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NTR 213 Chapters 8 & 9 Study Guide

by: Elizabeth Weathers

NTR 213 Chapters 8 & 9 Study Guide NTR 213-05

Elizabeth Weathers

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These notes cover the chapters for Exam 4
Introductory Nutrition
Laurie H. Allen
Study Guide
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This 44 page Study Guide was uploaded by Elizabeth Weathers on Friday April 1, 2016. The Study Guide belongs to NTR 213-05 at University of North Carolina - Greensboro taught by Laurie H. Allen in Winter 2016. Since its upload, it has received 21 views. For similar materials see Introductory Nutrition in Environmental Science at University of North Carolina - Greensboro.

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Date Created: 04/01/16
Water  60% of body weight  2/3 intracellular (within cells), 1/3 extracellular  Cell membranes are permeable to water  Water crosses the membrane by osmosis to dilute dissolved solutes  Blood pressure – the amount of force exerted by blood against the walls of arteries  is generated by the heart to move water through blood vessels and into tissues Water Functions  Acts as a solvent: solutes (for example: glucose, proteins, minerals) dissolve in water  Participates in chemical reactions Water in the Body Water Balance  Water is not stored  Water in must equal water out  In: consumption of water, fluids, foods and production during cellular respiration  Out: excretion in urine and feces, evaporation from the skin and lungs, and sweating Increased Water Loss Stimulates Thirst Kidneys Regulate Body Water • Kidneys act as a filter • Water moves from the blood into kidney tubules • Blood cells and proteins are too large and remain in the blood • Needed substances are reabsorbed back into the blood • Un-needed substances are excreted in urine Antidiuretic Hormone (ADH) Increased ADH Water Decreased Blood Sodium Secretion Reabsorption Blood Sodium  If more water is lost than taken in, then the concentration of solutes in the blood increases  This stimulates thirst and secretion of ADH from the brain  ADH stimulates the kidneys to reabsorb water (to keep the blood from becoming more concentrated The Functions of Water  Medium for & participant in metabolic reactions  Helps regulate acid-base balance (PH)  Transports nutrients & waste  Provides protection  Regulates body temp Water Helps Cool the Body Dehydration  Water loss is greater than water intake  Reduces blood volume which reduces blood pressure  Reduces the ability of the circulatory system to deliver oxygen and nutrients to muscles  Reduces blood flow to the skin and sweat production limiting the body’s ability to cool itself  Causes a reduction in blood volume, impairs ability to deliver oxygen and nutrients to cells, and ability to remove waste products  Symptoms: Dry mouth, decreased urination, thirst, fatigue, headache, muscle cramps  Severe dehydration: increased heart rate, decreased blood pressure, increased respiration, confusion Alcohol and Dehydration  Alcohol blocks the secretion of ADH  Kidneys do not reabsorb water they excrete it Oral Rehydration Solutions Water Intoxication (Overhydration)  Water intake is greater than water loss  Sodium in blood is diluted causing hyponatremia  Hypo means low, Na is the chemical symbol for sodium, emia means in thesolutes causing tissue swelling, or edema blood  Water moves by osmosis from the blood into the tissues to try to dilute the higher concentration of water Hyponatremia Meeting Water Needs • AI: men = 3.7 liters/day, women = 2.7 liters/day • Need increased intake with:  Increased activity  Increased temperature  Decreased humidity  Low-calorie diet  High-salt diet  High-fiber diet  Alcohol intake Fluid Recommendations for Exercise  Generous amounts of fluid in the 24 hours before an exercise session  About 2 cups of fluid 4 hours before exercise  6–12 ounces of fluid every 15–20 minutes for the duration of the exercise  After exercise, each pound of weight lost should be replaced with 16–24 oz (2 to 3 cups)  For exercise lasting an hour or