1 kcal is?
Amount of energy it takes to
RAISE 1g of water 1 degree celcius
1g Carbohydrate
in kcal
4 kcal
1g Fat
kcal
9kcal
1g Protein
kcal
4 kcal
1g Alcohol
kcal
7 kcal
Metabolic Rate
Sum Total of ALL ENGERGY EXPENDED each day
- Dependent on:
- Basal Metabolic rate
- Thermic effect of food
- Physical Activity
6 Classes of Nutrients
for overall good health
-
Carbs -
- 45-65%
-
Fats -
- 20-35%
-
Proteins -
- 35%
- Vitamins
- Minerals
- Water
MACROnutrients
Carbs
Fats
Proteins
Micronutrients
Vitamins
Minerals
Water
Fiber
If fiber is >5grams
You can SUBTRACT IT from the total carbs
decreases risk of CHD & diabetes
Recommended 14g / 1k calories
Non-starch carbs from plant foods
Beans / Oats / Lentils / Citrus / Wheat / Barley
Carbohydrates
MACROnutrient
45-65% of daily calories
-
Simple
- __calories with little to no nutrients to our diet
- Complex
- storage form of carbs, energy in form of GLUCOSE
- Dietary Fiber
- 14g / 1k calories
Lipids / Fats
MACROnutrient
20-35% of daily calories
- Carrier for absorption of FAT SOLUBLE VITAMINS__
- Fatty Acids:
-
Unsaturated - Mono/poly unsaturated
- 10-20% of calories
- liquid at room temperature
-
Saturated
- <10% of calories, solid
- Cis/TransFats
-
Unsaturated - Mono/poly unsaturated
Cholesterol
NOT AN ESSENTIAL NUTRIENT
<300mg/day
- __Fat-like substance
- Leads to Increased LDL / Cholesterol
- -> CHD risk
- From:
- Meat / poultry / seafood / dairy / EGG YOLKS
Protein
MACROnutrient
35% of daily calories
- __Converted into carbs in starvation/semistarvation
- Essential AA’s
- Regulates metabolism
- Structural basis for tissues
Vitamins
Micronutrient
Not a source of energy = No caloric Value
-
Antioxidents - BEC
- 3 types, fight free radicles
-
Fat Soluble Vitamins
- ADEK
-
Water Soluble
- 8 B-complex vitamins + VIT C
Antioxidants
Type of Vitamins - BEC
Beta Carotine
Vit E
Vit C
Fat Soluble Vitamins
A
D
E
K
Water Soluble Vitamins
EIGHT B - Complex vitamins
Vitamin C
Minerals
Micronutrients
Not a source of energy/calories
Component for building tissues
Regulation of metabolism
C**h**IMPS
Calcium / Iron / Magnesium / Potassium / Sodium
Water & Recommended Intake
Most Essential Nutrient
- Males:
- 3.7 L/day = 16 cups
- Women:
- 2.7L/day
- 2 hours Prior to exercise:
- 17 oz
Principles of
Dietary Guidelines for America
2015-2020
- Follow a healthy eating pattern across the lifespan
- Focus on variety, nutrient densisty** and **amount.
- Shift to healthier food / beverage choices
- consider cultural/personal preferences
- Support healthy eating patterns for ALL
-
Limit calories from added _sugars_ and _saturated fats_
- and reduce _sodium_ intake
Limit Calories from added what?
