8 - Diet, Nutrition, Energy Balance Flashcards
(49 cards)
1
Q
2015 Dietary guidelines from HHS & FDA
A
- Eating pattern w/ Appropriate Calorie Level
- –> reduce risk of chronic disease
- Variety / Nutrient Density / Amount
- within all food groups in recommended amounts
- Diatary guidelines are Always Changing:
- British study that says fats/saturated fats REDUCE CHANCE OF STROKE??
2
Q
What food groups should you limit calories from?
A
Added Sugars
Saturated Fats
Sodium
3
Q
Ways that WATER is LOST
A
- Regularly:
- Respiration / Sweating / Excretion
-
EXTRA LOSS FROM:
- Prolonged Sweating
- Vomiting
- Diarrhea
- EXTENSIVE BURN INJURIES
-
Certain Diseases
- __that affect water / Na excretion
4
Q
Daily Recommended Water Intake
A
3.7 L / day for Adult Males
BEWARE: HYPONATREMIA
Drinking TOO MUCH water -> Diluted Sodium levels in body
CELLS CAN SWELL
5
Q
Lipids (TG’s)
Macronutrient Energy Production
A
-
Beta Oxidation (in MITO)
-
FA’s -> Acetyl-CoA
- -> TCA CYCLE
-
FA’s -> Acetyl-CoA
6
Q
Carbs
Macronutrient Energy Production
A
- Polysaccharides -> Monosaccharides
- -> Glycolysis
- -> TCA Cycle
- -> Glycolysis
7
Q
Proteins
Macronutrient Energy Production
A
- Proteins -> Amino Acids + NH2
- NH2 -> Ammonia / Urea cycle
- Carbons -> TCA cycle
8
Q
Basal Metabolic Rate Formula
BMR =
A
( weight in kg ) x 24 Cal/kg
or 100 kj/kg
- Energy needed by awake person at REST
- Only accounts for 60-70% of total energy expenditure for sedentary individuals
- Exercise / Cold / Fever -> INCREASE BMR
- Hormones can also affect BMR
- Hyperactive Thyroid -> RAISE BMR
9
Q
% of BMR Factor for Active Adults
A
Sedentary = x30%
Moderately Active = x40%
Active = x50%
10
Q
Protein / AA’s
FOOD SOURCES
A
Meat / Fish / Legumes (tofu)
Dairy / Cereal
11
Q
Lipids (TG’s)
FOOD SOURCES
A
Meat / Fish
Oily seeds
Nuts
Vegetable Oils
12
Q
Carbs
FOOD SOURCES
A
Veggies
Fruits
Cereals
13
Q
Daily Value (DV) levels are high / low when?
A
HIGH > 20%
LOW <5%
- Based on 2000 Cal/day
- SERVING SIZE MUST BE SPECIFIED
14
Q
Reading a Nutritional Food Label
A
-
Serving Size
- needs to be specified
- Check Calories
-
LIMIT THESE NUTRIENTS:
- Fat / Cholesterol / Sodium
-
Get enough of these nutrients:
- Vitamins / Iron / Fiber
- Footnotes
15
Q
Glycemic Index
GI
A
-
GI of 100:
-
AUC under 2 hour curve of measured blood glucose
- after ingestion of 50g of glucose
-
AUC under 2 hour curve of measured blood glucose
- Higher GI = Worse for you
- Used to help DIABETIC patients to avoid foods that would greatly raise BG levels
16
Q
Factors that affect Glycemic Index
A
- Complex, many factors involved:
- Portion size
- Fiber content
- processing
- Physiological state of subject
17
Q
Foods with HIGH GI >70
A
Candy
Bread
Rice
Potatoes
18
Q
Food w/ Low GI <55
A
Fruits
Unsweetened dairy products
Nuts
19
Q
Glycemic Load
GL
A
GL = GI x Amount of Carbs (grams)
- Factors in PORTION SIZE
- more useful than GI, in limiting postprandial hyperglycemia
20
Q
Carbohydrate Intolerance
A
- Typically caused by:
-
defect in digestive enzyme
- sucrase or lactase
- Impaired Sugar Transporter
-
defect in digestive enzyme
- RBS - Symptoms
- reducing sugars in stool
- fermentation of sugars by bacteria in colon
- Acetate / propionate / gasses
- Diarrhea
21
Q
Lactose Intolerance
Type of Carbohydrate intolerance
A
Defect or Lack of LACTASE
GENETIC COMPONENT
- Avoid dairy products
- But, monitor levels of:
-
Calcium
- can get from dried beans / leafy veggies
- Vitamin (d)
- Phosphorous
-
Calcium
22
Q
What are the ESSENTIAL CARBS?
