Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 4 Carbohydrates: Sugars, Starches and Fibers Carbohydrates in our Foods • Unrefined foods: foods eaten either just the way they are found in nature or with minimal processing. • Refined: foods that have undergone processing to remove the coarse parts of the original food What is a Whole Grain? • Whole -grain product: include the entire kernel of the grain. • Germ: located at the base of the kernel; is the embryo where sprouting occurs. It is a source of oil and is rich in Vitamin E. • Bran: outermost la yers of the kernel; contain most of the fiber and are a good source of many vitamins and minerals. • Endosperm: makes up most of the kernel. It is primarily starch, but also contains protein along with some vitamins and minerals. • Enrichment: adds back some but not all nutrients lost during processing. Some nutrients added back are thiamin, riboflavin, niacin, iron and folic acid. What is a Refined Sugar? • Nutritionally and chemically identical to sugars that occur naturally in foods. • When separated from thei r plant source, they no longer come with fiber, vitamins, minerals and other substances found in plants. • Empty calories: energy with few additional nutrients. • Account for about 13 % of the calories consumed in a typical American diet. Types of Carbohydrates Simple carbohydrates • Monosaccharides: carbohydrates made up of only one sugar unit. Contain 6 carbon, 12 hydrogen, and 6 oxygen molecules. The three most common are glucose, fructose, and galactose. o Glucose: primary form of carbohydrate used to provide energy in the body; often called blood sugar o Fructose: found in fruits and vegetables. It makes up more than half the sugar in honey and in the high -fructose corn syrup used to sweeten many foods and beverages. o Galactose: part of milk sugar. • Di saccharides: carbohydrates made up of two sugar units. o Maltose: glucose + glucose. Formed whenever starch is broken down. o Sucrose: glucose + fructose. Table sugar. It is the only sweetener that can be called “sugar” on food labels in the US. o Lactose: glucose + galactose. Milk sugar. Complex carbohydrates • Polysaccharides: carbohydrates made up more than two sugar units. • Glycogen: storage form of glucose in humans and animals. Found in the liver and muscles. • Starch: storage form of glucose in plants. • Fiber: type of complex carbohydrate that cannot be digested by human digestive enzymes. o Soluble fiber: dissolves in water or absorbs water and can be bro ken down by intestinal microbiota . ▪ Pectins, gums, and some hemicelluloses ▪ Food sour ces: oats, apples, beans and seaweed. o Insoluble fiber: does not dissolve in water and cannot be broken down by bacteria in the large intestine so it adds bulk to fecal matter. ▪ Primarily the structural parts of plants. ▪ Cellulose, some hemicelluloses and lig nin. ▪ Food sources: wheat, rye bran, broccoli and celery. • Photosynthesis — the process by which plants use the sun’s energy to make carbohydrates from carbon dioxide and water o Plants often convert the glucose made during photosynthesis to starch. When it’s eaten the starch is converted back to glucose. Carbohydrate Digestion and Absorption Carbohydrate Digestion • Disaccharides and complex carbohydrates must be digested to monosaccharides before they can be absorbed into the body. • Digestion begins in the mouth; the enzyme salivary amylase starts breaking down starch into shorter polysaccharides. • In the stomach, salivary amylase is inactivated by acid so no carbohydrate digestion occurs. • In the small intestine, most starch digestion and breakdown of disacc harides occur. Pancreatic amylase completes the job of disaccharide breakdown. • Enzymes attached to the brush border of the small intestinal villi complete the digestion of d isaccharides and oligosaccharides into monosaccharides. • In the large intestine, fib er and other indigestible carbohydrates are partially broken down by bacteria to form short chain fatty acids and gas. Some fiber is excreted in the feces. Lactose Intolerance • The inability to digest lactose due to a reduction in the levels of the enzyme lactase. • Produces gas and abdominal distension, cramping and diarrhea. • Incidence varies among populations. Indigestible carbohydrates • Oligosaccharides: short carbohydrate containing 3 -10 sugar units. o Not digested because they cannot be broken down by human enzymes. • Resistant starch: not digested beca use of the structure of the pla nt or because cooking and processing alter their digestibility. o Examples: legumes, unripe bananas, and cold cooked potatoes, rice and pasta. • Fiber s low s the rate at which nutr ients are absorbed. • Fiber can bind to certain minerals, preventing their absorption. • Speed transit through the intestine by increasing the amount of water and the volume of material in the intestine. Carbohydrate Absorption • The monosaccharides from carboh ydrate digestion enter the portal circulation and travel to the liver. • The liver uses fructose and galactose for energy. • Glucose can be used for energy, stored as liver glycogen, or delivered via circulation to other body tissues, causing the blood glucose levels to rise. • Glycemic response: the rate, magnitude, and duration of the rise in blood glucose that occurs after food is consumed. What a Scientist Sees • Glycemic index: ranking of how a food affects blood glucose relative to the effect of an equivalen t of carbohydrate from a reference food. o Contains a set amount of carbohydrate: 50 grams. o On a glycemic index scale, white bread is 100, potatoes are 90, and kidney beans are 25. • Glycemic load: this compare s the effect of a typical portion of food on blood glucose . Carbohydrate Functions • Main function of carbohydrate is to provide energy. • Other roles in the body: o Galactose is needed by nerve tissue. o In breast -feeding women, galactose combines with glucose to produce lactose. o The monosaccharides ribose and deoxyribose play non -energy roles as components of RNA and DNA. o Ribose is compound of the B vitamin riboflavin. o Oligosaccharides are associated with cell membranes. o Large polysaccharides found in connective tissue provide cushion ing and lubrication. Getting Enough Glucose to Cells • Glucose is an important fuel for body cells. o Brain cells, red blood cells must have glucose to stay alive. • The concentration of glucose in the blood is regulated by the liver and hormones secreted by th e pancreas. • Insulin: hormone made in the pancreas that allows glucose to enter cells and stimulates the synthesis of protein, fat, and liver and muscle glycogen. • Glucagon: hormone made in the pancreas that raises blood glucose levels by stimulating the bre akdown of liver glycogen and the synthesis of glucose. Glucose as a Source of Energy • Cells use glucose to provide energy via cellular respiration. • Uses oxygen to converts glucose to carbon dioxide and water and provide energy in the form of ATP. • Glycolysis: an anaerobic metabolic pathway that splits glucose into two three -carbon pyruvate molecules; the energy released from one glucose molecule is used to make two molecules of ATP. The first step in cellular respiration. • Anaerobic metabolism: metab olism in the absence of oxygen. • Aerobic metabolism: metabolism in the presence of oxygen. It can completely breakdown glucose to yield carbon dioxide, water, and energy in the form of ATP. Carbohydrate and protein breakdown • In the absence of adequate carb ohydrate, amino acids can supply three -carbon molecules that can be broken and used to synthesize glucose. • Body proteins used for glucose synthesis are no longer available to do their job. • Fatty acids break down to two -carbon molecules and cannot be used to synthesize glucose. • Spare protein: sufficient carbohydrate is ensures that protein is not used for glucose synthesis. Carbohydrate and fat breakdown • Ketones or ketone bodies: acidic molecules formed when there is not sufficient carbohydrate to completely metabolize the acetyl -CoA produced from fatty acid breakdown. o Can be used for energy by the heart, muscle, kidney and brain. o Ketones not used for energy are excreted in the urine. • Ketosis: high levels of ketones in the blood. o Occurs during starvation or when consuming a low -carbohydrate weight -loss diet. o Symptoms: reduced appetite, headaches, dry mouth, and odd -smelling breath. o Can increase the blood’s acidity so much that normal body processes are disrupt ed. o Severe ketosis can occur with untreated diabetes and can cause coma and death. Carbohydrates in Health and Disease Diabetes • Diabetes mellitus: disease characterized by elevated blood glucose due to either insufficient production of insulin or decreased sensitivity of cells to insulin. • Damages the heart, blood vessels, kidneys, eyes, and nerves. • Leading cause of adult blindness. • Accounts for over 40% of new cases of kidney failure. • Accounts for more than 60% of non -traumatic lower -limb amputatio ns. • 29.1 million people in the US diagnosed with diabetes. • Another 8.1 million have undiagnosed diabetes. • The incidence of diabetes is greater in minority populations. • Glucose levels in diabetes: o Normal blood glucose: less than 100 mg/100 ml blood after an eight -hour fast. o Prediabetes: fasting blood level between 100 -125 mg/100 ml o Diabetes: fasting blood level at or above 126 mg/100 ml Types of diabetes • Type 1 diabetes: is an autoimmune disease in which insulin -secreting pancreatic cells are destroyed by the body’s immune system. o Accounts for 5 -10% of diagnosed cases. o Usual diagnosis is before age 30. o Must inject insulin to keep blood glucose levels in the normal range. • Type 2 diabetes: characterized by insulin resistance and relative (rather than absolute) insulin deficiency. o Accounts for 90 -95% of all cases. o Insulin resistance: body cells lose their sensitivity ; or amount of insulin secreted is reduced . o Due to genetic and lifestyle factors. • Prediabetes: condition in which glucose levels are above normal but not high enough to be diagnosed as diabetes. o Adjustments in diet and lifestyle can keep prediabetes from progressing to type 2 diabetes. • There are many risk factors for type 2 diabetes including consuming a poor diet that is high in refin ed carbohydrates. • Gestational diabetes: an elevation of blood sugar that is diagnosed during pregnancy. o High levels of glucose in the mother’s blood are passed to the fetus, frequently resulting in a baby who is large for gestational age and at increased risk of complications. o Women with gestational diabetes are at increased risk of developing type 2 diabetes later in life. Symptoms and Complications of diabetes • Early symptoms: frequent urination, excessive thirst, blurred vision, and weight loss. • Long -term complications: damage to heart, blood vessels, kidneys, eyes, and nerves. o Increased risk of heart attack and stroke. o Blindness, kidney failure, and nerve dysfunction. o Infections may lead to amputations of toes, feet, and legs . Mana ging blood glucose • Diet: carbohydrate must be coordinated with exercise and medication o Limit amount of carbohydrates at each meal o Unrefined carbohydrates o Limit satur ated fat and trans fat o Weight management • Exercise: helps achieve and maintain a healthy bod y weight. o Increases cells sensitivity to insulin. • Medication o Type 1 requires insulin by injection. o Type 2 and gestational: may require oral medications or insulin injections. Hypoglycemia • Abnormally low blood glucose levels. o below 70 mg glucose/100 ml blood o Symptoms: irritability, sweating, shakiness, anxiety, rapid heartbeat, headache, hunger, weakness, and sometimes seizures and coma. o Occurs most frequently in people with diabetes as a result of overmedication. • Fasting hypoglycemia: occ urs when an individual has not eaten. o Often related to underlying condition: excess alcohol consumption, hormonal deficiencies or tumors. o Treatment: identify and treat underlying disease. • Reactive hypoglycemia: occurs in response to the consumption of high -carbohydrate foods. o Treatment: small, frequent meals that are low in carbohydrate and high in protein and fiber. Weight Management Carbohydrates and weight loss • Type of carbohydrates consumed can affect hunger and whether weight is gained or lost. • Diet high in unrefined carbohydrates: high in fiber and filling. o Can help promote weight loss. o May be problematic for children who become satiated before meeting nutrient requirements. • Diets high in refined carbohydrate: cause a rapid rise in blood glucose and stimulate release of insulin. o May shift metabolism toward fat storage. • Low carbohydrate diets: lead to weight loss because they reduce insulin levels and raise blood ketone levels, both of which suppress appetite. o Limit food choices le ading to monotony and resulting in reduction of calorie intake. Debate: Is sugar making us sick ? • Issue: Is sugar “toxic”? Few would argue that the sugar calories we consume would be better spent on healthier foods. Sugar has been implicated as a cause of not only dental problems but obesity, diabetes, heart disease, and even cancer. Do the current levels of sugar consumption pose a serious health risk? Heart Disease • A diet high in sugar can raise blood lipid levels and thereby increase the risk of heart disease. • Diets high in fiber from grains, vegetables, and fruits have been found to reduce the risk of heart disease. o Soluble fibers may lower blood cholesterol levels. o May help lower blood pressure, normalize blood glucose levels, and prevent obesity. Dental Caries • Best documented health problem associated with carbohydrate intake. • Occur when bacteria on teeth metabolize carbohydrates, producing tooth -damaging acids. • Prevention: limit intake of sweet or sticky foods and proper dental hygiene. Bowel Hea lth • Fiber and other indigestible carbohydrates add bulk and absorb water in the GI tract. o Make feces larger and softer and reducing the pressure needed for defecation. • Hemorrhoids: swelling of veins in the rectal or anal area. • Diverticulosis: condition in which outpouches form i n the wall of the colon . o Treatment: high fiber diet. • Diverticulitis: inflammation, irritation and pain. o May lead to infection. o Treatment: antibiotics and low -fiber diet. Meeting Carbohydrate Needs Carbohydrate Recommendations • RDA : 130 g/day • Acceptable Macronutrient Distribution Range: 45 – 65% of total calorie intake. • Adequate Intake for fiber: 38 g/day for men and 25 g/day for women. • No Upper Limit has been established for total carbohydrate, fiber or added sugar intake. • Dietary Guidelines 201 5-2020 : limit added sugars to less than 10% of calories . Choosing Carbohydrates Wisely • Use Dietary Guidelines 2015 -2020 and MyP late to make healthy choices • Pros and Cons of Nonnutritive sweeteners o Artificial sweeteners which provide no calories. o FDA has approved acesulfame K, advantame, aspartame, Luo Han Guo, neotame , saccharin, stevia , and sucralose . o When sweeteners are used instead of sugar, calorie intake is reduced. o Can help reduce the incidence of dental caries and manage blood sugar levels. • Interpret food labels o Find foods that are good sources of fiber. o Identify whole -grain products and sources of added sugar. What Should I Eat? Carbohydrates • Make half your grains whole. • Increase your fruits and vegetables. • Limit added sugars
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 2 Guidelines for a Healthy Diet Nutrition Recommendations Past and Present U.S. Recommendations • In 1894 , USDA recommended protein, fat, carbohydrate and “mineral matter” amounts . • Food Guides: developed by the United States Department of Agriculture (USDA); translate nutrient intake recommendations into recommended food choices o How to Select Foods (1917) heal thy diet based on five food groups: meat and milk, cereals, vegetables and fruits, fats and fatty foods, sugars and sugary foods • Food and Nutrition Board was established to advise the Army and federal agencies o Developed recommendations for specific amounts of nutrients: Recommended Dietary Allowances (RDAs): energy, protein, iron, calcium, vitamins A and D, thiamin, riboflavin, niacin, and vitamin C. o Based on the amounts that would prevent deficiencies • How information is presented by food guides keeps chan ging, but the central message is the same: Choose the right combinat ion of foods to promote health and reduce the risk of disease. • In addition, standardized food labels have been developed to help consumers choose foods that meet these recommendations. • All of these nutrition tools provide recommendations that promote health and ways to decrease risk s of chronic diseases. These tools are periodically revised or replaced over time. o Example: Dietary Guidelines revised every 5 years How We Use Nutrition Recommendations • Nutritional status: health is influenced by intake and utilization of nutrients • Evaluating food intake data in populations o National Health and Nutrition Examination Survey (NHANES): population survey o Healthy People 2020: set of health promotion and disease prevention objectives ▪ Goal: increase the quality and length of health y lives for the population ▪ Eliminate health disparities ▪ Revised every 10 years • Assessing nutritional status in individuals o Determine typical food intake o Compare intake to recommendations o Evaluate physical health o Consider medical history and lifestyle o Ass ess with laboratory tests Wha t A Scientist Sees: Trends in M ilk Consumption • Estimates of milk consumption from 1970 -20 10 • Public health implications Dietary Reference Intakes (DRIs) • Recommendations for amounts of energy, nutrients, and other food components that healthy people should consume in order to stay healthy, reduce the risk of chronic diseases, and prevent deficiencies. • Can be used to evaluate a person’s diet. • There is a set of recommendations for males and females at various stages of lif e. Recommendations for Nutrient I ntake • Estimated Average Requirements (EARs): nutrient intakes estimated to meet the needs of 50% of the healthy individuals in a given gender or life stage group . o Used to assess the adequacy of a population’s food supply and typical intake. o Not appropriate for evaluating an individual’s intake. • Recommended Dietary Allowances (RDAs): nutrient intakes that are sufficient to meet the needs of almost all healthy people in a specific gender and life -stag e group . o Can be used as goals for individual intake and to plan and evaluate individual diets. • Adequate Intakes (AIs): nutrient intakes used when no RDA exists. o Can be used as goals for individual intake and to plan and eva luate individual diets. o Meant to represent the amounts that most healthy people should consume on average, over several days or even weeks, not each day. o Set high enough to meet the needs of almost all healthy people. • Tolerable Upper Intake Levels (ULs) : maximum daily intake levels that are unlikely to pose risks of adverse health effects to almost all individuals in a given gender and life – stage group. o Difficult to exceed by consuming food. o Depending on nutrient, UL is set for total intake from all sources, from supplements alone, or from supplements and fortified foods o Not all nutrients have a UL because too little information is available to determine it. Recommendations for E nergy I ntake • Estimated Energy Requirements (EERs): average energy inta ke values predicted to maintain body weight in healthy individuals. o Calculations take into account a person’s age, gender, weight, height, and level of physical activity. • Acceptable Macronutrient Distribution Ranges (AMDRs): healthy ranges of intake for carbohydrate, fat, and protein, expressed as percentages of total energy intake. o 10 -35% of total calories from protein o 45 -65% of total calories from carbohydrate o 20-35% of total calories from fat o Intended to promote diets that minimize disease risk while allowing flexibility in food intake patterns. Tools for Diet Planning • The DRIs provide recommended amounts of nutrients but do not help you choose foods to meet your needs. • Recommendations on how to plan your diet include the Dietary Guideline for Americans and MyPlate . Recommendations of the Dietary Guidelines for Americans • Evidence -based nutritional guidelines to promote health and reduce the prevalence of overweight and obesity and risk of chronic disease. • Focus on balancing caloric intake wit h physical activity and consuming nutrient dense foods and beverages. • Designed for Americans 2 years and older. • Revised every 5 years; 2015 -2020 is the 8 th edition • Key Recommendations of the Dietary Guidelines for Americans, 2010 o Foods and nutrients to in crease: ▪ vegetables and fruits ▪ whole grains ▪ fat -free and low -fat milk and milk products ▪ variety of protein foods from both animal and plant sources ▪ amount and variety of seafood ▪ oils to replace solid fats o Foods and nutrients to decrease: ▪ sodium intake ▪ saturated fat ▪ dietary cholesterol ▪ trans fatty acids ▪ intake of calories from solid fat and added sugars ▪ consumption of refined grains ▪ alcohol o In tandem with the Dietary Guidelines , Americans of all ages – children, adolescents, adults, and older adults should meet the Physical Activity Guidelines for Americans to help promote health and reduce the risk of chronic disease. o Americans should aim to achieve and maintain a healthy body weight. What Should I Eat? To follow the Dietary Guidelines: • Balance calories with activity. • Meet food group recommendations. • Limit added sugars, saturated fat, and sodium. :ow healthy is the American Diet? • The current U.S diet needs improv ement. The graph shown here illustrates how the typical American diet compares with recommendations for various food groups and dietary components. DEBATE: How involved should the government be in your food choices? Healthy Eating Patterns • A dietary pattern is the combination of food and beverage intake over time. • Different dietary patterns can promote health : o USDA Food Patterns o Mediterranean -Style Eating Pattern o Vegetarian Patterns o DAS: Eating Plan M yP late : Putting the Guidelines into Practi ce • Based on Dietary Guidelines • USDA’s most recent food guide • Illustrates proportions of the five food groups o Fruits o Vegetables o Grains o Protein o Dairy • The MyPlate icon is a visual educational tool to show people how much food they should put on their plate. o ½ of the plate = fruit & vegetables o ¼ of the plate = meat o ¼ of the plate = grains o Dairy accompanies the meal • Emphasizes a healthy diet based on o Proportion – how much of your plate should be filled with food from each of the five food groups o Variety – includes 5 vegetable subgroups, varied protein sources, grains, fruits, and dairy o Nutrition – choose nutrient -dense food and beverages within each food group to help balance calories • MyPlate Daily Checklist o Tells how much to eat from each food group o Ounces: grains and protein ▪ 1 cup cold cereal; ½ cup cooked cereal/grains; slice of bread; 1 ounce cooked meat/fish poultry, 1 tablespoon peanut butter; 1 egg; ¼ cup of cooked dry beans, nuts, or seeds o Cups: fruits, vegetables, and dairy o Teaspoons: oils (liquid at room temperature) o Be active: age 6 -17 years 60 minutes per day; adults 2 ½ hours per week • Foods to Limit o Minimize saturated fats, sodium, and added sugar s o Empty calories from fats and added sugars such as butter, table sugar, so ft drinks, and candy add Calories but few nutrients o Limit saturated fats by choosing low fat meats and dairy products, and liquid oils (corn, olive) o Reduce sodium and added sugars by choosing fresh foods and less processed foods What should I eat? • Balance calories to maintain weight • Increase foods that promote health • Limit nutrients that increase health risks • Personalized approach: us e the interactive Web site: www.chooseMyPlate.gov o Enter age, gender, physical activity, height, weight o Select if you would like to maintain weight or reach a goal weight (to gain or lose weight) o Recommendations will be based on this information o Track progress online with Supertracker, once you have created a profile Healthy Eating Plate • A variation of MyPlate • Emphasis: healthy diet based on whole grains, fruits, vegetables, healthy protein sources, and oils. Limits: red meat, refined grains, and dairy. Avoid sugary soft drinks, trans fat, processed meat • Think Critically o :ow does the :ealthy Eating Plate differ from MyPlate? o Which of these tools do you think would better help Americans improve their diets? Why? Choice ( Exchange ) Lists • Food -group recommendations developed in the 1950s to plan diets for people with diabetes . • Expanded to planning diets fo r anyone who has to monitor calorie intake. • Foods are grouped based on the amount of energy, carbohydrate, protein, and fat they provide per serving. • Any foods on a list can be exchanged with any other food on the list without altering percentages of carb ohydrate, protein or fat in the diet. • Comparison of food groupings to MyPlate , example: o Choice List : potato listed as a starch because it same amount of carb ohydrate , pro tein , energy , and fat as bread and grains o MyP late : potato is in vegetable group because it is a starchy vegetable that is a good source vit amin s, min eral s, and fiber. Food and Supplement Labels Standardized Food Labels • Designed to help consumers make healthy food choices by providing information about the nutrient composition of food. • Required on all packaged foods except those produced by small businesses or those in packages too small to accommodate the information. • Must provide basic product information: name, weight or volume of the contents, the name a nd place of business of the manufacturer, packager or distributor. • Nutrition Facts panel: presents information about the amounts of specific nutrients in a standard serving. o Daily Value: a reference value for the intake of nutrients used on food labels to help consumers see how a given food fits into their overall diet. ▪ The amount of a nutrient as a percentage of the Daily Value recommended for a 2000 -Calorie diet. • =nstructor – To make this interactive, hand out labels or copies of labels or have students bring labels from home. :ave them answer questions about each of the items on the list above in class or on assignments and tests (e.g., what is the serving size, how many serving s per container , etc.) To practice math skills, have them calculat e nutrients if they ate two servings or the whole box. :aving students bring labels is a great way to create a collection. Pair labels for similar foods (e.g., white bread and whole -wheat bread or two different brands of whole -wheat bread) allow students to practice making comparisons and food choices. • Serving Sizes: The FDA determines the serving size for all foods o Labels must use the FDA serving sizes (beverages = 8 fl oz; ice cream= ½ cup) o It is important to compare the serving size on the label to the amount you actually consume o Serving sizes are not the same as the ones used in the USDA food guide • Ingredient List: contents of the product in order of their prominence by weight. o Required for foods with more than one ingredient o Helpful for people wit h food allergies or avoiding certain ingredients o Must be listed: food additives, food colors and flavorings. o Instructor – To make this more active, hand out labels or copies of labels or have students bring labels from home. Have them answer questions abo ut the most abundant and least abundant nutrient in class or on assignments and tests. Ingredient lists can also be used to have them identify classes of nutrients here or in the upcoming chapters (for example, sources of added sugars). • Nutrient content claims: statements that highlight specific characteristics (e.g. “fat free” or “low sodium”) o Standard definitions established by the Food and Drug Administration. o Health claims : refer to a relationship between a nutrient, food, food component, or dietary supplement and reduced risk of a disease or health -related condition. ▪ Must be a naturally good source of one of six nutrients (vitamin A, vitamin C, protein, calcium, iron or fiber). ▪ Must not contain more than 20% of the Daily Value for fat, satura ted fat, cholesterol , or sodium. ▪ Qualified health claim: a health claim where there is emerging but not well established evidence. Cannot mislead consumers. ▪ Instructor – To make this more active, hand out labels or copies of labels or have students bring labels from home. :ave them answer questions about the qualified health claims and/or mark them on the labels in class or on assignments and tests. ▪ Health vs. Qualified Health Claims: Oatmeal contains enough soluble fiber to include a health claim about t he relationship between soluble fiber and the risk of heart disease. Thinking I t Through: A Ca se Study Using Food Labels to Guide Food Choices Dietary Supplement Label • Similar to the Nutrition Facts label. • Governed by laws for food, not drugs. • Must provide directions for use and must provide information about ingredients that are not nutrients. • Must include the words dietary supplement on the label. • Must include a disclaimer that the FDA has not evaluated the product. And that the product is not inte nded to diagnose, treat, cure or prevent any disease. • May carry structure/function claims Structure/Function Claims o Do not require approval but must notify FDA when used on dietary supplement labels o Must include a disclaimer ▪ The FDA has not evaluated the claim ▪ The product is not intended to diagnose, treat, cure, or prevent any disease o May appear on food labels but are not required to notify the FDA or include disclaimers o Manufacturer is responsible for ensuring accuracy and truthful ness of claims Health vs. Structure/Function Claims • Instructor – To make this more interactive, hand out labels or copies of labels or have students bring labels from home. Have them answer questions about the claims in class or on assignments and tests.