Dietary Guidelines for America
2015-2020
Sugars
Saturated Fats
Sodium intake
Serving Sizes Based
on your HAND
Fist = 1 cup
Palm = 3oz of meat/fish/poultry
Handful = 1-2oz of snack food
Thumb = 1oz of cheese
Thumb TIP = 1ts
Nutrition Fact Label
Alli
Dose / Indication / MoA
Orlistat OTC - Xenical(RX) is 120mg tid
60mg TID
during/within 1hr of fat-containing meal
I: Weight loss in overweight adults when used along with:
Reduced calorie + Low-fat diet
MOA = Reversible inhibitor of intestinal lipases
-> inhibits dietary fat absorption by approx 30%
Alli
CI-P
Orlistat
DNU - Pregnancy / Nursing Mothers / Pediatric patients
Misuse in anorexia/bulimia patients
Reduced absorption of:
Fat Solubule Vitamins (ADEK) + Beta Carotene absorption
Cyclosporin
Alli
Side Effects / Counsel
Orlistat
Ab Discomfort+Pain / DEFACATION URGENCY
anal discharge+leakage / flatulence / oily-loose stools
GI adverse effects decrease after FIRST MONTH of therapy
Take During or 1 hour after meals w/ fat
May SKIP if meal is missed or no fat
<3 doses a day
Seperate dose by >2 hours from fat soluble vitamins ADEK
Benefits of Physical Activity
insufficient phys activity is:
1 of the 10 leading risk factors for death
-
Reduces Risk of:
- CHD / Stroke / HTN
- T2DM
- Breast-Colon Cancer
- Metabolic Syndrome
- Depression
- falls / high cholesterol
Physical Activity Guidelines (PAG) For Americans
Key Recommendations
AVOID INACTIVITY
- AERIOBIC ACTIVITY:
-
Moderate-intensity - brisk walk
- 150 minutes each week
-
Vigorous Intensity physical activity = Jog/Run
- 75min each week
- Mix of both
-
Moderate-intensity - brisk walk
- Perform in episodes of >10 minutes
-
6-17yo children should perform
- < 60 minutes of moderate aerobic phys activity
Moderate Intensity Aerobic Physical Activity
Recommendations
Physical Activity Guidelines (PAG) For Americans
Brisk Walking / Tennis
150 minutes Each week
episodes of > 10 minutes
increase to up to 300 minutes / week
_VIGOROUS-_Intensity Aerobic Physical Activity
Recommendations
Physical Activity Guidelines (PAG) For Americans
Jogging / RUNNING / Sport
75 minutes each week
perform in episodes of > 10 minutes
Increase to 150minutes/week
Components of Physical Activity
Physical Activity Guidelines (PAG) For Americans
-
Warm-Up
- 5-10 min of low intensity stretch
- transition from rest to exercise
- Aerobic Conditioning - 3 stages
- Resistance Training
-
Cool-Down
- 5-10 min of low aerobic activity
- return to heart rate / circulation down to resting
-
Stretching
- 5-10 min of stretch after cool down
Aerobic Conditioning
3 stages
-
If not currently doing physical activity:
- Per CDC / ACSM
- start with a few minutes of phys-activity each day
- build up to > 30 minutes
- of moderate intensity activity on MOST days of week
- Per CDC / ACSM
- If Active, but building up to rec. levels:
- PAG 2008
- be consistent and develop routine
-
Active & at goal:
- Maintain routine, continue to push yourself daily
Resistance Training
- Allows the body to improve muscular strength & endurance
- esp in the UPPER body
- Increases / Improves:
- Bone Mass
- Balance / Coordination
- Mobility
-
Decreases:
- Fall Risk, esp for the elderly
Physical Activity Guidelines (PAG) For Americans
for Resistance Training
Perform muscle-strengthening activites that are
moderate or high intensity
target ALL major muscle groups
2-3 days/week
Other lifestyle Modifications:
Smoking Cessation
- Most Common preventable cause of death
- Very important to counsel ALL patients to abstain from smoking and to consider smoking cessation if currently smoking
- Benefits:
- ◦Circulation improves
◦Blood pressure starts to return to normal
◦Sense of smell and taste return
◦In the long term, giving up tobacco can help you live longer
Other Lifestyle Modifications:
Alcohol Consumption
Recommendation: MODERATION
Men = up to 2 drinks/day
Women = up to 1 drink a day
Drink =
12 oz beer
5 oz wine
1.5 oz hard liquor