an average adult about 9 cups per day for women and 13 cups per daily men Athlete need more water to regulate internal temperature and keep cool 0 Heat production in contracting muscles can rise 15 to 20 times above that of resting muscles 0 Fluid intake during exercise when possible should be adequate to minimize body weight loss Athlete should aim to replace the total amount of uid lost during exercise This can be accomplished by knowing the body s hourly sweat rate which can be calculated from the weight lost during exercise per hour plus the uid consumed during exercise per hour 0 The American College of Sports Medicine recommends losing no more than 2 of body weight during exercise 0 Thirst Is a late sign of dehydration An athlete who only rinks when thirsty may take 48 hours to replenish uids losses Chapter 14 0 Eating when your hungry Eating till satis ed not stopping just because you think you should 0 Choosing foods you like 0 Moderate constraint in food selection but not so restrictive that you miss out on pleasurable foods 0 Eating 3 meals a day or choosing to munch along 0 Both overeating and underrating at times Trusting your body to make up for your inaccuracy in eating 0 Leaving food on your plate because you know you can eat later Takes up some of your time and attention but keeps its place as only one important area of your life 0 Being exible about eating when you are hungry when it ts your schedule and when there is food around 0 Normal Eating teaches the how of eating Eat when you re hungry and when your body needs fuel and enjoy eating it Mild and shortterm changes in eating patterns that occur in relation to a stressful event an illness or a desire to modify one s diet This can be for a variety of health and personal appearance reasons A wide range of irregular eating behaviors that do not warrant a diagnosis of a speci c eating disorder unless sustained distressing interfere with everyday life and linked to physiological changes A style of eating Can lead to weight loss or weight gain as well as certain nutritional problems it rarely requires indepth professional attention Chronic yoyo dieting Frequent weight uctuations Extremely rigid and unhealthy food and exercise regime Feelings of guilt and shame when unable to maintain food and exercise habits Preoccupation with food body and exercise that can cause distress and has a negative impact on quality of life Compulsive or emotionallydriven eating Use of compensatory measures to quotmake upquot for food consumed An eating disorder involving psychological loss or denial of appetite followed by selfstarvation related in part to a distorted body image and to carious social pressures commonly associated with puberty Anorexia Nervosa is de ned as quoteating disorder that makes people lose more weight than is considered healthy for age and heightquot NIH It is characterized by a fear of gaining weight 0 Persistent restriction of energy intake leading to signi cantly low body weight 0 Either an intense fear of gaining weight or of becoming fat or persistent behavior that interferes with weight gain Disturbance in the way one39s body weight or shape is experienced or persistent lack of recognition of the seriousness of the current low body weight 0 Warning signs 0 Dramatic weight loss 0 Preoccupation with weight food calories fat grams and dieting Refusal to eat certain foods cutting out entire food groups Anxiety associated with weight gain Denial of being hungry Excuses to avoid mealtimes Excessive exercise routine that individual will perform despite weather etc Withdrawal from usual activities Physical Effects Abnormal slow HR and low BP Reduced bone density Muscle loss Severe dehydration a kidney failure Fatigue and weakness 0 Dry hair and skin Anorexia Nervosa has the highest mortality rate of any other psychiatric disorder 0 00000 00000 Characteristics Rigid dieting causing dramatic weight loss generally to less than 85 of what would be expected for one s age False body perception thinking quotI m too fatquot even when extremely underweight Rituals involving food excessive exercise and other aspects of life Maintenance of rigid control in lifestyle security found in control and order Feeling of panic after a small weight gain intense fear of gaining weight Feelings of purity power and superiority through maintenance of strict discipline Preoccupation with food its preparation and observing another person eating Helplessness in the presence of food Lack of menstrual periods Possible presence of bingeing and purging lllness characterized by binging on food and partaking in compensatory behaviors to mitigate the feeling a loss of control Mayoclinic characterizes bulimia as Purging bulimia Vomiting or misuse of laxatives diuretics ampenemas Nonpurging bulimia Other methods to ride excess calories fasting strict dieting excessive exercise Eating an unusually large portion of food for a de ned period of time up to 2hrs and feeling out of control The behavior occurs at least once a week for three months on average Selfevaluation is overly in uenced by body shape and weight Severity is indicated by Mild An average of 13 episodes per week Moderate An average of 4 7 episodes per week Severe An average of 813 episodes per week Extreme An average of 14 or more episodes per week Warning Signs Evidence of binge eating in a short time period Evidence of purging frequent bathroom trips after meals smells of vomit Excessive exercise routine completes regardless of illness or