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 6 Proteins and Amino Acids Proteins in our Food • Animal foods contain the most concentrated sources of proteins in the diet. o Also provide B vitamins and readily absorbable minerals such as iron, zinc and calcium. o Low in fiber. o High in saturated fat. • Legumes: starchy seeds of plants that produce bean pods. o Include: peas, peanuts, beans, soybeans and lentils. o Also an important source of protein. o Provide most, but not all B vitamins. o Also supply iron, zinc and calcium in less absorbable f orms. o Excellent sources of fiber, phytochemicals and unsaturated fats. • Amino acids: the building blocks of proteins. o Each contains an amino group, an acid group and a unique side chain. The Structure of Amino Acids and Proteins Amino Acid Structure • Amino acids consist of: a carbon atom bound to a hydrogen atom; o An amino group which contains nitrogen; o A side chain: varies in size and structure; gives the amino acids their unique properties. • Essential amino acids: amino acids that cannot be synthesi zed by the body in sufficient amounts to meet its needs. o Must be included in the diet. o Also called indispensable amino acids. o Nine amino acids needed by the adult human body. • Nonessential amino acids: can be made by the body. o Also called dispensable amino acids. o Eleven amino acids are considered dispensable. • Conditionally essential amino acids: some of the nonessential amino acids cannot be synthesized in sufficient amounts to meet needs. o Phenylketonuria (PKU): an inherited disease where ph en ylalanine cann ot be converted into tyrosine. • What a Scienti st Sees: Phenylketonuria (PKU) inherited disease where phenylalanine is not metabolized correctly, leading to a buildup of phenylketones. o In infants and young children this will interfere with brain development. o In pregnant woman can cause birth defects. o To prevent the buildup of phenylketones, individuals must consume a special diet. o The artificial sweetener aspartame is a source of phenylalanine. Protein Structure • Peptide bonds: links amino acids together. Amino Acid and Protein Structure • Dipeptide: two amino acids linked together. • Tripeptide: three amino acids linked together. • Polypeptide: a chain of amino acids linked by peptide bonds that is part of the structure of a protein. o The order and chemical properties of the amino acids determine its final shape. • Denaturation: alternation of a protein’s three -dimensional structure. o Examples: digestion or cooking. Protein Digestion and Absorption • Proteins must be digested before their amino acid s can be absorbed into the body. • Mechanical digestion begins in the mouth, chewing breaks down the food • Chemical digestion begins in the acid environment of the stomach. • Pepsin: the protein digesting enzyme; breaks some of the peptide bonds leaving shorter polypeptides. • Most digestion occurs in the small intestine; polypeptides are broken into smaller peptides and amino acids. o Utilizing protein digesting enzymes from the pancreas and small intestine. o Single amino acids, dipeptides and tripe ptides ar e absorbed into the mucosal cells. • Amino acids enter the body by crossing from the lumen of the small intestine into the mucosal cells and then into the blood. o Process involves energy -requiring amino acid transport systems. o Amino acids may compete with one another for absorption. ▪ This is not a problem with foods because they contain a variety of amino acids, none of which occurs in excess. ▪ Could be a problem with amino acid supplements. Protein Synthesis and Functions • Amino acids are used to: o Make other ni trogen -containing molecules, including neurotransmitters; o The units that make up DNA and RNA; o The skin pigment melanin; o The vitamin niacin. o Creatine, which is used to fuel muscle contraction; o Histamine, which causes blood vessels to dilate. o Can provide energy or synthesize glucose or fatty acids. • Amino acid pool: all the amino acids in body tissues and flui ds that are available for use in the body. Synthesizing Proteins • Gene: a length of DNA that contains the information needed to synthesize a polypeptide chain. Regulating protein synthesis • The types of proteins made and when they are made is regulated by turning on and off the genes that code each protein. • Expressed: when a gene is turned on. Limiting amino acids • A shortage of one amino acid can stop the process of protein synthesis. o If the amino acid missing is a nonessential amino acid, it can be made and synthesis will continue. o If the amino acid missing is an essential amino acid, the body can break down its own protein to obtain it. o If an amino acid cannot be supplied, protein synthesis stops. • Transamination: the process by which an amino group from one amino acid is transferred to a carbon compound to form a new amino acid. • Limiting amino acid: the essential amino acid that is available in the lowest concentration relative to the body’s needs. Protein functions • Collagen: most abundant protein in the body. o Plays an important structural role: major protein in ligaments. o Forms protein structure of bones and teeth. • Enzymes: facilitates chemical reactions in the body. • Transport materials throughout the body and into and out of cells. • Help protect from disease. o Antibodies: part of the immune system. • Help body movement. o Actin and myosin in long muscles of arms and legs. o Contrac tions in the heart muscle . o Muscles of the digestive tract, blood vessels, and body glands. • Regulate fluid balance. o Edema: swelling caused by too little protein in the blood. Proteins Provide Structure and Regulation • Structural prot eins: skin, hair, ligaments, tendons , and bones . • Structure to individual cells: integral part of cell membrane, cytoplasm, and organelles. • Enzymes: speed up biochemical reactions. • Transport proteins that travel in the blood or help materials cross membrane s. • Part of the body’s defense -mechanisms: skin, antibodies. • Contractile properties: allow muscle movement to various parts of the body. • Hormones: regulate b iological processes. o Examples: insulin, growth hormone, and glucagon. • Help regulate fluid balance. • Regulate s body pH. Protein as a Source of Energy • If the diet does not provide enough energy to meet the body’s needs, body protein can be used to provide energy. o Example: starvation. • When excess amino acid s are consumed, they can be metabolized for energ y. o Extra amino acids can’t be stored. • When diet provides more calories than needed, amino acids can be converted to fatty acids which are stored as triglycerides thus contributing to weight gain . • Deamination: the removal of the amino group. Protein in Health and Disease Protein Deficiency • Protein -energy malnutrition (PEM): long -term consumption of insufficient amounts of energy and/or protein to meet the body’s needs. o Characterized by loss of muscle and fat tissue and increased susceptibility to infect ion. • Kwashiokor: form of protein -energy malnutrition in which only protein is deficient. o Characterized by a swollen belly, growth impairment. o Poor immune function, changes in hair color, and impaired nutrient absorption. o The word literally means: “the dise ase that the first child gets when a second child is born.” ▪ Children are weaned from breastmilk to a nutritionally inadequate diet. • Marasmus: form of protein -energy malnutrition in which a defic iency of energy in the diet caus es severe body wasting. o Charac terized by depletion of fat stores and wasting of muscle. o The word means “to waste away.” High Protein Diets and Health Debate: Is a high -protein diet safe and effective for weight loss? • Recent popularity of high -protein, low -carbohydrate diets for weight loss. • Little evidence that a high -protein diet would precipitate kidney disease in a healthy person. • Epidemiological studies suggest that diets rich in animal protein, high in sodium, and low in fluid contribute to the for mation of kidney stones. • High -protein diets are high in animal products; also high in saturated fat and low in fiber. Increases the risk of heart disease. • These diets are typically low in grains, vegetables and fruits. May be high in red meat and processed meat. This pattern is associated with an increased risk of cancer. Proteins and Food Allergies and Intolerances • Food allergy: an adverse immune response to a specific food protein. • Most c ommon food allergens: milk, eggs, peanuts, tree nuts, wheat, soy, f ish and shellfish. • Food intolerance or food sensitivity: an adverse reaction to food that does not involve the production of antibodies by the immune system. o Example: MSG complex or Chinese restaurant syndrome. • Celiac disease : a n autoimmune disease that ca uses damage to the villi in the small intestine when the protein gluten is eaten. o Gluten is found in wheat, rye and barley. o Celiac Disease affects 3 million Americans, where as non -celiac gluten sensitivity affects 18 million. • Food allergy labeling: food label must indicate if it contains a common food allergen. o Often highlighted at end of list. ▪ Example: “Contains soy ingredients.” o May contain a warning if a product could be cross -contaminated by a common food allergen. ▪ Example: “Manufactur ed in a facility that processes p eanuts.” Meeting Protein Needs Balancing Protein Intake and Losses • Nitrogen balance: the amount of nitrogen consumed in the diet compared with the amount excreted over a period of time. • Nitrogen balance: nitrog en intake equals nitrogen output. • Negative nitrogen balance: nitrogen intake is less than nitrogen output. o Examples: injury, illness or diet low in protein or calories. • Positive nitrogen balance: nitrogen intake exceeds nitrogen output. o Examples: pregnancy or individuals increasing muscle mass by lifting weights. Recommended Protein Intake • Protein RDA for adults : 0.8 g/kilogram of body weight • Protein recommendations are higher for children, adolescents, and pregnant or lactating women. • Protein needs increase when the body is healing due to injury or illness. • Athletes need more protein. • Acceptable Macronutrient Distributi on Range: 10 -35% of total calories. Protein needs of athletes • Athletes: 1.2 to 2.0 g of protein/kilogram of body weight. • Because athletes also consume more calories, they should be able to meet increased protein needs with diet alone. Protein and amino acid supplements • Athletes use s upplements to boost total protein intake and to add individual amino acids. • Weak evidence to support many of the claims. • Consuming a large amount of one amino acid may interfere with the absorption of others. • Due to insufficient research, no ULs have been set for amino acids. Choosing Protein Wisely • Pr otein quality: a measure of how good the protein in a food is at providing the essential amino acids the body needs to synthesize proteins. • High -quality protein or complete dietary protein: foods of animal origin. • Incomplete dietary protein: plant proteins . o More difficult to digest and lower in one or more of the essential amino acids. Protein comple me ntation • The process of combining proteins from different sources so that they collectively provide the proportions of amino acids required to meet the body’s needs. • Grains, nuts, or seeds + Legumes = Complete protein o Plant proteins are limited in lysine, methionine, and cysteine. o Legumes are deficient in methionine and cystein e, but high in lysine. o Grains, nuts and seeds are deficient in lysine by high in methionine and cystein e. • Traditional diets take advantage of complementary plant proteins o India: lentils and rice or chickpeas and rice o Mexico and South America: rice and pinto or black beans o Middle East: hummus (chickpeas and sesame seeds) and bread o Unit ed States: bread and peanut butter MyP late and Dietary Guideline s recommendations • Choosing a variety of foods will provide enough protein and enough of each of the essential amino acids to meet the body’s needs. • Include both animal and plant sources of pr otein. • Food groups high in protein: Dairy and Protein . What Should I Eat? Protein Sources • Increase your plant protein. • Get protein without too much saturated fat. • Reduce your portions of animal proteins. Vegetarian Diets • Diets that include plant -based foods and eliminate s some or all foods of animal origin. o Semivegetarian: occasional red meat , fish and poultry, as well as dairy products and eggs. o Pescetarian: exclud es all animal flesh except fish. o Lacto -ovo vegetarian: excludes all animal fl esh but does include eggs and dairy products such as milk and cheese. o Lacto vegetarian: excludes animal flesh and eggs but does include dairy products. o Vegan: excludes all food of animal origin. • Benefits of vegetarian diets: o Can be a healthy, low -cost alt ernative to traditional American diet. o Lower body weight and reduced incidence of obesity and other chronic diseases. • Risks of vegetarian diets: o Poorly plan diets can cause nutrient deficiencies or excess . o Nutrients of concern: vitamin B12, calcium, vitami n D, iron, zinc, iodine, and omega -3 fatty acids. Thinking it Through: A Case Study on Choosing a Healthy Vege tarian Diet
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 3 Digestion: From Meals to Molecules The Organization of Life • Begins with atoms that form molecules, which are then organized into cells to form tissues, organs, and whole organisms. o Atom : the smallest unit of an element that retain s the properties of the element. o Molecule : group of two or more atoms of the same or different elements bonded together. o Cell: the smallest unit of life. o Tissue : made up of cells that are similar in structure and function. ▪ Types of tissue: muscle, nerve, ep ithelial, and connective. o Organ: structure composed of more than one tissue that performs a specialized function. o Organ system: 11 organ systems interact to perform all the functions necessary for life. ▪ An organ may be part of more than one organ system. • Major organ systems of the human body: integumentary system, muscular system, skeletal system, lymphatic system, respiratory system, digestive system, nervous system, endocrine system, circulatory system, urinary system, and reproductive system. The Digestive System • Digestion: the process by which food is broken down into components small enough to be absorbed into the body. • Absorption: the process of taking substances from the gastrointestinal tract into the interior of the body. o Feces: body waste, including unabsorbed food residue, bacteria, mucus, and dead cells. Eliminated from the gastrointestinal tract. Organs of the Digestive System • Gastrointestinal tract: hollow tube, about 30 feet long. o Also called: gut, GI tract, alimentary canal or digesti ve tract. • Organs include: mouth, pharynx, esophagus, stomach, small intestine and large intestine • Transit time: time it takes food to travel the length of the GI tract: healthy adult 24 -72 hours. o Dependent on the composition of the diet, level of physical activity, emotional state, health status and use of medications. • Accessory organs: salivary glands, liver, gall bladder and pancreas. Digestive System Secretions • Muc us: viscous fluid secreted by glands in the digestive tracts and other parts of the body. o Lubricates, moistens, and protects cells from harsh environments. • Enzymes: protein molecules that accelerate the rate of specific chemical reactions without themselves being changed. • Hormone: chemical messengers that are produced in one location in t he body, released into the blood, and travel to other locations, where they elicit responses. • The digestive enzyme, Amylase , breaks down large carbohydrate molecules, like those in bread, into smaller ones. Amylases have no effect on fat, whereas enzymes called lipases digest fat and have no effect on carbohydrate. Digestion and Absorption of Nutrients The Mouth • Chemical and mechanical digestion begins in the mouth. • Saliva: moistens food. o Salivary amylase: enzyme which begins the chemical digestion of foods . ▪ Helps protect against tooth decay. • Chewing: mechanical breakdown of food. The Pharynx • Responsible for swallowing. o Bolus: chewed food mixed with saliva. o Epiglottis: connective tissue that covers the opening to the lungs during swallowing. • Also part of the respiratory system. The Esophagus • Connects the pharynx with the stomach. • Peristalsis: coordinated muscular contractions that move material through the GI tract. • Sphincter: muscle that encircles the tube of the digestive tract and acts as a valve. The Stomach • Temporary storage place for food. • Chyme: semiliquid food mass produced when a food bolus mixes with highly acidic stomach secretions. • Chemical digestion occurs. o Gastric juice: hydrochloric acid and pepsin. • Little absorption occurs. • Regulation of stomach activity: regulated by signals from nerves and hormones. o Signals originate from the brain, stomach and the small intestine. o Large meal takes longer than a liquid meal. o Solids take longer than liquids. o Nutriti onal composition: ▪ Carbohydrates leave quickly. ▪ Fiber and protein take longer. ▪ High fat meal stays in the stomach the longest. The Small Intestine • Narrow tube about 20 feet long. • Main site for the chemical digestion of food. • Primary site for absorption of water, vitamins, minerals, and the products of carbohydrate, fat and protein digestion. • Secretions that aid digestion: o Pancreas secretes pancreatic juice: contains bicarbonate. ▪ Neutralizes the acid in the chy me. ▪ Makes the environment of the small intestine neutral or slightly basic. o Pancreatic amylase: enzyme that continues the breakdown of starch and sugars. o Pancreatic proteases: enzymes that breakdown protein to shorter chain amino acids. o Lipases: fat digesting enzymes. o Gall bladder stores and secretes bile made by the liver . ▪ Aids in fat digestion and absorption. • Absorption o Diffusion: movement of substances from an area of high concentration to an area of lower concentration. o Simple diffusion: material moves freely across the cell membrane. o Osmosis: unassisted diffusion of water across the cell membrane. o Facilitated diffusion: a ca rrier molecule is needed for a substance to cross the cell membrane. o Active transport: requires energy and a carrier molecule. ▪ Can transport material from an area of lower concentration to one of higher concentration. The Large Intestine • About 5 feet long. • Divided into the colon, and the rectum. • Water and some vitamins a nd minerals can be absorbed in the colon. • Peristalsis occurs slowly. Fecal material may spend 24 hours or more in the colon. • Intestinal microbiota : beneficial bacteria o Breakdown unabsorbed portions of food. o This breakdown may produce gas, which causes fla tulence. • Rectum: temporarily stores unabsorbed material until it is evacuated through the anus as feces. Digestion in Health and Disease The Digestive System and Disease Prevention • Intestinal Microbiota: o Most of the 100 trillion microorganisms in the gut are found in the colon o Established in infancy and early childhood o A healthy microbiota resists change under physiological stress and supports health o Right mix is needed for optimal GI function, maintenance of immune function, and overall health • Intestinal Microbiota Functions: o Act on unabsorbed food and substances secreted by GI tract to produce nutrients used by the bacteria and can affect human health o Helps maintain mucosal layer lining the intestine ▪ Serves as a ba rrier ▪ Modulates inflammation in the gut ▪ Prevents growth of disease causing bacteria o Assists in maturation of immune system • Unhealthy Microbiota: Less diverse , u nable to maintain balance between beneficial and harmful bacteria, b een implicated in develop ment of intestinal diseases o Chrohn’s disease , Obesity , Type 2 diabetes , Colon cancer , Heart disease • Effect of Diet on Microbiota : determines the food available to the microorganisms in the gut and therefore what bacteria grow there. • What a Scientist Sees: Bacteria on the Menu o Prebiotic: a substance that passes undigested into the colon and stimulates the growth and/or activity of c ertain types of bacteria. o Probiotic: live bacteria that, when consumed, live temporarily in the colon and confer health benefits on the host. • Mucosa of the GI tract contains tissue that is part of the immune system. o Antigen: foreign substance. Stimulates an immune response when introduced to the body. o Phagocytes: type of white blood cell; part of the body’s defense. o Lymphocytes: specific type of white blood cell. • Food Allergies: o Food allergies affect 5% adults and 8% children in U.S. Even a tiny amount can cause anaphylaxis and can be fatal. o Antibodies: proteins released by a type of lymphocyte; interact with and deactivate specific antigens. o Allergen: a substance causing an immune reaction. ▪ An allergic reaction occurs when the immune system produ ces antibodies to a substance. ▪ Common food allergens: peanuts, tree nuts, milk, eggs, fish, shellfish, soy, and wheat. Manufacturers must clearly state on the label any of the 8 major allergens. • Celiac disease: a protein gluten, found in wheat, barley and rye, triggers an immune system response that damages or destroys the villi of the small intestine. o Causes: abdominal pain, diarrhea and fatigue. o Can lead to: malnutrition, weight loss, anemia, osteoporosis, intestinal cancer, and other chronic ailments. o Also called: gluten intolerance, celiac sprue, non -tropical sprue, gluten sensitive enteropathy. o Diagnosed by a blood test or intestinal biopsy; inherited condition (1% of the population) . o Treatment: Eliminate all products made with wheat, barley, or rye DEBATE: Should You Be Gluten -Free? • Gluten -free diets are essential for people with gluten -related disorders, but a gluten – free diet has also been promoted for weight loss and to treat a host of other ailments. Should you be gluten free? Digestive System Problems and Discomforts • Heartburn and gastroesophageal reflux: when the acidic contents of the stomach leak back into the esophagus. Produces a burning sensation in the chest or throat. • GERD: gastroesophageal reflux disease: a chronic condition in which acidic stomach contents leak into the esophagus, causing pan and damaging the esophagus. o If left on treated can lead to bleeding, ulcers and cancer. o To avoid discomforts: limit amounts and types of foods consumed; eat small meals; consume beverages between rather than with meals; avoid fatty and fried foods, chocolate, peppermint, and caffeinated beverages; remain upright after eating; wear loose clothing; avoid smoking and alcohol; lose weight. • Peptic Ulcers: open sores in the lining of the stomach, esophagus, or small intestine. o Causes: GERD; misuse of medications such as aspirin or nonsteroidal anti – inflammatory drugs; infection with the bacterium Helicobacter pylori (H. pylori) . ▪ H. pylori can be treated with antibiotics. • Gallstones: clumps of solid material that accumulates in either the gallbladder or the bile duct. o They can cause pain when the gallbladder contracts in response to fat in the intestine. o Treatment: removal of the gallbladder. • Diarrhea and constipation: common discomforts related to problems in the intestines. o Diarrhea: frequent water y stools. ▪ Can be caused by: bacterial or viral i nfections; irritants that inflame the lining of the GI tract; the passage of undigested food into the large intestine; medications; and chronic intestinal diseases. ▪ Causes loss of fluids and minerals. ▪ Can be life threatening if lasting for more than a day or two. o Constipation: hard, dry stools that are difficult to pass. ▪ Occurs when the water content of the stool is too low. ▪ Causes: low intake of water or lack of fiber; lack of exercise; weakening of the muscles of the large intestine; and a variety of med ications. ▪ Prevention: drinking plenty of fluids; consuming a high fiber diet; and getting plenty of exercise. What Should I Eat? For Digestive Health • Reduce your risk of adverse reactions. o Read food labels to avoid foods that you are allergic to. o Chew each bit thoroughly to maximize digestion and avoid choking. o Don’t talk with food in your mouth. o Learn the Heimlich maneuver: You could save a life. • Reduce the chances of heartburn. o Eat enough to satisfy your hunger but not so much that you are stuffed. o Wa it 10 minutes between your first and second courses to see how full you feel. o Stay upright after you eat – don’t flop on the couch in front of the television. • Avoid constipation by consuming enough fiber and fluid. o Choose whole -grain cereals such as oatmea l or raisin bran. o Double your servings of vegetables at dinner. o Eat two pieces of fruit with your lunch. o Choose whole -grain bread. o Have one or two beverages with or before each meal. Thinking It Through: Case Study on How Changes in the Digestive System Affect Health (Answers: Appendix L ) • Medications and their effect on saliva production. • Ill-fitting dentures. • Dietary fiber increased. • Treatment for colon cancer. • Gallstones. • Deficiency of pancreatic enzymes. • Gastric banding surgery. Delivering Nutrients and Eliminating Wastes The Cardiovascular System • Delivery of digested and absorbed nutrients to the cells. • Capillaries: small, thin -walled blood vessels through which blood and the body’s cells exchange gases and nutrients. • Lacteals: lymph vessels in the villi of the small intestine that pick up particles containing the products of fat digestion. o Part of the lymphatic system. • Heart and blood vessels: the heart is the workhorse of the cardiovascular system. o Vei ns: blood vessels that transport blood and dissolved substances toward the heart. ▪ Venules: the smallest veins. o Arteries: blood vessels that transport blood and dissolved substances away from the heart. ▪ Arterioles: the smallest blood arteries. • Blood flow at rest: 25% of blood goes to the digestive system; 20% to skeletal muscles; and the rest to the heart, kidneys, brain, skin and other organs. o Changes when eating or exercising. • Blood flow during exercise: 70% directed to skeletal muscles during stren uous exercise. Delivering Nutrients to the Liver • Liver acts as a gatekeeper between the body and substances absorbed from the intestine. o Some nutrients are stored in the liver, some are changed into different forms, and others are allowed to pass through unchanged. • Hepatic portal vein: carries molecules from the intestine to the liver. • The liver determines whether nutrients are stored or delivered immediately to the cells. • The liver is important in the synthesis and breakdown of amino acids, proteins and lipids. • The liver contains enzyme systems that protect the body from toxins absorbed in the GI tract. The Lymphatic System • An important component of the immune system. • Absorbs fat -soluble nutrients such as cholesterol, fatty acids, and fat -soluble vitamins • Removes fluids from tissues to prevent swelling • Contains immune cells to fight infection Elimination of Wastes • Gastrointestinal tract: material not absorbed from the gut is eliminated as feces. • Lungs: carbon dioxide and some water. • Skin: water, minerals and some nitrogen containing material. • Kidneys: primary site for the excretion of metabolic wastes. Overview of Metabolism • Metabolism: chemical reactions that break down molecules to provide energy and those that synthesize l arge molecules • Metabolic pathways: actions of metabolism • Mitochondria: cell organs that responsible for breaking down molecules to release energy. Releasing Energy • Cellular respiration: occurs in the mitochondria. The breakdown of glucose, fatty acids and amino acids in the presence of oxygen to produce carbon dioxide and water and release energy. • Adenosine triphosphate (ATP): a high -energy molecule that the body uses to power activities. Synthesizing New Molecules • Glucose molecules are used to synthesize the glycogen and, in some cases, fatty acids. • Fatty acids are used to make body fat, cell membranes, and regulatory molecules. • Amino acids are used to synthesize the various proteins that the body needs, and when necessary, to make glucose. Exce ss amino acids can also be converted to fatty acids and stored as body fat.
