Nutrition A

diet relates to
development of vitamin and mineral deficiency diseases
compromised growth and impaired mental development in children
body’s ability to fight off infectious diseases
Dietary guidelines for americans
Science-based guidelines to promote health and reduce risk for major chronic disease
Stresses consumption of nutrient-dense foods, balancing caloric intake and output, and increasing physical activity
Epidemiological studies
identify conditions and specific health events
clinical trial
test the effects of a treatment or intervention
requires control and experimental group
evidenced based medicine
The conscientious, explicit, and judicious use of the current best evidence in making decisions about health care of individuals
Grade A: strong methods, results consistent
A1: Clear that benefits outweigh risk
A2: Unclear whether benefits outweigh risk
Grade B: strong methods, results inconsistent
Grade C: Methods weak
Decision-making mechanisms in food choices
Attraction to sweet-tasting foods
Dislike for bitter foods
Thirst when water is needed
People deficient in sodium experience an increased preference for salty foods
Most have an aversion to foods that “smell bad”
steps in changing one’s diet
People are most willing to make dietary changes when benefits outweigh costs
Make a specific plan
Start with small, easy changes
Be prepared for relapses
Alcohol
food-contains carbs
drug-modifies actions, harmful in large doses
Benefits of alcohol
Men: 2 drinks/day, women:1 drink /day
Reduces risk of heart disease, type 2 diabetes, hypertension, stroke, dementia
Increases HDL cholesterol
Improves glucose utilization
Decreases chronic inflammation
Improves cognitive function
Alcoholism
Illness characterized by dependence on alcohol and a level of alcohol intake that interferes with health, family, social relationships, and job performance
alcohol poisoning
Life-threatening condition due to excess alcohol consumption; a medical emergency
Characterized by mental confusion, vomiting, seizures, slow or irregular breathing, and low body temperature
Effects of alcohol
As calories from alcohol increase, quality of the diet decreases
Heavy drinkers receive too little thiamin, vitamins A and C, calcium, and iron
Alcohol absorption
Alcohol easily and rapidly absorbed in stomach and small intestine
Due to lag time between intake and utilization, blood levels of alcohol build up
Blood alcohol levels increase faster in women than in men
Women experience intoxicating effects of alcohol on lower amounts of alcohol than men require
underage drinking
Underage drinking accounts for 20% of all alcohol consumed in the US
binge drinking
Defined as consuming 5 or more drinks in a row for men; 4 or more drinks in a row for women
Dietary Supplement
Intended to supplement the diet not substitute for healthy foods
Vitamins, Minerals, Herbs or other botanicals, Amino acids
Other dietary substances such as enzymes
Is intended to be taken by mouth as a pill, capsule, tablet, liquid, or powder; and
Is labeled on the front panel as being a dietary supplement
requirements for supplementation
safety of ingredients
label information is accurate
declared contents matches container contents
bioavailability
Amount of a nutrient consumed that is available for absorption and use by the body
vitamins for pregnant and lactating women
increased need for some nutrients, of note iron & folate
vit for women with heavy periods
iron, vitamin c
vit for premenopausal women
folate, iron, calcium
vit for smokers
vitamins b and c
vit for alcohol
vitamin b1, folate, b6, 12
vit for vegetarians
calcium, iron, zinc, vitamin B2 and B12, vitamin D
vit for adults over 70
calcium, vitamin D, vitamin B6 and B12, zinc
herbs
Crude drugs of vegetable origin utilized for the treatment of disease states or to attain or maintain a condition of improved health
Herbal supplements are regulated by FDA as foods and do not undergo the same stringent approval process as drugs
Many herbs contain toxins in addition to active “useful” components
determinants for herbs’ risks to health
amount and duration of use
age and health status of user
other factors
functional foods
AKA “neutraceuticals”
Functional foods are modified to enhance contribution to health
Formulated to improve health, or with high amounts of compounds to prevent disease
No statutory definition of “functional foods”
No specific regulations that apply
Whole foods
Enriched foods
Fortified foods
Enhanced foods
prebiotics
non-digestible carbohydrates broken down by colon bacteria
Breakdown products foster good bacteria
probiotics
live, beneficial bacteria found in fermented foods
prevention
assessing and minimizing risk
50% drop in death from heart disease
declines in blood cholesterol levels
reduced rates of smoking
improved blood pressure control
advances in medical care
gender differences in heart disease
Risk for heart disease in women increases substantially after menopause
Menopause brings declines of estrogen and HDL and increases in LDL
Women have higher HDL and total blood cholesterol than men
Coronary heart disease
slow, complex disease that begins in childhood and progresses with age
Theorized to begin with an injury to the endothelium (inner most layer of the artery)
The most common form of cardiovascular disease
Characterized by the accumulation of plaques along the inner walls of the coronary arteries
Plaques may grow large enough to significantly reduce the blood flow through an artery
blood cholesterol
Generally, the higher the blood cholesterol level, the more plaque builds up
Diets high in saturated fat and cholesterol raise blood cholesterol
Trans fat raises cholesterol levels more than saturated fat
risk factors for heart disease
Increasing age
80% mortality in persons 65 years or older
Gender
men are at greater risk and at earlier ages
Heredity
family history of premature CHD in first degree relatives
male ; 55 years, female ;65 years
race
modifiable risk factors for heart disease
Tobacco smoke
risk of heart attack is more than twice that of nonsmokers
High blood cholesterol
High blood pressure
Diabetes Mellitus
Obesity
Physical inactivity
cholesterol
Cholesterol is a fat-like, waxy substance that is present in all animal cell membranes