poor weather conditions etc Unusual swelling of the cheeks Calluses on back of knuckles Noticeably discolored teeth Withdrawal from usual activities Characteristics Secretive binge eating generally not overeating in front of others Eating when depressed or over stressed Bingeing on a large amount of food followed by fasting laxative or diuretic abuse selfinduced vomiting or excessive excerise at least twice a week for 3 months Feeling of shame embarrassment deceit and depression low selfesteem and guilt Fluctuation weight 10 pounds from alternate bingeing and fasting Loss of control People pleaser Erosion of teeth swollen glands F Blood potassium imbalance Dental decay Ironde ciency anemia Low white blood cells countdecline in immune function Constipation F Frequent episodes of consuming very large amount of food but without behaviors to prevent weight gain A feeling of being out of control during the binge eating episodes Feelings of strong shame or guilt regarding the binge eating Indications that the binge eating is out of control Physical Effects High blood pressure High cholesterol levels Heart disease Diabetes mellitus Gallbladder disease Musculoskeletal problems Characteristics Recurrent episodes of binge eating An episode of binge eating is characterized by Eating an unusually large portion of food for a de ned period of time up to 2hrs and feeling out of control during episode Binge eating episodes are associated with 3 of the following Eating much more rapidly than normal Eating until feeling uncomfortably full Eating large amounts of food when not feeling physically hungry Eating alone because of feeling embarrassed by how much one is eating Marked distress regarding binge eating The binge eating occurs on average at least 2 days a week for 6 months Behavior does not occur only during the course of bulimia nervosa or anorexia nervosa F Renamed Other Speci ed Feeding or Eating Disorder OSFED According to the DSM5 criteria a person with OSFED 0 Must present with a feeding or eating behaviors that cause clinically signi cant distress and impairment in areas of functioning 0 Does not meet the full criteria for any of the other feeding and eating disorders 0 Examples o Atypical Anorexia Nervosa criteria is met for behavior but weight is within normal range 0 Binge Eating Disorder criteria is met for BED but symptoms occurred for less than 3 months 0 Bulimia Nervosa criteria is met but occurs at a lower frequency 0 Night Eating Syndrome Eating a lot of food in the late evening and nocturnal awakening with ingestion of food Eating 13 of total daily calories after the evening meal Occurs in nonobsese persons 0 Female Athlete Triad condition characterized by disordered eating lack of menstrual periods amenorrhea and osteoporosis 15 swimmers 62 gynnasics 32 varsity athletes Suggestions Discourage restrictive dieting and meal skipping Provide info about normal puberty changes Misconception about nutrition healthy body approaches to weight loss Phrase any weightrelated recommendations and comments Don t over emphasize numbers on a scale Encourage normal expression of disruptive emotions Encourage children to only eat when hungry Teach basis of nutrition and regular physical activity Increase selfacceptable and appreciation of the power and pleasure emerging from one s body Enhance tolerance for diversity in body weight and shape Build respectful environments Treatment Options 0 Psychotherapy Evaluate underlying in uence for eating disorder work on client s mental health and nd ways to cope with trigger situations Cognitive Behavioral Therapy individual and group setting 0 Medical treatment Physician evaluation for overall plan Monitor blood pressure uids caloric intake vitamin de ciencies 0 Nutrition Counseling Individualized assessment Education and planning o Medications Depression and anxiety medications based on individual case Treatment Effectiveness 0 Effectiveness is largely based on client s response 0 Rapid responders tend to make greater gains in reducing the frequency of binging and purging 0 Not certain what determines responder type 0 Study ruled out BMI weightrelated selfevaluation anxiety demographics and clinical variables Chapter 16 1 Young Children 2 Older people 3 Poor immune systems FDA Food Safety Modernization Act was signed into law by President Obama New law strengthens the food safety system enabling FDA to better protect our health It allows FDA to focus on protection of food safety problems before they occur Provides new tools for inspection and compliance and for holding imported foods to the same standards as domestic foods The law also directs FDA to build a national food safety system that is integrated and in partnership with state and local authorities Most foodborne illnesses are transmitted through food in which microorganisms are able to grow rapidly These foods are generally moist rich in protein and have neutral or slightly acidic pH Increasing the shelf life of food products however a longer shelf life allows more time for bacteria in foods to multiply Practically cooked and some fully cooked Consumer trends sushi Centralization of food production by the foodprocessing and restaurant industry enhances the risk of foodborne illness Ready to eat food imported from foreign countries Antibiotics in animal feeds Bacteria Viruses Parasites Fungi Bacteria speci cally cause health problems either directly by invading the intestinal wall and producing an infection via a toxin contained in the organism