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 8 Water and Minerals Water • Essential nutrient that is often overlooked. Water in the Body • In adults, water accounts for 60% of body weight. • Different proportions in different tissues: o About 75% of muscle. o About 25% of bone. • Intracellular fluid: water inside of cells. o About one -third of the body water. • Extracellular fluid: water outside of cells. o About two -thirds of the body water. o Includes the water in the blood and lymph, the water between cells, and the water in the digesti ve tract, eyes, joints, and spinal cord. • The distribution between intra – and extracellular fluid depends on differences in the concentrations of dissolved substances, or solutes. o Examples: proteins, sodium and potassium. o The concentration drive osmosis: th e diffusion of water in a direction that equalizes the concentration of dissolved substances on either side of a membrane. • Blood pressure: the amount of force exerted by the blood against the walls of arteries. o Forces water from the capillary blood vessels into the spaces between the cells of the surrounding tissues. Water Balance • Cannot be stored in the body. • Intake and output must be balanced to maintain the right amount. • Most water consumed comes from water and liquids that we drink. o Solid foods also provide water; most fruits and vegetables are over 80% water. o Small amount of water is produced as a by -product of metabolic reactions. • Water loss: urine and feces, evaporation from the lungs and skin, and in sweat. • Regulating water intake: o Thirst: sensation that signals the need to drink. ▪ Caused by dryness in the mouth. ▪ Powerful urge that lags behind the need for water. ▪ Cannot be relied on alone to maintain water balance. • Regulating water loss: o The kidneys: regulate water loss in urine. ▪ About 1 to 2 L/day. ▪ Varies depending on consumption and amount of waste to be excreted . ▪ Act as a filter. ▪ Antidiuretic hormone (ADH) signal s the kidneys to reabsorb water, reducing the amount lost in urine. ▪ Also affected by the amount of sodium in the blood , blood volume, and blood pressure . The Functions of Water • Essential to life; does not provide energy. • Water in metabolism and transport: o An excellent solvent: glucose, amino acids, minerals, proteins and other substances. o Participates in reaction s that join small molecules together or break apart large ones. o Help maintain the acidity of the body. o Primary constituent of blood. • Water as protection: o Bathes cells of the body. o Lubricates and cleanses internal and external body surfaces. ▪ Example: tear s lubricate eyes and wash away dirt. ▪ Water in synovial fluid lubricates joints. ▪ Water in saliva lubricates the mouth, helping chewing and swallowing. o Resists compression. ▪ Cushions the joints and other parts of the body against shock. ▪ Example: amniotic sac protects the fetus as it grows inside the uterus. • Water and body temperature: o Helps regulate body temperature by increasing or decreasing the amount of heat lost at the surface of the bo dy. o Cooling is aided by the production of sweat. Water i n Health and Disease • Dehydration: water loss exceeds water intake. o Causes a reduction in blood volume, which impairs the ability to deliver oxygen and nutrients to cells and remove waste products. o Early symptoms: thirst, headache, fatigue, loss of appetite , dry eyes and mouth, and dark -colored urine. o Affects physical and cognitive performance. o As dehydration worsens, it causes: nausea, difficulty concentrating, confusion, and disorientation. o Can become severe and require medical attention. o Water loss of 10 -20% of body weight can be fatal. o Groups at risk: ▪ Older adults because thirst mechanism becomes less sensitive with age. ▪ Infants because their body surface area relative to their weight is much greater than that of adults, so they lose proportionately mo re water through evaporation; also their kidneys cannot concentrate urine efficiently. o Rehydration saves lives: dehydration due to diarrhea is a major cause of childhood death in the world. • Overhydration ( Water intoxication ): condition that occurs when a person drinks enough water to significantly lower the concentration of sodium in the blood. o Water moves out of the blood vessels into the tissues by osmosis causing them to swell. o Swelling of the brain can cause disorientation , convulsions, coma, and death . o Early symptoms are similar to dehydration: nausea, muscle cramps, disorientation, slurred speech, and confusion. Meeting Water Needs • Need more water than any other nutrient. • AIs: 3.7 L /day for men and 2.7 L/day for women. • Varies with activity, environme ntal temperature and humidity, and diet. o Activity increases water need as the amount of sweat increases. o A high -protein diet increases water needs because the urea produced from protein breakdown is excreted in urine. o A low -calorie diet increases water ne eds because as body fat and protein are broken down for fuel, ketones and urea are produced and must be excreted. o A high -salt diet increases water losses because the excess must be excreted in the urin e. o A high fiber diet increases water needs because more water is held in the intestines and excreted in the feces. • Diuretic: a substance that increases the amount of urine passed from the body. o Caffeine: effect in the course of an entire day is probably small. o Alcohol: depends on the amount of water and alcohol in the beverage is consumed. DEBATE: Is Bottled Water Better? • The Issue: Americans consume about 36 gallons of bottled water per person per year. It is convenient and we may think it tastes better and is safer than tap water. But the cost to our pocketbook and the environment is high? Should we be drinking from the tap? An Overview of Minerals • Minerals: elements needed by the body in small amount to maintain structure and regulated chemical reactions and body processes. • Major minera ls: required in the diet in amounts greater than 100 mg/day or present in the body in amounts greater than 0.01% of body weight. o Includes: sodium, potassium, chloride, calcium, phosphorous, magnesium, and sulfur. • Trace minerals: minerals required in the di et in amounts of 100 mg or less/day or present in amounts of 0.01% of body weight or less. o Includes: iron, copper, zinc, selenium, iodine, chromium, fluoride, manganese, molybdenum. Minerals in Our Food • Minerals are found in both plant and animal sources. • Some are present as functioning components of the plant or animal. o Present in consistent amounts. o Example: iron content of beef. • Some are present as contaminants from the soil or processing. o Examples: plants grown in an area where the soil is high in selenium. o Milk from dairies that use sterilizing solutions that contain iodine. • Added to food intentionally during processing. o Examples: sodium as a flavor enhancer. o Iron added to enriched grains. o Calcium, iron, and others added to fortified breakfast cere als. • Handling and p rocessing can remove minerals from foods. o Examples: when vegetables are cooked. o When skins of fruits and vegetables or the bran and germ of grain are detached. Mineral Bioavailability • Bioavailability in foods consumed varies. o Can vary f rom food to food, meal to meal, and person to person. • Minerals in animal products are better absorbed that those in plant foods. o Plants contain substances that bind minerals in the GI tract and reduce absorption. ▪ Phytic acids, tannins, oxalates, and fiber. • Compounds that interfere with absorption: o Oxalates: spinach, rhubarb, beet greens, and chocolate. ▪ Interfere with absorption of calcium and iron. o Phytates: found in whole grains, bran and soy products. ▪ Bind calcium, zinc, iron, and magnesium; limiting absorption. ▪ Can be broken down by yeast. Bioavailability higher in yeast -leavened bread. o Tannins: found in tea and some grain. ▪ Interferes with absorption of iron. • The presence of one mineral can interfere with the absorption of others. o Ion: an at om or a group of atoms that carries an electrical charge. o Minerals that carry the same charge compete in the intestinal tract. ▪ Examples: calcium, magnesium, zinc, copper, and iron. ▪ Generally not a problem when whole foods are consumed. ▪ A large dose from a dietary supplement may interfere with the absorption of other minerals. • The body’s need for a mineral may affect how much of that mineral is absorbed. o Example: if plenty of iron is stored, less will be absorbed. • Life stages can affection absorption. o Examples: calcium absorption doubles during pregnancy. Mineral Functions • Minerals contribute to the body’s structure. • Help regulate body processes. • Many serve more than one function. o Example: calcium needed for bone strength and mai ntaining a normal blood pressure, allow muscles to contract, and transmit nerve signals between cells. • Help regulate water balance. • Help regulate energy production. • Affect growth and development through their role in the expression of certain genes. • Act as cofactors needed for enzyme activity. o Cofactor: an inorganic ion or coenzyme that is required for enzyme activity. • None of the minerals act in isolation. o Interact with each other as well as other nutrients and components in the diet. Understanding Minera l Needs • Need to choose a variety of foods from each of the food groups. • Some minerals are found in large amounts in a limited amount of food. o Example: best sources calcium are dairy products and leafy greens. If these foods are not included in the diet then the addition of fortified foods or supplements is needed • Some found in small amounts in many foods, depending on where it ’s grown or processed, so variety of foods from different locations is needed to meet needs. • Some minerals in minute quantities are present due to the environment. • Deficiency can lead to major health consequences. • DRI’s set for 7 major minerals and 9 trace minerals. • Current Nutrition Facts panel on food label required to list amount of sodium, calcium, and iron plus potassium will be added to the planned Nutrition Facts panel Electrolytes: Sodium, Potassium, and Chloride • Electrolytes: positively or negatively charged ions that conduct an electrica l current in solution. • Refers to sodium, potassium, and chloride. • Important for maintain ing fluid balance and nerve impulse transmission. Electrolytes in the Body • Sodium and potassium carry a positive charge. o Potassium is the principle positively charged intracellular ion. o Sodium is the principle positively charged extracellular ion. • Chloride is the principle negative charge d extracellular ion . • Salt or table salt: sodium chloride. • Functions of electrolytes: o Help regulate fluid balance. o Essential for generating and conducting nerve impulses. • Regulating electrolyte balance: o Thirst and salt appetite help ensure that appropriate proportions of salt and water are taken in. o Kidneys are the primary regulator of concentrations in the bo dy. ▪ Blood pressure regulation. Electrolyte Deficiency and Toxicity • Electrolyte deficiencies and toxicities are uncommon in healthy people. • Electrolyte deficiency: deficiencies of any electrolyte can lead to electrolyte imbalances . o Can cause disturbances in poor appetite, muscle cramps, confusion, apathy, constipation , and acid -base and fluid balance . o Example: sudden death can occur from an irregular heartbeat as a result of fasting, anorexia nervosa or starva tion o Electrolyte losses may be in creased by heavy and persistent sweating, chronic diarrhea or vomiting, or kidney disorders. o Medications can also interfere with electrolyte balance. ▪ Example: some diuretics used to treat high blood pressure cause potassium loss. • Electrolyte toxicity: not possible for healthy people to consume too much potassium from foods. o Potassium supplements consumed in excess can increase blood levels of potassium and potentially cause death due to an irregular heartbeat. ▪ If too much potassium enters the blood, it can cause the heart to stop. o Difficult to consume more sodium than the body can handle. ▪ Generally drink more water when sodium is consumed. • Hypertension: high blood pressure. Most common disease associated with electrolyte imbalance. o Called “the silent killer ” because n o outward symptoms. o Can lead to atherosclerosis, heart attack, stroke, kidney disease, and early death. o Caused by an increase in blood volume and/ or narrowing of the blood vessels. o Treated with diet, exercise, and medication. o Healthy blood pressure: 120/80 mm of mercury or less. o Prehypertension: blood pressure between 120/80 and 139/89 mm mercury. o Hypertensi on: blood pressure consistently 140/90 mm mercury or above. o Risk Factor s: ▪ Genetics: family history of the disease. ▪ Race: more common in African Americans. ▪ Age: increases with age. ▪ Overweight, particularly excess fat in the abdominal region. ▪ Lack of physica l activity. ▪ Heavy alcohol consumption. ▪ Stress. o Public health concern: 1/3 of American adults age 20 and older are diagnosed with it but only 53% of those diagnosed have their blood pressure under control. • Diet and blood pressure: o High sodium diets associa ted with hypertension. o Diets high in potassium, calcium, and magnesium are associated with lower average blood pressure. o The DASH diet: Dietary Approaches to Stop Hypertension eating plan; shown to reduce blood pressure significantly ▪ Plenty of fiber, potas sium, magnesium, and calcium. ▪ Low in total fat, saturated fat, and cholesterol. ▪ Lower in sodium than the typical American diet. Meeting Electrolytes Needs • 2300 mg sodium or less for adults: 2015 -2020 Dietary Guidelines and UL • 1500 mg sodium or less: people with prehypertension and hypertension . • Average US intake of sodium: 34 40 mg /day . o Salt is 40% sodium and 60% potassium by weight. o This represents 8 .6 g ( 86 00 mg) of salt per day. • 4700 mg potassium/day: DRIs. • 3500 mg potassium/ day: Daily Value. o No UL for potassium. • Ty pical US intake of potassium: 26 00 mg /day . • Processing adds sodium and chloride to the diet. o Over three -quarters of the salt eaten in from foods that have had salt added during processing and manufacturing . o 77% of sa lt in the diet comes from processed foods. o 12% of salt comes naturally in foods. o 11% of salt is added during cooking or at the table. • Sodium added for flavoring and as a preservative • Fresh, unprocessed foods are high in potassium: fruits, vegetables, whole grains . • Sodium on food labels: o Health claim can be made if the product is low -sodium that is may reduce the risk of high blood pressure o Health claim can be made if product is low -sodium and a good source of potassium that it may reduce t he risk of high blood pressure and stroke . o Sodium free: food contains less than 5 mg of sodium/serving . o Low sodium: food contains 140 mg or less sodium/serving. (about 5% of the daily value). o Reduced sodium: food contains at least 25% or less sodium per se rving than the reference food . What Should I Eat? Water and Electrolytes • Stay hydrated • Increase potassium intake • Decrease sodium intake Minerals and Bone Health • Bones are the hardest, strongest structures in the body. • Bone is composed of a protein framework (matrix consisting mostly of collagen) that is hardened by deposits of minerals. • Mineral portion of bone is composed mainly of calcium associated with phosphorous. o Also contains magnesium, sodium, fluoride, etc. • Health bone requires adequ ate dietary protein and vitamin C to maintain collagen. • Healthy bone requires a sufficient supply of calcium and other minerals to assure solidity. • Adequate vitamin D is needed to maintain appropriate levels of calcium and phosphorous. • Vitamin K may also b e important. • Loss of bone mass with age increasing risk of fractures (osteoporosis). Osteoporosis • Bone is alive. • Bone remodeling: a continuous process in which bone is broken down and replaced by new bone. • Most bone is formed early in life. • Bone mass cont inues to increase into young adulthood. • Peak bone mass: the maximum bone density at tained at any time in life . o Achieved somewhere between ages 16 and 30. • Osteoporosis: a bone disorder characterized by reduced bone mass, increased bone fragility, and increased risk of fractures. • Factors affecting the risk of osteoporosis: o Gender: more common in women than men. ▪ Postmenopausal bone loss: accelerated bone loss that occurs in women for about five to ten years after the menstrual cycle stops. o Age: risk incr eases with age. o Race: African Americans have denser bones than do Caucasians and Southeast Asians. o Family history. o Body weight : those who are small and light have an increased risk. o Smoking: tobacco weakens bones. o Exercise: weight bearing exercise throughout life strengthens bones. o Alcohol abuse: long -term abuse reduces bone formation and interferes with the absorption of calcium. o Diet: diet lacking in calcium and vitamin D plays a major role in development. • Preventing and treating osteoporosis: o Ac hieve a high peak bone mass early in life. o Slow the rate of bone loss. o Diet with adequate calcium and vitamin D. o Higher intakes of zinc, magnesium, potassium, fiber , vitamin K, and vitamin C. ▪ Found in fruits and vegetables. o Maintaining an active lifestyle. ▪ Includes weight -bearing exercise. ▪ Limit smoking. ▪ Limit alcohol consumption. o Treatment: estrogen to reduce bone breakdown and increase calcium absorption. ▪ Other hormones or drugs: bisphosphonates. ▪ Weight bearing activity. Calcium • 1.5% of body weight is due to calcium. o 99% found in bones and teeth. o Remaining in body cells and fluids. • Needed for muscle contraction, release of neurotransmitters, blood pressure regulations, cell communication, blood clotting, and other essential functions. • Calcium in health and disease: o Parathyroid hormone (PT H) is released when calcium levels drop. o Calcitonin is released if blood calcium levels become too high. o Bone resorption: when too little calcium is consumed, the body maintains normal blood levels by breaking down bone to release calcium. o Low calcium intake during the years of bone formation results in lower peak bone mass. o Elevated blood calcium can cause: loss of appetite, abnormal heart beat, weight loss, fatigue, frequent urination and soft tissue calcification . ▪ Severe elevation may cause confusion, delirium, coma, and even death. ▪ Rare. Most often caused by cancer and disorders that increase the secretion of PTH. ▪ Can also result from increases in intestinal calcium absorption due to excessive vitamin D intake or high intakes of calcium from supplements or antacids. o High calcium intake from supplements can interfere with the availability of iron, zinc, magnesium, an d phosphorous. Causes constipation, and elevated blood and urinary calcium. ▪ May promote the formation of kidney stones. • Meeting calcium needs: o 1000 mg Calcium per day: adults ages 19 to 50. ▪ Men ages 50 to 70. o 1200 mg Calcium per day: women ages 50 to 70. ▪ Both genders over age 70. o Main food source: dairy products. ▪ Other food sources: leafy dark green vegetables, fish consumed with bones, foods processed with calcium – juices and breakfast cereals. o Supplements: can help to meet needs. ▪ High bioavailability: • Vitamin D. • Acidic foods, lactose, and fat. ▪ Low bioavailability: • Oxalates, phytates, tannins, and fiber. Thinking Critically: Soda versus milk • How will the trend away from milk consumption affect the incidence of osteoporosis 30 years from now? Phosphorus • Most is associated with calcium as part of the hard mineral crystals in bones and teeth. o Smaller amoun t in soft tissue : an essential role as a structural component of phospholipids, DNA and RNA, and ATP. o Important in regulating enzyme activity and maintaining acidity in cells. • Phosphorous in health and disease: kidneys help maintai n phosphorus levels in a ratio with calcium. • Deficiency: can lead to bone loss, weakness, and loss of appetite. o Inadequate intake: rare. o May be caused by chronic diarrhea or poor absorption due to overuse of aluminum -containing antacids. • Excessive intake: can lead to bone loss. o Concern that increased use of food additives that contain phosphorous (soft drinks) may affect bone health. • UL: 4000mg/da y for adults. • Meeting phosphorus needs: dairy products, meat, cereals, bran, eggs, nuts, and fish. o Food additives in baked goods, processed meat, carbonated beverages, etc . Magnesium • Essential for bone health. o About 50 -60% of magnesium helps maintain bone structure. o Rest in cells and fluids. • Involved in regulating calcium homeostasis and is needed for the action of vitamin D and many hormones. • Important for blood pressure regulation. • Needed in every metabolic reaction that generates or uses ATP. • Magnesium in health and disease: o Deficiency is rare. o Typical intake is below RDA. o Low intake associated with chronic diseases including osteoporosis , Type 2 diabetes, hypertension, and atherosclerosis . ▪ Deficiency can cause: nausea, muscle weakness and cramping, irritability, mental derangements, and changes in blood pressure and heartbeat. o Toxicity: no adverse effects from food. ▪ Drugs containing magnesium (example: milk of magnesia): cause nausea, vomiting, low blood pressure, and other cardiovascular c hanges. ▪ UL: 350 mg for adults and adolescents over age 9. • Meeting magnesium needs: found in many foods in small amounts. o Single food sources are limited. Fluoride • Helps prevent dental caries by strengthening tooth enamel in both children and adults. • Inco rporated into the mineral crystals in bones and teeth. • Meeting fluoride needs: o Present in small amounts in almost all water, plants, and animals. o Richest dietary sources: toothpaste, tea, and marine fish consumed with their bones. o Water sources can provide fluoride. Foods cooking with fluoride containing water absorb fluoride. ▪ Teflon cooking utensils can pick up fluoride. ▪ Aluminum cookware can decrease the fluoride content of foods. ▪ Bottled water usually does not contain fluoride. • Recommended intake: o 0.05 mg/kg/day: 6 months and older ▪ About 3.8 mg/day for a 76 -kg man. ▪ About 3.1 mg/day for a 61 -kg woman o Fluoridated water provides about 0.7 mg fluoride/liter. o Supplements: ▪ American Academy of Pediatrics suggests a supplement of 0.25 mg/day for children 6 months to 3 years; ▪ 0.5 mg/day for children ages 3 to 6 years; ▪ 1.0 mg/day for those ages 6 to 16 years. ▪ Available by prescription for children living in areas with low fluoride concentration in the water. • Fluoridation of water: o Added to public wa ter supplies to promote dental health. o 75% of the population is served by public water supplies. • Toxicity: o Fluorosis: condition caused by chronic over -consumption of fluoride, characterized by black and brown stains and cracking and pitting of the teeth. ▪ Chronic ingestions of fluoride -containing toothpaste. o UL: 0.1mg/kg/day for infants and children less than 9 years of age. ▪ 10 mg/day for those 9 years and older. What Should I Eat? Calcium, Phosphorus, Magnesium, and Flouride • Get calcium into your body and your bones • Don’t fret about phosphorus • Maximize your magnesium • Find your flouride Minerals and Healthy Blood • Iron and copper are trace minerals essential for the synthesis of adequate amounts of hemoglobin. Iron • Most iron in the body is in the protein hemoglobin. o Also part of myoglobin. • Essential for ATP production. • Iron -containing proteins are also involved in drug metabolism and immune function. • Iron absorption and transport. o Heme iron: readily absorbable form of iron found in meat, fish, and poult ry. ▪ Absorbed twice as efficiently as nonheme iron. o Nonheme iron: found in plant sources such as leafy green vegetables, legumes and grains. ▪ Absorption can be enhanced or reduced by foods and nutrients consumed in the same meal. o Once absorbed, the amou nt delivered to cells depends to some extent on the body’s needs. • Meeting iron needs: o 8 mg/day: RDA for adult men and postmenopausal women. o 15 mg/day: young women 14 to 18 years. o 18 mg/day: women 19 to 50 years. o Separate recommendations for vegetarians. o Assumes that food sources include both plant and animal proteins. o Iron cookware increases iron content of food. o Absorption decreased by fiber, phytates, tannins, and oxalates. ▪ Calcium may also decrease absorption. • Iron in health and disease. o Iron deficiency anemia: iron deficiency disease that occurs when the oxygen – carrying capacity of the blood is decreased because there is insufficient iron to make hemoglobin. ▪ Symptoms: fatigue, weakness, headache, decreased work capacity, inability to maint ain body temperature in a cold environment, changes in behavior, decreased resistance to infection, impaired development in infants, and increased risk of lead poisoning in children. ▪ Anemia is the last state of iron deficiency. ▪ Most common nutrient deficie ncy. ▪ Risks: • Women of child bearing age, pregnant women, infants, children, adolescents. • Low total iron intake, vegetarian diets, dieting. • Poverty, intestinal parasites. Thinking It Through: A Case Study on Iron Deficiency • Case: 23 -year -old graduate student eating a lacto -ovo vegetarian diet for the past 6 months has a complaint of always being tired. o Toxicity: caused by excessive consumption of iron -containing supplements. ▪ Most common form of poisoning in children under age 6. ▪ UL: 45 mg/day from all sources o Iron overload: accumulation of iron in the body over time . ▪ Hemochromatosis: inherited disorder that results in increased iron absorption. • More than 1 million Americans affected. • Most common genetic disorder in Caucasians. • Symptoms that oc cur in middle -age: nonspecific symptoms such as weight loss, fatigue, weakness and abdominal pain. • Excess iron can damage the heart and liver and increase the risk of diabetes and cancer. • Treatment: regular blood withdrawal. Copper • Interrelated with iron. • Copper deficiency results in iron deficiency which may lead to anemia. • Functions as a component of a number of important proteins and enzymes involved in connective tissue synthesis, antioxidant protection, lipid metabolism, mainten ance of heart muscle, and function of the immune and central nervous system. • Sources: o Seafood, nuts and seeds, whole -grain breads and cereals, and chocolate. o Organ meats: liver and kidney. o Soil content affects the amount of copper in plants. • RDA: 900 micro grams/day. • Deficiency: o Protein collagen does not form normally, resulting in skeletal changes similar to those seen in vitamin C deficiency. o Causes elevated blood cholesterol. o Associated with impaired growth, degeneration of the heart muscle and the nervou s system, and changes in hair color and structure. o Increases incidence the incidence of infections. o Severe deficiency is relatively rare. o Can also occur with high intake of dietary zinc. • Toxicity: o Rare. o Results from drinking contaminated water supplies or consuming acidic foods or beverages. o Most likely to occur from supplements. o Causes pain, vomiting, and diarrhea. o UL: 10 mg/day. Antioxidant Minerals • Antioxidants vitamins (vitamin C and E) protect cells from damaging effects of reactive oxygen molecules. • Minerals (selenium, zinc, copper, and manganese) act as cofactors for antioxidant enzyme systems. Selenium • Amount of selenium in food varies depending on the concentration in the soil. • Keshan disease: a form of heart disease occurs in children and young women in regions of China with low selenium levels. • Incorporated in the structure of certain proteins. o Glutathione peroxidase: selenium -containing enzyme that protects cells from oxidative dama ge by neutralizing peroxides. • Needed for the synthesis of the thyroid hormones, which regulate metabolic rate. • Meeting selenium needs: o Deficiencies and excesses are not a concern in the US. o RDA: 55 µg/day. o Excellent sources: seafood, kidney, liver, and egg s. o Good sources: grains, nuts, and seeds – depending on selenium content of soil. o Poor sources: fruits, vegetables, and drinking water. o UL: 400 µg/ day from diet and supplements. • Selenium and cancer: o Incidence of cancer has been observed where selenium int ake is low. o Role of supplementation is under investigation. Zinc • Most abundant intracellular trace mineral. • Involved in the function of 100 different enzymes. o Vital for protecting cells from free -radical damage. • Maintain adequate levels of metal binding proteins. • Enzymes that function in the synthesis of DNA and RNA, in carbohydrate metabolism, in acid -base balance, and for the absorption of folate. • Plays a role in the storage and release of insulin, the mobilization of vitamin A from the liver, a nd the stabilization of cell membranes. • Influences hormonal regulation of cell division. • Needed for the growth and repair tissues, the activity of the immune system, and the development of sex organs and bone. • Role in gene expression. • Zinc transport from the mucosal cells of the intestine into the blood is regulated. • Meeting zinc needs: o Red meat, liver, eggs, dairy products, vegetables, and seafood. o Absorbed better from animal sources. • Zinc in health and disease: o Deficiency: uncommon in North America. o Imp ortant consequences in developing countries: ▪ Deficiency interferes with growth and development, impairs immune function, and causes skin rashes and diarrhea. ▪ Risk is greater where the diet is high in phytate, fiber, tannins, and oxalates. o Toxicity: not wit h food. ▪ Supplements can cause toxicity symptoms. o Supplements: ▪ No evidence of improved immune function, enhanced fertility and sexual performance. ▪ May be helpful in individuals with mild zinc deficiency. ▪ If taken with 24 hours of cold symptoms, may reduce t he severity and duration of a cold. • UL: 40 mg/day from all sources. Manganese: • A constituent of some enzymes and an activator of others. • Involved in carbohydrate metabolism, and cholesterol metabolism; bone formation; synthesis of urea; and prevention of oxidative damage. • Recommended Intake: 2.3 mg/day for adult men o 1.8 mg/day for adult woman • Dietary sources: whole grains, nuts, legumes, and leafy green vegetables. Sulfur • Part of the proteins in the body and amino acids and vitamins. o Includi ng cysteine, a part of glutathione which is essential for the antioxidant enzyme glutathione peroxidase • No recommended intake level. • No deficiency diseases or symptoms. • Toxicity is not likely. • Sources: prot eins foods, preservatives , and sulfur containing v itamins . Molybdenum: • Needed to activate enzymes. • Functions: in the metabolism of sulfur -containing amino acids and nitrogen -containing compounds present in DNA and RNA. o Production of waste products: uric acid. o Oxidation and detoxification of various other compounds. • Recommended intake: 45 µg/day for adult men and women. • Content in food varies with soil content of molybdenum. • Sources: milk and milk products, organ meats, breads, cereals and legumes. o Readily absorbed from food. o Regulated by excr etion in the urine and bile. Minerals and Energy Metabolism Iodine • Most iodine is found in the thyroid gland. • Essential component of the thyroid hormones. o Regulate metabolic rate, growth, and development, and promote protein synthesis. • Iodine in health a nd disease: o Thyroid hormone levels carefully regulated. ▪ If blood levels drop, thyroid -stimulating hormone is released. o Goiter: an enlargement of the thyroid gland caused by a deficiency of iodine. o Cretinism: a condition resulting from poor maternal iodine intake during pregnancy that impairs mental development and growth in offspring. o Deficiency: most common in regions where soil is low in iodine and there is little access to fish and seafood. ▪ Risk increases with consumption of foods that contain goi trogens: turnips, rutabaga, cabbage, millet, and cassava. ▪ Problem in African countries. o UL: 1100 µg of iodine/day from all sources. • Meeting iodine needs: o Foods from the seas: fish, seafood, and seaweed. o Iodized salt: table salt to which a small amount of s odium iodide or potassium iodide has been added. o RDA: 150 µg/day. o Contaminant and additives in food : used in food dye and cattle feed , used in sterilizing agent for farm equipment . Chromium • Required to maintain normal blood glucose levels. • Dietary sources : liver, brewer’s yeast, nuts, and whole grains. • Intake can be increased by cooking in stainless -steel cookware. • Recommended intake: o 35 µg/day for men age 19 to 50. o 25 µg for women age 19 to 50. • Deficiency: not a problem in the US. • Supplement: chromium picolinate, common. o No evidence of any action. • UL: insufficient data to establish. What Should I Eat? Trace Minerals • Add more iron and increase iron absorption • Think zinc • Trace down your minerals
