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The Role of Nutrition in Our Health Chapter 1 Test Yourself 1. 2. 3. 4. A calorie is a measure of the amount of fat in a food. T F Proteins are not a primary source of energy for our bodies. T F All vitamins must be consumed daily to support optimal health. T F The Recommended Dietary Allowance is the maximum amount of a nutrient that people should consume to support normal body functions. T F What is Nutrition? Nutrition is a relatively new discipline of science. Nutrition: the study of food, including How food nourishes our bodies How food influences our health Digestion Absorption Utilization Excretion How Does Nutrition Contribute to Health? Nutrition contributes to wellness. Wellness: more than absence of disease Many factors contribute to an individual’s wellness. Primary among these are: Nutrition Physical activity How Does Nutrition Contribute to Health? Healthful diet is part of disease prevention How Does Nutrition Contribute to Health? How Does Nutrition Contribute to Health? Nutrition is so important it has become a national goal to promote optimal health and disease prevention. Goals of Healthy People 2020 – this is a health promotion and disease prevention plan for the United States. Increase quality and years of healthy life 2. Eliminate health disparities 1. How Does Nutrition Contribute to Health? Obesity is a growing problem in the U.S. Note the states in dark “red” which indicates a prevalence of obesity >30% What Are Nutrients? Nutrients: chemicals in foods that our bodies use for energy and to support the growth, maintenance, and repair of our tissues. Six groups of nutrients: 1. 2. 3. 4. 5. 6. Carbohydrates Lipids Proteins Vitamins Minerals Water What Are Nutrients? Essential nutrients: nutrients for which specific biological functions have been identified, and which our bodies cannot make enough of to meet our biological needs ♦ Essential nutrients must be obtained from our diet ♦ Examples: Vitamin C, Calcium, Thiamin What Are Nutrients? Macronutrients: nutrients required in relatively large amounts. Carbohydrates, lipids, proteins Provide energy to our bodies Micronutrients: nutrients required in smaller amounts. Vitamins and minerals What Are Nutrients? Organic nutrients: nutrients contain an element of carbon that is an essential component of all living organisms Carbohydrates, lipids, proteins, vitamins Inorganic nutrients: nutrients that do not contain carbon Minerals and water Energy From Nutrients We measure energy in kilocalories (kcal). Kilocalorie: amount of energy required to raise the temperature of 1 kg of water by 1oC. On food labels, “calorie” actually refers to kilocalories. Carbohydrates •Primary source of fuel for the body, especially for the brain and physical activity. •Provide 4 kcal per gram. Carbohydrates are found in grains (wheat, rice), vegetables, fruits, and legumes (lentils, beans, peas), milk products. Lipids - triglycerides, phospholipids, sterols •Insoluble in water. •Provide 9 kcal per gram. •An important energy source during rest or low intensity exercise. •Stored as adipose tissue (body fat) – major form of stored energy. •Foods containing lipids also provide fatsoluble vitamins and essential fatty acids. Proteins •Proteins are chains of amino acids. •Support tissue growth, repair, and maintenance. •Proteins can supply 4 kcal of energy per gram, but are not a primary energy source. •Proteins are an important source of nitrogen. Vitamins Vitamins are organic molecules that assist in regulating body processes: critical in building and maintaining healthy bones and tissues support immune system ensure healthy vision Many can be destroyed by heat and oxidation Vitamins do not supply energy to our bodies; however, many vitamins act as coenzymes for energy producing reactions Vitamins Type Names Distinguishing Features Fat Soluble A,D,E, and K •Soluble in fat •Stored in the human body •Toxicity can occur from consuming excess amounts, which accumulate in the body Water Soluble C, B-vitamins (thiamin, riboflavin, niacin, vitamin B6, vitamin B12, pantothenic acid, and folate) •Soluble in water •Not stored to any extent in the human body •Excess excreted in urine •Toxicity generally occurs as a result of vitamin supplmentation Minerals Minerals are inorganic substances required for body processes. Minerals have physiological functions, such as fluid regulation, energy production, bone structure, muscle movement, and nerve functioning. Minerals Our bodies require at least 100 mg per day of the major minerals such as: •Calcium •Phosphorus •Magnesium •Sodium •Potassium •Chloride. We require less than 100 mg per day of the trace minerals such as: •Iron •Zinc •Copper •Selenium •Iodine •Fluoride Water Inorganic nutrient, essential for survival Involved in many body processes: fluid balance and nutrient transport nerve impulses body temperature removal of wastes muscle contractions chemical reactions Determining Nutrient Needs Dietary Reference Intakes (DRIs): updated nutritional standards Expand on the traditional RDA values Set standards for nutrients that do not have RDA values Dietary standards for healthy people only For preventing deficiency diseases and reducing chronic diseases Determining Nutrient Needs Determining Nutrient Needs Estimated Average Requirement (EAR) The average daily intake level of a nutrient that will meet the needs of half of the healthy people in a particular category Used to determine the Recommended Dietary Allowance (RDA) of a nutrient Determining Nutrient Needs Recommended Dietary Allowances (RDA) The average daily intake level required to meet the needs of 97 – 98% of healthy people in a particular category Determining Nutrient Needs Adequate Intake (AI) Recommended average daily intake level for a nutrient Based on observations and experimentally determined estimates of nutrient intakes by healthy people Used when the RDA is not yet established: calcium, vitamin D, vitamin K, fluoride Determining Nutrient Needs Tolerable Upper Intake Level (UL) Highest average daily intake level likely to pose no risk of adverse health effects to most people Consumption of a nutrient at levels above the UL, the potential for toxic effects and health risks increases Determining Nutrient Needs Vitamin C (adult age 19-70) Example Nutrient DRI UL = 2,000 mg/d RDA = 75 mg/d (female) 90 mg/d (male) EAR = 60 mg/d (female) 75 mg/d (male) Amount needed to prevent Deficiency = ~10 mg/d Determining Nutrient Needs Estimated Energy Requirement (EER) Average dietary energy intake (kcal) to maintain energy balance in a healthy adult Based on age, gender, weight, height, level of physical activity Determining Nutrient Needs Acceptable Macronutrient Distribution Ranges (AMDR) Describes the portion of the energy intake that should come from each macronutrient Carbohydrates: 45-65% Fats: 20-35% Proteins: 10-35% Potential for increased chronic disease risk if nutrient intake falls above this range AMDR Potential for inadequate nutrient levels if nutrient intake falls below this range Malnutrition Nutritional status is out of balance: Individual is getting too much or too little of a particular nutrient or energy over a significant period of time Undernutrition: too little energy or too few nutrients, causing weight loss or a nutrient deficiency disease Overnutrition: too much energy or too much of a given nutrient over time, causing obesity, heart disease, or nutrient toxicity Assessing Nutritional Status – A,B,C,D’s A – Anthropometric Data ♦ Weight, Height, Muscle Mass, Fat Mass B – Biochemical Data ♦ Cholesterol, Glucose, Albumin, Sodium, Liver Enzymes, Kidney Enzymes C- Clinical Data ♦ Disease history, Socioeconomic Status, Physical Exam D – Dietary Data ♦ Nutrient intake, supplement use Dietary Intake Tools Dietary Intake Tools 24-Hour Recall Diet History Food Frequency Questionnaire Diet Records Twenty-four Hour Recall Recalls all food and beverages consumed in the previous 24-hour period Accurate recall includes serving sizes, food preparation methods, and brand names of convenience foods or fast foods Limitations: may not be typical intake rely on memory ability to estimate portion sizes Diet History Information from interview or questionnaire: Weight (current and usual weight, goals) Factors affecting appetite and food intake Typical eating pattern (time, place, dietary restrictions, frequency of eating out, etc.) Disordered eating behaviors (if any) Education and economic status Living, cooking/food purchasing arrangements Medication and dietary supplements Physical activity Food Frequency Questionnaires Determine typical dietary pattern over a predefined period of time Include lists of foods with the number of times these foods are eaten Some assess only qualitative information (typical foods without amounts) Semiquantitative questionnaires assess specific foods and quantity consumed Diet Records List of all foods and beverages consumed over a specific time period (3-7 days) Kept by person seeking nutritional advice More accurate with: foods are weighted or measured labels of convenience foods and supplements People may change food intake to