Secondary Prevention

• early detection to halt, reduce, or reverse the effects of a disease or poor health
• manages disease

Essential Nutrients

• body CAN NOT synthesize
• must be obtained from diet

Nonessential Nutrients

• nutrients that the body can synthesize

Dietary Standards

• a guide to adequate nutrient intake levels against which to compare nutrient values of foods consumed

Recommended Dietary Allowance (RDA)

• the amount of nutrient and calorie intake per day considered necessary for maintenance of good health
• amount of nutrient needed to satisfy the needs of almost healthy individuals at a life stage or gender study

Estimated Average Requirement (EAR)

• The daily intake of a specific nutrient estimated to meet the requirement in 50% of healthy people in an age- and gender-specific group

Adequate Intake (AI)

• A recommended intake value based on observed or experimentally determined approximations or estimates of nutrient intake by a group of healthy people
• used when recommended allowance is not determined

Tolerable Upper Intake Level (UL)

• is the level of nutrient intake that should not be exceeded to prevent adverse health risks

Acceptable Macronutrient Distribution Range (AMDR)

• daily percent of calories intake that should come from carbs, lipids, and proteins

daily kcal intake for carbs

• 45-65%

daily kcal intake for saturated fats

• 10% or less

daily kcal intake for lipids/fats

• 20-35%

daily kcal intake for proteins

• 10-35%

Estimated Energy Requirement (EER)

• the DRI for dietary energy intake

Nutrient Density

• ratio comparison of a food's nutrient content with the kcal value that the food contains
• nutrient value vs caloric value

Overnutrition

• consumption of too many nutrients and too much energy in comparison with DRI values

Malnutrition

• condition resulting from an imbalanced nutrient and/or energy intake

Undernutrition

• consumption of not enough energy or nutrients in comparison with DRI values

Four Themes of MyPlate

1. Variety
2. Proportionality
3. Moderation
4. Activity

Variety (MyPlate Theme)

• eat foods from all food groups and subgroups

Proportionality (MyPlate Theme)

• eat more of some foods and less of others

Moderation (MyPlate Theme)

• choose types of foods that limit intake of saturated or trans fats, added sugars, cholesterol, salt, and alcohol

Activity (MyPlate Theme)

• be physically active every day

Food Labels

• a way for consumers to see how individual foods fit their nutritional needs

Metabolism

• enzyme mediated chemical reactions
• cells use energy to build and acquire energy from the breakdown of organic molecules
• absorbed nutrients are used by the body for energy and to form and maintain body structures and functions

Anabolism

• process of synthesis from which substances are formed
• uses energy to build organic molecules
• endothermic

Catabolism

• breakdown of food components into smaller molecular particles
• acquires energy breaking down organic molecules
• exothermic

GER (gastroesophagel reflux)

• A backflow of the contents of the stomach into the esophagus, caused by relaxation of the lower esophageal sphincter

Strategies to prevent GER

• avoid high-fat meals
• avoid overeating
• avoid laying down after eating
• avoid pressure on stomach
• avoid eating too fast

3 Elements found in Carbohydrates

• Carbon, Hydrogen, and Oxygen

Ratio of elements in Carbs

• 1:2:1

Monosaccharides (simple carbohydrates)

• composed of single carbohydrate units
• ex: glucose, fructose, galactose

Disaccharides (simple carbohydrates)

• consists of two single carbohydrates bound together
• ex: sucrose, maltose, lactose

Polysaccharides (complex carbohydrates)

• consists of many subunits of monosaccharides joined together
• ex: starch, fiber, glycogen

Glycogen

• storage form of carbohydrate energy
• stored in the liver and muscles
• retrieved as needed for energy

Glycogenesis

• the process of converting glucose to glycogen

Carbohydrates

• provides energy (function)
• protein-sparing effect
  • If enough carbohydrate is provided to meet the energy needs of the body, protein can be spared or saved to use for specific protein functions
• the CNS functions best from glucose
• the GI tract has the role of digesting carbs into monosaccharides for easy absorption

Blood glucose homeostasis

• between 70 to 100 mg/dL

Glycogenolysis

• the process of converting glycogen back to glucose

Glycolysis

• a metabolic process that breaks down carbohydrates through a series of reactions to either pyruvic acid or lactic acid and releases energy for the body in the form of ATP

Gluconeogenesis

• the process of producing glucose from fats or protein

Ketone Bodies

• created when fatty acids are broken down for energy when sufficient carbs are unavailable