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 7 Vitamins A Vitamin Primer • Vitamins are organic compounds that are essential in small amounts. • Promote and regulated body processes necessary for growth, reproduction, and maintenance of health. • When a vitamin is lacking, deficiency symptoms occur. • When the vitamin is restored to the diet, deficiency symptoms disappear. • Water -soluble vitamins: o B vitamins and vitamin C • Fat -soluble vitamins: o Vitamins A, D, E, and K. Vitamins in Our F ood • All foods contain some vitamins. • All the food gr oups contain foods that are good sources of a variety of vitamins. • The amount present in food depends on: o The amount that is naturally present. o What is added to it. o How the food is processed, prepared, and stored. • Even though vitamins are in all food groups, the amounts vary. Example: grains, fruits, and vegetables lack B12; grains, dairy, and protein foods are low in Vitamin C. • Fortification adds nutrients to foods. • DEBATE: Discretionary Fortification: Is it Beneficial? o Do we need these extra nutrients? Can they pose a risk of toxicity if eaten in large quantities? o Fortification began as a way to address nutrient deficiencies. ▪ Government mandated fortification: B vitamins, vitamin A and D, and iodine. ▪ Indiscriminate fortification: e.g. breakfast cereals. ▪ Increasing product sales. • Vitamins in foods can be damaged by exposure to light or oxygen. o Washed away during preparation. o And destroyed during cooking. Vitamin Bioavailability o Bioavailability: the extent to which the body can absorb and use a nutrient. o 40 -90% of the vitamins in food are absorbed. o Absorption is affected by the composition of the diet and conditions in the digestive tract. o Provitamin or vitamin pr ecursor: a compound that can be converted into the active form of a vitamin in the body. Vitamin Functions • Antioxidants : substances that help protect cells from oxidative damage. o Vitamin C, vitamin E, and provitamin A. • Healthy immune function. o Vitamins A, B6, C and D, and folate. • Normal growth and development. o Vitamin A and D. • Needed to produce ATP from carbohydrate, fat, and protein. o B vitamins thiamin, riboflavin, niacin, biotin, pantothenic acid and vitamin B6. • Important for protein and amino acid metabolism. o Folate, vitamin B6, and vitamin B12. • Keep blood healthy. o Folate, vitamin B6, vitamin B12, and vitamin K. • Needed for bone health. o Vitamins A, D, K, and C. • Coenzymes : organic non -protein substances that bind to enzymes to promote their activity. Meeting Vitamin Needs • In developing countries: vitamin deficiencies remain a major public health concern. • In develop ed countries: eliminat ion of most vitamin -deficiency diseases. o Concern for meeting needs of high -risk groups – pregnant women and children. o Determining consequences of marginal deficiencies. o Evaluating the risk of consuming toxic amounts of certain vitamins. • RDAs and AI of the DRIs recommend amounts that provide enough of each of the vitamins to prevent a deficiency and promote health. • Established ULs to avoid risk of toxicity. • Food labels can help identify packaged foods that are good sources of vitamins. o Required to list vitamin D. o General Guide: ▪ If the %Daily Value is 5% or less, the food is a poor source of that nutr ient. ▪ If the %Daily Value is 10 -19%, the food is a good source of that nutrient. ▪ If the %Daily Value is 20% or more, the food is an excellent source of that nutrient. Vitamin and Energy Metabolism Thiamin • Vitamin B1 is water soluble . • Deficiency: Dry Beriberi: causes we akness, nerve degeneration. Wet Beriberi: causes heart changes. o Common where polished white rice is a staple of the diet. o Wernicke -Korsakoff syndrome: a thiamin deficiency occurring most often in alcoholics. ▪ Confusion, los s of coordination , vision changes, hallucinations, and eventually coma and death . • Co -enzyme needed for the breakdown of glucose to provide energy. o Important for nerve function. • Needed for the synthesis of neurotransmitters: chemical substances produced by a nerve cell that can stimulate or inhibit another cell. • Needed for the metabolism of other sugars and certain amino acids. • Needed for the synthesis of ribo se and deo xyribose , part of the structure of RNA and DNA respectively . • Food Sources: bran layer of rice and whole grains, o Added to enriched grains. o Abundant in pork , legumes, and seeds. • No UL because no toxicity has been reported when an excess of this vit amin is consumed in food or supplements. Riboflavin • Water soluble vitamin. • Excess consumption turns the urine bright fluorescent yellow; it is harmless. • No adverse effects from high doses from either food or supplements have been reported. • Forms two active coenzymes that act as electron carriers. • Function in the reactions needed to produce ATP from carbohydrate, fat, and protein. • Involved directly or indirectly in converting a number of other vitamins, including folate, niacin, vitamin B6 and vitamin K, into their active forms. • Foo d sources: dairy products , red meat, poultry, fish, whole grains, and enriched breads and cereals. o Vegetable sources: asparagus, broccoli, mushrooms, and leafy green vegetables. • Deficiency symptoms: injuries heal poor ly becau se new cells cannot grow. o Tissues that grow rapidly are the first affected: skin and the linings of the eyes, mouth and tongue; cracking of the lips and corners of mouth . o Increased sensitivity to light; burning, tearing, and itching of the eyes. o Flaking of the skin around the nose, eyebrows and earlobes. o A deficiency usually occurs in conjunction with deficiencies of other B vitamins. Niacin • Pellagra: disease resulting from niacin deficiency, which causes dermatitis, diarrhea, dementia, and, if not treated, death. • Water soluble vitamin. • Coenzymes essential for gluc ose metabolism and th e synthesi s of fatty acids and cholesterol. • Food sources: meat, fish, peanuts, and whole and enriched grains are the best sources. o Other sources: legumes and wheat bran. • Can be synthesized from tryptophan – if diet is adequate. • RDA expressed as niacin equivalents (NEs). o One NE is equal to 1 mg niacin or 60 mg tryptophan. • Toxicity possible from supplements. o Excess niacin from supplement s can cause flushing of the skin , a tingling sensation in the hands and feet, a red skin rash, nausea, vomiting, diarrhea, high blood sugar levels, abnormalities of liver function, and blurred vision. o No evidence of adverse effects from food but supplements can be toxic . o UL for adults is 35 mg. Biotin • Coenzyme that functions in energy production and glucose synthesis. o Also important in the metabolism of fatty acids and amino acids. • Water soluble vitamin. • Good food sources: cooked eggs, liver, yogurt, and nuts. o Fruit and meat are poor so urces. o Bacteria in the GI tract can synthesize. • AI 30 µg/day for adults . • Deficiency is uncommon. o Deficiency has been observed in people with malabsorption and those taking certain medications for a long period. o Eating raw eggs can cause a deficiency. o Symptoms: nausea, thinning hair, loss of hair color, a red skin rash, depression, lethargy, hallucinati ons, and tingling of the extremi ties. • No UL set . Pantothenic Acid • Water soluble vitamin. • Functions: part of coenzyme A (CoA) needed for the breakdown of carbohydrates, fatty acids, and amino acids. o Synthesis of neurotransmitters, steroid hormones, and hemoglobin. o Needed to form a molecule that is essential for the synthesis of cholesterol and fatty acids. • Sources: widely distributed in fo ods. o Good sources: meat, eggs, whole grains, legumes • Deficiency: rare. • AI is 5 mg/day for adults . • Nontoxic. No established UL. Choline • Not currently classified as a vitamin but is considered an essential nutrient. • Water -soluble substance. • Included in supplements called “vitamin B complex.” • Needed to synthesize a number of important molecules in the body, including the neurotransmitter acetylcholine; the structure and function of cell membranes, lipid transport, and homocysteine metabolism. o Can be synthesized by the body. • Deficiency: during pregnancy can interfere with brain development of fetus; in adult it causes fatty liver and muscle damage. • AIs: 550 mg/day for men; 425 mg/day for women. o UL: 3.5 g/day for adults o Deficiency is unlikely in healthy humans in the U.S. • Food sources: large amounts in egg yolks, liver, meat, fish, nuts, and wheat germ. • Excess choline intake from food and supplements: causes a fishy body odor, sweating, reduced growth rate, low blood pressure, and liver damage. Vitamins and Healthy Blood ▪ Vitamins needed to support the synthesis of red blood cells and blood -clotting proteins. Vitamin B6 • Functions: a water soluble vitamin important for amino acid and protein metabolism. o Needed to synthesize nonessential amino acids, make neurotransmitters, synthesize hemoglobin, convert tryptophan into niacin, and break down of glucose and amino acids, and synthesis of lipids . • Three forms: pyridoxal, pyridoxine, and pyridoxamine. o Can be c onverted into the active coenzyme pyridoxal phosphate. ▪ Needed for the activity of more than 100 enzymes involved in the metabolism of carbohydrate, fat, and protein. • Deficiency: leads to poor growth, skin lesions, decreased immune function, anemia, and ne urological symptoms. o Can be hastened by a diet that is low in vitamin B6 but high in protein. o If vitamin B status is low, homocysteine levels rise. ▪ Elevated homocysteine levels have been shown to increase risk of heart disease. • Food sources: o Animal source s: chicken, fish, pork, and organ meats. o Good plant sources: whole -wheat products, brown rice, soybeans, sunflower seeds, and some fruits and vegetables. ▪ Bananas, broccoli and spinach. • RDA for adults is 1.3 mg/day. • Toxicity: no adverse effects from high in take in foods. o Large doses from supplements can cause severe nerve impairment. o UL 100 mg/day from food and supplements for adults . o Some evidence that excess vitamin B will relieve symptoms of carpal tunnel syndrome or premenstrual syndrome ; will improve immune function but only in people deficient in Vitamin B6 . Folate (Folic Acid) • Water soluble vitamin. • Important during embryonic develo pment. o Low folate intake during pregnancy increases the risk of neural tube defects: abnormalities in the bra in or spinal cord that result from errors that occur during prenatal development. • Folic acid: an easily absorbed form of the vitamin folate that is used in dietary supplements and fortified foods. • RDA for folate: expressed in dietary folate equivalents (DFEs) o This measure corrects for differences in the bioavailability of different forms of folate. o One DFE is equal to 1 µg of food folate, 0.6 µg of synthetic folic acid from fortified foods or supplements consumed with food, or 0.5 µg of synthetic folic acid consumed on an empty stomach. • Folate coenzymes are needed for the synthesis of DNA and the metabolism of some amino acids. o Important in tis sues in which cells are dividing rapidly: intestines, skin, embryonic and fetal tissues, and bone marrow. • Deficiency symptoms: macrocytic anemia or megaloblastic anemia. o Other symptoms: poor growth, problems with nerve development and function, diarrhea, a nd inflammation of the tongue. o Low folate status may increase the risk of developing heart disease . o Folate and vitamin B12 are both needed to prevent homocysteine levels from rising. o Populations most at risk of folate deficiency: pregnant women, premature infants, the elderly, alcoholics, and tobacco smokers. • Food sources: Excellent source : leafy greens, such as spinach, asparagus, oranges, legumes, and liver. o Fair sources: whole grains, corn, snap beans, mustard greens, and broccoli; some nuts. o Small amounts: meats, cheese, milk, fruits, and other vegetables. • RDA 400 µg/day for adult men and women . Vitamin B12 • Also known as cobalamin is water soluble . • Pernicious anemia: macrocytic anemia resulting from vitamin B12 deficiency that occurs when dietary v itamin B12 cannot be absorbed due to a lack of intrinsic factor. o Intrinsic factor: protein produced in the stomach that is needed for the absorption of adequate amounts of vitamin B12. o Atrophic gastritis: an inflammation of the stomach lining that results in reduced secretion of stomach acid, microbial overgrowth, and, in severe cases, a reduction in the production of intrinsic factor. • Functions: necessary for the production of ATP from certain fatty acids. o Needed to convert homocysteine to methionine o Need to maintain the myelin coating on nerves. o When vitamin B12 is deficient, homocysteine levels rise, and folate cannot be converted into its active form. The lack of folate causes macrocytic anemia. ▪ Lack of vitamin B12 also leads to degeneration of the myeli n that coa ts the nerves in the spinal cord and brain. ▪ Symptoms: numbness and tingling, abnormalities in gait, memory loss, and disorientation. If not treated, leads to paralysis and death. • Food sources: found only in animal products. o Supplements or fortifi ed foods are needed to provide this nutrient for vegans. o RDA 2.4 µg/day for adult men and women. ▪ UL: Insufficient data to establish. Vitamin K • A fat soluble vitamin needed for blood clotting. • The K in vitamin K comes from the Danish word for coagulation, koagulation, which means “blood clotting.” • Deficiency: abnormal blood coagulation. o With vitamin K deficiency, blood clotting factor, including prothrombin, are not made correctly, and the blood will not clot. What a Scientist Sees: Anticoagulants Takes Lives and Save Them • Warfarin is an anticoagulant, prevents blood from clotting. • Used as a rat poison. • Used as an anticoagulant to prevent blood clot formation in humans. o Known by brand name Coumadin. Meeting vitamin K needs • Needed for the synthesis of several proteins involved in bone formation and breakdown. Inhibit blood vessel calcification. Regulate cell growth. • Adequate vitamin K may be important to decrease risk of fractures due to osteoporosis, and reduce risk of atherosclerosis and cancer. • The body uses vitamin K rapidly; a constant supply is needed. • Food sources: leafy green vegetables and some vegetable oils. • Nonfood source: synthesis by bacteria in the intestine. • Deficiency: can be precipitated by poor diet, Crohn’s disease, or long -term antibiotic use, which kills the bacteria in the GI tract. o Newborns at risk: no bacteria in the GI tract at birth; little vitamin K is transferred from the mother before birth; breast milk is a poor s ource. ▪ Infants are commonly given a vitamin K injection within six hours of birth. Antioxidant Vitamins • Antioxidant: substance that decreases the adverse effects of reactive molecules on normal physiological function. • Oxidative stress: imbalance between r eactive oxygen molecules and antioxidant defenses that result in damage. • Free radical: type of highly reactive molecules that cause oxidative damage Vitamin C • It i s water soluble, and also known as ascorbic acid. • Functions: synthesis and maintenance of co llagen o Needed in reactions that synthesize neurotransmitters, hormones, bile acids, and carnitine. o An antioxidant that acts in the blood and other body fluids. ▪ Regenerates the active antioxidant form of vitamin E. ▪ Enhances iron absorption in the small intestine. • Deficiency: Scurvy: characterized by bleeding gums, tooth loss, joint pain, bleeding into the skin and mucous membranes, and fatigue. • Food sources: citrus fruits, strawberries, kiwis, and cantaloupe. o Vegetables: cabbage family, dark green leafy vegetables, green and red peppers, okra, tomatoes and potatoes. o Poor sources: meat, fish, poultry, eggs, dairy products, and grains. • Is destroyed by oxygen, light, and heat. o Readily lost in cooking. • RDA: 90 mg/day for men; 75 mg/day for women. o Cigarette sm oking increases requirement by an extra 35 mg/day (1/2 cup broccoli) . o UL: 2000 mg/day from food and supplements. • Supplements: one -third of the population takes in hopes of preventing the common cold. o Does not prevent colds or reduce the severity of symptoms; however it may help reduce the duration. o Insufficient data to support claims of reducing the risk of cancer or cardiovascular disease. o Excessive supplementation: diarrhea, nausea, abdominal cramps, and increased risk of kidney stone formation. ▪ In individuals unable to regulate iron absorption, excess vitamin C can increase absorption, allowing iron to reach toxic levels. ▪ In individuals with sickle cell anemia, excess vitamin C can worsen symptoms. ▪ Doses greater than 3 g/day may interfere with drug s prescribed to slow blood clotting. ▪ In chewable form, large doses of vitamin C can dissolve tooth enamel. Vitamin E • An antioxidant that protects lipids through -out the body by neutralizing reactive oxygen compounds before they can cause damage. • May help reduce risk of heart disease, and other diseases. • Protects membranes in red blood cells, white blood cells, nerve cells, and lung cells as well as lipids in lipoproteins . • Role in modulating immune response, reducing inflammation, allowing cells to com municate, regulation of genes, and inhibiting an early step in blood clot formation. • Fat soluble vitamin. Vitamin E deficiency • Hemolytic anemia: vitamin E deficiency where red blood cells may rupture; most common in premature infants. • Rare in adults. o Occu rs only when other health problems interfere with the absorption of fat. • The antioxidant role of vitamin E suggests that it may help reduce the risk of heart disease, and a variety of other chronic diseases associated with oxidative damage. • Vitamin E has a nti -inflammatory properties . • Supplementation has not been found to benefic ial in preventing heart disease. Meeting vitamin E needs • Food sources: nuts, seeds, and plant oils. o Fortified products such as breakfast cereals. • Vitamin E is sensitive to destruction by oxygen, metals, light, and heat. o When oil is heated repeatedly, most of the vitamin E is lost. • Tocopherol: the chemical name for vitamin E. o Several forms occur naturally in foods. o Only alpha -tocopherol (α -tocopherol) is used by the body. o RDA is expressed as mg α -tocopherol. o Synthetic α -tocopherol is used in supplements and fortified foods. ▪ Provides only half the vitamin E activity of the natural form. • No adverse effects from consuming large amount naturally present in foods. • The amou nt typically found in supplements is safe for most people. o Large doses can interfere with blood clotting. o Should not be used by individuals on blood -thinning medications o UL 1000 mg/d Vitamins in Gene Expression • Vitamin A and D have functions that depend o n their ability to regulate gene expression o Gene Expression: the events of protein synthesis in which the information coded in a gene is used to synthesize protein or a molecule of RNA • Cell differentiation o Immature cells change in structure and function to become specialized by changing gene expression (turning genes on and off) o Vitamin A helps ensure healthy eyes o Vitamin D promotes strong bones Vitamin A • It is a fat soluble vitamin. • Beta -carotene (β -carotene): a provitamin that can be converted into vitamin A in the body. Vitamin A in the diet • Retinoids: the chemical forms of preformed vitamin A: retinol, retinal, and retinoic acid. • Carotenoids: natural pigments synthesized by plants and many microorganisms . o They give yellow and orange fruits a nd vegetables their color. • Beta -carotene: most potent vitamin A precursor. o Alpha -carotene (α -carotene) and beta -cryptoxanthin (β -cryptoxanthin) are also provitamin A carotenoids. ▪ Not converted into retinoids as efficient as β -carotene. • Food sources: o Retino id sources: animal products such as liver, fish, eggs and dairy products. o Retinol sources: fruits and vegetables like carrot, broccoli, and cantaloupe. ▪ Not absorbed as well as retinoids. o Retinol activity equivalent (RAE) is used to express the amount of usable vitamin A in foods. ▪ 1 RAE is the amount of retinol, β -carotene, α -carotene, or β – cryptoxanthin that provides vitamin A activity equal to 1 µg of retinol. o Absorption is impaired when dietary fat intake is low. o Protein and zinc are important in preven ting vitamin A deficiency. Vitamin A functions and deficiency • Needed for vision and eye health. • Needed for normal cell differentiation: the process where immature cells change in structure and function to become specialized. • Retinal is part of rhodopsin, a visual pigment in the eye. o Night blindness: delay in the regeneration of rhodopsin. ▪ First sign of vitamin A deficiency. ▪ Easily reversible. • Necessary for the maintenance of epithelial tissue. o Skin, the linings of the eyes, intestines, lungs, vagina, and b ladder. o Eye is particularly susceptible. o Xerophthalmia: spectrum of eye conditions resulting from vitamin A deficiency that may lead to permanent blindness. • Needed for normal reproduction, growth, and immune function. Vitamin A toxicity • Preformed vitamin A is toxic in large doses. o Symptoms: nausea, vomiting, headache, dizziness, blurred vision, and lack of muscle coordination. ▪ Example: polar bear liver. • Excess vitamin A in pregnant women may contribute to birth defects. o Derivatives of vitamin A tha t used to treat acne (Retin A and Accutane) should never be used by pregnant women. • High intakes have been found to cause liver damage. • UL: 2800 µg/day of preformed vitamin A for 14 -18 year olds; 3000 µg for adults • Hypercarotenemia: condition caused by the accumulation of carotenoids in the adipose tissue, causing the skin to appear yellow -orange. o β-carotene supplements have been associated with an increase in lung cancer in cigarette smokers. o UL: none for carotenoids. o The small amount in a standard strengt h multivitamin supplement not likely to be harmful. Vitamin D • It is fat soluble and is known as the sunshine vitamin. o It can be made in the skin with exposure to ultraviolet light. • It is essential in the diet only when exposure to sunlight is limited or t he body’s ability to synthesize it is reduced. Vitamin D functions and deficiency • Vitamin D is inactive until it is modified by biochemical reactions in both the liver and the kidney. • Active vitamin D is needed to maintain normal levels of the minerals calcium and phosphorous in the blood. • Important in bone health and proper function of nerves, muscles, glands, and other tissues • When vitamin D is deficient, only about 10 -15% of the calcium in the diet can be absorbed. • Rickets: vitamin D deficien cy in children, characterized by narrow rib cage, known as pigeon breasts, and bowed legs. • Osteomalacia: vitamin D deficiency in adults, characterized by loss of minerals from bone, bone pain, muscle aches, and an increase in bone fractures. o Can precipitat e or exacerbate osteoporosis, which is loss of total bone mass. o Common in adults with kidney failure. • Affects cells in the pancreas, heart, skeletal muscles, and immune system. • May play a role in preventing cells from being transformed into cancerous cells . • Evidence that vitamin D may play a role in the increased risk of type 1 diabetes, multiple scle rosis, high blood pressure , inflammatory bowel disease, infections, CVD, cancer, and neurological disorders ( i.e. Alzheimer’s ). Meeting vitamin D needs • Not widespread in the diet. • Natural food sources: liver, egg yolks, and oily fish. • Fortified food sources: milk , milk substitutes , margarine, some yogurts, cheeses, and breakfast cereals. • Sunlight: major source. o Anything that interferes with the transmission o f UV radiation to the Earth’s surface or its penetration into the skin will affect the synthesis of vitamin D. ▪ Living at h igher latitudes. ▪ Those who do not spend time outside. ▪ Those who cover their skin when outside with clothing or sunscreen . • Recommended intake: 15 µg/day for age 1 -70 years; 20 µg/day for 70+ years . o Contained in about 5 cups of vitamin D -fortified milk. o Recommended intake increases with age. • Toxicity: can cause high calcium concentrations in the blo od and urine. o Deposition of calcium in soft tissues such as the blood vessels and kidneys, and cardiovascular damage. o Synthesis of vitamin D from the sun does not produce toxic amounts. o UL: 100 µg (4 000IU)/day for a ge 9+ . Vitamins: What Should I Eat? • Focu s on folate, vitamin A, and vitamin K. • B (vitamin) sure. • Get your antioxidants. • Soak up some D. Meeting Needs with Dietary Supplements • Currently about 60% of all adult Americans take a form of dietary supplement. • Can be beneficial under some circumstances but also have potential to harm . • Do not provide all of the benefits of food. o Do not provide energy, protein, minerals, fiber, or phytochemicals supplied b y food sources. Who Needs Vitamin/Mineral Supplements • Dieters: who consume fewer than 1600 Calories/day. • Vegans and those who eliminate all dairy foods. o Need adequate vitamin B12, calcium and vitamin D. • Infants and children: supplemental fluoride, vitamin D, and iron may be recommended. • Young women and pregnant women: need adequate folate and iron. • Older adults: may need vitamin B12 with atrophic gastritis; Vitamin D and calcium may be needed. • Individuals with dark skin pigmentation: may need vitamin D. • Individuals with restricted diets. • People taking medications: some medications interfere with the body’s use of some nutrients. • Cigarette smokers and alcohol users. o Smokers may require more vitamin C and vitamin E. o Alcohol consumption inhibits the absorption of B vitamins. Herbal Supplements • Herb: term generally used to refer to any botanical or plant -derived substance. • Folk medicine has used herbs to prevent and treat disease. • Readily available and relatively inexpensive. • Purchased over -the -counter. • Some are toxic, either alone or in combination with other drugs or herbs. Choose Supplements with Care • The Dietary Supplement Health and Education Act (DSHEA), 1994 defined the term “dietary supplement. o Created standards for labeling products. o Left most of the responsibility for manufacturing practices and safety in the hands of the manufacturers. o The FDA does not approve the safety and effectiveness of supplements before they are marketed. ▪ FDA must prove that the supplement represents a risk before it can require the manufacturer to remove the supplement from the market. ▪ Exception: if products contain new ingredients. Then the manufacturer must provide the FDA with safety data. ▪ U.S. Pharmacopeia (USP) Re gulations: More stringent set of manufacturing regulations o Voluntary dietary supplement verification program o If the manufacturer chooses to participate they can include the USP -verified mark on product label • Supplements are not regulated as strictly as drugs. • Safe option for multivitamin/multimineral supplement: that does not exceed 100% of the RDAs. • Suggestions for safe use: o Consider why you want it. o Compare product costs. o Read the label. o Check the expiration date. o Consider your medical hist ory. o Approach herbal supplements with caution. o Report harmful effects.
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 10 Nutrition, Fitness, and Physical Activity Food, Physical Activity, and Health • Both food and physical activity are necessary components of optimal health. • Fitness: set of attributes related to the ability to perform routine physical activities without undo fatigue. Physical Activity Reduces the Risk of Chronic Disease • Physical activity includes both planned exercise and daily activities (i.e. cleaning, yard work, etc.) • Regular exercise can prevent or delay the onset of chronic condit ions: cardiovascular disease, hypertension, type 2 diabetes, breast and colon cance r, and bone and joint disorders (i.e. weight -bearing exercise stimulates bones to become denser and stronger and therefore reduces the risk of osteoporosis). • Physical activity reduces overall mortality, regardless if person is lean, normal weight, or obese. • Physical activity improves mood and self -esteem and increases vigor and overall well – being. • Increases muscle mass, strength and endurance. • Improves flexibil ity and balance. • Reduces sleeplessness, depression , stress, and anxiety. • Benefits of exercise can overcome some of the health risks of carrying excess body fat. • Exercise stimulates the release of endorphins, boosting mood and helping with relaxation, pain tolerance, and appetite control. Physical Activity Makes Weight Management Easier • Exercise increases both energy needs and lean body mass. • The more energy you expend, the more food you can eat and still maintain a healthy weight. • Exercise is an essential component of any weight -reduction program: o Increases energy needs. o Promotes loss of body fat. o Slows the loss of lean tissues that occurs with energy restriction. o Reported to reduce risk of stress -induced weight gain. The Four Com ponents of Fitness • Fitness defined by endurance, strength, flexibility, and body composition. • Fitness achieved by regular exercise. • Overload principle: the concept that the body adapts to the stresses placed on it. Cardiorespiratory Endurance • Cardiorespiratory endurance: the efficiency with which the body delivers to cells the oxygen and nutrients needed for muscular activity and transports waste products from cells. o Aerobic exercise: endurance exercise that increases heart rate and uses oxygen to provide energy as ATP. ▪ Examples: jogging, bicycling, and swimming. ▪ Decreases resting heart rate: the rate at which the heart beats when the body is at rest. o Aerobic capacity: the maximum amount of oxygen that can be consumed by the tissues during exercise. ▪ Also called maximal oxygen consumption or VO 2max. Muscular Strength and Endurance o Muscular strength: the a bility to perform tasks such as pushing or lifting . ▪ Example: lifting a gallon of milk off top shelf of refrigerator with one hand . o Muscular endurance: the ability of a muscle group to continue repetitive muscle activity . ▪ Example: shoveling snow . o Muscle strengthening : activities that are specifically design ed to increase muscle strength, endurance and size. ▪ Also called strength -training exercise or resistance -training exercise. ▪ Examples: weight lifting and calisthenics. o Hypertrophy: the building of larger, stronger muscles. “Use it or lose it”. Flexibilit y • Range of motion, how far you can bend and stretch muscles and ligaments . o Example s: static or dynamic stretching exercises . Body C omposition • Proportion of muscle to fat in the body. o Affected by fitness. o Affected by age and gender. o Desirable amount of body fat: ▪ Young adult women: 21 – 32% of total weight. ▪ Young adult men: 8 – 19% of total weight. Physical Activity Recommendations • Public health guidelines to reduce risk of chronic diseases : o At least 150 minutes of moderate -intensity physical activity or 75 minutes of vigorous -intensity aerobic activity each week or an equivalent combination of both. • Greater health benefits: exercising more vigorously or for a longer duration. • Examples: o Moderate exercise: walking 3 miles in about an hour or bicycling 8 miles in about an hour. o Vigorous intensity : jogging at a rate of 5 miles per hour or faster or bicycling 10 miles per hour or faster. o Muscle -strengthen ing activities: 2 or more days per week. o Even a small amount of exercise is better th an none. What to Look for in a Fitness Program • A complete fitness program includes: o Aerobic exercise for cardiovascular conditioning. o Stretching exercises for flexibility. o Muscle -strengthening exercises to increase muscle strength and endurance and maintain or increase muscle mass. • The program should be integrated into an active lifestyle that includes a variety of everyday activities, enjoyable recreational activities, and minimum amount of ti me spent in sedentary activities. • Moderate or vigorous aerobic activity most days of the week. o Maximum heart rate: the maximum number of beats per minute that the heart can attain. o Aerobic zone: heart rate 60 – 85% of maximum heart rate. • Structure fitness program based on needs, goals, and abilities. • Muscle -strengthening exercises : 2 – 3 days per week on nonconsecutive days. • Flexibility exercises: 2 – 7 days per week. Time spe nt in stretching does not count towards meeting aerobic or strength training guidelines. Creating an Active Lifestyle • Steps to starting and maintaining an exercise program: o Find an exercise you enjoy. o Set aside a time that is realistic and convenient. o Find a place that is appropriate and safe. • Suggestions for starting and maintaining an exercise program: o Start slowly. Set specific, attainable goals. Once you have met them, add more. o Make your exercise fun and convenient. o Stay motivated. o Keep your exercise safe. ▪ Overtraining syndrome: a collection of emotional, behavioral, and physical symptoms that occurs when the amount and intensity of exercise exceeds an athlete’s capacity to recover. Fueling Activity • ATP: high -energy compound used to fuel activity. Made from carbohydrate, protein, and fat. • Anaerobic metabolism: production of ATP in the absence of oxygen. o Produces ATP rapidly. o Must use glucose as the fuel. o Produces lactic acid, which can be used as a fuel for aerobic metabolism. • Aerobic metabolism: production of ATP with oxygen. o Can