simplify record keeping Analyses are time consuming and costly Nutrition Deficiencies Primary deficiency occurs when a person does not consume enough of a nutrient, a direct consequence of inadequate intake Secondary deficiency occurs when… a person cannot absorb enough of a nutrient in his or her body too much nutrient is excreted from the body a nutrient is not utilized efficiently by the body Primary or Secondary Deficiency? Jane and John were both told by their primary care physicians that they had a type of anemia called “pernicious anemia” which is caused by a deficiency of vitamin B12 in the body. What type of deficiency do Jane and John have based on the evidence below? Jane is a strict vegetarian and does not consume any animal-based foods and does not consume a vitamin/mineral supplements. John consumes a regular diet consisting of all major food groups but has a condition called “gastritis” preventing his production of intrinsic factor, which is needed to help absorb vitamin B12 Deficiency Symptoms Subclinical deficiency occurs in the early stages, few or no symptoms are observed Covert symptoms are hidden and require laboratory tests or other invasive procedures to detect Symptoms of nutrition deficiency that become obvious are referred to as overt Nutrition Deficiencies What happens in the body: Which assessment method reveals changes: Physical deficiency caused by inadequate diet OR secondary deficiency caused by problem inside the body Diet history Health history Declining nutrient stores Laboratory tests Abnormal functions inside the body Laboratory test Physical (outward) signs and symptoms Physical examination and anthropometric measures Registered Dietitians (RD) Requirements: Bachelor’s degree in nutrition Completion of supervised clinical experience Passing a national registration examination Work in a variety of settings: Hospitals, clinics, nursing homes Sports nutrition Food-service management Community and public health nutrition Nutrition research Nutrition Advice: Who Can You Trust? Nutrition is a new science Increased interest in nutrition Overwhelming amount of health claims Reliability of nutrition information Misinformation Potential harmful quackery Trustworthy Nutrition Experts Registered Dietitian (RD) Licensed Dietitian meets the credentialing requirements of a given state Nutritionist has no legal definition Professional with advanced nutrition degree (masters-MS, MA; doctoral-PhD) Physician Government Information Sources Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey (NHANES) Behavioral Risk Factor-Surveillance System (BRFSS) National Institutes of Health (NIH) Reliable Nutrition Information American Dietetic Association American Society for Nutrition Sciences American Society for Clinical Nutrition Society for Nutrition Education American College of Sports Medicine North American Association for the Study of Obesity Evaluating Research • Case Control Studies • Clinical Trials • Randomized • Single Blind • Double Blind • Placebo Evaluating Media Reports • Questions to ask? • • • • • • Who conducted/paid for the research? Who is reporting the information? Is it based on reputable research studies? Is the report based on testimonials? Are the claims too good to be true? Is someone profiting? Activity Calculate the Nutrition Fat = 18 grams Carbs = 6 grams Protein = 7 grams Total Calories: _________ ____% Fat _____ % Carbs ______% Protein Calculate the Nutrition Fat = 18 grams Carbs = 6 grams Protein = 7 grams Total Calories: 214 76% Fat 11% Carbs 13% Protein Calculate the Nutrition Fat = 8.4 grams Carbs = 23.4 grams Protein = 4.2 grams Fat = 2 grams Carbs = 0 grams Protein = 28 grams Calculate the combined calories, protein, fat, carbs and the percentage. Calculate the Nutrition Fat = 10.4 grams (93.6 calories) Carbs = 23.4 grams (93.6 calories) Protein = 32.2 grams (128.8 calories) Total Calories: 316 ~30% Fat ~30% Carbs ~40% Protein Calculate the Nutrition Total Calories: 680 Fat: ______ Carbs: 71 grams Protein: 44 grams Calculate the Nutrition Total Calories: 680 Fat: 24 grams Carbs: 71 grams Protein: 44 grams Calculate the Nutrition The doctor has recommended his patient eat a 1600 calorie diet that is 50% carbs, 25% protein and 25% fat. How many grams and calories will the patient be eating from each of the three macronutrients? Calculate the Nutrition Answer: Calories: 1600 Carbs: 200 grams (800 calories) Protein: 100 grams (400 calories) Fat: 44 grams (400 calories) Evaluating Research Health Benefits of Chocolate A Look at Goji Juice – Scam or Super Fruit High Fructose Corn Syrup