less, water is the only fluid needed  For exercise lasting more than an hour, beverages containing carbohydrate (about 10 to 20 g of carbohydrate/cup) and electrolytes (around 150 milligrams of sodium in a cup) are recommended  Fruit juices and soft drinks are not recommended unless diluted with an equal volume of water Minerals  20 needed by the body in small amounts  Maintain structure and regulate chemical reactions and body processes  Major mineral: need >100 milligrams/day  sodium, potassium, chloride, calcium, phosphorus, magnesium, and sulfur  Trace mineral: need <100 milligrams/day  iron, copper, zinc, selenium, iodine, chromium, fluoride, manganese, molybdenum, and others Minerals Major Trace Electrolytes Bone Health Sodium Calcium Iron Chromium Potassium Phosphorus Copper Fluoride Chloride Magnesium Zinc Manganese Sulfur Selenium Molybdemum Minerals from Food  From plant and animal sources  Affected by:  Amount in soil  Processing:  Added (for example, during fortification) or  Removed (for example, by cooking or removing skins, bran, or germ)  Absorption & Bioavailability • Inhibited by substances in plants, other minerals, or amount in body Mineral Functions  Contribute to body structures  Regulate body processes  Regulate blood pressure  Regulate water balance  Regulate energy metabolism  Affect growth and development through their role in the expression of certain genes  Act as cofactors needed for enzyme activity Electrolytes  Positively or negatively charged ion that conducts a current in solution  Ions = charged atoms - charge: gained a negative electron + charge: lost a negative electron  Fluid balance maintenance, nerve impulse conduction, cellular signaling  Sodium  + charge: lost a negative electron  extracellular: outside of cells  Potassium  + charge: lost a negative electron  intracellular: inside of cells  Chloride  – charge: gained a negative electron  extracellular: outside of cells Electrolyte Imbalance  Deficiency:  Results in: acid–base imbalance, poor appetite, muscle cramps, confusion, apathy, constipation, irregular heartbeat, death  Caused by: heavy/persistent sweating, chronic diarrhea or vomiting, kidney disorders, or medications  Excess:  Excess potassium from supplements can cause the heart to stop  Excess sodium from dehydration/water loss: confusion, headache, and seizures Regulation of Blood Pressure Hypertension  Blood pressure consistently at or above 140/90 mm mercury  Caused by: increased contractions of the heart, increased blood volume, or decreased radius of blood vessels  Results in: atherosclerosis, heart attacks, strokes, death  Treated with: diet, exercise, and medication  Risks: genetics, race, age, obesity, diet, activity Dietary Approaches for Stopping Hypertension Hypertension and Diet Electrolyte Recommendations  Sodium:  UL: 2300 mg/day = 1 tsp of salt  Over 51 years old, African American or with medical conditions = 1500 mg/day  Typical consumption = 3400 mg/day  Potassium:  DRI = 4700 mg/day  DV = 3500 mg/day  Typical consumption = 2000-3000 mg/day Sodium in Foods Bones  Protein matrix: mostly collagen  Hardened by minerals: mostly calcium, phosphorus, also magnesium, sodium, fluoride, other minerals  Require:  Protein and vitamin C to maintain collagen  Calcium and other minerals to ensure solidity  Vitamin D to maintain calcium and phosphorus levels  Living tissue  Support weight and participate in movement  Constantly broken down and re-formed during bone remodeling  Peak bone mass: maximum bone density attained life, usually in young adulthood  Age related bone loss: bone loss that occurs in men and women as they advance in age (Amount of bone broken down starts to exceed amount that is formed) Osteoporosis  Osteoporosis- bone disorder characterized by reduced bone mass and increased bone fragility  Prevention  Achieve a high peak bone mass  Diet  Weight bearing exercise  No smoking  Limit alcohol  Treatment  Supplements Ca and Vitamin D  Weight bearing exercises  Estrogen  Biphosphonates NOTE: those with osteoporosis may be bent over because over time, the front edge of the spinal vertebrae collapses