use any fuel: carbohydrate, protein, or fat. o Slower, but more efficient than anaerobic metabolism. Exercise Duration and Fuel Use • Instant energy: ATP first few seconds then we use creatine phosphate . o Creatine phosphate: a compound stored in muscle that can be broken do wn quickly to make ATP. • Short -term energy: Anaerobic metabolism after about 15 seconds . o Limited amount of glucose leads to limited ability to produce ATP fast and efficiently. • Long -term energy: Aerobic metabolism after 2 -3 minutes . o ATP produced at a slowe r rate, but much more efficient. o Able to use fatty acids and amino acids as a source of fuel. o Exercising at a low to moderate intensity, fatty acids become the primary fuel source. • Protein as a fuel for exercise: not considered a major source of energy. o Mo re protein is used if there is not enough total energy intake, more protein is consumed than needed, or if endurance exercise is involved. What a Scientist Sees: The Fat -Burning Zone • Which workout will help you to lose the most weight: 30 -minute in the cardio zone or 30 -minute in the fat burning zone? Why? Exercise Intensity and Fuel Use • Exercise intensity determines the contributions of carbohydrate, protein, and fat as fuels for ATP production. o At rest and low -to -moderate intensity exercise: aerobic m etabolism predominates: fatty acids are an important fuel source. o As exercise intensity increases: proportion of energy supplied by anaerobic metabolism increases: glucose becomes the predominant fuel. o During exercise, the total amount of energy expended i s greater than the amount expended at rest. • Fatigue: inability to continue an activity at an optimal level. o Occurs more quickly with high -intensity exercise than with lower -intensity exercise. o “Hitting the wall ” or “bonking” : an overwhelming feeling of fat igue: depletion of glycogen. o Lactic acid build -up is one of many metabolic changes associated with muscle fatigue. Fitness Training and Fuel Use • Regular exercise to improve fitness causes physiological changes in the body. o The heart becomes larger and str onger so that the amount of blood pumped with each beat is increased. o Aerobic training causes physiological changes in the cardiovascular system that incre ases the delivery of oxygen to cells. o The total blood volume and number of red blood cells expands, i ncreasing the amount of hemoglobin, so that more oxygen can be transported. o In the muscle, there is an increase in the ability to store glycogen and an increase in the number and size of muscle -cell mitochondria. Energy and Nutrient Needs for Physical Act ivity • Major difference between the nutritional needs of a serious athlete and those of a casual exerciser: amount of energy and fluid required , and the quantity and timing of their protein intake . Energy Needs • Amount of energy expended depends on the intensity, duration, and frequency of the ac tiv ity and environmental conditions under which the exercise is performed . o The more intense the activity, the more energy it requires. o The more time spent exercising, the more energy required. • Energy intake to op timize body weight and composition : body weight and composition can affect exercise performance. o Achieving an increase in muscle mass: combination of increased energy intake, adequate protein intake, and strength -training exercise to pro mote an increase in lean tissue rather than fat. o Dieting to maintain an unrealistically low weight may threaten health and performance. ▪ Weight loss should be done in advance of the competitive season to prevent calorie restriction from affecting performance. ▪ Gener al guidelines: reduce energy intake by 200 to 500 Calories/day, increase activity, and change the behaviors that led to weight gain. • Relative energy deficiency in sport (RED -S): occurs when athletes do not consume enough to support their energy expenditure , so they do not have enough energy available to maintain their health and support body functions. o Example: female athlete with low energy availability may progress to RED -S, changing hormone levels affecting menstrual cycle and lead to low bone mineral density. ▪ Previously known as “female athlete triad” but is now recognized as a part of RED -S. o Can affect male or female athletes . o Can alter many other aspects of physiology that impair health and exercise performance. o These athletes are vulnerable to eatin g disorders. ▪ Example: anorexia and bulimia . o More common in a thletes involved in weight class sports: risk of unhealthy weight -loss practices to compete in a lower weight class. ▪ Example: wrestling, boxing ▪ Severely restrict energy intake, or dehydrating themselves through vigorous exercise, fluid restriction, wearing of vapor -impermeable suits, use of hot environment to increase sweat loss. May also vomit or use diuretics and laxatives. ▪ Can be dangerous and fatal. ▪ Can impair performance and negatively affect heart and kidney function, temperature regulation, and electrolyte balance. Carbohydrate, Fat, and Protein Needs • Carbohydrate: 3 to 1 2 g of carbohydrate/kg of body weight per day. • Fat: 20 – 35% of total calories; same as that of the general population. • Protein: 15 – 20% of total calories. o 1.2 to 2.0 g protein/kg of body weight. Vitamin and Mineral Needs • Exercise increases the amounts of many vitamins and minerals used both in metabolism and in repairing tissues after exercise. • Exercise may increase losses of some micronutrients. o Nutrients of key concern: iron, calcium, Vitamin D, and some antioxidants. • Iron o Prolonged training may increase iron requirements because iron loss in feces, urine, and sweat increases. o Foot -strike hemolysis: breaking of red blood cells due to the contraction of large muscles or impact in events such as running. o Reduced iron stores: common in athletes. ▪ Females at particular risk due to menstrual blood loss . ▪ Ina dequate iron intake for both genders . ▪ Reduced absorption from GI tract that occurs several hours after exercise. o Sports anemia: an adaption to training that does not seem to impair the delivery of oxygen to tissues. o Iron needs of athletes: 30 to 70% higher than the general population. • Calcium and Vitamin D o Needed for bone health o Low calcium intake occurs from disordered eating, restricted energy intake or in those that avoid dairy products. o Risk of low bone mineral density and stress fractures is increased by RED -S. o Adequate vitamin D intake needed to regulate calcium absorption and metabolism. • Antioxidant Nutrients o Dietary antioxidants: vitamin C, vitamin E, β -carotene, and selenium. o Little evidence that supplementation with antioxidants improves performanc e. Water and Electrolyte Needs • Exercise increases water needs: increases loss from sweat and evaporation. • Meeting the needs of thirst, may not be enough for an athlete. • Dehydration: risk is greater in the hot. Can occur in the cold. o May be difficult to drink enough to compensate for losses. • Dehydration and heat -related illnesses: conditions including: heat cramps, heat exhaustion, and heat stroke, that can occur due to an unfavor able combination of exercise, hy dration status, and climatic co nditions. o Heat cramps: involuntary muscle spasms that occur during or after intense exercise. ▪ Caused by an imbalance of electrolytes at the muscle cell membranes. ▪ Can occur when water and salt are lost during extended exercise. o Heat exhaustion: water loss causes blood volume to decrease so much that it is not possible both to cool the body and to deliver oxygen to active muscles. ▪ Characterized by a rapid but weak pulse, low blood pressure, disorientation, profuse sweating, and fainting. o Heat stroke: most se rious form of heat -related illness. ▪ Occurs when core body temperature rises above 105 0F, causing the brain’s temperature -regulatory center to fail. ▪ The individual does not sweat. ▪ Characterized by: elevated body temperature; hot, dry skin; extreme confusion; and unconsciousness. Requires immediate medical attention. o As the severity of dehydration increases, exercise performance declines. • Hyponatremia: Low blood sodium. o Caused by excessive sweating and fluid replacement with plain water. ▪ Sodium conce ntration in the blood decreases. ▪ Water moves into body tissues by osmosis, causing swelling. ▪ Fluid in the lungs interferes with gas exchange. ▪ Fluid accumulation in the brain causes disorientation, seizure, coma and death. o Risk can be reduced by consuming sodium -containing sports drinks during long – distance events. ▪ Increasing sodium intake several days prior to competition. ▪ Avoiding acetaminophen , aspirin, ibuprofen, and other nonsteroidal anti – inflammatory drugs. Food and Drink to Optimize Perfo rmance • For competitive athletes, when and what they eat and drink before, during, and after exercise are as important as a balanced overall diet. • Type and amount of fluids and foods eaten at these times may give or take away extra seconds that can mean victory or defeat. What to E at and Drink Before Exercise • Maximizing glycogen stores: larger glycogen stores allow exercise to con tinue for longer periods . o Glycogen supercompensation or carbohydrate loading: a diet and exercise regimen designed to increase muscle glycogen stores beyond their usual capacity. ▪ Rest for 3 to 4 days prior to competition. ▪ Consume a very high -carbohydrate diet: 10 to 12 g of carbohydrate/k g of body weight per day . ▪ Beneficial for endurance athletes. ▪ No benefit and provides disadvan tages for those exercising for less than 90 minutes. The P recompetition M eal • Beverages and food consumed should provide plenty of fluid and carbohydrate and not cause GI distress. • 1-4 hours before exercise: Eat 300 -500 calories. o High carbohydrate 1 -4 g/kg body weight o Protein 10 -20% of total C alories o Fat 10 -25% of total C alories o Low fiber • 2-4 hours before exercise: Drink 5 -10 mL/kg. • “Lucky” foods may add a psychological advantage. What to E at and Drink During Exercise • For adequ ate hydration drink 1.5 to 3.5 cups ( 400 -800 mL ) of fluid per hour for duration of the exercise. • Exercise less than 45 minutes: no food needed and drink plain water . • Exercise greater than 45 minutes : need carbohydrate to maintain glucose and delay fatigue. o For exercise lasting more than about 1 hour, consume a sodium -containing beverage or snack to reduce risk of hyponatremia, improve glucose and water absorption, and stimulate thirst. o Example: sports drink containing carbohydrate and sodium . • Exerci se 45 to 75 minutes: small amount of carbohydrate from food or beverages consumed per hour . • Exercise 60 to 150 minutes: 30 -60 g of carbohydrate per hour . o Example: large banana or an energy bar. • Exercise greater than 150 minutes: 90 g of carbohydrate per hour . o Examples: sports drink, solid -food snack, or carbohydrate gel with water. What to E at and Drink After Exercise • Replenish lost fluid, electrolytes and glycogen and provide protein for building and repairing muscle tissue. • Restore hyd ration; replace each kilogram of body weight lost with 1.25 to 1.5 L of fluid (approximately 2 .5-3 cups/pound lost). • For athletes competing over consecutive days, for glycogen replacement consume carbohydrate 1 .0-1.2 g/kg/hour for 4 -6 hours . • To stimulate muscle protein synthesis and provide amino acids needed for protein synthesis and repair consume high -quality protein 0.3 g/kg within 2 h ou rs after exercise; consume balanced meals including protein for 24 hours after exercise . Thinking It Through: A Case Study on Snacks for Exercise • Examine the advantages and disadvantages of energy bars. Ergogenic Aids • Ergogenic aid: a substance, appliance, or procedure that improves athletic performance. o Weigh the health risks against the potential benefits. Vitamin and Mineral Supplements • Many promises about the benefits of vitamin and mineral supplements are extrapolated from the biochemical functions of these micronutrients. o B vitamins promoted to enhance ATP production because of their roles in muscle energy metabolism. o Vitamin B 6, B 12, folic acid , and iron are promoted for aerobic exercise because they are involved in the transport of oxygen to exercising muscle. o Vitamin E, vitamin C, and selenium are promoted because of their antioxidant functions. o Chromium and vanadium are marketed to increase lean body m ass and decrease body fat. o No evidence that supplements improve athletic performance. o These micronutrient supplements are only needed if the athlete is deficient in one or more of them. Supplements to Build Muscle • Ergonomic aids are used to increase muscl e size and strength. • Protein supplements are marketed with the promise of enhancing muscle strength and growth. • Protein needs can be met without supplements by eating high -quality protein foods. o Eat foods such as lean meat, eggs, milk, or soymilk after exe rcise to optimize protein synthesis. • Protein supplements should only be used to optimize exercise recovery not to replace nutrient -dense whole foods. • β-hydroxy -β-methylbutyrate (HMB): claims to increase strength and muscle growth and improves muscle recovery. o Recent studies: some studies found that supplementation in trained athletes have a beneficial effect on body composition and aerobic capacity. • Anabolic steroids: synthetic fat -soluble hormones that mimic testosterone and are used to increase muscle strength and mass. o Accelerate protein synthesis. o Taken in conjunction with exercise and an adequate diet, they can cause increases in muscle size and strength. o Extremely d angerous side effects. o Prohibited by International Olympic Committee, National Collegiate Athletic Association ( NCAA ), and other sporting organi zations . • Think Critically : Anabolic Steroids o Question: Why does anabolic steroid use promote muscle development but cause the testes to shrink? • Growth hormone: increases muscle pr otein synthesis. o It has not been shown to have ergogenic benefits. o Prolonged use can cause heart dysfunction, high blood pressure, and excessive growth of some body parts. o Is on the World Anti -Doping Agency list of banned substances. Supplements to Enhance Performance in Short, Intense Activities • Bicarbonate and β -alanine : acts as a buffer in the body. o Supplementing it is thought to neutralize acid which preserves muscle function , delay s fatigue and improve s performance. ▪ Bicarbonate p ossible side effects: abdominal cramps and diarrhea. ▪ β-alanine : safety has not been studied, use caution • Creatine: nitrogen containing compound, found primarily in muscles, is used to make creatine phosphate. o Higher levels of creatine phosphat e provide more quick energy for short -term muscular activity . o Shown to improve performance in short -duration high -intensity intermittent exercise . ▪ Example: sprinting, weight lifting. o Increase in strength , power, and muscle mass when combined with strength training . o For healthy adult: up to 3 g per day. o Do not take if at risk for kidney disease, consult a physician before use. o May cause weight gain and GI discomfort. Supplements to Enhance Endurance • Carnitine supplements: substances that increase the utilization of fat during exercise. o Enough carnitine is made in the body to ensure efficient use of fatty acids. o Found in red meat and dairy products. o Supplements have not been shown to increase endurance. • Medium -chain triglycerides (MCT): composed of fatt y acids with carbon chains of 8 to 10 carbons. o Can be absorbed directly into the blood, causing blood fatty acid levels to rise and increasing availability of fat as a fuel for exercise. o Research has not found that sup plementation increases enduranc e. • Caff eine: stimulant found in coffee, tea, some soft drinks, and in pill form. o Enhances the release of fatty acids, sparing the use of glycogen and delaying fatigue. o Taking caffeine up to an hour before exercise has been shown to improve endurance. o Athletes una ccustomed to caffeine respond well verses those who consume it routinely. o Also increases vigilance and alertness. o May cause GI upset. o Excess caffeine before competition used to be prohibited by the International Olympic Committee but now it is not restrict ed. • Erythropoietin (EPO): hormone used to enhance endurance. o Naturally produced by the kidneys and stimulates cells in the bone marrow to differentiate into red blood cells. o Can enhance endurance by increasing the ability to transport oxygen to the muscle s. o Can cause production of too many red blood cells and can lead to excessive blood clotting, heart attacks, and strokes. o Banned in 1990 after it was linked to the deaths of more than a dozen cyclists. DEBATE: Energy Drinks for Athletic Performance? • Question: Should energy drinks be used as ergogenic aid s? Is drinking them a safe way to improve your game? Diet, Supplements , and Performance • Bottom line with ergogenic aids is to do no harm . • Impact on performance is small compare d to benefit of a well -planned healthy diet . • Consider risks before using these products.
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 1 Nutrition: Everyday Choices Food Choices and Nutrient Intake • nutrients: substances in food that provide energy and structure to the body and regulate body processes • essential nutrients: must be supplied in the diet Nutrients from Foods, Fortified Foods, and Supplements • nutrie nt density: a measure of the nutrients provided by a food relative to its calorie content. o this is important when choosing a healthy diet. o Typically, less processed foods have higher nutrient density. • fortification: the addition of nutrients to foods. o Federal government mandates that certain nutrients be added to certain foods. Example: Vitamin D added to milk o Voluntary: example: vitamins and minerals added to breakfast cereals. • calorie: unit of m easure used to express food energy • dietary supplements: products sold to supplement the diet; may include nutrients, enzymes, herbs or other substances Food Provides More Than Nutrients • phytochemicals: substances found in plant foods that are not essential nutrients but may have health -promoting properties. • functional foods: foods that have health promoting properties beyond their nutrients o unmodified whole foods; examples: broccoli and fish o designer foods or nutraceuticals: foods with added nutrients; examples: orange juice with calcium added What Determines Food Choices? • What is put in front of us • What we have learned to eat • What is socially acceptable in our cultural herit age or religion • What we think is healthy • Our personal convictions – environmental consciousness or vegetarianism • Tradition and Values • Individual preferences: taste, smell appearance, texture • Food does more than meet our physiological requirements. It also provides sensory pleasure and helps meet our social and emotional needs. • DEBATE: How involved should the government be in your food choices? Nutrients and Their Functions The Six Classes o f Nutrients • organic compounds: substances that contain carbon bonded to hydrogen. Includes: carbohydrate, lipids and protein • macronutrients: carbohydrates, lipids and protein • micronutrients: vitamins and minerals • Carbohydrates: chemically they all contain carbon, along with hydrogen and oxygen, in the same proportion as water. Includes starches, sugars and fiber o fiber: cannot be broken down by human digestive enzymes • Lipids: class of nutrients that is commonly called fats. Includes: cholesterol, saturated and unsaturated fats o cholesterol: found in the diet and in the blood. High blood levels increase the risk of heart disease o saturated fats: most abundant in solid animal fats and are associated with an incr eased risk of heart disease o unsaturated fats: most abundant in plant oils and are associated with a reduced risk of heart disease • Protein: made up of units called amino acids • Vitamins: organic molecules needed in small amounts to maintain health. Thi rteen vitamins help with regulating energy metabolism, maintaining vision, protecting cell membranes, and helping blood to clot. • Minerals are elements that are essential in small amounts to provide a variety of diverse functions. • Water: makes up about 60% of adult body weight What Nutrients Do • Provide energy: o carbohydrate: 4 calories per gram o lipids : 9 calories per gram o protein : 4 calories per gram o alcohol: 7 calories per gram. This is not a nutrients and is not needed for life. • Provide structure: contribute to the shape and structure of our bodies • Regulation: water helps regulated body temperature. Lipids help regulated body processes. o hormones: regulatory molecules made from lipids and proteins Nutrition in Health and Disea se Undernutrition and Overnutrition • undernutrition: occurs when intake doesn’t match the body’s needs • overnutrition: excess intake of calories or nutrients Diet -Gene Interactions • nutrition genomics or nutrigenomics: study of how diet affects our genes and how individual genetic variation can affect the impact of nutrients or other components on health. Choosing a Healthy Diet • Eat a Variety of Foods : choose foods from different f ood groups and diverse foods from within each food group. • Balance Your Choices : balance calories in with calories out. • Practice Moderation Evaluating Nutrition Information The Science Behind Nutrition • hypothesis: proposed explanation for an observat ion or a scientific problem that can be tested through experimentation • theory: a formal explanation of an observed phenomenon made after a hypothesis has been supported and tested through extensive experimentation • The scientific method: o Observation: make an observation and ask questions about it. o Hypothesis: propose an explanation for the observation. o Experiment: design to test the hypothesis. o Result: the findings of the experiment o Repeated measure: is the same result found? o If the hypothesis is supported: develop a theory. o If the hypothesis is not supported, a new hypothesis can be formulated. • How Scientists Study Nutrition o epidemiology: branch of science that studies health and disease trends in populations. o control group: in a scientific study, the group of participants used as a basis of comparison. o experimental group: in a scientific study, the group of participants who undergo the treatment being tested. o variable: the treatment. o placebo: a fake product. o peer -review process: used in determining whether experimental results should be published in scientific journals. • Types of nutrition studies: o Epidemiological studies: studies of populations around the world to identify patterns. o Clinical trials: studi es that explore the health effects of altering people’s diets. Example: the possible effects of eliminating meat on blood cholesterol levels. o Animal studies: don e to model possible effects of diet on humans. Avoids the cost and ethical concerns of using human subjects. Care needs to be taken with extrapolation of results. o Biochemistry and molecular biology: laboratory technique used to study nutrient functions in the body. What a Scientist Sees: Behind the Claims • Does it make sense? Some claims are too outrageous to be true. • What’s the source? o Testimonials are not a reliable source. o Look for information disseminated by universities or the government. o Results may be misinterpreted in order to sell products. o Check the author’s credentials. • Is it selling something? If a person or company will profit from the information, be wary. • Has it stood the test of time? A single study cannot serve as a basis for a reliable theory.
Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition – 30 points After you have completed your IProfile analysis and your personal iProfile questions – you must now review
Chapter 5 Lipids: Fats, Phospholipids, and Sterols Fats in our Foods Sources of Fat in our F ood • Visible fat: fat on meat, added as butter to bread • Less obvious: within foods such as dairy products, crackers, cookies, donuts • Added: fat used to cook or fry foods Types of Lipids • Lipids are group of organic molecules that do not dissolve in water. • Lipids include: triglycerides, phospholipids and sterols. • Triglycerides are the major type of lipids in food and the body; it’s made up of three fatty acids and a glycerol molecule. • Phospholipid is a lipid structure that includes a phosphorous atom. • Sterols are lipids with a structure composed of multiple chemical rings. Triglycerides • When we use the word fat, we generally mean the lipid triglyceride. • Triglycerides are made up a 3 carbon molecule of glycerol and 3 fatty acids. Fatty A cids • Fatty acids are chains of carbon linked to hydrogen with an acid group at the end of the chain. • Fatty acids can differ from one another in carbon chain length, and carbon to carbon bonds and location. • Their bonds and locations determine the function of the triglyceride in the body and the properties it has in food. o short chain: 4 -7 carbon atoms o medium chain: 8 -12 carbon atoms o long chain: over 12 c arbon atoms o most plants and animals: 14 -22 carbon atoms in a chain • Saturated fatty acid : straight chains of carbons tightly packed together therefore are less likely to spoil or become rancid . o Shown to increase the risk of heart disease. o Triglycerides high in saturated fatty acids are solid at room temperature . o Examples: butter and lard. o Animal fats and tropical (coconut and palm) oils are high in saturated fatty acids. • Unsaturated fatty acid : have bent carbon chains. o Triglycerides high in unsaturated fatty acids are liquid at room temperature. Examples: corn, safflower, and sunflower oil o Monounsaturated fatty acid: single double bond in the carbon chain. Examples: canola, olive and peanut oil. o Polyunsaturated fatty acid: two or more double bonds in the carbon chain. o Plant foods are generally high in unsaturated fatty acids. o Omega -6 polyunsaturated linoleic fatty acid: first double bond is between the sixth and seventh carbon atoms. Examples: co rn oil, safflower oil, soybean oil and nuts. o Omega -3 polyunsaturated linolenic fatty acid: the first double bond is between the third and fourth carbon atoms. Examples: flaxseed oil, canola oil and nuts. Fish oil is high in longer chain omega -3 fatty acids . • Essential fatty acids: must be consumed in the diet because they cannot be made by the body or cannot be made in sufficient quantities. o Linoleic (omega -6). Found in vegetable oils such as corn and safflower oil. ▪ Arachidonic acid: synthesized from linol eic acid; found in both animal and plant fats. o Alpha -linolenic (omega -3). Found in nuts, flaxseed, and canola oil. ▪ Eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA); synthesized from alpha -linolenic acid; found in fatty fish • The fats and oils in our diets contain combinations of saturated, monounsaturated, and polyunsaturated fatty acids. • The types of fatty acids in a triglyceride determine the texture, taste and physical characteristics of the food. • Hydrogenatio n is the process used to make partially hydrogenated oils in which hydrogen atoms are added to the carbon –carbon double bonds of unsaturated fatty acids, making them more saturated. Trans fatty acids are formed during the process. o Cis fatty acids: hydrogen atoms are on the same side of the double bond making the carbon chain bent; the primary form in nature o Trans fatty acids: hydrogen atoms are on opposite sides of the double bond making the carbon chair straighter and taking on the characteristics of saturated fatty acids; primarily occurs in manufactured fats Trans fat in the News • The margarine vs. butter recommendations are good examples of how nutritional information changes. When saturated fats were linked with health problems, it was thought that making h ealthier unsaturated fats “spreadable” would be better. When research suggested that trans fats were less healthy than saturated fat, the n butter seemed like the better choice. Now, trans -fat free margarine is available. Trans fat vs. Palm Oil • Students could be assigned to read about the palm oil and rainforest connection Test Your Understanding • These slides are designed to test students’ knowledge of previous concepts. These could be used with clickers, color -coded voting cards, or fingers. These questions could also be passed out and done as individual or group quizzes. Phospholipids • Phospholipids contain the backbone of glycerol and two fatty acids. In place of the third fatty acid is a chemical group containing phosphorous (phosphate gr oup). • Fatty acids at one end of the molecule are soluble in fat. • The phosphate containing group is soluble in water. • Can act as emulsifiers . Emulsifiers allow fat and water to mix. • Lecithin is a phospholipid. Sources: eggs and soybeans o The food industry u ses lecithin as an emulsifier in margarine, salad dressings, chocolate, frozen desserts and baked goods. o In the body, lecithin is a major constituent of cell membranes. It is also used to synthesize the neurotransmitter acety lcholine, which activates muscles and plays a role in memory. • Phospholipids are an important component of cell membranes. They form a double – layered sheet called the lipid bilayer by orienting the water -soluble, phosphate – containing “heads” toward the aqueous (water) environments inside and outside the cell and the fatty acid “tails” toward each other to form the lipid center of the membrane. • Phospholipid structure supports its function because it allows one end of the molecule to be soluble in fat, while the o ther end is soluble in water . • The salad dressing shown does not contain an emulsifier, so it separates into layers of oil and vinegar and must be shaken before it is poured on a salad. Many salad dressings are emulsified so that they do not separate when left standing. Sterols • Rings of carbon atoms form the backbones • Cholesterol is the best -known sterol. It is not essential because the body manufactures it in the liver. o More than 90% of the cholesterol in the body is found in cell membranes. o Also part of the myelin on many nerve cells. o Cholesterol is needed to synthesize other sterols, including Vitamin D. o Cholesterol is found only in foods from animal sources. • Plant sterols help form plant cell membranes. Found in small quantities in most plant foods. o When consumed in the diet, help to reduce cholesterol levels in the body. Concept Check • How are phospholipids and cholesterol similar and different? • W hat is an example of a non -essential nutrient? o Both phospholipids and cholesterol are found in animal cell membranes and are used to make other materials. Cholesterol and omega -6 fats are two examples of non -essential nutrients so far in this chapter. This can be done in pairs or groups, as a think -pair -share activity, or as a whole -class discussion. Digestion and A bsorption of Fat • Most fat digestion and absorption occur in the sma ll intestine . • A small amount of lipid digestion occurs in the stomach due to lipases produced by the mouth and stomach. • The liver produces bile, which is stored in the gallbladder and released into the small intestine. • The pancreas produces the enzyme pancreatic lipase, which is released into the small intestine to break down triglycerides into monoglycerides, fatt y acids, and glycerol. • In the small intestine, the products of fat digestions and bile form micelles, which allow lipids to diffuse into the mucosal cells. • Inside the mucosal cells, fatty acids and monoglycerides are reassembled into triglycerides and inco rporated into lipid transport particles, which enter the lymph. • Fat absorption in the small intestine is efficient. Little fat is lost in the feces. • Bile acts an emulsifier, breaking down large lipid droplets into small globules. • The triglycerides in the globules can then be digested by enzymes from the pancreas. • The resulting mixture of fatty acids, monoglycerides, cholesterol, and bile forms smaller droplets called micelles, which facilitate absorption. • The bile in the micelles is also absorbed and retur ned to the liver to be reused. • Once inside the mucosal cells of the intestine, the fatty acids, cholesterol, and other fat – soluble substances must be further process before they can be transported in the blood. Transporting Lipids in the B lood • Lipoprotein : particles made up of a water -soluble envelope of protein, phospholipids, and cholesterol. • Different types of lipoproteins transport dietary lipids from the small intestine to body cells, from the liver to body cells, and from body cells back to the liver for disposal. Lipoprotein Structure • A lipoprotein consists of a core of triglycerides and cholesterol surrounded by a shell of protein, phospholipids, and cholesterol. • Phospholipids orient with their fat -soluble “tails ” toward the interior and their water – soluble “heads ” toward the outside. • This allows fat -soluble substances in the interior to travel through aqueous blood. Types of Lipoproteins o Chylomicrons: lipoproteins that transport lipids from the mucosal cells of the small intestine and deliver triglycerides to other body cells. These are the largest