or by indirectly by producing a toxin secreted into the food which later harms us Intoxication 0 40 to 140 Hand washing 0 Avoid Cross Contamination Store food at proper temperature 0 Wash Foods 0 Cook food all the way through Chapter 17 o A full term pregnancy lasts 38 42 weeks 0 lst trimester conception to 13th week 0 2nd trimester 14th to 27th week Fetus weighs 1 oz Arms hands ngers legs feet and toes are fully formed Begins to look like an infant 0 3rd trimester 28th to 40th week Fetus is 2 to 3 pounds Fetus will double in length and will increase tis weight by 3 to 4 times Embrvonic stage day 15 to the 8th week 0 After the 8th week the developing baby is called a fetus o 2 4 lb of weight gain during the lst trimester o 075 1 lb weekly weight gain during the 2nd and 3rd trimester 0 Total weight gain goal is 2535 lb for normal weight women Underweight women should gain 28 40 lb 0 BMI 250 299 should gain 1525 lb 0 BMI gt30 should gain 1120 lb Copyrlght The Mr la 7Hlll Companies inc Permission required or reproduction or display Weight lib 25 Maternal fat stores 4 H llb f I I V Uterus and wy 39 breasts 39 6 lb Blood fr F 4llb ii 39 Fetus placenta li amniotic uid 5 i i 11 lb fetus quot i itself weig l rls about 8 lb ill 20 30 40 Weeks39 gestation F Folate 600 ugday 0 Synthesis of DNA 0 Fetal and maternal growth 0 Increase red blood cell formation 0 Neural tube defect prevention 0 Iron 27 mgday during last 2 trimesters 0 Increased hemoglobin 0 Iron stores for the fetus 0 Need to take iron supplement Calories 0 Need 350 to 450 kcal more in the second and third trimester 0 Extra calories should come from nutrient dense food Medical assessment 0 Monitoring 0 Educate about an adequate diet 0 Learn what to avoid 0 Proper health habits Women Infants and Children WC supplemental food program CYK Q CH 17 pg 627 Ques 16 10 Chapter 18 0 An infants birth weight doubles in the rst 4 to 6 months and triples within the rst year 0 It takes 5 years to double the weight seen at 1 year 0 An infant also increases in length in the 1st ve years by 50 and then continues to gain height through the teen years Replete iron store 0 Need for vitamin D and uoride 0 Physiological capabilities Physical readiness Allergy prevention 0 Infant can sit with little support 0 Infant shows interest in foods you re eating 0 Infant can move foods from the front to the back of the mouth 0 Take food from spoon o Diminished suckswallow re exextrusion re ex Infant s weight has doubled since birth or weighs at least 13 pounds 0 Infant nurses eight or more times or drinks more than 32 oz infant formula daily Reaching 13 pounds is a preliminary sign Consuming more than 32 ounces of formulas daily more than 8 to 10 times within 24 hours 0 Build to a variety of foods 0 Pay attention to infant s appetite to avoid overfeeding 0 Infant needs fat 0 Choose fruits vegetables grains but limit high ber foods 0 Sugar in moderation Sodium in moderation Choose foods containing iron zinc and calcium 0 Rapid growth rate of infancy begins to slow Gain 55 to 75 inches an 911 pounds 0 Higher energy expended for increased activity level 0 Whole milk fat proportion as much as 40 Carbohydrates 4565 0 Protein 520 0 Fat 3040 0 Ensure adequate intake of the micronutrients obtained from fruits and vegetables including o Vitamins A C E calcium iron zinc 0 Iron de cient anemia is the most common nutrient de ciency in young children 0 Growth rate continues to slow 0 Will gain 3 4 inches and 5 6 pounds per year 0 Macronutrient needs fat diminish uids 0 Carbohydrates 4565 0 Protein 1030 0 Fat 2535 Vitamins and minerals from fruits and vegetables continue to be a concern Vitamins A C E calcium iron zinc 0 Don t promote the quotClean Plate Clubquot Don t be pushy Don t make food the focus 0 Enjoy being together Make mealtime a positive experience 0 Make everyday conversation CYK Q CH 18 pg 666 Ques 1 35 710 Chapter 19 Demographics are shifting as a population we are getting older 0 The group 85 and older fastest growing segment Expected to reach 19 million by 2050 o By 2030 about 20 of Americans will be 65 years of age and older CDC 2004 0 Life Expectancy Average length of life for a group of people 0 In 2008 reached 779 0 Life span Maximum oldest age a person can reach 0 122 years for women 0 114 years for men 0 Health Span Living as long and as healthy as we can 0 Look young forever 0 Increase longevity 0 Increase quality of life Liver functions less efficiently damage due to chronic alcohol use Gallbladder gallstone formation gall bladder removal Pancreas diminished insulin type 2 diabetes Kidney decline in function Lung smoking lung disease Hearing and vision decline Macronutrients 0 Energy needs usually decrease due to reduced activity levels 0 Recommendations for fat carbohydrate and proteins intakes are the same as for younger adults 0 Older adults can consume slightly less ber 0 Vitamin D o 50 to 70 years 5 to 10 ug day 0 gt 70 years 15 ug day 0 Needed why Decreased bone density Decreased ability to convert Vitamin D in skin Decreased calcium absorption 0 Calcium 0 lt 51 years 1000 mg day 0 gt 51 years 1200 mg day 0 Why Decreased bone density Decreased calcium absorption 0 Iron 0 Men 8 mg day 0 Women 18 mg day a 8 mg 1 day 0 Menopause o Optimize immune function 0 Wound healing 0 Avoid excessive supplementation 0 Only modi cation known to increase lifespan consistently 40 less calories nutritionally adequate 0 Highly effective yet highly impractical
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