more than the back edge, so the spine bends forward; women also have a higher chance of getting Osteoporosis Calcium  99% in bones and teeth  In body cells and fluids, needed for:  Muscle contraction  Neurotransmitter release  Blood pressure regulation  Cell communication  Blood clotting  Levels regulated by hormones: Homeostasis vital  Too high: calcitonin “tones” it down  Too low: PTH and calcitriol “try” to bring it up  RDA: 19-50 years = 1000 mg/day; UL= 2500 mg/day  Sources: dairy products, dark green vegetables, fish with bones, foods processed and fortified with calcium  Deficiency: Osteoporosis  Excess: caused by cancers, increased PTH, excessive calcium and/or vitamin D intake causing altered availability of iron, zinc, magnesium, phosphorus; constipation; loss of appetite, abnormal heartbeat, weight loss, fatigue, frequent urination, soft tissue calcification, kidney stones and damage Calcium Hormones Decreased blood PHT & Calcitriol Stimulates intestinal Increased Blood calcium secretion absorption, kidney Calcium reabsorption, & bone resorption Increased Blood Calcitonin secretion Inhibit bone Decreased Blood Calcium resorption Calcium Calcium Supplements Phosphorus  Most found with calcium in bones and teeth  In soft tissues, needed for:  Phospholipid, DNA, RNA, and ATP structures  Enzyme activity regulation  Cellular acidity maintenance  RDA: adults = 700 mg/day; UL= 4000 mg/day  Sources: dairy products; meat; cereal; bran; eggs; nuts; fish; and food additives used in baked goods, cheese, processed meats, and soft drinks  Deficiency: rare; due to chronic diarrhea or poor absorption due to overuse of aluminum- containing antacids; causes bone loss, weakness, loss of appetite  Excess: high dietary phosphorus does not appear to be harmful for healthy adults, concern with sodas Magnesium  50-60% in bones  In cells and fluids, needed for:  Calcium regulation  Blood pressure regulation  ATP structure stabilization which is important for:  Energy release from carbohydrate, fat, and protein  Nerve and muscle functioning  DNA, RNA, and protein synthesis  RDA: men = 420 mg/day; women = 320 mg/day  Sources: leafy greens, nuts, seeds, legumes, bananas, germ and bran of whole grains  Deficiency: rare; causes osteoporosis, nausea, muscle weakness and cramping, irritability, mental derangement, blood pressure, heartbeat changes  Excess: no effects from foods; drugs or supplements can cause nausea, vomiting, low blood pressure, and other cardiovascular changes Sulfur  Part of:  amino acids and proteins  glutathione – needed for detoxification  B vitamins thiamin and biotin  Regulates acidity  RDA: none  Sources: part of dietary proteins and sulfur-containing vitamins, found in some food preservatives  Deficiency: none known Iron  Part of hemoglobin which transports oxygen to body cells and carries carbon dioxide away from them for elimination by the lungs  Needed for other iron-containing proteins such as myoglobin, a muscle protein which increases oxygen available for contraction  Essential for ATP production  Heme iron in proteins is absorbed more than twice as efficiently as the nonheme iron in plant sources Iron Availability  RDA: adults = 8 mg/day; UL = 45 mg/day  Sources: red and organ meats, legumes, leafy greens, whole and enriched grains  Deficiency: iron-deficiency anemia causing fatigue, weakness, headache, decreased work capacity, body temperature problems, behavior changes, increased infection, impaired development, lead poisoning  Excess: intestinal lining damage, abnormal body acidity, shock, liver failure; iron overload from inherited hemochromatosis Iron Deficiency Iron Excess  Iron can be harmful or fatal to children if taken in large doses  Excess iron in vital organs, even in mild cases of iron overload, increases the risk for liver disease (cirrhosis, cancer), heart attack or heart failure, diabetes mellitus, osteoarthritis, osteoporosis, metabolic syndrome, hypothyroidism, hypogonadism, numerous symptoms and in some cases premature death Copper  A copper-containing protein is needed for iron transport from intestinal cells  Component of