particles and contain the greatest proportion of triglycerides. o Very -low -density lipoproteins: made in the liver and transport triglycerides and deliver them to the cells. These are smaller than chylomicrons but still contain a high proportion of triglycerides. o Low -density lipoproteins transport and deliver cholesterol to the cells. These contain a higher proportion of cholesterol than do other lipoproteins. o High -density li poproteins help return cholesterol to the liver for reuse or elimination. These are high in cholesterol and are the densest lipoproteins due to their high protein content. Lipid functions • Diet: fat is needed to absorb fat -soluble vitamins; it is a source of essential fatty acids and energy. • In the body: lipids form structural and regulatory molecules and are broken down to provide ATP (energy). o Triglycerides found in oils lubricate body surfaces, keeping the skin soft and supple. • Adipose tissue: the prim ary storage form of triglyceride in the body, cushions our internal organs, and insulates the body from changes in temperature. o The amount and location of adipose tissue affect body size and shape. o Cells contain large droplets of triglyceride. As weight i s gained, the triglyceride droplets enlarge. Role of Essential Fatty A cids • Essential fatty acids are important for health: o needed for the formation of phospholipids. o essential for growth, development, fertility and maintaining the structure of red blood cells and cells in the skin and nervous system. • Omega -3 fatty acid DHA is important in the retina of the eye. • DHA and omega -6 fatty acid arachidonic acid are needed to synthesize cell membranes in the nervous system and important for normal brain dev elopment in young children. • Needed to prevent essential fatty acid deficiency – a condition characterized by dry, scaly skin and poor growth. • Eicosanoids: hormone like molecules made from omega -3 and omega -6 polyunsaturated fatty acids. Help regulated bloo d clotting, blood pressure, immune function, and other body processes. • Increasing consumption of foods rich in omega -3 fatty acids increases the proportion of omega -3 eicosanoids. This reduces the risk of heart disease by decreasing inflammation, lowering blood pressure, and reducing blood clotting. Fat as a Source of E nergy • Depositing fat in adipose tissue is an efficient way to store energy. Each gram of fat provides 9 Calories. • Feasting: consuming more calories than needed. The excess is stored primari ly as fat. • Fasting: consuming fewer calories than needed. An enzyme inside of fat cells receives a signal to break down stored triglycerides . The fatty acids and glycerol are released directly into the blood and circulate throughout the body. Lipids in H ealth and D isease Heart Disease • Cardiovascular disease: any disease that affects the heart and blood vessels. Number – one cause of death for both men and women in the United States • Atherosclerosis: type of cardiovascular disease in which cholesterol is de posited in artery walls, reducing elasticity and eventually blocking the flow of blood. • Development of atherosclerosis: begins with inflammation • Risk factors for heart disease: o Obesity: increases risk of increased blood pressure, blood cholesterol and diabetes; increases the amount of work the heart muscle must do o Diabetes: damages vessel walls o High blood pressure: damage vessel walls; forces the heart do work harder o Gender: men are generally affected a decade earlier than women o Age: inc reased risk for men over age 45 and women over age 55 o Family History: increased risk if a male family member exhibited heart disease before age 55 or a female family member before age 65; African Americans have higher risk due to high incidence of high blo od pressure o Lifestyle: smoking increases risk; exercise decreases risk by reducing blood pressure, increasing health HDL cholesterol levels, reducing diabetes and promoting a healthy weight; Diet can affect risk. o Blood lipid levels: Low risk: Cholesterol < 200 mg/100 ml; LDL cholesterol: <100 mg/100 ml; HDL cholesterol >60 mg/100 ml; Triglycerides: <150 mg/100 ml • Diet and heart disease risk : risk is affected by individual nutrients and whole foods o Increase risk: high sodium and saturated fat; diets high in red meat o Decrease risk: high in fiber, B vitamins; consuming fish, nuts and whole grains; fruits and vegetables o Reduced risk: Mediterranean diet: uses olive oil, typical diet is high in nuts, vegetables, and fruits; Fish is consumed routinely; red meat rar ely. Cancer • Second leading cause of death in the US • Lower risk: diet high in fruits and vegetables – rich in antioxidants; Mediterranean diet • Higher risk: diets high in fat, particularly animal fat Obesity • Excess intake of fat • Dietary fat is stored efficiently as body fat • Energy intake the exceeds expenditure Meeting Lipid Needs Fat and Cholesterol Recommendations • DRI: total fat intake of 20 -35% of calories for adults • AI for linoleic acid: 12 g for women and 17 g for men • AI for α -linolenic acid: 1.1 g for women and 1.6 g for men • Reduce saturated fat to less than 10 % of calories • Keep trans fat as low as possible • Limit sources of solid fat • Cholesterol: 2015 -2020 Dietary Guidelines do not set a limit on dietary cholesterol but still recommend eating as little as possible What a Scientist Sees : Are Eggs OK? - Think Critically o Why do you think the Dietary Guidelines removed the limit on dietary cholesterol but still recommend that people eat as little cholesterol as possible? Choosing Fats Wisely • Use of MyP late for menu planning • Analysis of the Nutrition Facts on the Food Label Role of Fat Replacers • Low fat or reduced fat dairy products: the total fat has been removed • Some reduced fat foods contain added sugars to improve tas te and texture • Some reduced fat foods contain soluble fiber or modified proteins to simulate fats; many of these are not absorbable Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review Chapter 9 Energy Balance and Weight Management Body Weight and Health • Overweight: being too heavy for one’s height, usually due to an excess of body fat. o Body mass index of 25 to 29.9 kilograms/meter 2. • Obese: having excess body fat. o Body mass index of 30 kg/m 2 or greater. • Globesity: reflects the escalation of obesity world wide. • In the United States: 70 % of adults are overweight or obese. o The obesity rates for minorities exceed those of the general population. ▪ African Americans: 48.4 % are obese. ▪ Hispanic Americans: 42.6 % are obese. Why Are We Getting Fatter? • Obesogenic environment: promotes weight gain and is not conducive to weight loss. • Eating more: constantly bombarded with cues to eat. o Advertisements; tasty, inexpensive foods; convenience stores; food courts; and vending machines. • Appetite: a desire to consume specific foods that is independent of hunger. o Triggered by external cues such as sight or smell of food. • Hunger: a desire to consume food that is triggered by internal phy siological signals. • Portion sizes have increased. o The more food put in front of people, the more they eat. • Social changes have contributed to the increase in the number of calories consumed. o Busy schedules. o Increase in single -parent households or household s with two working parents. o Prepackaged, convenience, and fast -food meals have become more common. • Moving less: decline in the amount of energy Americans expend at work and at play. o Labor saving devices; driving to work, elevator instead of stairs, etc. o Us e of television, video games, tablets, and computers has increased. o Inactivity is also contributing to excess body weight among children. What’s Wrong with Having Too Much Body Fat? • Having too much body fat increases a person’s risk of developing chronic health problems. o Includes: high blood pressure, heart d isease, high blood cholesterol, diabetes, asthma and breathing problems, gallbladder disease, liver disease, arthritis, sleep disorders, respiratory problems, and menstrual irregularities . o Cancers of t he breast, uterus, prostate, and colon. • Obesity increased the incidence and severity of infectious disease. o Has been linked to poor wound healing and surgical complications. • The more excess body fat, the greater the health risks. • The longer excess body fat is present, the greater the risks. • Excess weight at a younger age and remaining overweight throughout life, the greatest health risk. • Being overweight also has psychological and social consequences. o More l ikely to experience depression . o May be discrimi nated against in college admissions, in the workplace, and on public transportation. • Obesity increases health care costs. What Is a Healthy Weight? • A healthy weight is a weight that minimizes health risks. • Lean body mass: body mass attributed to nonfat bo dy components such as bone, muscle, and internal organs. o Also called: fat -free mass. • Body mass index (BMI): a measure of body weight relative to height. o Current standard for assessing the healthfulness of body weight. o Underweight: BMI of <18.5 kg/m 2 o Healthy: BMI of 18.5 -24.9 kg/m 2 o Overweight: BMI of ≥25 and <30 kg/m 2 o Obese: BMI of ≥30 kg/m 2 o Extreme or morbid obesity: ≥40 kg/m 2 o Useful tool but other information needed to assess health risk . ▪ In muscular athletes, BMI does not provide an accurate estimate of health risk. • Body composition: relative proportions of fat and lean tissue. o Healthy level of body fat: ▪ Women tend to store more body fat than men . ▪ Young adult females: 21 -32% of total weight. ▪ Young adult males: 8 -19% of total weight. o Underwater weighing: relies on the fact that lean tissue is denser than fat disuse. The difference between a person’s weight on land and his/her weight in water is used to calculate body density; the higher the density, the less fat he/she has. ▪ Can’t be used for sma ll children or ill, frail adults. o Skinfold thickness: uses calipers to measure the thickness of the fat layer under the skin at several locations. ▪ Assumes that the amount of fat under the skin is representative of total body fat. ▪ Fast, easy, and inexpensiv e. ▪ Should be performed by a trained professional for accuracy . o Air displace ment: measures air displacement in a closed chamber to determine body density. ▪ Accurate and easy for the subject. ▪ Expensive and not readily available. o Bioelectrical impedance: measu res an electrical current traveling through the body. ▪ Based on the fact that current moves easily through lean tissue, which is high in water, but is slowed by fat, which resists current flow. ▪ Fast, easy, and painless. ▪ Can be inaccurate if the amount of body water is higher or lower than typical. o Dual energy X -ray absorpti ometry (DXA): distinguishes amo ng various body tissues by measuring differences in levels of X -ray absorption. ▪ Can accurately determine total body mass, bone mineral mass, and body fat percentage. ▪ Expensive and not readily available. • Locations of body fat o Subcutaneous fat: adipose tissue located under the skin. ▪ Does not increase health risk as much as excess visceral fat. o Visceral fat: adipose tissue located around internal organs in the abdomen. ▪ More metabolically active than subcutaneous fat. ▪ Associated with a higher incidence of heart disease, high blood cholesterol, high blood pres sure, stroke, diabetes, and some types of cancer. ▪ More common in men than in women. ▪ After menopause, the amount of visceral fat in women increases. ▪ Increases with age. ▪ Stress, tobacco use, and alcohol consumption predispose people to visceral fat storage. o Where fat is deposited is determined primarily by genes. ▪ Age , gender, ethnicity, and lifestyle also i nfluence fat storage. Energy Balance • Energy balance: the amount of energy consumed in the diet compared with the amount expended by the body over a given period of time. Balancing Energy Intake and Expenditure • Energy Intake: the amount of energy consumed from foods and beverages. • Total energy expenditure: the amount of energy used by the body each day. • Basal metabolism: the energy expended to maintain an awake, resting body that is not digesting food. o For most people, 60 -75% of total energy expend iture is for basal metabolism. o Basal metabolic rate: the rate of energy expenditure under resting conditions. ▪ It is measured after 12 hours without food or exercise. o Increases with increasing body weight. o Lean tissue takes more energy to maintain than fat tissue. o Generally higher in men than in women. o Decreased with age, partly due to a decrease in lean body mass. o Lower when calorie intake is consistently below the body’s needs. o Factors that increase basal metabolism: ▪ Higher lean body mass. ▪ Greater height and weight. ▪ Pregnancy or lactation. ▪ Growth. ▪ Low calorie diet. ▪ Starvation. ▪ Fever. ▪ Low thyroid hormone levels . ▪ Stimulant drugs such as caffeine and tobacco. ▪ Exercise. • Physical activity: second major component of total energy expenditure. o Average: 15 -30% of energy requirements. • Non -exercise activity thermogenesis (NEAT): the energy expended for everything we do other than sleeping, eating, or sports -like exercise. o Depends on individual’s occupation and daily movements. o Depends on the size of the person , how strenuous the activity is, and the length of time it is performed. • Thermic effect of food (TEF) or diet -induced thermogenesis: the energy required for the digestion of food and absorption, metabolism, and storage nutrients. o Estimated to be about 10% of total energy intake. o Depends on the amounts and types of nutrients consumed. o A bigger meal produces a greater thermic effect of food. o A high -fat meal yields a lower TEF than one high in carbohydrate or protein. • The basics of weight gain and w eight loss. o If more energy is consumed than expended, the excess energy is stored for later use. o A small amount of energy is stored as glycogen in liver and muscle. o Adipocytes: cells that store fat as triglycerides . ▪ Can increase in size to accumulate more fat; can shrink as fat is removed. ▪ The larger the number, the greater the body’s ability to store fat. ▪ Most adipocytes are formed during infancy and adolescence. ▪ Excess weight gain can cause the formation of new adipocytes. o Stored energy is used when ener gy intake is low . o An energy deficit of about 3500 Calories results in the loss of a pound of adipose tissue. Estimated Energy Requirements • Estimated Energy Requirement (EER): the number of calories needed for a healthy individual to maintain his/her weight. o Calculated using equations that take into account gender, age, height, weight, act ivity level, and life stage. o Need to know physical activity (PA) value What Determines Body Size and Shape? • Genes determine body size and shape. • There are many genes that have been linked to obesity. • Environment and l ifestyle choices also play an important role in determining body weight and size . Genes vs. Environment • If one or both parents are obese, your risk of obesity increases with the magnitude o f the obesity . • Through twin studies, determined about 40 -70% of the variation in BMI between individuals can be attributed to genes. • Remaining amount is determined by your environment and lifestyle choices. Regulation of Food Intake and Body Weight • Set -point: the body compensates for variation in diet and exercise by adjusting energy intake and expenditure to keep weight at a particular level. o Determined in part by genes. • Satiety: the feeling of fullness and satisfaction caused by food consumption th at eliminates the desire to eat. Regulating how much we eat at each meal • Physical sensations of hunger or satiety are triggered by signals from the gastrointestinal tract, levels of nutrients, and hormones circulating in the blood, and messages from the brain. • Ghrelin: hormone produced by the stomach; stimulates the desire to eat at usual mealtimes. o Blood levels of ghrelin rise an hour or two before a meal and drop very low after a meal. • Peptide YY : hormone that causes a reduction in appetite. o Released fro m the gastrointestinal tract after a meal. o The amount released is proportional to the number of calories in the meal. • Psychological factors affect hunger and satiety. o Some people eat for comfort or to relieve stress. o Others lose their appetite when under s tress. Regulating body fat over the long term • Leptin: hormone produced by the adipocytes. o The amount produced is proportional to the size of the adipocytes that regulates body fatness in the long term . o The effect of leptin on energy intake and exp enditure depends on the amount releas ed. o Better at preventing weight loss than preventing weight gain. o Obese individuals generally have high levels of leptin, but this is not effective in reducing calorie intake and increasing energy expenditure. What a S cientist Sees: Leptin and Body Fat What might happen to someone who does not produce enough leptin? How about a person with a defect that causes overproduction of leptin? Why Do Some People Gai n Weight More Easily ? • Mutations in single genes are not responsible for most human obesity. • Some people may gain weight more easily because they inherited genes that make them more efficient at using energy and storing fat. • Some people may gain weight more easily because they inherit a tendency to expend less e nergy on activity. Managing Body Weight • Make healthy food choices. • Control portion sizes. • Maintain an active lifestyle. Weight -Loss Goals and Guidelines • To lose 1 pound per week, energy balance must be negative by about 500 Calories per day. • A loss of 10% of body weight will significantly reduce disease risk. • Lose weight slowly: rate of ½ to 2 lbs/week. o Helps ensure that most of what is lost is fat and not lean tissue. • Successful long -term weight management involves a combination of decreasing intake, increasing activity, and changing the behavior patterns that led to weight gain. Decreasing energy intake • Intake must be low in energy but high in nutrients. • If consuming less than 1200 Calories/day, a multivitamin/multimineral supplement is recom mended. • Medical supervision is recommended if intake is below 800 Calories/day. Increasing physical activity • Exercise increases energy expenditure, making weight loss easier. • Exercise promotes muscle development. o Muscle is metabolically active tissue. o Inc reased muscle mass increases energy expenditure. • Physical activity improves overall fitness and relieves boredom and stress induced weight gain . • Recommend ed that adults engage in the equivalent of 150 minutes of moderate - intensity aerobic activity per week . o This amount varies; s ome individuals may need the equivalent of 300 minutes of moderate -intensity activity each week to maintain body weight. What Should I Eat? Balance Your Intake and Output • Balance your intake and output. • Moderate your intake . • Expand your expenditure . Modifying behavior • Behavior modification: a process that is used to gradually and permanently change behaviors. • ABCs of behavior modification: o Identify the antecedents . o Recognize the behavior. o Fee l the consequences. o Modify the beh avior. o Enjoy the new consequences. Managing America’s weight • We need strategies that can help Americans improve their food choices, reduce portion sizes, and increase physical activity. • Food manufacturers and restaurants: healthier options, smaller port ions. • Communities: parks, bike path, and recreational facilities. • Business and schools: opportunities for physical activity during the day. Suggestions for Weight Gain • Medical evaluation to rule out medical reasons for low body weight. • Gradually increase consumption of energy dense foods. • Eat more frequently. • Muscle s trength en ing exercises Diets and Fad Diets • Any diet that reduces energy intake will promote weight loss. • True test of the effectiveness of a weight loss plan: whether it promotes wei ght loss that can be maintained over the long term. • Selecting a weight loss plan: o Based on sound nutrition and exercise principles. o Suits your individual preferences of food choices. o Time and c ost. o Promotes long -term lifestyle changes. • Common methods for reducing calorie intake: o Food guides for diet planning (i.e. MyPlate) . o Eating pre -packaged meals or liquid meals. o Reduce fat and carbohydrate content in diet. Think It Through: A case study on food choices and body weight Weight -Loss Drugs and Supplements • Prescription drugs . o Approved by FDA. o Reduce appetite and increase sense of fullness . ▪ Lorcaserin . ▪ Phentermine . o Decrease the absorption of fat in the intestine. ▪ Orlistat . o Recommended only for those whose health is compromised by their body weight. o Disadvantage: weight is usually regained when the drug is discontinued. • Over -the -Counter drugs. o Also regulated by the FDA and must adhere to strict guidelines. ▪ Ver sion of Orlistat (Alli). • Weight -Loss Supplements. o Not strictly regulated by FDA. o Herbal products: often contain prescription drugs or compounds that have not been adequately studied in humans . o Soluble fiber: reduce the amount eaten by filling up the stomach. ▪ Safe. ▪ Promote only a small amount of weight loss. o Supplements that promise to enhance fat loss by altering metabolism to prevent the synthesis and deposition of fat. ▪ Examples: hydroxycit ric aci d, conjugated linoleic acid, and chromium picolinate. ▪ None shown to be effective in humans. o Fat burners. ▪ Boost energy expenditure. ▪ Can be effective. ▪ Have serious and life -threatening side effects. ▪ Example: ephedra. • Banned by the FDA in 2004. ▪ Typically contain guarana, an herbal source of caffeine. ▪ Green tea extract. • Source of caffeine and phytochemicals • Small effect on weight loss . • Associated with liver damage. o Diuretics. ▪ Lose weight through water loss not decrease in body fat. o Herbal laxatives. ▪ Overuse can have serious side effects. Think Critically : Alli: Blocking Fat Absorption • Question: Will Alli be an effective weight -loss aid for someone eats a low fat diet ? Why or why not? Weight -Loss Surgery • Surgical procedures to decrease body weight by altering the gastrointestinal tract so as to reduce food intake and absorpti on. • Recommended only in cases of extreme obesity. • Gastric bypass: surgical procedure that reduces the size of the stomach and bypasses a portion of the small intestine. • Adjustable gastric banding: surgical procedure in which an adjustable band is placed around the upper portion of the stomach to limit the volume that the stomach can hold and the rate of stomach emptying. • Liposuction: surgical procedure to remove a fat deposit under the skin. o Considered a cosmetic procedure. o Does not significantly reduce overall body weight. DEBATE: Is surgery a good solution to obesity? • When conventional methods to lose weight do not work does the risk of surgery outweigh the benefits? Eating Disorders • A psychological illness characterized by spec ific abnormal eating behaviors, often intended to control weight. • When the emotional aspects of food and eating overpower the role of food as nourishment . • Affect phys ical and nutritional health and psychosocial functioning . • If left untreated, they can be fatal. Types of Eating Disorders • Anorexia nervosa: characterized by self -starvat ion, a distorted body image, abnormally low body weight , and a pathological fear of becoming fat . • Bulimia nervosa: characterized by the consumption of a large amount of food a t one time (binge eating) followed by purging behaviors such as self -induced vomiting to prevent weight gain. • Binge -eating disorder: characterized by recurring episodes of binge eating accompanied by a loss of control ove r eating in the absence of purging behavior. What Causes Eating Disorders? • Genetic, psychological, and sociocultural factors contribute to their development. • Can be triggered by traumatic events. o Sexual abuse. o Day -to -day occurrences: teasing or judgmental comments. • Occur in people of all ages, races, and socioeconomic backgrounds. o Women are more likely than men to develop eating disorders; however the number of men with eating disorders is increasing . o Those who are concerned with maintaining a low body weight: dancers, models. o Commonly begin in adolescence. • Psychological issues. o Body image: the way a person perceives and imagines his/her body. o People with eating disorders often have low self -esteem. o Distorted body image. o Often perfectionists who set very high standards for themselves an d strive to be in control of their bodies and their lives. o May feel inadequate, defective, and worthless. o May use their relationship with food to gain control over their lives and boost their self -esteem. • Sociocultural issues. o Cultural ideals about body si ze are linked to body image and incidence of eating disorders. o Occur in societies where food is abundant and the body ideal is thin. ▪ Do not occur in societies where food is scarce. o Media messages. Anorexia Nervosa • Characterized by distorted body image, excessive dieting, and pathological fear of being fat. • Affects about 1% of female adolescents in the US. • Death rate: 5 in 1000 people per year; 1 in 5 of those commit suicide. • Psychological component: overwhelming fear of gaining weight. o Feel they would rather be dead than fat. o Disturbances in body image. • Behaviors associated with anorexia nervosa: o Restriction of food intake. o Binge -eating and purging in some individuals. o Strange e ating rituals. o Excessive activity. • Symptoms: o Weight loss with sym ptoms of starvation. o Apathetic, dull, exhausted, and depressed. o Muscle wasting. o Inflammation and swelling of the lips. o Flaking and peeling of the skin. o Lanugo hair. o Females: estrogen levels drop and menstruation is irregular or stops. o Males: testosterone levels decrease. o Abnormalities in electrolyte and fluid balance and cardiac irregularities. o Suppression of immune function. • Goal of treatment: o Resolve the underlying psychological and behavioral problems. o Provide physical and nutritional rehab ilitation. Bulimia Nervosa • Characterized by an intense fear of becoming fat and a negative body image. o Accompanied by a distorted perception of body size. o Blame all of their problems on their appearance. o Preoccupied with the fear that once they start eati ng, they will not be able to stop. o Engage in continuous dieting and preoccupation with food. o Often socially isolated and avoid situations that will expose them to food. o Typically begins with food restriction motivated by a desire to be thin. ▪ Overwhelming h unger leads to a period of overeating. ▪ Pattern of semi -starvation interrupted by period of gorg ing. o Binges usually last less than 2 hours and occur in secrecy. o Use behaviors to eliminate extra calories and prevent weight gain: ▪ Fasting. ▪ Excessive exercise. ▪ Vomiting. ▪ Taking laxatives, diuretics or other medications. • Goals of therapy: o Reduce or eliminate binge ing and purging behavior. o Resolve psychological issues related to body image. o Nutritional therapy to address physiological imbalances. o Educatio n. Binge -Eating Disorder • Most common eating disorder. • Affects both genders. o Men account for 40% of the cases. • Engage in recurrent episodes of binge eating but do not engage in purging behaviors. • Complications: health problems associated with obesity. • Trea tment: o Counseling to improve body image and self -acceptance. o Nutritious low -calorie die t. o Increased exercise to promote weight loss. o Behavior therapy to reduce bingeing. Eating Disorders in Special Groups • Anorexia athletic a: athletes • Avoidant/restrictive food intake disorder: infant, children, and adults. • Insulin misuse (diabulimia): people taking insulin to control diabetes. • Female athlete triad: female athletes in weight -dependent sports. • M uscle dysmorphia (megarexia or reverse anore xia ): bodybuilders and avid gym -goers. o More common in men than women. • Night -eating syndrome: obese adults and those experiencing stress. • Pica: pregnant women, children, people whose family or ethnic customs include e ating certain nonfood substance s. • Rumination Disorder: infants, adolescents, and adults. • Selective eating disorder: children. Preventing and Getting Treatment for Eating Disorders • Prevention: o Elimination of weight -related criticism. o Change media images and messages away from an unrealistically thin body. o Education through schools and communities. o Recognize who may be at risk. o Early intervention. Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 1 iProfile / Intake Spreadsheet Taylor Jo Campbell Start date: Sun Feb 23 2020 End date: Wed Feb 26 2020 Item Name Quantity Weight Kilocalories (kcal) Calories from Fat (kcal) KELLOGG'S APPLE JACKS Cereal 2 cups 56.0 g 220.0 18.0 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla 1 items 99.0 g 120.0 31.5 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 2 cups 488.0 g 480.0 144.0 ARBY'S USA Side Snacks, Mozzarella Sticks 6 items 206.0 g 620.0 288.0 KELLOGG'S FROOT LOOPS 2 cups 60.0 g 225.0 18.4 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 2 cups 488.0 g 480.0 144.0 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 MCDONALD'S Cheeseburger, Double 1 items 165.0 g 440.0 207.0 MCDONALD'S French Fries, Medium 1 svgs 117.0 g 380.0 171.0 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 6 items 97.0 g 280.0 162.0 DIET COKE Soda 16.9 fl.oz 500.0 g 0.0 0.0 BETTER CHEDDARS Crackers, Baked 22 items 31.0 g 160.0 72.0 EASY CHEESE Cheese Spread, American Cheese 4 tbsp 64.0 g 180.0 108.0 DIET COKE Soda 12 fl.oz 355.0 g 0.0 0.0 BOB EVANS Macaroni and Cheese 2 svgs 368.0 g 636.0 198.0 CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 0.5 items 152.5 g 95.0 22.5 Beef, Ground, Lean, Broiled, Medium 1.5 oz 42.5 g 115.6 70.6 Turkey, Ground, Cooked 1.5 oz 42.5 g 86.3 39.8 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy 1 items 128.0 g 270.0 90.0 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 2 BOB EVANS Macaroni and Cheese 1 svgs 184.0 g 318.0 99.0 Turkey, Ground, Cooked 0.5 oz 14.2 g 28.8 13.3 Beef, Ground, Lean, Broiled, Medium 0.5 oz 14.2 g 38.5 23.5 CAMPBELL'S Soup, Tomato, Condensed 0.25 cups 61.0 g 45.0 0.0 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 3 oz 85.1 g 159.9 62.8 BARILLA Pasta, Rotini, Classic, Dry 1.5 svgs 3.0 oz 300.0 13.5 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 LITTLE DEBBIE Zebra Cakes 1 svgs 74.0 g 320.0 126.0 DIET COKE Soda 20 fl.oz 591.7 g 0.0 0.0 Totals 5998 2123 Item Name Fat, Total (g) Saturated Fat (g) Trans Fatty Acid (g) Monounsatu rated Fat (g) KELLOGG'S APPLE JACKS Cereal 2.0 1.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla 3.5 2.0 0.0 - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 16.0 6.0 0.0 - ARBY'S USA Side Snacks, Mozzarella Sticks 32.0 13.0 1.0 - KELLOGG'S FROOT LOOPS 2.0 1.08 0.0 0.36 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 16.0 6.0 0.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double 23.0 11.0 1.5 9.33 MCDONALD'S French Fries, Medium 19.0 2.5 0.0 9.13 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 18.0 3.0 0.0 7.72 DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked 8.0 1.5 0.0 - EASY CHEESE Cheese Spread, American Cheese 12.0 4.0 0.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 3 BOB EVANS Macaroni and Cheese 22.0 6.0 0.0 - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 2.5 0.75 0.0 - Beef, Ground, Lean, Broiled, Medium 7.8 3.08 - 3.43 Turkey, Ground, Cooked 4.4 1.13 0.05 1.47 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy 10.0 5.0 0.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese 11.0 3.0 0.0 - Turkey, Ground, Cooked 1.5 0.38 0.02 0.49 Beef, Ground, Lean, Broiled, Medium 2.6 1.03 - 1.14 CAMPBELL'S Soup, Tomato, Condensed 0.0 0.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 7.0 2.55 - 2.89 BARILLA Pasta, Rotini, Classic, Dry 1.5 0.0 0.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes 14.0 8.0 0.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 236 82.0 2.6 36.0 Item Name Polyunsatur ated Fat (g) PFA 18:2, Linoleic (g) PFA 18:3, Linolenic (g) Cholesterol (mg) KELLOGG'S APPLE JACKS Cereal 0.0 0.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - - - 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - 30.0 ARBY'S USA Side Snacks, Mozzarella Sticks - - - 75.0 KELLOGG'S FROOT LOOPS 0.54 0.5 0.02 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - 30.0 DIET COKE Soda 0.0 0.0 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 4 MCDONALD'S Cheeseburger, Double 2.22 1.89 0.21 80.0 MCDONALD'S French Fries, Medium 5.45 0.08 0.41 0.0 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 5.33 4.92 0.3 40.0 DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - 5.0 EASY CHEESE Cheese Spread, American Cheese - - - 30.0 DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - 44.0 CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - 2.5 Beef, Ground, Lean, Broiled, Medium 0.29 0.22 0.03 37.0 Turkey, Ground, Cooked 1.24 1.09 0.07 39.5 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - 25.0 DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - 22.0 Turkey, Ground, Cooked 0.41 0.36 0.02 13.2 Beef, Ground, Lean, Broiled, Medium 0.1 0.07 0.01 12.3 CAMPBELL'S Soup, Tomato, Condensed 0.0 0.