A
-
Technically there are NO ESSENTIAL SUGARS
- as long as you have sufficient protein
- Protein -> AA’s -> carbs
- as long as you have sufficient protein
-
VITAMIN C might be an exception
- needed as a COFACTOR
- for hydroxylations
- scurvy / hemorrhage / loose teath / wound healing
- needed as a COFACTOR
23
Q
What are the 9 Essential Amino Acids?
A
H I L L T T MPV
His / Ile / Leu / Lys
Thr / Trp
Met / Phe / Val
24
Q
What Extra AA’s are needed for children ?
A
Growing Children need extra
Arg
25
**What extra AA's are needed for premature infants?**
Premature infants may need extra:
## Footnote
**Cys**
**Tyr**
26
**Celiac Disease**
"Toxic Protein"
* **Immune sensitivity to GLUTEN**
* -\> inflammation
* Damages *small intestine fxn &*
* ***small-scale structure***
* ********diarrhea / malnutrution**
* ****Gluten is found in:
* **Wheat / Barley / Rye**
* gliadin / glutenin
27
**Can you have TOO MUCH Protein in diet?**
* No tolerable upper limit yet:
* Normal = ~**15%** of daily caloric intake
* Possible to survive with a diet:
* ***free of carbohydrates***
* **Large amounts of meat / fat**
* ***Can result in some side effects if \>45% of calories***
28
**Effects of high-protein diet?**
**\>45 %** of total calories
**Ketoaciduria**
***Calcium*** loss in urine
**Renal HYPERtrophy + Damage**
29
**Two Essential Fatty Acids**
**PUFA** (polyunsaturated FA's)
* **Linoleic Acid******
* ****w-6 or n-6 FA
* **Alpha-LinoleNIC Acid**
* ****w-3 or n-3 FA
30
**Linoleic Acid**
**n-6 PUFA**
* Essential Fatty Acid, **most abundent PUFA** in US Diet
* Provides **eicosanoids (arachidonic acid)**
* ****-\> **Prostaglandins + Leukotriens**
* **Shingolipids**
* **Gene regulatory Proteins**
* ******PPARs**
* **Signal Transduction pathways**
* form phosphoinositol-containing lipids
31
**Deficiency in n-6 PUFA ( Lineleic Acid)**
*Symptom takes MONTHS to appear*
* Compromise the **Skin-Water Barrier**
* major role for sphingolipids
* **Blood Clotting / BP / Immune Fxn**
* ****n-6 -\> Arachidonic acid
* -\> prostaglandins / leukotrienes
* **Signal Transduction Pathways**
* that use inositol as phospholipids
* PPAR
32
**Alpha - linoleNIC acid**
n-3 PUFA
* Essential FA, present in:
* **Soybeans**
* **Canola Oil**
* **Flax Seeds**
* **Oily Fish** (salmon)
* *deficiency -\> visual acuity loss & peripheral neuropathy*
33
**Deficiency in** **n-3 alpha linoleNIC acid**
* ***LOSS OF VISUAL ACUITY***
* ***PERIPHERAL NEUROPATHY***
* Can be compensated possibly by n-6 PUFA (linoleic acid)
34
**LCFA Bad Effects**
* LCFA -\> **Lumen of Small Intestine** can be harmful
* esp in _INFANTS & Small CHILDREN_
* __Mucosa becomes more resistant as you AGE.