proteins and enzymes involved in:  Connective tissue synthesis  Lipid metabolism  Heart muscle maintenance  Immune and central nervous system functions  RDA: adults = 900 micrograms/day; UL = 10 mg/day  Sources: organ meats, seafood, nuts, seeds, whole-grain breads and cereals, chocolate  Deficiency: iron-deficiency anemia, decreased collagen, high blood cholesterol, impaired growth, heart and nervous system degeneration, hair color and structure changes, increased infections, decreased antioxidants  Excess: from supplements, copper containers, contaminated water, causing abdominal pain, vomiting, diarrhea Zinc  Involved in the functioning enzymes involved in:  Scavenging free radicals  DNA and RNA synthesis  Carbohydrate metabolism  Acid–base balance  Absorption of folate from food  Storage and release of insulin  Mobilization of vitamin A from liver  Stabilization of cell membranes  Influences hormonal regulation of cell division  RDA: men = 11 mg/day; women = 8 mg/day  Sources: meat, liver, eggs, dairy products, vegetables, legumes, seeds  Deficiency: decreased growth, development and immunity; skin rashes; diarrhea, taste changes  Excess: from supplements causing gastrointestinal irritation; vomiting; appetite loss; diarrhea, abdominal cramps; headaches; decreased immunity, HDL, copper and iron absorption Zinc & Gene Expression Selenium  Incorporated into the structure of certain proteins:  Glutathione peroxidase which decreases oxidative damage  A protein needed to make thyroid hormones  RDA: adults = 55 mg/day; UL = 400 mg/day  Sources: seafood, kidney, liver, eggs, grains, nuts, seeds  Deficiency: Keshan disease = heart disease in China; increased risk of cancer Iodine  ¾ in the thyroid gland  Component of thyroid hormones which regulate metabolic rate, growth, and development and promote protein synthesis  RDA: adults = 150 mg/day; UL = 1100 mg/day  Sources: seafood, iodinized salt, food contaminants and additives  Deficiency: decreased thyroid hormones causing decreased metabolic rate, fatigue, weight gain; goiter (enlarged thyroid); during pregnancy causes spontaneous abortions, stillbirths, cretinism (brain damage)  Excess: goiter Chromium  Component of “glucose tolerance factor,” a small peptide required to maintain normal blood glucose levels  RDA: ages 19–50: men = 35 micrograms/day; women = 25 micrograms/day  Sources: liver, brewer’s yeast, nuts, whole grains  Deficiency: rare in US  Excess: little evidence Fluoride  Incorporated into crystals in tooth enamel which protects against cavity-causing acids produced by bacteria  In saliva, decreases bacterial acid production, inhibits dissolution of tooth enamel by acid, and increase enamel re-mineralization after acid exposure  Incorporated into crystals in bone  RDA: 0.05 mg/kg/day; UL = 0.1 mg/kg/day for infants and children less than 9 years old and 10 mg/day between 9 and 70 years  Sources: in small amounts in almost all soil, water, plants, and animals; toothpaste; tea; marine fish with bones; fluoridated water  Deficiency: tooth decay  Excess: fluorosis causing black and brown stains and cracking and pitting of the teeth 5-10% 60 -75% 15-30% Basal Metabolic Rate (BMR)  Lowest rate of energy expenditure. Amount of calories your body burns at rest; energy needed for essential body functions  Calculated from oxygen consumption measured over a 6 to 12 minute period  12 hr fast & rested quietly for 30 minutes in a thermally neutral environment  True BMR occurs in early morning hours of deep sleep - impractical to study  Resting Metabolic Rate usually used to estimate calorie needs  60-75% of total energy expenditure Basal Metabolism NOTE: these factors affect Resting Metabolic rate as well Physical Activity  15-30% of total energy expenditure Includes:  Planned & daily activities  Walking, yard work, work-related activities, fidgeting  Non-exercise activity thermogenesis (NEAT): energy expended for everything that is not sleeping, eating, or sports-like exercise NOTE: exercising can raise your metabolic rate overall, not just for a few hours during/after exercising Thermic Effect of Food  Energy required