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 0.25 0.19 0.03 66.3 BARILLA Pasta, Rotini, Classic, Dry - - - 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 15.8 9.3 1.1 552 Item Name Carbohydrat e (g) Sugar, Total (g) Dietary Fiber, Total (g) Soluble Fiber (g) KELLOGG'S APPLE JACKS Cereal 50.0 24.0 6.0 - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 5 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla 21.0 14.0 1.0 - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 70.0 10.0 6.0 - ARBY'S USA Side Snacks, Mozzarella Sticks 52.0 6.0 3.0 - KELLOGG'S FROOT LOOPS 52.8 25.0 5.6 - DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 70.0 10.0 6.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double 34.0 7.0 2.0 - MCDONALD'S French Fries, Medium 48.0 0.0 5.0 - MCDONALD'S CHICKEN MCNUGGETS 6 Piece 18.0 0.0 1.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked 18.0 0.0 1.0 - EASY CHEESE Cheese Spread, American Cheese 4.0 4.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese 88.0 22.0 4.0 - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 16.0 12.0 1.0 - Beef, Ground, Lean, Broiled, Medium 0.0 0.0 0.0 0.0 Turkey, Ground, Cooked 0.0 0.0 0.0 0.0 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy 30.0 7.0 3.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese 44.0 11.0 2.0 - Turkey, Ground, Cooked 0.0 0.0 0.0 0.0 Beef, Ground, Lean, Broiled, Medium 0.0 0.0 0.0 0.0 CAMPBELL'S Soup, Tomato, Condensed 10.0 6.0 0.5 - DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' 0.0 0.0 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 6 Fat, Roasted BARILLA Pasta, Rotini, Classic, Dry 63.0 3.0 3.0 - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes 48.0 32.0 0.5 - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 737 193 51 0 Item Name Insoluble Fiber (g) Protein (g) Histidine (mg) Isoleucine (mg) KELLOGG'S APPLE JACKS Cereal - 2.0 80.6 107.5 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - 0.5 - - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - 16.0 - - ARBY'S USA Side Snacks, Mozzarella Sticks - 32.0 - - KELLOGG'S FROOT LOOPS - 3.2 60.0 93.6 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - 16.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - 25.0 - - MCDONALD'S French Fries, Medium - 4.0 - - MCDONALD'S CHICKEN MCNUGGETS 6 Piece 0.0 13.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - 3.0 - - EASY CHEESE Cheese Spread, American Cheese 0.0 8.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - 22.0 - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - 1.5 - - Beef, Ground, Lean, Broiled, Medium 0.0 10.5 359.5 472.2 Turkey, Ground, Cooked 0.0 11.6 344.9 521.8 DIET COKE Soda 0.0 0.0 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 7 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - 17.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - 11.0 - - Turkey, Ground, Cooked 0.0 3.9 115.0 173.9 Beef, Ground, Lean, Broiled, Medium 0.0 3.5 119.9 157.4 CAMPBELL'S Soup, Tomato, Condensed - 1.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 0.0 22.8 727.2 1036.7 BARILLA Pasta, Rotini, Classic, Dry - 10.5 - - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - 1.0 - - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 0 239 1807 2563 Item Name Lysine (mg) Leucine (mg) Methionine (mg) Cystine (mg) KELLOGG'S APPLE JACKS Cereal 73.9 262.1 47.0 53.8 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - - - - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 60.0 261.0 46.8 53.4 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - - - - MCDONALD'S French Fries, Medium - - - - MCDONALD'S CHICKEN MCNUGGETS 6 Piece - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 8 EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium 874.2 830.5 269.0 117.7 Turkey, Ground, Cooked 1042.7 961.9 342.7 123.3 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 347.6 320.6 114.2 41.1 Beef, Ground, Lean, Broiled, Medium 291.4 276.8 89.7 39.2 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 1925.5 1812.4 593.6 294.3 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 4615 4725 1503 723 Item Name Phenylalani ne (mg) Tyrosine (mg) Threonine (mg) Tryptophan (mg) KELLOGG'S APPLE JACKS Cereal 141.1 73.9 100.8 33.6 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - - - - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 147.0 87.0 100.2 53.4 DIET COKE Soda 0.0 0.0 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 9 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - - - - MCDONALD'S French Fries, Medium - - - - MCDONALD'S CHICKEN MCNUGGETS 6 Piece - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium 410.1 353.2 459.0 117.7 Turkey, Ground, Cooked 454.2 412.9 535.0 132.7 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 151.4 137.6 178.3 44.2 Beef, Ground, Lean, Broiled, Medium 136.7 117.7 153.0 39.2 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 899.8 726.3 910.0 149.7 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 2340 1909 2436 571 Item Name Valine (mg) Alanine Aspartic Glutamic iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 10 (mg) Acid (mg) Acid (mg) KELLOGG'S APPLE JACKS Cereal 147.8 147.8 194.9 793.0 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - - - - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 120.6 154.2 201.0 810.0 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - - - - MCDONALD'S French Fries, Medium - - - - MCDONALD'S CHICKEN MCNUGGETS 6 Piece - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium 510.9 633.7 959.7 1578.4 Turkey, Ground, Cooked 540.1 725.5 1125.6 1876.6 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 180.0 241.8 375.2 625.5 Beef, Ground, Lean, Broiled, Medium 170.3 211.2 319.9 526.2 CAMPBELL'S Soup, Tomato, Condensed - - - - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 11 DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 1130.3 1385.4 2075.2 3420.7 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 2800 3500 5251 9630 Item Name Serine (mg) Arginine (mg) Glycine (mg) Proline (mg) KELLOGG'S APPLE JACKS Cereal 154.6 114.2 121.0 208.3 DIET COKE Soda 0.0 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - - - - CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 160.8 106.8 120.6 207.6 DIET COKE Soda 0.0 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - - - - MCDONALD'S French Fries, Medium - - - - MCDONALD'S CHICKEN MCNUGGETS 6 Piece - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium 401.6 663.8 573.3 464.1 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 12 Turkey, Ground, Cooked 495.0 846.2 637.9 515.8 DIET COKE Soda 0.0 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 165.0 282.1 212.6 171.9 Beef, Ground, Lean, Broiled, Medium 133.9 221.3 191.1 154.7 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 897.3 1473.0 1387.1 1086.1 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda 0.0 0.0 0.0 0.0 Totals 2408 3708 3244 2809 Item Name Moisture (g) Vitamin A (RAE) (µg) Vitamin D (ug) (µg) Vitamin E (Alpha- Tocopherol) (mg) KELLOGG'S APPLE JACKS Cereal 1.4 295.1 2.0 0.1 DIET COKE Soda 398.1 0.0 - 0.0 HUNT'S Pudding, Snack Pack, Vanilla 70.9 0.0 0.0 0.3 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 379.7 - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 1.5 300.6 2.1 0.1 DIET COKE Soda 398.1 0.0 - 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 379.7 - - - DIET COKE Soda 398.1 0.0 - 0.0 MCDONALD'S Cheeseburger, Double 78.7 - - - MCDONALD'S French Fries, Medium 44.5 0.0 - - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 13 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 44.8 0.0 - - DIET COKE Soda 336.4 0.0 - 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 238.9 0.0 - 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 129.3 - - - Beef, Ground, Lean, Broiled, Medium 23.7 0.0 0.0 - Turkey, Ground, Cooked 26.4 10.2 0.1 0.0 DIET COKE Soda 398.1 0.0 - 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 398.1 0.0 - 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 8.8 3.4 0.0 0.0 Beef, Ground, Lean, Broiled, Medium 7.9 0.0 0.0 - CAMPBELL'S Soup, Tomato, Condensed - 10.0 - - DIET COKE Soda 398.1 0.0 - 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 55.0 0.0 0.2 0.3 BARILLA Pasta, Rotini, Classic, Dry - 0.0 - - DIET COKE Soda 398.1 0.0 - 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda 398.1 0.0 - 0.0 Totals 5013 619 4 1 Item Name Vitamin K (µg) Thiamin (mg) Riboflavin (mg) Niacin (mg) KELLOGG'S APPLE JACKS Cereal 0.2 0.74 0.84 10.0 DIET COKE Soda 0.0 0.02 0.08 0.0 HUNT'S Pudding, Snack Pack, Vanilla 0.6 0.01 0.07 0.1 CHEF BOYARDEE Beef Ravioli in Tomato & - 0.3 0.34 - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 14 Meat Sauce ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 0.2 0.76 0.88 10.3 DIET COKE Soda 0.0 0.02 0.08 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - 0.3 0.34 - DIET COKE Soda 0.0 0.02 0.08 0.0 MCDONALD'S Cheeseburger, Double - 0.26 0.4 6.4 MCDONALD'S French Fries, Medium - 0.38 0.04 3.2 MCDONALD'S CHICKEN MCNUGGETS 6 Piece - 0.15 0.1 7.0 DIET COKE Soda 0.0 0.01 0.07 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.0 0.01 0.05 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium - 0.02 0.09 2.2 Turkey, Ground, Cooked 0.0 0.03 0.09 3.7 DIET COKE Soda 0.0 0.02 0.08 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.0 0.02 0.08 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 0.0 0.01 0.03 1.2 Beef, Ground, Lean, Broiled, Medium - 0.01 0.03 0.7 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda 0.0 0.02 0.08 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 1.1 0.05 0.12 4.0 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.0 0.02 0.08 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 15 LITTLE DEBBIE Zebra Cakes - 0.06 0.06 0.4 DIET COKE Soda 0.0 0.02 0.08 0.0 Totals 2 3.2 4.2 49 Item Name Biotin (µg) Pantothenic Acid (mg) Pyridoxine (Vitamin B6) (mg) Folate (DFE) (µg) KELLOGG'S APPLE JACKS Cereal - 0.18 1.0 332.6 DIET COKE Soda - 0.0 0.0 0.0 HUNT'S Pudding, Snack Pack, Vanilla - 0.15 0.01 2.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS - 0.2 1.02 343.8 DIET COKE Soda - 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda - 0.0 0.0 0.0 MCDONALD'S Cheeseburger, Double - - - - MCDONALD'S French Fries, Medium - 0.75 0.61 - MCDONALD'S CHICKEN MCNUGGETS 6 Piece - 0.83 0.37 - DIET COKE Soda - 0.0 0.0 0.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda - 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium - 0.16 0.11 3.8 Turkey, Ground, Cooked - 0.5 0.26 3.0 DIET COKE Soda - 0.0 0.0 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 16 DIET COKE Soda - 0.0 0.0 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked - 0.17 0.09 1.0 Beef, Ground, Lean, Broiled, Medium - 0.05 0.04 1.3 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda - 0.0 0.0 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted - 0.44 0.29 6.8 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda - 0.0 0.0 0.0 LITTLE DEBBIE Zebra Cakes - - - - DIET COKE Soda - 0.0 0.0 0.0 Totals 0 3.4 3.8 694 Item Name Cobalamin (Vitamin B12) (µg) Vitamin C (mg) Sodium (mg) Potassium (mg) KELLOGG'S APPLE JACKS Cereal 3.0 30.0 260.0 60.0 DIET COKE Soda 0.0 0.0 66.7 20.0 HUNT'S Pudding, Snack Pack, Vanilla 0.14 0.0 135.0 64.3 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - 0.0 1800.0 700.0 ARBY'S USA Side Snacks, Mozzarella Sticks - 0.0 2530.0 - KELLOGG'S FROOT LOOPS 3.12 31.2 281.4 70.2 DIET COKE Soda 0.0 0.0 66.7 20.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - 0.0 1800.0 700.0 DIET COKE Soda 0.0 0.0 66.7 20.0 MCDONALD'S Cheeseburger, Double 1.95 1.2 1050.0 356.4 MCDONALD'S French Fries, Medium - 9.0 270.0 655.2 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 0.31 1.2 540.0 239.0 DIET COKE Soda 0.0 0.0 56.3 16.9 BETTER CHEDDARS Crackers, Baked - 0.0 360.0 - EASY CHEESE Cheese Spread, American - 0.0 840.0 - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 17 Cheese DIET COKE Soda 0.0 0.0 40.0 12.0 BOB EVANS Macaroni and Cheese - - 1548.0 - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - 12.0 325.0 450.0 Beef, Ground, Lean, Broiled, Medium 1.0 0.0 32.7 127.9 Turkey, Ground, Cooked 0.56 0.0 33.2 125.0 DIET COKE Soda 0.0 0.0 66.7 20.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - 1.2 640.0 - DIET COKE Soda 0.0 0.0 66.7 20.0 BOB EVANS Macaroni and Cheese - - 774.0 - Turkey, Ground, Cooked 0.19 0.0 11.1 41.7 Beef, Ground, Lean, Broiled, Medium 0.33 0.0 10.9 42.6 CAMPBELL'S Soup, Tomato, Condensed 0.0 3.0 240.0 345.0 DIET COKE Soda 0.0 0.0 66.7 20.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 1.26 0.0 29.8 184.6 BARILLA Pasta, Rotini, Classic, Dry - 0.0 0.0 - DIET COKE Soda 0.0 0.0 66.7 20.0 LITTLE DEBBIE Zebra Cakes - 0.0 150.0 11.0 DIET COKE Soda 0.0 0.0 66.7 20.0 Totals 11.9 89 14291 4362 Item Name Calcium (mg) Magnesium (mg) Iron (mg) Zinc (mg) KELLOGG'S APPLE JACKS Cereal 0.0 16.0 9.0 3.0 DIET COKE Soda 17.8 4.0 0.6 0.0 HUNT'S Pudding, Snack Pack, Vanilla 100.0 4.0 0.0 0.2 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 40.0 - 3.6 - ARBY'S USA Side Snacks, Mozzarella Sticks 900.0 - 0.7 - KELLOGG'S FROOT LOOPS 6.0 18.6 9.3 3.1 DIET COKE Soda 17.8 4.0 0.6 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & 40.0 - 3.6 - iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 18 Meat Sauce DIET COKE Soda 17.8 4.0 0.6 0.0 MCDONALD'S Cheeseburger, Double 300.0 34.7 3.6 4.3 MCDONALD'S French Fries, Medium 20.0 37.4 1.1 0.5 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 20.0 23.0 0.7 0.6 DIET COKE Soda 15.0 3.4 0.5 0.0 BETTER CHEDDARS Crackers, Baked 20.0 - 1.1 - EASY CHEESE Cheese Spread, American Cheese 400.0 - 0.0 - DIET COKE Soda 10.6 2.4 0.4 0.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 10.0 - 0.2 - Beef, Ground, Lean, Broiled, Medium 4.7 8.9 0.9 2.3 Turkey, Ground, Cooked 11.9 12.8 0.6 1.3 DIET COKE Soda 17.8 4.0 0.6 0.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy 350.0 - 1.8 - DIET COKE Soda 17.8 4.0 0.6 0.0 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 4.0 4.3 0.2 0.4 Beef, Ground, Lean, Broiled, Medium 1.6 3.0 0.3 0.8 CAMPBELL'S Soup, Tomato, Condensed 0.0 - 0.4 - DIET COKE Soda 17.8 4.0 0.6 0.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 5.1 14.4 1.9 3.8 BARILLA Pasta, Rotini, Classic, Dry 0.0 - 2.7 - DIET COKE Soda 17.8 4.0 0.6 0.0 LITTLE DEBBIE Zebra Cakes 4.4 - 0.4 - DIET COKE Soda 17.8 4.0 0.6 0.0 Totals 2405 215 48 21 Item Name Copper (mg) Fluoride (µg) Iodine (µg) Phosphorus (mg) iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 19 KELLOGG'S APPLE JACKS Cereal 0.04 - - 40.0 DIET COKE Soda 0.008 239.2 - 53.2 HUNT'S Pudding, Snack Pack, Vanilla 0.01 - - 40.6 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - ARBY'S USA Side Snacks, Mozzarella Sticks - - - - KELLOGG'S FROOT LOOPS 0.04 - - 44.4 DIET COKE Soda 0.008 239.2 - 53.2 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce - - - - DIET COKE Soda 0.008 239.2 - 53.2 MCDONALD'S Cheeseburger, Double 0.12 - - 273.9 MCDONALD'S French Fries, Medium 0.13 - - 154.4 MCDONALD'S CHICKEN MCNUGGETS 6 Piece 0.04 - - 258.0 DIET COKE Soda 0.007 202.12 - 45.0 BETTER CHEDDARS Crackers, Baked - - - - EASY CHEESE Cheese Spread, American Cheese - - - - DIET COKE Soda 0.005 143.52 - 32.0 BOB EVANS Macaroni and Cheese - - - - CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - - - - Beef, Ground, Lean, Broiled, Medium 0.025 - - 67.2 Turkey, Ground, Cooked 0.06 - - 108.0 DIET COKE Soda 0.008 239.2 - 53.2 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - - - - DIET COKE Soda 0.008 239.2 - 53.2 BOB EVANS Macaroni and Cheese - - - - Turkey, Ground, Cooked 0.02 - - 36.0 Beef, Ground, Lean, Broiled, Medium 0.008 - - 22.4 CAMPBELL'S Soup, Tomato, Condensed - - - - DIET COKE Soda 0.008 239.2 - 53.2 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 20 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 0.05 - - 141.2 BARILLA Pasta, Rotini, Classic, Dry - - - - DIET COKE Soda 0.008 239.2 - 53.2 LITTLE DEBBIE Zebra Cakes - - - 4.0 DIET COKE Soda 0.008 239.2 - 53.2 Totals 0.62 2259.2 0 1693 Item Name Selenium (µg) Alcohol (g) Caffeine (mg) KELLOGG'S APPLE JACKS Cereal 3.2 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 HUNT'S Pudding, Snack Pack, Vanilla 0.0 0.0 0.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 14.0 0.0 0.0 ARBY'S USA Side Snacks, Mozzarella Sticks - 0.0 0.0 KELLOGG'S FROOT LOOPS 3.5 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 14.0 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 MCDONALD'S Cheeseburger, Double - 0.0 0.0 MCDONALD'S French Fries, Medium - 0.0 0.0 MCDONALD'S CHICKEN MCNUGGETS 6 Piece - 0.0 0.0 DIET COKE Soda 0.0 0.0 60.0 BETTER CHEDDARS Crackers, Baked - 0.0 0.0 EASY CHEESE Cheese Spread, American Cheese - 0.0 0.0 DIET COKE Soda 0.0 0.0 42.6 BOB EVANS Macaroni and Cheese - 0.0 0.0 CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato - 0.0 0.0 Beef, Ground, Lean, Broiled, Medium 12.3 0.0 0.0 Turkey, Ground, Cooked 13.2 0.0 0.0 iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 21 DIET COKE Soda 0.0 0.0 71.0 OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy - 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 BOB EVANS Macaroni and Cheese - 0.0 0.0 Turkey, Ground, Cooked 4.4 0.0 0.0 Beef, Ground, Lean, Broiled, Medium 4.1 0.0 0.0 CAMPBELL'S Soup, Tomato, Condensed - 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 23.3 0.0 0.0 BARILLA Pasta, Rotini, Classic, Dry - 0.0 0.0 DIET COKE Soda 0.0 0.0 71.0 LITTLE DEBBIE Zebra Cakes - 0.0 - DIET COKE Soda 0.0 0.0 71.0 Totals 92 0 671 Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 1 iProfile / My DRI / Complete View Taylor Jo Campbell Start date: Sun Feb 23 2020 End date: Wed Feb 26 2020 Nutrient Recommended Daily Intake Comments Kilocalories 3126 kcal Calories from Fat 625 - 1094 kcal 20 - 35% total Kcalories Fat, Total 69 - 122 g 20 - 35% total Kcalories     Saturated Fat < 34.7 g < 10% total Kcalories     Trans Fatty Acid minimize     Monounsaturated Fat not determined     Polyunsaturated Fat not determined          PFA 18:2, Linoleic 12.0 g show info          PFA 18:3, Linolenic 1.1 g show info Cholesterol not determined Carbohydrate 352 - 508 g 45 - 65% of total Kcalories     Sugar, Total not determined show info Dietary Fiber, Total 25 g     Soluble Fiber not determined     Insoluble Fiber not determined Protein 78 - 274 g 10 - 35% of total Kcalories Protein Based on Body Weight 106 g Based on grams of protein per kilogram of body weight     Histidine 1907 mg     Isoleucine 2649 mg     Lysine 5828 mg     Leucine 5404 mg     Methionine Methionine can be used to synthesize Cysteine so the recommended intake is given as the sum of Methionine plus Cysteine     Cystine Methionine can be used to synthesize Cysteine so the recommended intake is given as the sum of Methionine plus Cysteine iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 2 Nutrient Recommended Daily Intake Comments     Phenylalanine Phenylalanine can be used to synthesize Tyrosine so the recommended intake is given as the sum of Phenylalanine plus Tyrosine     Tyrosine Phenylalanine can be used to synthesize Tyrosine so the recommended intake is given as the sum of Phenylalanine plus Tyrosine     Threonine 2861 mg     Tryptophan 742 mg     Valine 3391 mg     Alanine not determined     Aspartic Acid not determined     Glutamic Acid not determined     Serine not determined     Arginine not determined     Glycine not determined     Proline not determined Moisture 2700 g Vitamin A (RAE) 700 µg Vitamin D (ug) 15 µg Vitamin E (Alpha-Tocopherol) 15 mg Vitamin K 90 µg Thiamin 1.1 mg Riboflavin 1.1 mg Niacin 14 mg Biotin 30 µg Pantothenic Acid 5.0 mg Pyridoxine (Vitamin B6) 1.3 mg Folate (DFE) 400 µg Cobalamin (Vitamin B12) 2.4 µg Vitamin C 75 mg Sodium 1500 - 2300 mg iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 3 Nutrient Recommended Daily Intake Comments Potassium 4700 mg Calcium 1000 mg Magnesium 310 mg Iron 18 mg Zinc 8 mg Copper 0.9 mg Fluoride 3000.0 µg Iodine 150 µg Phosphorus 700 mg Selenium 55 µg Alcohol not determined Caffeine not determined Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 1 iProfile / Intake Compared to DRI / Complete View Taylor Jo Campbell Start date: Sun Feb 23 2020 End date: Wed Feb 26 2020 Nutrient My DRI My Intakes Kilocalories 3126 kcal 1500 kcal 48.0% Calories from Fat 625 - 1094 kcal 531 kcal below recommended range Fat, Total 69 - 122 g 59 g below recommended range     Saturated Fat < 34.7 g 20.5 g within recommended range     Trans Fatty Acid minimize 0.6 g within recommended range     Monounsaturated Fat not determined 9.0 g n/a     Polyunsaturated Fat not determined 4.0 g n/a          PFA 18:2, Linoleic 12.0 g 2.3 g 19.4%          PFA 18:3, Linolenic 1.1 g 0.3 g 25.0% Cholesterol not determined 138 mg n/a Carbohydrate 352 - 508 g 184 g below recommended range     Sugar, Total not determined 48 g n/a Dietary Fiber, Total 25 g 13 g 50.6%     Soluble Fiber not determined 0 g n/a     Insoluble Fiber not determined 0 g n/a Protein 78 - 274 g 60 g below recommended range Protein Based on Body Weight 106 g 60 g 56.4%     Histidine 1907 mg 452 mg 23.7%     Isoleucine 2649 mg 641 mg 24.2%     Lysine 5828 mg 1154 mg 19.8%     Leucine 5404 mg 1181 mg 21.9%     Methionine 2649 mg 376 mg 14.2%     Cystine 2649 mg 181 mg 6.8%     Phenylalanine 4980 mg 585 mg 11.7% iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 2 Nutrient My DRI My Intakes     Tyrosine 4980 mg 477 mg 9.6%     Threonine 2861 mg 609 mg 21.3%     Tryptophan 742 mg 143 mg 19.2%     Valine 3391 mg 700 mg 20.6%     Alanine not determined 875 mg n/a     Aspartic Acid not determined 1313 mg n/a     Glutamic Acid not determined 2408 mg n/a     Serine not determined 602 mg n/a     Arginine not determined 927 mg n/a     Glycine not determined 811 mg n/a     Proline not determined 702 mg n/a Moisture 2700 g 1253 g 46.4% Vitamin A (RAE) 700 µg 155 µg 22.1% Vitamin D (ug) 15 µg 1 µg 7.3% Vitamin E (Alpha- Tocopherol) 15 mg 0 mg 1.3% Vitamin K 90 µg 1 µg 0.6% Thiamin 1.1 mg 0.8 mg 73.5% Riboflavin 1.1 mg 1.1 mg 95.5% Niacin 14 mg 12 mg 87.9% Biotin 30 µg 0 µg 0.0% Pantothenic Acid 5.0 mg 0.9 mg 17.2% Pyridoxine (Vitamin B6) 1.3 mg 1.0 mg 73.1% Folate (DFE) 400 µg 174 µg 43.4% Cobalamin (Vitamin B12) 2.4 µg 3.0 µg 123.5% Vitamin C 75 mg 22 mg 29.6% iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 3 Nutrient My DRI My Intakes Sodium 1500 - 2300 mg 3573 mg above recommended range Potassium 4700 mg 1090 mg 23.2% Calcium 1000 mg 601 mg 60.1% Magnesium 310 mg 54 mg 17.3% Iron 18 mg 12 mg 66.9% Zinc 8 mg 5 mg 64.1% Copper 0.9 mg 0.16 mg 17.3% Fluoride 3000.0 µg 564.8 µg 18.8% Iodine 150 µg 0 µg 0.0% Phosphorus 700 mg 423 mg 60.5% Selenium 55 µg 23 µg 41.9% Alcohol not determined 0 g n/a Caffeine not determined 168 mg n/a Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review Taylor Jo Campbell April 22, 2020 Iprofile Questions FSM 159 W1 Nutrition Online What is the three-day average percent of the total calories you consumed is from carbohydrates? (Macronutrient Distribution Report) 48% How does this compare with the DRI recommendations for Acceptable Macronutrient Distribution Ranges (AMDRs) for carbohydrate? It is below the recommended amount, my intake was 184g while the recommended range is between 352-508g. hence I have to take more carbohydrates Using the Intake Compared to DRI report, what is your total fiber intake? It was within the range although I still have to take more because I took 13g and I was supposed to take 25g. How does your intake compare to your recommended for fiber? My intake was low when compared to the recommended intake because I am supposed to take 25g but I took only 13g which is low. Explain the difference between soluble and insoluble fiber? List 3 examples of food sources for each that you documented in your iProfile. Soluble fiber is able to dissolve in gastrointestinal fluids and water when it enters the stomach and intestines where it is transformed to gel like substance, it is digested by bacteria in large intestines where it releases gasses and calories. Examples in my food include: tomatoes, cheeseburger, barley, and ground. Insoluble fiber does not dissolve in water and gastrointestinal fluids. It remains unchanged and it is not digested. It does not produce calories examples in my food include: zebra cake because of wheat, potatoes and green beans. Define complex carbohydrates. List 3 foods from your Food Journal that are sources of complex carbohydrates They are foods with high fiber and digest slowly. They include the following from the list: KELLOGG'S APPLE JACKS Cereal KELLOGG'S FROOT LOOPS BOB EVANS Macaroni and Cheese Define simple carbohydrates. List 5 foods from your food diary are simple carbohydrates? These are sugars that occur in milk and are added to the foods, they include: CAMPBELL'S Soup, Tomato, Condensed OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy EASY CHEESE Spread, American cheese What percent of the total calories you consumed, is from protein? (Macronutrient Distribution Report) 15.9% How does this compare with the DRI recommendations for Acceptable Macronutrient Distribution Ranges (AMDRs) for Protein? It is below the amount recommended. This is because I took 60g and my DRI recommendations are 78g to 274g. List the top three sources of non-animal protein that you consumed from your iProfile (Intake Spread Sheet) KELLOGG'S APPLE JACKS Cereal KELLOGG'S FROOT LOOPS BETTER CHEDDARS Crackers, Baked List the top three sources animal protein that you consumed from your iProfile (Intake Spread Sheet) CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce MCDONALD'S CHICKEN MCNUGGETS 6 BOB EVANS Macaroni and Cheese What average percent of the total calories you consumed is from total fat? (Macronutrient Distribution Report) 36.2% How does this compare with the DRI recommendations for Acceptable Macronutrient Distribution Ranges (AMDRs) for fat? It is also below the range that is recommended for my DRI where I consumed only 59 g and I was supposed to take between 69 and 122g. Using the Intake Compared to DRI how many grams of your fat intake is coming from saturated fat? 20.5 g What foods do you typically consume that are high in saturated fat? (Intake Spreadsheet) ARBY'S USA Side Snacks, Mozzarella Sticks CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce MCDONALD'S Cheeseburger, Double List the dairy products in your diet and indicate if they are high or low fat? (Intake Spreadsheet) Indicators of high fat: beef, double cheese, macaroni and zebra cake Indicators of low fat: coke soda, BARILLA Pasta, Rotini, Classic, Dry, tomato, What types of foods are typically high in Tran’s fats? (Book information or if available Intake Spreadsheet) MCDONALD'S Cheeseburger, Double ARBY'S USA Side Snacks, Mozzarella Sticks Turkey, Ground, Cooked Looking at all three days of your food intake, which foods are high in omega-3 fatty acids? What could you add to your diet to boost your omega-3 fat intake? (Intake Spreadsheet) MCDONALD'S CHICKEN MCNUGGETS 6 Piece MCDONALD'S French Fries, Medium CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce What is the average number of teaspoons of fat you consumed? First, find out how many total grams of fat were consumed (refer to Intake Compared to DRI report). Next calculate teaspoons of fat. The total fat was 59 g A teaspoon has 5 grams Calculate how many teaspoons of fat you consumed (1 teaspoon = 5 grams of fat). ___59__g fat /5 = __11.8___teaspoons of fat consumed What is your average intake for calcium in mg. (Intake Compared to DRI report)? 601 mg What is your DRI recommendation for calcium? Compare your actual intake found on the 3-day average Intake with your recommended intake – what percent of calcium are you consuming? (Intake Compared to DRI) The calcium amount that I took we not adequate when compared to my DRI this is because I took 601 mg and I was supposed to that 1000mg. the percentage of calcium I consumed was 60.1% What are the top three foods providing calcium on your food record? (Intake Spreadsheet) ARBY'S USA Side Snacks, Mozzarella Sticks EASY CHEESE Spread, American cheese OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy What is your average intake for vitamin D in ug? (Intake Compared to DRI) 1 ug What is your recommendation for vitamin D? Compare your actual intake found on the average Intake with your recommended intake – what percent of vitamin D are you consuming? The average amount of vitamin D that I take should be increased this because I took 1 ug compared to 15 ug which is my recommended about which was only 7.3% What is your average intake for Folate (Folic Acid) in ug? (Intake Compared to DRI report)? 174 ug What is your recommendation for Folate (Folic Acid)? Compare your actual intake found on the average Intake with your recommended intake – what percent of Folate are you consuming? There is need to consume more folate acid since I took only 174 ug compared to the recommended 400 ug which was 43.4% Look up your Folate (Folic Acid) intake? What are the top three foods providing Folate on your food record? KELLOGG'S FROOT LOOPS KELLOGG'S APPLE JACKS Cereal Beef, Ground, Lean, Broiled, Medium What is your average intake for iron in mg (Intake Compared to DRI report)? 12 mg What is your recommendation for iron? Compare your actual intake found on the average Intake with your recommended intake – what percent of iron are you consuming. There is need to take more iron since I should take 18 mg but I took only 12 mg which is 66.9% What are the top three foods providing iron on your food record? (Intake Spreadsheet) KELLOGG'S APPLE JACKS Cereal KELLOGG'S FROOT LOOPS CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce How do low intakes of iron over a long period of time affect your body and health? There is the issue of unusual tiredness Headache and dizziness because of low hemoglobin cells hence making the brain to have less oxygen. Health palpitation because of iron deficiency anemia. Shortness of breath because of low hemoglobin in the body that is used to transport oxygen in the body. Dry skin and damaged hair. Swelling of the tongue and mouth. Restless legs What is your recommendation for sodium in mg? How does that compare your actual intake (Intake Compared to DRI report)? I should take sodium amounts of between 1500 – 2300 mg but I took 3753 mg which was obviously above the average. Meaning that I have to reduce the amounts of sodium that am taking because excess sodium has other effects on my body. Look up your Sodium intake. What are the top three foods providing sodium on your food record? (Intake Spreadsheet) ARBY'S USA Side Snacks, Mozzarella Sticks CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce MCDONALD'S Cheeseburger, Double Using your vitamin and mineral intakes, list the vitamins and minerals that you consumed less than 25% (Intake Compared to DRI) Vitamin A Vitamin D Vitamin E Vitamin K Thiamin Biotin Pantothenic acid Folate Calcium Magnesium Copper Iodine Fluoride Referring to question #34 - in general do you believe that you normally consume less than recommended of these vitamins or minerals on a regular basis? Explain you answer. Yes, I believe that am consuming less vitamins than it is expected. This is because if you look at my statistics among all the vitamins that are listed there, I have only attained the target for two minerals that are sodium and riboflavin and for the rest of the others there is none o have made it to the target meaning that I need to improve the amounts of minerals and vitamins that I consume. Compare your average calorie intake with the recommended calorie intake for your height and weight. (Refer to Energy Balance report) Should you be gaining, losing or being at a stable weight? When I compare with the energy report balance, I should be losing weight. This is because the recommended is 3125kcal, I took 1500kcal and used 2726kcal which means that I lost 1226kcal. This means that I used less calories than I took meaning that there is still a deficit of calories in my body. One pound of fat equals 3500 calories. How much weight would you gain/loss in 4 weeks based on your average calorie intake compared to your recommended calorie intake? Your answer should be exact. 