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1 WHAT NOURISHES YOU? CHAPTER OVERVIEW Chapter 1 introduces major concepts of nutrition science to undergraduates who have completed at least one introductory course in basic chemistry. The survey at the beginning of the chapter suggests that most students have already had considerable contact with nutrition, courtesy of the popular media. This chapter, and all subsequent chapters, begins with a brief quiz to test the students' current knowledge on topics that are about to be covered. Using the definition devised by the American Medical Association, nutrition is described in general terms as “food and what happens to food once it is ingested.” The author introduces the six classes of nutrients and briefly describes their role in the body. General information about the status of nutrition in the United States and Canada is summarized, and the source of this material is identified. The link between chronic diseases (such as heart disease, hypertension, diabetes, obesity, osteoporosis and cancer), diet and genetics is explained in the first of many Nutrition Focus boxes. Food choices are examined in relation to social, educational and economic constraints. The chapter concludes with the Nutrition Perspective: Genetics and Nutrition, which identifies genetic risks for chronic diseases and the interplay of nutrition on these risks. CHAPTER OBJECTIVES By the end of this chapter the student should be able to: 1. Establish a relationship between nutrition and chronic health problems. 2. Identify the 6 major classes of nutrients. 3. Describe foods in terms of their fuel values, including alcohol. 4. Identify food in its simplest chemical structure. 5. Describe the food components that behave as biochemical regulators. 6. Distinguish between organic and inorganic nutrients. 7. Describe Healthy People 2000 Objectives. 8. Explain the ABCD's of nutrition assessment. 9. Explain the various factors that influence our choice of foods. 10. Identify genetic risks for chronic diseases. LECTURE NOTES A. Introduction B. Role of Nutrition Focus on prevention Risk factors Heart disease Stroke Hypertension Diabetes Certain cancers Cirrhosis of liver Osteoporosis Anemia Even death C. Definition of Nutrition as a Science Difference between food and nutrients and nutrition Two criteria for a nutrient to be considered essential D. Six Major Classes of Nutrients (energy nutrients) and Their Main Functions 1. Carbohydrates (glucose) 4 kcal/g Simple carbohydrates - table sugars Complex carbohydrates - starches and dietary fibers 2. Lipids/Fats (fatty acids) 9 kcal/g Triglycerides - major form of fat in food Essential fatty acids (only need 1 T. oil/d) Avg. American’s intake is 3x’s amount needed Saturated vs. Unsaturated Animal fats vs. plant oils 3. Proteins (amino acids) 4 kcal/g American consumption of protein Structural building blocks of body Essential amino acids (9) 4. Vitamins Fat soluble (Vitamins A,D,E, and K) Water soluble (vitamin C and B vitamins) 5. Minerals Major Trace 6. Water Daily requirement E. Organic or Inorganic Compounds F. Major Functions Essential nourishment for life Regulation of key metabolic functions Release of energy G. Energy Sources of nutrient energy Uses of nutrient energy Definition of Calorie, Kilocalorie, Celsius 4 - 9 - 4 rule Calculating Deluxe hamburger sandwich 39g CHO x 4 kcal/g = ______ or ___% total kcal 30g PRO x 4 kcal/g = ______ or ___% total kcal 32g FAT x 9 kcal/g = ______ or ___% total kcal total kcal = Alcohol 7 k cal/g H. Nutritional Status - 3 General Categories Desirable nutrition Undernutrition Example: iron deficiency (red blood cells live for 120 days) Overnutrition Examples: obesity and vitamin and mineral toxicity Definition of malnutrition I. Nutritional Assessment (ABCDs) Family history Medical history and medications Social and economic history Anthropometric (height, weight, body skinfold, and body circumference) Biochemical (serum blood levels i.e., blood sugar and hemoglobin) Clinical (physical symptoms: i.e. eyes, skin, BP, temperature, etc.) Diet history (24-hour food recall) Limitations J. Healthy People 2000 Definition of report, involvement of USDHH and PHS Main objectives Examples of nutrition related challenges K. Adequate Nutrition and Good Health Habits Effects of: Diet Physical Activity Lifestyle L. The American Diet % estimates of protein, CHO and fat intake (average) Main food sources of each nutrient class NHANES Study Results: low in iron, calcium, vitamin A, various B vitamins, vitamin C, zinc, and dietary fiber Individual awareness of nutritional health progress, issues of concern M. Nutrition Focus - Fountain of Youth We all have some control over nutrition-related diseases Ways to promote health and prevent chronic diseases healthful diet - variety, lower fat fluid intake physical activity smoking limit alcohol intake adequate sleep control stress medical check-ups N. What Shapes Our Tastes? Early experiences/food cues Taste and texture Habits Health/nutritional needs Advertisements Eating on the run/Eating out Social status/religion/culture Availability/convenience Economics/budget/comparison to other countries O. Reliable Nutrition Information Sources Accredited university Public, private, school libraries Credible information? World Wide Web AHA, ADA, Tufts; Registered Dietitian P. Diet Improvement Increased intake of complex CHO and vegetables Decreased intake of high fat foods Shopper Surveys Lower death rates from chronic diseases and strokes Total diet balance Q. Genetic Risks Heart disease (CVD) Hypertension (HTN) Obesity Diabetes mellitus (DM) Cancer (CA) Osteoporosis Genetic profile Gene therapy ACTIVITIES, EXERCISES, AND ASSIGNMENTS 1. Students take a pretest on popular nutrition topics and discuss results. Sources of nutrition information are explored and evaluated. 2. Students complete a 3-day dietary recall that includes 2 weekdays and 1 weekend day and discuss the various methods for evaluating this information. Factors that influence food choices are examined. 3. Students identify important nutrition-related problems facing the United States, Canada, and other countries. Methods and techniques used to solve these problems can be discussed and evaluated in class. 4. Students bring in a food label from a favorite food or beverage they consume. Percentages of CHO, protein and fat are then calculated and compared to other students’ food labels. 5. The instructor should provide detailed information about NutriQuest and demonstrate the software. Students would benefit from one, easy, computer-based exercise so they can learn how to use the package before their first assignment. The location of campus computer facilities should be shared with students, and University rules and regulations for the use of hardware and software should be explained. The following computer nutrient analysis can be assigned using NutriQuest software for a semester project to help the student personalize nutrition information. STUDENT ASSIGNMENT Nutrient Analysis 24 Hour Food Diary Record DAY 1 - DAY 2 - DAY 3 ~ (circle) Code Number Food Description Amount