for the digestion, absorption, storage and/or disposal of ingested food  5-10% of total energy expenditure Techniques for Measuring Energy Expenditure  Estimation using Equations  Direct Calorimetry Method: measures body’s heat output Walls contain layer of water Chamber measures heat expelled by radiation, convection, evaporation 30 diff measurements monitored Highly accurate, expensive, time consuming No indication of type of fuel being used  Indirect Calorimetry Energy metabolism depends on use of oxygen and production of carbon dioxide Compares [O 2 & [CO 2 volume in inspired vs. expired air Results close to direct calorimetry Less expensive DRI Equations: Estimated Energy Requirements  Estimated energy requirement (EER): number of calories needed for a healthy individual to maintain his or her weight  Calculated based on gender, age, height, weight, activity level, and life stage  Need to know physical activity (PA) value Physical Activity & PA Level NEAT Energy Intake Review Carbs: 4 cal/gram Fat:9 cal/gram Protein: 4 cal/gram Alcohol:7 cal/gram Energy Balance  Maintain weight: calories consumed = calories expended  Weight gain: calories consumed > calories expended  Weight loss: calories consumed < calories expended Storage of Excess Calories Excess Body Fat Increases Health Risks  high blood pressure  heart disease  high blood cholesterol  diabetes  gallbladder disease  arthritis  sleep disorders  respiratory problems  menstrual irregularities  breast, uterus, prostate, & colon cancer  incidence and severity of infectious disease  poor wound healing  surgical complications Body Mass Measurements  Lean body mass: mass of non-fat body parts  Body weight = lean body mass + weight of fat Body mass index (BMI) = Weight in kilograms/(Height in meters) or 2 [Weight in pounds/(Height in inches) ] x 703 BMI  Overweight: > 25 and < 30 kg/m  Underweight: <18.5 kg/ m  Obesity: >30 kg/ m 2  Morbid/extreme obesity: > 40 kg/m Measuring Body Composition Skinfold Underwater Weighing Thickness Bod Pod DX Bioelectric alpedanc A e Percent Body Fat  Young, healthy female: 21–32% of total weight  Young, healthy male: 8–19% of total weight  With age: Lean body mass decreases Body fat increases Body Fat Location  Subcutaneous fat: adipose tissue under the skin, for example, in hips and legs (pear shape)  Visceral fat: adipose tissue around abdominal organs (apple shape)  more metabolically active  associated with higher disease risk Genes & Body Weight  >100 genes are associated with body weight management  20–30 obesity genes produce proteins affecting how much food you eat, how much energy you expend, and the way fat is stored Genes & Environment Set Point  Body compensates for diet and exercise variations by adjusting energy intake and expenditure to keep weight at a particular level  Body responds to short-term changes in food intake and activity and long-term changes in stored body fat  Determined in part by genes Appetite, Hunger, & Satiety  Appetite: desire to consume specific foods triggered by external cues (for example, smell) independent of hunger  Satiety: Feeling of fullness and satisfaction caused by food consumption that eliminates desire to eat  Hunger: desire to consume food that is triggered by internal physiological signals Short-Term Regulation of Food Intake Hormones & Weight Control  Ghrelin: released by the stomach to stimulate the desire to eat at usual mealtimes  Peptide YY: released by the gastrointestinal tract after a meal in proportion to the number of calories consumed to reduce appetite  Leptin: secreted from adipocytes in proportion to their size to regulate energy intake and expenditure Leptin Weight Management  Balance between energy intake & expenditure Portion Distortion Weight-Loss Decisions Losing Weight  Eat less, exercise more, or both  Change behaviors that led to weight gain  To lose a pound of fat, decrease intake and/or increase expenditure by about 3500 Calories  To lose a pound in a week, tip energy balance by about 500 Calories/day  Losing weight at a rate of 1/2 – 2 lbs/week helps ensure mostly fat loss and not lean tissue  For