4 weeks is equal to 28 days. I lost 1126 kcal per day multiplied by 28 = 31528 One pound of fat = 3500 calories So 31528/3500= 12.61 This means by the end of four weeks I will have lost 12.61 pounds Do you feel that the level of activity you chose for this project in the beginning was accurate? Do you feel that your intake for this project was accurate? (If the answer for either/both are no, explain why) Yes, the level of activity that I choose at the beginning of the project was accurate. Yes, the intake was accurate and I was able to record everything but the problem is where the amounts of alcohol and caffeine were not determined, this may partly affect the project. Refer to your MyPlate Report. How does your actual intake compare to the MyPlate Recommendations? According to my grain pie chart and the graphs of what I took for the tree days they do not compare at all. I am doing it opposite of what it should have been done, example I should take a bigger portion of vegetables and I took just a small piece of then, I took no fruits but according to my plate report, there should be fruits that are included in my diet. For the proteins I performed well and also for the grains my performance was relatively good although not what was expected. Matter got worse when it came to the consumption of empty calories which were not needed and they became more than even 100% Do you take any vitamin/mineral supplements? If yes complete a, b and c below. If no, complete no I do not. List the total average percentages of Vitamin A, D, E, K and C - Minerals Iron, and Zinc and that you consume each day from food? (From your Intake Compared to DRI): Vitamin A =22.1 % Vitamin D =7.3 % Vitamin E =1.3 % Vitamin K =0.6 % Vitamin C =29.6 % Iron=66.9% Zinc =64.1% Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 1 iProfile / Food Journal Summary / View by Day of the Week Taylor Jo Campbell Start date: Sun Feb 23 2020 End date: Wed Feb 26 2020 Breakfast Lunch Dinner Snacks Sunday, February 23 2.0 cups KELLOGG'S APPLE JACKS Cereal 20.0 fl.oz DIET COKE Soda 2.0 cups CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 6.0 items ARBY'S USA Side Snacks, Mozzarella Sticks 1.0 items HUNT'S Pudding, Snack Pack, Vanilla Monday, February 24 2.0 cups KELLOGG'S FROOT LOOPS 2.0 cups CHEF BOYARDEE Beef Ravioli in Tomato & Meat Sauce 1.0 items MCDONALD'S Cheeseburger, Double 1.0 svgs MCDONALD'S French Fries, Medium 6.0 items MCDONALD'S CHICKEN MCNUGGETS 6 Piece 16.9 fl.oz DIET COKE Soda 20.0 fl.oz DIET COKE Soda 20.0 fl.oz DIET COKE Soda Tuesday, February 25 22.0 items BETTER CHEDDARS Crackers, Baked 12.0 fl.oz DIET COKE Soda 4.0 tbsp EASY CHEESE Cheese Spread, American Cheese 2.0 svgs BOB EVANS Macaroni and Cheese 1.5 oz Turkey, Ground, Cooked 20.0 fl.oz DIET COKE Soda 0.5 items CAMPBELL'S SOUP AT HAND Soup, Creamy Tomato 1.5 oz Beef, Ground, Lean, Broiled, Medium Wednesday, February 26 1.0 items OSCAR MAYER LUNCHABLES Pizza, Extra Cheesy 20.0 fl.oz DIET COKE Soda 1.0 svgs BOB EVANS Macaroni and Cheese 0.5 oz Beef, Ground, Lean, Broiled, Medium 20.0 fl.oz DIET COKE Soda 0.5 oz Turkey, Ground, Cooked 0.2 cups CAMPBELL'S Soup, Tomato, Condensed 1.5 svgs BARILLA Pasta, Rotini, Classic, Dry 3.0 oz Beef, Round Tip, Separable Lean and Fat, 0'' Fat, Roasted 20.0 fl.oz DIET COKE Soda 1.0 svgs LITTLE DEBBIE Zebra Cakes 20.0 fl.oz DIET COKE Soda Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review iProfile 3.1 Copyright © 2020 John Wiley & Sons, Inc. All rights reserved. 1 iProfile / Energy Balance Taylor Jo Campbell Start date: Sun Feb 23 2020 End date: Wed Feb 26 2020 Date kCal Consumed kCal Burned Net kCal Sunday, February 23 1440 2726 -1286 Monday, February 24 1805 2726 -921 Tuesday, February 25 1273 2726 -1453 Wednesday, February 26 1480 2726 -1246 Totals: 5998 10903 -4905 Caloric Summary Recommended: 3126 Average Intake: 1500 Average Expenditure: 2726 Average Net Loss: -1226 Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile an alysis and your personal iProfile questions - you must now review your overall diet and nutritional health . You will thoroughly review your ipr ofile reports and the information you documented for your questions, then based on the informat ion that was presented in class you will create a report that finalizes this project. You will create a final general document which includes assessment of you r overall nutritional health. Using the information that you learned from the class and the IProfile Assignment your Report must include an overall summ ary along with changes you need to make in your diet and activity. Be very specific with recommendat ions. Following ar e some basic examples of what type of information may be included for sample nutrients – You should addr ess any nutrients in which you feel ne ed attention. Look carefully at your intake of carbohydrates (especially complex carbs), Fiber, proteins and fats. Make that you address any micro nutrients - vitamins or minerals – that are less than 25% . Make sure you look at your overall calorie intake. Make recommendations for better health based on these recommendations. This is your own thoughts based on the information you have learned from your Diet Analysis and this course . Examples of how present the information. A. 1. Based on My Intake To DRI I am only in taking ____% of my required Vitamin C, ( A,D,E,K, Thiamin etc ) I need to increase my daily intake of vitamin C by -- % - I will do this by eating more _______( specific food) 2. Based on My Intake Compared to DRI , I am in taking excessive (or insufficient ) sodium (Potassium, Iron, Calcium, etc) ( ____%). I need to reduce (increase ) my daily intake of sodium by -- % - I will do this by eating less ______ and replacing it with more _______. 3. According to my Macronutrient Distribution Report my average intake of Protein (Carbohydrate , Fat) is _____%. I need to decrease (increase ) my overall intake of protein. To do this I will increase my intake of _______ and decrease my intake of ________ 4. My intak e of saturated fat was _____. I need to decrease my intake of saturated fat by eating less _________ and eating more. 5. Etc. B. If your average analysis is stating that y ou should be losing or gaining weight and you are not – you need to also address that issue. What was the problem? Did you overestimate your activity level? (thinking that you expend more calories per day than you actually do) or did you underestimate your portion size intake ( remember one portion of spaghetti is only one cooked cup – that is the size of a tennis ball – is that really the amount you consumed?) --- You need to address what you believe that you did incorrectly C. Make sure you include a stat ement as to what you need to do in the future to increase your nutrition health ( if necessary) D. When you have finished your analysis and review, make a final statement – TRUTHFULLY - stating if you feel that you will make these changes or not and why. Do not complete this until you have read and re viewed at least Chapter 11. Your analysis/summary must be a minimu m of 1 single spaced typed page to earn any points. Final Review and Assessment of Profile and Nutritional Health – FSM 159 Nutrition - 30 points After you have completed your IProfile analysis and your personal iProfile questions - you must now review Chapter 11 Nutrition During Pregnancy and Infancy Changes in the Body During Pregnancy • Fertilization: the union of a sperm and an egg. • Implantation: the process through which a developing embryo embeds itself in the uterine lining. • Embryo: the developing human from two through eight weeks after fertilization. • Prenatal development: o Ovulation releases an egg from the woman’s ovary. o Fertilization occurs in the oviduct 12 to 24 hours later. o About 30 hours after fertilization, the fertilized egg has completed its first cell division. o About 3 or 4 days after fertilization, the developing embryo is a ball of about 100 cells. o About 6 days after fertilization, the developing embryo begins to implant itself in the uterine lining. ▪ Implantation is complete by 14 days after fertilization. o During the embry onic stage of development (2 to 8 weeks) , cells differentiate and arrange themselves in the proper locations to form the major organ systems. o The fetal stage of development (9 weeks until birth) the fetus gro ws, and internal and external structures continue to develop . Nourishing the Embryo and Fetus • Placenta: an organ produced from maternal and embryonic tissues. o Secretes hormones, transfers nutrients and oxygen from the mother’s blood to the fetus, and removes metabolic wastes. • Fetus: a developing human from the ninth week after fertilization to birth. • Fetal period usually ends after 40 weeks with the birth of an infant. o Birth weight: 3 to 4 kg (6.5 to 9 pounds). • Small for gestational age: infants born o n time but have failed to grow well in the uterus. • Pre -term or premature: infant born before 37 weeks of gestation. • Low birth weight: a birth wei ght of less than 2.5 kg (5.5 lb). • Very low birth weight: a birth we ight of less than 1.5 kg (3.3 lb ). Maternal Weight Gain During Pregnancy • Healthy, normal weight woman should gain 11 to 16 kg (25 to 35 lb) during pregnancy. o Little gain is expected during the first trimester: 1 to 2 kg (2 to 4 lb). o Second and third trimester: 0.5 kg (1 lb)/week. • Underweigh t women should gain up to 18 kg (40 lb ). • Overweight women should gain onl y about 7 to 11 kg (15 to 25 lb ). • Obese women should gain on ly about 5 to 9 kg (11 to 20 lb ). • Excessive weight or excess weight gain during pregnancy increases risks for high blood pressure, diabetes, difficult delivery, and need for cesarean section. o Large -for -gestational -age: weighing more than 4 kg (8.8 lb ) at birth. o Increases mother’s long -term risk for obesity. Physical Activity During Pregnancy • Benefits of physical activity during pregnancy: improve digestion, prevent excess weight gain, low back pain, and constipation, reduce risk of diabetes and high blood pressure, and speed recovery from childbirth. • Guidelines: maximize benefits of exercise and minimize risk of injury to mother and fetus. o General: 30 minutes of carefully chosen moderate exercise per day. o Limit intense exercise. Discomforts of Pregnancy • Edema: accumulation of extracellular fluid in the tissues. o Increases medical risk s if it is associated with a rise in blood pressure. • Morning sickness: nausea and vomiting occurring during the first trimester. o Thought to be related to hormones that are released early in pregnancy. o Can be alleviated with small frequent snacks of dry, starchy foods. • Heartburn and constipation: caused by relaxation of the GI tract and crowding of the organs by the growing fetus. Complications of Pregnancy • High blood pressure: occurs in 10 % of pregnancies in U.S. o Hypertensive disorders of pregnancy: spectrum of conditions involving elevated blood pressure during pregnancy. o Accounts for more than 12% of pregnancy -related maternal deaths . o Preeclampsia and eclampsia are m ore common in mothers under 18 and over 35 years of age, low -income mothers, obese mothers, and mothers with chronic hypertension or kidney disease. o Gestational hypertension: an abnormal rise in blood pressure that occurs after the 20 th week of pregnancy and resolves within 12 weeks of birth . o Preeclampsia: a condition characterized by elevated blood pressure, a rapid increase in body weight, protein in the urine, and edema. ▪ Also called toxemia. ▪ Dangerous to the baby because it reduces blood flow to the placenta. ▪ Dangerous to the mother because it can progress to a more severe form of pregnancy -induced hypertension (eclampsia) . o Eclampsia: convulsions or seizures brought on by preeclampsia. ▪ Untreated, it can lead to coma or death. ▪ Requires bed rest and careful medical monitoring. ▪ Condition resolves after delivery. • Gestational diabetes: a condition characterized by high blood glucose levels that develop during pregnancy. o More common: obese women and those with a family history of type 2 diabetes. ▪ More frequently: Asian, African American, Hispanic/Latino, and Native American women. o Usually resolves after birth. ▪ Mother has a 35 to 60% chance of developing diabetes in the next 5 to 10 years. o Requires treatment to normalize maternal blood glucose levels. ▪ Glucose passes freely across the placenta. ▪ When the mother’s blood g lucose levels are high, the growing fetus receives extra glucose and calories. ▪ Increases risk of large for gestational age. ▪ Increased risk for difficult delivery , preterm delivery, and birth defects . ▪ Increased risk of diabetes as adults. Nutritional Needs During Pregnancy Energy and Macronutrient Needs • Energy needs: o First trimester: same as nonpregnant . o Second and third trimester: additional 340 to 452 calories/day. • Protein needs: additional 25 g above RDA or 1.1 g/kg/day. • Carbohydrate: additional 45 g to 175 g/day. o Whole grains, fruits, and vegetables. o Additional 3 g of fiber/day. • Fat: not necessary to increase total fat intake. o Additional amounts of the essential fatty acids linoleic and α -linol enic a cid. o Docosahexaenoic acid (DHA ) and arachidonic acid (ARA) are important: essential for eye and nervous system development in the infa nt. Fluid and Electrolyte Needs • Water need s increase from 2.7 L/day in nonpregnant women to 3 L/day during pregnancy. • No eviden ce that requirements are increased for potassium, sodium, and chloride than nonpregnant women . Vitamin and Mineral Needs • Calcium and vitamin D: AI for calcium is not increased during pregnancy; absorption doubles. o Can be met with foods. o Low calcium intake increases the risk of developing preeclampsia in pregnant teens, individuals with inadequate calcium intake, and women at risk for preeclampsia . o May need more vitamin D. • Folate (folic acid) and vitamin B12 o Folate is needed for the synthesis of DNA a nd cell division. o Low folate levels increase the risk of abnormalities in the formation of the neural tube which forms the baby’s brain and spinal cord . o Recommendation prior to pregnancy: increase of 400 µg daily of synthetic folic acid from fortified foods, supplements or combination o During pregnancy: RDA 600 µg/day. o Folate def iciency: can cause m acrocytic anemia in the mother. ▪ Associated with prematurity, low birth weight, and birth defects. o What a Scientist Sees: Folic Acid Fortification and Neural Tube Defects ▪ Since the initiation of folic acid fortification, the incidence of neural tube defects has been reduced by 36% in the United States and 31 to 50% on other countries where folic acid fortification is mandatory. o Vitamin B12 : essential for the regeneration of active forms of folate. ▪ Deficien cy can result in macrocytic anemia in the mother which impair s growth and cognitive development in the fetus . ▪ RDA: 2.6 µg/day. ▪ Easily met with small amounts of animal products. ▪ Vegans: must include vitamin B12 supplements or B12 fortified foods and beverages . • Iron and Zinc o Iron: RDA: 27 mg/day, 50% higher than recommended for nonpregnant women ▪ Required for the synthesis of hemoglobin and other iron -containing proteins . ▪ Iron deficiency anemia during pregnancy has been associated with low birth weight , preterm delivery , and cognitive development . ▪ Well planned diet can meet needs. ▪ Iron supplements are typically recommended. ▪ Consuming vit amin C foods or beverages along with iron containing foods enhances absorption. o Zinc: RDA: 13 mg/day for pregnant women age 1 8 and younger; 11 mg/day for pregnant women age 19 and older. ▪ Involved in the synthesis and function of DNA and RNA , and synthesis of protein . ▪ Zinc deficiency during pregnancy: associated with increased risks of fetal malformations, premature birth, and low birth weight. • Iodine o Iodine: RDA: 220 μg/day from food or supplement sources. ▪ During pregnancy there is a 50 % increase in maternal thyroid hormone production and increase in iodine lost in urine. ▪ Deficiency causes brain damage in the fetus as well as fetal goiter, hypothyroidism, and cretinism. Meeting Nutrient Needs with Food and Supplements • Energy and nutrient needs of pregnancy can be met by following the Mediterranean - style eating pattern, the DASH Eating Plan, or MyPlate . • Prenatal supplement generally recommended for all pregnant women. Food Cravings and Aversions • Most women experience some food cravings and aversions during pregnancy. • Not known why women experience cravings and aversions. o May be hormonal or physiological changes. o Psychological and behavioral factors may also be involved. • Pica: an abnormal craving for and ingestion of nonfood substances that h ave little or no nutritional value. Example: clay, laundry starch, ashes. o May be related to cultural beliefs ; protection against harmful pathogens and toxins; suppression of nausea, vomiting, and diarrhea, and contribution of micronutrients . o Risks outweigh the benefits . o Complications: iron -deficiency anemia, lead poisoning, and parasitic infections. o Anemia and high blood pressure more common in those with pica. o In newborns, anemia and low birth weight are often related to pica in the mother. Thinking It Th rough: A Case Study on Nutrient Needs for a Successful Pregnancy What Should I Eat ? During Pregnancy • Make nutrient -dense choices. • Drink plenty of fluids. • Indulge your cravings, within reason. Factors That Increase the Risks Associated with Pregnancy • Anything that interferes with embryonic or fetal development can cause a baby to be premature, too small or result in birth defects. • Developmental errors causes: deficiencies or excesses in the maternal diet, harmful substances present in the environment o r consumed in the diet, or taken as medications or recreational drugs. • Teratogen: any chemical, biological, or physical agent that causes a birth defect. • Critical period: the specific development time and rate of an organ system. • Increased risk for complic ations during pregnancy: nutritional status, age, or preexisting health problems. Maternal Nutritional Status • Before pregnancy: proper nutrition is important to allow conception and maximize the likelihood of a healthy pregnancy. o Women with reduced body f at may have abnormal hormone levels. ▪ Ovulation does not occur, and conception is not possible. o Too much body fat can also reduce fertility by altering hormone levels. • During pregnancy: maternal malnutrition can cause fetal growth retardation, low birth wei ght, birth defects, premature birth, spontaneous abortion, or stillbirth. o Effects vary depending on when during pregnancy malnutrition occurs. o May also cause changes that can affect the child’s risk of developing obesity and other chronic diseases later in life. Maternal Age and Health • Teens: still growing, so their nutrient intake must meet their needs for growth as well as for pregnancy. o Increased risk: hypertensi ve disorders . o More likely to deliver preterm and low -birth -weight infants. o Needs early medical intervention and nutrition counseling to produce a healthy baby. o Remains a major public health problem. • Pregnancy after age 35: carries additional risks. o Nutritional requirements the same as for women in their 20s. o More likely to already have one o r more medication conditions: cardiovascular disease, kidney disorders, obesity, or diabetes. o More likely t o develop gestational diabetes, hypertensi ve disorders of pregnancy , and other complications. o Higher incidence of low -birth -weight infants , pr eterm birth, stillbirth, and peri natal death . o More likely to have infants with chromosomal abnormalities, especially Down syndrome. o Frequency of twins and triplets higher among older mothers – partly due to use of fertility treatments. • Other risks: o Women with hi story of miscarriage or birth defects. o Multiple pregnancies increase nutrient needs and risk of preterm delivery . ▪ An interval of less than 18 months between pregnancies increases risk of delivering preterm or small -for -gestational age infant as well as ris k of neonatal or infant mortality . Poverty • One of the greatest risk factors for poor pregnancy outcome. o Limits access to food, education, and health care. o Higher incidence of low -birth -weight and preterm infants. o Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): federally funded program. o Provides nutrition counseling and funds to purchase nutritious foods and referrals to health and other services for low -income women who are pregnant, postpartum, or breast feeding, and for infants and children up to age 5. Exposure to Toxic Substances • Caffeine: in excess, have been associated with increa sed risks of miscarriage or low - birth -weight. o Recommendation: avoid consuming more than 200 mg of caffeine (1-2 cups of coffee) per day or 2 to 3 20 -ounce soft drinks. • Mercury in fish: consumption during pregnancy can cause developmental delays and brain damage. o Avoid varieties of fish that are highest in mercury and limit intake of low -mercury fish. • Food -born e illness: immune system is weakened during pregnancy, increasing susceptibility to and the severity of certain food -borne illnesses. o Listeria infection : results in miscarriage, stillbirth, or infection of the fetus. ▪ About one -thi rd of babies born with Lis teria infections , do not survive. ▪ Bacteria are commonly found: unpasteurized milk, soft cheeses, uncooked hot dogs and lunch meats. • Toxoplasmosis: infection caused by a parasite. o If a pregnant woman is infected, she can pass the infection to her unborn baby. o Infected babies: develop vision and hearing loss, intellectual disability, and/or seizures and some die within days of birth . o Parasite is found in cat feces, soil, and undercooked infected meat. • Alcohol: consumption during pregnancy is one of the leading causes of preventable birth defects. o Teratogen that is particularly damaging to the developing nervous system. o Indirectly affects fetal growth and development. o Fetal alcohol syndrome (FAS): a characteristic group of p hysical and mental abnormalities in an infant resulting from maternal alcohol consumption during pregnancy. o Fetal alcohol spectrum disorders (FASD s): refers to all the physical or behavioral disorders or condition s and functional or mental impairments linked to prenatal alcohol exposure. ▪ Affects 2 to 5% of all young school children in the US. o Complete abstinence during pregnancy is recommended. • Tobacco use: if a woman uses tobacco products during pregnancy, her baby will be affected before birth and throughout life. o Carbon monoxide in tobacco smoke binds to maternal and fetal hemoglobin, reducing the amount of oxygen delivered to fetal tissues. o Nicotine absorbed from any tobacco product , including e -cigarettes, is a teratogen that can affect brain development. ▪ Also constricts arteries and limits blood flow; reducing the amounts of oxygen and nutrients delivered to the fetus. o Reduces birth weight and increases the risks of stillbirth, preterm delivery, birth defects, an d early infant death. o Environmental exposure to cigarette smoke: increase the risk of having a low - birth -weight baby o Sudden infant death syndrome (SIDS) or crib death : unexplained death of an infant, usually during sleep. ▪ Higher incidence of SIDS and respi ratory problems in infants exposed to cigarette smoke both in the uterus and after birth . • Legal and illicit d rug use: certain drugs can affect both fertility and fetal development. o Prescription, over -the -counter, or illegal. ▪ Example of prescription drug: Accutane and Retin -A are derivatives of vitamin A that can cause birth defects during pregnancy. o Illegal s ubstance abuse during pregnancy is a national health issue. ▪ 4.4 % of pregnant women use illicit drugs . ▪ Marijuana and cocaine can cross the placenta and enter the fetal blood. • Cocaine is a central nervous system stimulant. Reduces the delivery of oxygen and nutrients to the fetus. • Cocaine use is a ssociated with an increased risk of miscarriage, fetal growth retardation, premature labor and delivery, low birth weight, and birth defects. • Has also been show to affect infant behavior and influence learning and attention span during childhood. Lactation • The need for many nutrie nts is greater during lactation than during pregnancy. Milk Production and Let -Down • Lactation involves: o The synthesis of milk components – proteins, lactose, and lipids. o And movement of these components through the milk ducts to the nipple. • Let -down: the release of milk from the milk -producing glands and its movement through the ducts and storage sinuses. o Triggered by hormones that are released in response to an infant’s suckling. o Prolactin: the pituitary hormone; stimulates milk production. The more the infant suckles, the more milk is produced. o Oxytocin: another pituitary hormone; causes let -down. Also stimulated by suckling. ▪ May also occur in response to just the sight or sound of an infant. o Can be inhibited by nervous tension, fatigue, or embarras sment. o Slow let -down can make feeding difficult. Energy and Nutrient Needs During Lactation • Human milk contains about 70 Calories/100 mL (160 Calories/cup). • During the first 6 months of lactation, an average infant consumes 600 to 900 mL (about 2.5 to 4 c ups/day). • Approximately 500 Calories are required for the mother each day. o From the diet. ▪ Additional 330 Calories/day above nonpregnant, nonlactating needs during the first 6 months of lactation. ▪ Additional 400 Calories during the second 6 months. o Maternal fat stores. ▪ Beginning 1 month after birth, most lactating women lose 0.5 to 1 kg (1 to 2 lbs)/month for 6 months. ▪ Rapid weight loss is not recommended. • Protein: RDA for lactation is increased by 25 g/day. • Carbohydrate, fiber, and the essential fatty acids are also higher during lactation. • Adequate hydration: need to consume about 1 L of additional water per day. • Vitamins and minerals: increased during lactation to meet the needs of synthesizing milk and to replace the nutrients secrete d in the milk. o Low m aternal intake of thiamin, riboflavin, selenium, iodine, and vitamins B 6, B 12, A, and D can affect the composition of milk. o Others, including folate, calciu m, iron, copper, and zinc levels in milk are maintained at the expense of matern al stores. Nutrition for Infants Infant Growth and Development • Developmental milestones: infants develop physically, intellectually, and socially. o Critical periods during infancy for growth and development. • Generally: an infant’s birth weight should dou ble by 4 months of age and triple by 1 year of age. • In the first year, most infants increase their length by 50%. • Growth is the best indicator of adequate nutrition. • Growth charts: can be used to compare an infant’s growth with that of other infants of the same age. o Results in a percentile ranking. o Children generally remain at the same percentile as they grow. • Failure to thrive: inability of a child’s growth to keep up with normal growth curves. o Causes: congenital condition, disease, poor nutrition, neglect, abuse, or psychosocial problems. o Critical periods during infancy for growth and development. Energy and Nutrient Needs of Infants • Human milk and commercially produced formula are designed to meet infants’ nutrient needs. • Infants may st ill be at risk for iron, vitamin D, and vitamin K deficiencies and for suboptimal levels of fluoride. • Energy and macronutrients: infants require more calories and protein per kilogram of body weight than do individuals at any other time of life. o Require an energy dense diet: high energy needs and small stomach. o Fat: 55% of energy needs during the first 6 months. 40% during the second 6 months. DEBATE: DHA/ARA -Fortified Infant Formula s • Issue: the fatty acids docosahexaenoic acid (DHA) and arachidonic acid (ARA) are essential for development of the retina and brain. Breast milk provides these fatty acids, and most infant formulas in the U .S. are fortified with them. A dvertisements suggest that these formulas provide an advant age for infant develo pment. Will feeding babies formulas fortified with DHA and ARA make them smarter and improve their vision ? • Fluid needs: need to consume more water per unit of body weight than adults. o Infants have a higher proportion of body water than adults. o Infants lose proportionately more water in urine and through evaporation. o Urine losses are high because the kidneys are not fully d eveloped. o Breast fed infants do not required additional water. • Micronutrients at risk: o Iron: deficiency is usually not a problem during the first 6 months. ▪ By 7 to 12 months old, the diet of breast fed infants should contain sources of iron. ▪ Formula fed in fants should be fed iron -fortified formula. o Vitamin D: breast milk is low. ▪ Breast fed and partially breast fed infants should supplement with 400 IU of vitamin D beginning in the first few days of life and continuing until they consume vitamin D -fortified formula or milk daily. ▪ Infants consuming 1 L/day of i nfant formula can meet their vitamin D needs . ▪ Exposure to the sun produces vitamin D . o Vitamin K: newborns receive an intramuscular injection within the first six hours of life to reduce the risk of bleeding. ▪ Little vitamin K crossed the placenta. ▪ The infant’s gut is sterile, so there are no bacteria to synthesize this vitamin. o Fluoride: important for tooth development. ▪ Breast milk is low in fluoride. ▪ Formula is made with unfluoridated water. ▪ Where the water supply is fluoridated, infant formulas should be reconstituted with it. ▪ Supplements may be necessary starting at 6 months. Meeting Needs with Breast Milk or Formula • Breast feeding is the recommend choice for the newborn of a healthy, well -nourished mother. o U.S. Health professionals recommend: exclusive breast feeding for the first 6 months of life. ▪ Breast feeding with complementary foods for at least the first year. • Infants should be fed f requently and on demand. o Breast fed infants: 10 to 15 minutes at each breast. o Well -fed infant should urinate enough to soak six to eight diapers a day and gain about 0.15 to 0.23 kg (0.33 to 0.5 lb) /week. o Nursing bottle syndrome: rapid and serious decay o f the upper teeth caused by an infant being put to bed with a bottle. • Nutrients in breast milk and formula. o Human milk is tailored to meet the needs of human infants. ▪ The composition of milk changes continually to suit the needs of a growing infant. ▪ Colost rum: the first milk, produced by the breast late in pregnancy and for up to a week after deliver. Compared to mature milk, it contains more water, protein, immune factors, minerals, and vitamins and less fat . ▪ Has beneficial effect on the gastrointestinal t ract. o Infant formulas try to replicate human milk as closely as possible. • Health b enefits of breast feeding: o Benefits for infants: ▪ Optimum nutrition. ▪ Strong bonding with the mother. ▪ Enhances immune protection. ▪ Reduces allergies. ▪ Decreases ear infections, respiratory illnesses, and asthma. ▪ Less likely to suffer from constipation, diarrhea, or chronic digestive disorders. ▪ Reduces risk for SIDS. ▪ Reduces risk for obesity, type 1 and 2 diabetes, heart disease, hypertension, and childhood leukem ia. ▪ Aids in the development of the facial muscles, speech development, and correct formation of teeth. ▪ Reduces risk of overfeeding. o Benefits for the mother: ▪ Relaxing, emotionally enjoyable interaction; strengthens bonding with infant. ▪ Less expensive. ▪ Less preparation and clean up time; always available. ▪ Causes uterine contractions that help the uterus return to its normal size more quickly after delivery. ▪ Increases energy expenditure, which may speed return to prepregnancy weight. ▪ Lowers risk of developing type 2 diabetes and breast and ovarian cancers. ▪ Improves bone density so decreases risk of hip fracture. ▪ Inhibits ovulation, lengthening the time between pregnancies but it’s not a reliable birth control method . ▪ Decreases risk of post -partum depression. ▪ Enhances self -esteem in the maternal role. • When is formula -feeding better? o Tuberculosis and HIV infection can be passed through breast milk. o Some drugs pass from the mother to the baby in breast milk. ▪ Check with physician about prescription drugs. ▪ Alcohol, cocaine, and marijuana. ▪ Nicotine. o Formula feeding requires more preparation. o It can give the mother a break and other family members can feed the infant. o Special formulas needed: pre -term infants or those with genetic abnormalities. o If an infant is too sm all or week to take a bottle, can be fed through a tube. Safe Feeding for the First Year • Sanitation of water and equipment is important to avoid bacterial contamination. o Bottle feeding: wash hands, bottles, and nipples before preparing formula. o Breast feeding: wash hands, bottles, nipples, and breast pump. • Food allergies: common in infants because their digestive tracts are immature and therefore allow the absorption of incompletely digested proteins, which trigger an immune system response. o Risk is reduced after about 3 months of age. o Many children who develop food allergies before age 3 years eventually outgrow them. o Allergies that appear after 3 years of age are more likely to be a problem throughout life. o Exclusive breast feeding for the f irst 4 to 6 months reduces an infant’s risk of developing food allergies. • Appropriate introduction of solid and semisolid food starting at 4 to 6 months old . o Recommended first food: iron -fortified infant rice cereal mixed with formula or breast milk. o Intro duce each new food for a few days, before trying another new food. • Developmentally appropriate foods: foods should be appropriate for the infant’s digestive and developmental abilities. o Solid and semi -solid foods can be gradually introduced. o Cow’s milk can be fed after 1 year of age. o Avoid foods that can cause a choking hazard. o After 6 months old, 100% f ru it juice can be fed from a cup . o Honey should not be fed to children less than 1 year of age; may contain spores of Clostridium botulism .