* *typically not a problem w/ adults*
* **Disrupt Mucosal Barrier**
* ******Inflammation / Infection**
* -\> **Enterocolitis / Diarrhea**
35
**LCFA GOOD effects**
* **Induce SATIETY**
* *inhibition of **FOOD INTAKE***
* Possibly involves peptide hormone signals such as:
* **Ghrelin**
* **Apolipoprotein A-4**
* **Choleecystokinin**
36
**Marasmus**
Protein-Energy MALnutrition
**Super Skinny**
**Lethargy / Impaired Immunity / Anemia**
* *Insufficient **Energy Intake***
* *lacking **Fuel** for the body in general*
* **Loss of **SC Fat & Skeletal muscle**
37
**Kwashiorkor**
Protein-Energy MALnutrition
**Swollen Abdomen**
**Edema / Fatty Liver**
+ Lethargy / Impaired immunity / anemia
* "**First - Second Child"**
* sickness in children who were **weaned** when a second child was born
* *no more milk / **protein***
* ****High starch diet (**yams / cassava / bananas)
38
**How does the body metabolically adapt to Starvation?**
1. **Carbs** (glycogen) are extensively ***DEPLETED*** in just a few days
2. **Lipolysis -\> FA's**
1. FA's to liver -\> **Gluconeogenesis**
1. ****Glucose for the brain
3. **Brain starts to use KETONE BODIES**
1. ketone bodies increase due to lack of glucose
1. from FATS
39
**Ketosis**
* Unusually HIGH concentration of **Ketone bodies in the BLOODSTREAM**
* ******0.3 - 7.0** mmol/L
* Excess ketone bodies are filtere out by KIDNEYS -\> Urine
* -\> results in **Ketonuria**
* *Deplete stores of ions such as:*
* ***Na / K / Phosphate***
* ***-\> Dehydration***
40
**Ketonuria**
* Result of Ketosis
* **Ketone Bodies** being filtered out by the kidneys and **_excreted in the urine_**
* exert **osmotic effect** on kidneys
* resulting in **MORE URINE** than usual
* depleted body stores of IONS:
* ***NA / K / P***
* ***-\> Dehydration***
41
**Types of Ketone Bodies**
**Acetoacetate**
**B-Hydroxybutyrate**
**Acetone**
42
**Where and Why are Ketone Bodies created?**
* When there is *not enough **OXALOACETATE** for the TCA CYCLE*
* ********Acetyl-CoA -\> Ketone Bodies******
* ****Oxaloacetate is used in both GLUCONEOGENESIS and the TCA cycle
* during starvation, there is not enough of it
* Fatty Acids and Amino acids still supplement Acetyl-CoA
* which is converted into Ketone bodies when TCA can't occur
43
**How do organs use KETONE BODIES?**
* Direct use of Ketone Bodies:
* **Cardiac / Skeletal Muscle**
* **Renal Cortex (Kidney)**
* ******Brain adapts to use them as fuel**
* *LIVER*
* ***liver lacks the key enzyme to breakdown ketone bodies***
44
**What causes Ketosis?**
* ***low CARB intake** (*high protein diet, or lipids only, or starvation)
* Body uses **FA's & AA's** instead of carbs
* Glycerol + AA's are used for gluconeogenesis
* **Diabetes**
* Glucose not being taken up by tissues
* = acts as if **Starved for energy**
* Metabolism shifts to fasting/starvation
* -\> Ketosis
* **DEHYDRATION**
45
**Oxaloacetate**
* Used in both the **TCA Cycle & Gluconeogenesis**
* In starvation / low or no Carb diet:
* Body is excessively going through **Gluconeogenesis**
* which uses up ***Oxalacetate*** to produce **glucose**
* ***TCA Cycle*** *can not occur w/o oxalacetate*
* -\> so **Acetyl-CoA** builds up from AA's/FA's
* Acetyl-CoA is then over converted into **Ketone Bodies**
* ****-\> **_KETOSIS_**
46
**How are Ketone bodies catabolised?**
* **@_Non-Helpatic Tissues:_**
* Ketone Bodies -\> **Acetyl-CoA**
* to produce energy for cell
* Rate limiting step = **Second Step**
* ***Enzyme that catalyzes this step is not expressed in the _LIVER_***
* -\> liver itself can not consume ketone bodies
47
**Ketoacidosis**
******Acidosis + Ketosis**
* Most common with **Diabetes** patients paired with:
* **Extreme / Uncontrolled _Ketosis_**
* more common with **Type 1**
48
**Symptoms of Ketosis**
* High levels of ketone bodies (**acetone / hydroxybutyrate)**
* -\> **BAD BREATH**
* *acetone might smell like ethanol*
* **Can result in **Acidosis**
* pH of blood drops below **\<7.3** **pH**
* Together Acidosis + Ketosis = Ketoacidosis
49
**Acidosis**
* Can be caused by **Ketosis**
* Ketone bodies **acidify environment**
* Acidosis is defined by **\<7.3 blood pH**
* ***reduce the oxygen carrying capacity of erythrocytes***
* **very serious condition
* Can develop to Ketoacidosis