most people, a loss of 5% to 15% of body weight will significantly reduce disease risk Weight Cycling (Yo-yo Dieting) Behavior Modification Gaining Weight  Have a medical assessment to determine reasons for low weight  Gradually increase energy-dense foods  To encourage muscle gain rather than fat, strength-training exercise should be a component of any weight gain program Weight-Loss Diets  Effective programs promote:  weight loss can be maintained over the long term  healthy weight-loss  changes in the lifestyle patterns that led to weight gain  To maintain weight loss, fewer calories need to be consumed Weight Loss Plans Self-Reflection  What are you eating?  When are you eating?  How much?  Who are you eating with?  Feelings/Mood  Satiety  Symptoms Tips for Weight Maintenance  Eat breakfast  Eating similar on weekend and weekdays Don’t go too low.  Small, frequent meals  Support  Avoidance of mindless eating  Self-Monitoring  Maintaining Physical Activity  Portion Control Eating Healthy When Eating Out  Cooking methods (roasted, broiled, steamed, poached, and baked)  Have it your way Nutrition Apps to Decrease Barriers = Increase in Positive Choicesation Prescription Weight-Loss Drugs  Reduce appetite by affecting brain neurotransmitters  EX: phentermine (Adipex)  Decrease fat absorption in the intestine  EX: orlistat (Xenical)  Recommended only if health is seriously compromised by body weight  Disadvantage: weight usually regained when drug is discontinued OTC Weight-Loss Drugs Weight-Loss Supplements  Not regulated by the FDA  Contain soluble fiber to help feel full  “Fat burners”  Ephedra - increases blood pressure and heart rate and constricts blood vessels (banned in 2004)  Bitter orange, guarana, green tea extract  Weight loss through water loss  Diuretics or laxatives (senna, aloe, buckthorn, rhubarb root, cascara, and castor oil) Weight-Loss Surgery  Alters the gastrointestinal tract to reduce food intake and absorption  Adjustable gastric banding: limits amount of food that can be consumed  Gastric bypass: reduces amount of food that can be consumed and absorbed  Liposuction: a large hollow needle is inserted under the skin into a fat deposit to vacuum out the fat; cosmetic Eating Disorders  Psychological illnesses characterized by specific abnormal eating behaviors, often intended to control weight  Anorexia nervosa: self-starvation, a distorted body image, and abnormally low body weight  Bulimia nervosa: consumption of a large amount of food at one time (binge eating) followed by purging behaviors (self-induced vomiting)  Binge-eating disorder: recurrent episodes of binge eating in the absence of purging behavior NOTE: binge-eating is the most common, yet least talked about eating disorder Anorexia Nervosa Criteria  Significantly low body weight  Intense fear of gaining weight/becoming fat  Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight. Bulimia Nervosa Criteria  Recurrent episodes of Binge Eating (Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances)  A sense of lack of control over eating during the episode  Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise  Mentioned events recurring at least once a week for 3 months  Self-evaluation unduly influenced by body shape & weight Binge-Eating Disorder Criteria An episode of binge eating is characterized by both of the following:  Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances  A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). Binge eating episodes are associated with at least three 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 being embarrassed by how much one is eating  Feeling disgusted with oneself, depressed or feeling very guilty after overeating. Marked distress regarding binge eating is present: At least once a week for 3 months The binge eating is not associated with the recurrent use of inappropriate compensatory behavior Help for Eating Disorders  Treat as early as possible  Get Treatment from multiple disciplines  Be aware of friends and family members who are at risk. Be supportive


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