Produced by liver and taken in through animal foods
Affected by age, gender, heredity, and diet
Carried by lipoprotein carriers in the blood:
LDL: Low Density Lipoprotein
HDL: High Density Lipoprotein
elevated blood cholesterol
Risk rises as cholesterol levels increases
Clinically defined as ; 240 mg/dl
All individuals should be screened
Requires diet and/or drug therapy for elevated levels
LDL
Primary carrier for cholesterol in the blood
Associated with increased risk for heart disease
Elevated levels injure arteries and promote plaque formation/progression of CHD
HDL
Transports 25-35% blood cholesterol
Associated with reduced risk for heart disease
Plays a role in transporting cholesterol away from arterial walls
HDL above 60 considered a “negative” risk factor, actually statistically removing one risk factor total risk factor profile
High blood pressure
Defined as blood pressure exceeding 140/90 mm Hg for an extended time
Increases the heart’s workload
Increases risk of stroke, congestive heart failure, and kidney failure
high blood pressure modifications
Weight control
Physical activity
Moderation in alcohol intake
Moderate sodium restriction
BMI
a formula used to assess weight relative to height kg/m2 (weight in kilograms divided by height in meters squared)
heart healthy diet choices
fruit and vegetable consumption
dietary fiber
fish consumption
soy protein
Moderate alcohol intake
Stress management and positive coping skills
DHA and EPA
Fatty fish from cold waters are sources of DHA and EPA
Omega-3 fatty acids protect against heart disease by:
decreasing blood clotting
decreasing blocked arteries
decreasing plaque build-up
decreasing blood pressure
decreasing blood triglyceride levels
vegan
A food plan consisting only of plant foods
lacto vegetarian
A food plan consisting of plant foods plus dairy products
lacto-ovo vegetarian
A food plant consisting of plant foods plus dairy products and eggs
quasi vegetarian
exclude beef, pork, and poultry, include fish, eggs, dairy products, and plant foods
far vegetarian
excludes red meat
flexitarian
those who eat a mostly vegetarian diet, but occasionally eat meat
Benefits of vegetarianism
Lower intake saturated fat and cholesterol
Higher intake dietary fiber
Lower Body Mass Index (BMI)
Lower blood cholesterol and LDL levels
Lower blood pressure
Lower risk of obesity, heart disease, stroke, hypertension, type 2 diabetes, chronic bronchitis, gallstones, and kidney
complete proteins
Proteins that contain all nine essential amino acids in the amounts needed to support protein tissue construction
complementary proteins
Plant sources of protein that together provide sufficient quantities of the nine essential
Mediterranean diet
Eating a generous amount of fruits and vegetables
Consuming healthy fats such as olive oil and canola oil
Eating small portions of nuts
Drinking red wine, in moderation, for some
Consuming very little red meat
Eating fish on a regular basis
contributors to cancer
Cancer has many causes primarily linked to environment and heredity
Diet is a factor that influences the development of most types of cancer
cancer
a group of conditions that result from the uncontrolled growth of abnormal cells
second leading cause of death in US
initiation stage
something alters DNA in certain cells, phase one of cancer
promotion phase
cancer cells with altered DNA divide, producing large numbers of abnormal cells, 10-30 yrs
progression phase
Unless corrected by some means, abnormal cells continue to divide
stages of cancer
initiation-promotion-progression
cancer causes
80-90% of cancers are initiated by environmental factors that alter DNA
Diet is a major environmental factor and may account for 40% of cancer risk
lifestyle risks associated with cancer
Cancer-promoting diets are low in vegetables and fruits
High saturated fat, regular intake of charred and nitrate-cured meats, and excessive alcohol are associated with cancer
Low intakes of whole grains, dried beans, nuts, and seeds increase cancer risk
Other risk factors include smoking, physical inactivity, and excess body fat
antioxidants in fruits and vegetables
Vitamin C, beta-carotene, vitamin E, and selenium
phytochemicals
Phytochemicals act as antioxidants
Phytochemicals participating in cancer prevention are brightly colored
Select and consume colorful vegetables and fruits
cancer preventing foods
Dried beans, soy products, nuts, and seeds
fish
brightly colored fruits and vegetables
whole grains
foods associated with increased risk of cancer
High saturated fats from meats and dairy products Cancer of stomach and liver related to regular consumption of hot dogs, lunch meats, bacon, pickled eggs, and vegetables preserved with nitrates
Substances in beef, chicken, fish, and other meats become cancer promoting if heated to high temperatures
cancer causing substances
Consumption of excessive alcoholic beverages is linked to cancer of the breast, mouth, throat, and liver
Risk of developing cancers of mouth and throat increase for people who smoke cigarettes or chew tobacco
methods of cancer prevention
not smoking or drinking
consuming five or more fruits and vegetables daily
sticking to a low-saturated-fat diet
being physically active
maintaining a normal level of body fat
prepare and store food safely
obesity
energy imbalance- involves eating too many calories and not getting enough physical activity.
factors effecting body weight
Genes, Metabolism, Behavior, Environment, Culture, Socioeconomic status *behavior and environment mostly
weight gain
more energy is consumed than expended
contributing factors to caloric utilization
Resting Metabolic Rate
Physical Activity-Occupational work, Household chores, Leisure time activity
Thermic Effect of Food
benefits of weight loss
Lowers blood insulin, triglycerides, glucose, and C-reactive protein
Increases insulin sensitivity and HDL cholesterol
Reduces risk of heart disease and diabetes
Decreased severity of sleep apnea
Reduced symptoms of degenerative joint disease
Improved gynecological conditions
strategies for weight loss
Dietary therapy, Physical activity, Behavior therapy, “Combined” therapy, Pharmacotherapy, Weight loss surgery

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