Glucose

• simple carbs (monosaccharides)
• blood sugar
• rapidly absorbed into the bloodstream
• food sources: fruits, sweeteners

Fructose

• simple carbs (monosaccharides)
• fruit sugars
• food sources: fruits, honey, syrups, vegetables

Galactose

• simple carbs (monosaccharides)
• food sources: part of lactose, found in milk

Sucrose

• simple carbs (disaccharides)
• glucose + fructose
• table sugar
• food sources: sugarcane, sugar beets, fruits, vegetables

Lactose

• simple carbs (disaccharides)
• milk sugar
• food sources: milk and milk products
• glucose + galactose

Maltose

• simple carbs (disaccharides)
• malt sugar
• food sources: germinating grains
• glucose + glucose

Starches

• complex carbohydrates
• strings of glucose
• storage form of plant carbohydrate
• food sources: grains, legumes, potatoes

Fiber

• roughage
• strings of monosaccharides, usually glucose
• cannot be broken down by human digestive enyzmes
• Insoluble vs Soluble Fiber
• food sources: legumes, whole grains, fruits, vegetables

Blood Glucose

• a source of energy to all cells

Ketoacidosis/Ketosis

• the result build up of ketones leading to acid-base imbalances in the body

Insulin

• hormone
• produced by the beta cells of the islets of Langerhans
• lowers/decrease blood glucose levels by enhancing the conversion of excess glucose to glycogen (glycogenesis)

Glucagon

• hormone
• increases blood glucose levels
• stimulates conversion of liver glycogen to glucose
• assists regulation of blood glucose throughout the night

Somatostatin effect on blood glucose

• hormone
• secreted from the hypothalamus and pancreas
• inhibits the functions of insulin and glucagon

Epinephrine effect on the liver

• hormone
• enhances the fast conversion of liver glycogen to glucose (glycogenolysis)

Steroid Hormones (Insulin Inhibitor)

effect on blood glucose

• functions against insulin
• promotes glucose formation from protein

Adrenocorticotrophic Hormone (ACTH)

effect on blood glucose

• insulin inhibitor
• promotes glucose formation from protein

Thyroid Hormones effect on blood absorption

• affects blood glucose level by enhancing intestinal absorption of glucose and releasing epinephrine

Growth Hormones effect on blood glucose

• insulin inhibitor
• increase gluconeogenesis from protein

Glycemic Index

• rankings of foods according to the level to which a food raises blood glucose levels
• measures a single component of food

Glycemic Load

• considers the total glycemic index effect of a mixed meal of dietary plan
• whole thing

What happens to fructose in the liver?

• liver cels rearrange fructose into glucose

What happens to starch in the digestive tract?

• it is broken down to provide glucose

Insoluble FIber

• fiber that does not dissolve in fluids

Soluble Fiber

• fiber that dissolves in fluids
• thickens substances
• provides structure and protection for plants

Health Effects of Dietary Fiber

• obesity
• constipation
• diverticular disease
• colon cancer
• heart disease
• diabetes control

Since the 1940s ______ grains are generally enriched with niacin, folate, thiamine, riboflavin, and iron.

refined

______/______ grains are sources of magnesium, riboflavin, niacin, thiamin, vitamin B6, zinc, and some protein that are k=lost when refined.

whole/unrefined

Palatibility (Lipids)

• fats make food taste and smell good

Satiety (Lipids)

• hormones released in response to the consumption of fat causes us to feel full and satisfied

Satiation (Lipids)

• increases our desire to eat more fatty food

Emulsifier

• a substance that works by being soluble in water and fat at the same time

Lipoproteins

• carriers or transporters of lipids

Lecithin

• a phospholipid
• extensive role as an emulsifier
• part of lipoproteins

Triglycerides (structure)

• composed of a glycerol and three fatty acids

How can you tell the difference between carbohydrates and triglycerides by looking at the chemical formula?

What elements are found in triglycerides?

• carbon
• hydrogen
• oxygen

Physiologic Function of Triglycerides

• stored energy
• organ protection
• temperature regulation
• insulation

Function(s) of Phospholipids

• form part of all cell membrane structure
• serve as emulsifiers to keep fats dispersed in body fluids

Function(s) of Sterols

• provides basic material to make bile, vitamin D, sex hormones, and cells in brain and nerve tissue

What elements are found in fatty acids?

• carbon atoms

Cholesterol

• a vital part of all cell membrane, nerve tissue, and building block for hormones

How many carbons are found in glycerol?

• there are three carbon atoms in glycerol
• tri = 3

Saturated Fatty Acid

• has a single-bonded carbon chain
• fully saturated b/c hydrogen atoms are attached to all available bonding sites
• contained in meats, butterfat, shortening, and vegetable oils

Monounsaturated Fatty Acid (MUFA)

• a carbon chain has only one unsaturated double bond
• dietary sources: olive oil, peanuts, and canola oil

Polyunsaturated Fatty Acid (PUFA)

• a carbon chain has two or more unsaturated double bonds
• characterized by the location of the unsaturation in the molecular structure
• dietary sources: vegetable oils, fish, and margarine

What two categories of polyunsaturated fatty acids are essential?

• omega-3 (linolenic)
• omega-6 (linoleic)

Americans consume a large amount of Omega-____.

omega-6 (linoleic)

Americans consumption of Omega-___ is low.

omega-3 (linolenic)

Types of Omega-_ help prevents heart disease.

omega-3 (linolenic)

Rich sources of Omega-__ are deep water fish such as salmon, tuna, sardines, and herring. Omega-__ can also be obtained from plant sources such as canola oil, some nuts such as walnuts, soybean and soybean oils, and extra virgin or virgin oils.

omega-3; omega-3

Hydrogenation

• process which forces hydrogen atoms to break a double bond and attach to the carbons
• creates saturated fat
• makes fats more solid/stable

Dietary Sources of Saturated Fatty Acids

• meats
• butterfat
• shortening
• vegetable oils
• beef
• poultry
• pork
• lamb
• egg yolks
• dairy products

Catabolism of Lipids

• involves the hydrolysis of triglycerides into two-carbon units that become part of acetyl coenzyme A (acetyl CoA)

Acetyl CoA (Lipids)

• an intermediate byproduct in metabolism
• formed from the breakdown of glucose, fatty acids, and certain amino acids
• enters the TCA cycle

Lipogenesis

• synthesis of lipids
• results in the formation of triglycerides, phospholipids, cholesterol, and prostaglandins

When found in excess, glucose and amino acids are converted to what form of lipid?

• triglycerides and phosphates

Lipid metabolism is primarily regulated by _______, ____ _____, and ______ ______ ______.

insulin; growth hormones; adrenal cortex hormones

Role of Bile Emulsification (Lipids)

• bile emulsifies fat to facilitate digestion

Chylomicrons

• the first lipoproteins formed after the absorption of lipids from food
• transport fats from the intestinal wall to the liver cells

Most Americans consume between _______ and _______ % of total energy as fat. How does this compare to the suggested ADMR?

• 35 to 40%
• it exceeds the ADMR for fat which is 20-35%

Very Low-Density Lipoproteins (VLDL)

• large lipoproteins rich in triglycerides;
• VLDLs circulate through the blood giving up their triglycerides to fat and muscle tissue until the VLDL remnants are modified and converted into LDL
• leaves the liver cells full of fats and lipid components to transfer newly made triglycerides to the cells

Low Density Lipoproteins (LDL)

• a lipoprotein that t ransports cholesterol in the blood; composed of moderate amount of protein and a large amount of cholesterol;
• high levels are thought to be associated with increased risk of coronary heart disease and atherosclerosis

Protease

• protein enzymes
• secreted in the mouth, stomach, and small intestine

Amino Acids (20)

• organic compounds
• contain carbon, hyrdrogen, oxygen, and nitrogen

Essential Amino Acids (9)

• must be eaten in food

Nonessential Amino Acids (11)

• liver can create as long as the structural components (including nitrogen) are available

Amino Acid Pool

• a collection of amino acids that is constantly resupplied with EAAs and NEAAs
• allows cells to build proteins easily

Functions of Proteins

• growth and maintenance
  • All growth depends on a sufficient supply of amino acids. The amino acids are needed to make the proteins required to support muscle, tissue, bone formation, and the cells themselves
• creation of communicators and catalysts
• immune system response
• fluid anf electrolyte balance
• acid-base balance
• transportation

Complete Protein

• contains all nine EAAs in sufficient quantities that best support growth and maintenance

Incomplete Protein

• lacks one or more of the nine essential amino acids

Protein Energy Malnutrition (PEM)