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Flashcards in Class Notes Midterm #1 Deck (145):

How do we describe our diet? (2)

1. In terms of food
2. In terms of nutrients


The food guide from 1977

Made all groups appear to be equally important


The food guide from 1992

Created for a grade 7 level, english speaking student


Why is the rainbow significant?

Because it is proportional to the intake


EWCFG (2007)

The first food guide with recommendations for children.


Facts About Mediterranean Food Guide (5)

1. Has a 3D base
2. Largest category consists of things made from plants (nutritious and deeply coloured veggies)
3. Fish are highly emphasized
4. Wine is on their food guide (<2 for men)
5. Emphasizing eating food with others (eating slower for pleasure and to relax)


Asian Diet Pyramid and Vegetarian Pyramid Facts (3)

1. Exercise is emphasized first
2. Plants and healthy fats
3. Sweets are higher then sweets on the asian pyramid..


What do all food guides have in common?

They emphasize plant and grain products.


The Nutrients (6)

1. Carbohydrates
2. Proteins
3. Fats
4. Vitamins
5. Minerals
6. Dietary Fibre


Essential Nutrients

Things that the body cannot make itself.


Essential Carbs, proteins, fats, vitamins, minerals, and fibre

1. Glucose
2. 9 are essential and 11 can only be made if the body gets enough of the other 9
3. Linoleic acid and alpha-linolenic acid
4. All 13 are essential except Vit D if someone is near the sun enough
5. All are essential (this course focuses on iron, calcium, and sodium)
6. Fibre is essential


How do we describe our nutrient intake? (2)

1. Absolute amount eaten/day (Mg, mg, g, niacin equivalent)
2. As a percentage of our total energy (kcal) eaten in a day (macronutrients)


What is the equivalent of 1 Cal?

1000 calories= 1 Kcal= 1Cal


Atwater Factors for Macronutrients

1g Carb= 4Kcal (17KJ)
1g Protein= 4Kcal (17KJ)
1g Fat= 9Kcal (38KJ)
1g Alcohol= 7Kcal (??)


DRI Values for % Energy Intake

Protein: 10-35%
Fat: 20-35%
CHO: 45-65%


Average Kcal intake in a day



What happened when the media told people fat was bad?

-People cut fat and ate more carbs
-People ate lower quality foods because they were 'low in fat'


What are the 3 trends that appear in Canadian diets?

1. Canadians have a lower % of fat intake, and have approximately 30% fat from their diets, however 'Other' foods account for a total of 25% of total energy and 30% of total fat
2. Obesity has become an epidemic
3. A large % of the population isn't eating even the minimum of their recommended portions from any of the 4 food groups


Why has overweight/obesity become an epidemic? (2)

1. Lowered levels of physical activity
2. "Toxic Food Environment" or obesegenic (constant exposure to high fat and Kcal intake)


Portion Distortion

The largely increased intake of fast foods compared to 40 years ago.
e.g. soft drinks increased 62%, french fries increased 57%, and cheeseburgers increased 24%


What are the mains nutrients that are not being received enough in the diet and are leading to many chronic diseases?

Ca (milk and alt.), Fe and Zn (meat and alt. & whole grains), Folate (green leafies & orange juice), and fibre (plant origin)


3 Main Nutrition Recommendations for Canadians

1. Balance: Proportion
2. Variety: Dilute anything bad
3. Moderation: Don't eat too much (portion distortion)


Nutrient-based DRIs Background and Purpose

The recommendations used to be to prevent nutrient deficiencies, now its is to do that and to optimize health and prevent chronic diseases


Estimated Average Requirement (EAR)

The amount of nutrients which meet the needs of half the populations


Recommended Dietary Allowance (RDA)

The average daily nutrient amount that covers almost all healthy people in the population (98%). Can be calculated from the EAR but the EAR cannot be calculated from the RDA.


Adequate Intake (IA)

When EAR is unknown and therefore RDA cannot be set AI is used. It is the average daily nutrient level which appears to cover the needs of the population.


Tolerable Upper Intake Level (UL)

Maximum amount of a nutrient that appears safe for most of the healthy people in the population. If one were to go above the UL they may experience adverse health effects.


Findings of the 'Health Survey' (CCHS)

Found that many Canadians are not consuming as many nutritious foods as they are foods from the 'other' category. 17-28% of adults consume more than the recommended level of fat.


What does and unhealthy diet and a lack of physical activity result in? (2)

1. Higher levels of obesity
2. Chronic Disease (heart disease, diabetes, and some cancers)


How many essential nutrients are there?

45 nutrients are essential for human life (anything our body cannot synthesize).


Where are fats found in vegetables and fruits?

avocado and coconut (technically french fries and onion rings..)


Where are fats found in grain products?

croissants, muffins, and doughnuts


Where are fats found in milk and alternatives?

cheese, milk (3.25%), and ice cream


Where are fats found in meats and alternatives?

nuts, seeds, bacon, and salmon


Are potatoes a high fat food?

Baked potatoes-plain is fine but with butter and sour cream the fat content increases drastically (1 Tbsp butter= 11g and sour cream as well= 13g). French fries= 8-11g of fat. Hash browns approx. 23g. Mashed potatoes with milk and butter= 9g of fat.


Triglyceride (TG)

glycerol backbone + 3 fatty acid tails (98% of fat consumed)


Important aspects of fatty acids (2)

1. Chain Length: a) 2-3 carbons- short chair f.a. b) 6-12 carbons- medium chain f.a. c) 14-22+ carbons- long chain f.a. (most prevalent in the diet)
2. Degree of saturation (full of hydrogens= saturated)


Formation of a Trigylceride

condensation reaction: water comes out of reaction to attach fatty acid tails


Linoleic Acid (Omega 6)

Polyunsaturated fat, 18:2n-6, essential recommended fat


Alpha-linolenic Acid (Omega 3)

Polyunsaturated fat, 18:3n-3, essential recommended fat


Naming Fatty Acids

1. Count Carbons
2. Count where the 1st double bond is from the methyl end
3. Bond will always present as follows: double, single, single, double


Eicosapentaeroic Acid (EPA)



Docoahexaenoic Acid (DHA)



Symptoms of Essential Fatty Acid Deficiency (3)

1. Scaly dermatitis- inflammation of the skin
2. Impaired growth in children, infants, or teens
3. Excess loss of water through the skin


Roles of fat in the body (4)

1. insulator (keeps the body warm)
2. protection (protects skeleton and vital organs)
3. energy reserve (for times of dearth- energy is stored in adipose cells, reduce levels only by oxidizing/ burning fat, used as an energy reserve only if ones energy intake is less than their energy expenditure)
4. precursor for other biomolecules


Made from fatty acids (2)

1. eicoanoids: biological messengers
2. phospholipids


Made from cholesterol (2)

1. bile acid
2. steroid hormones (this word may be different, writing was v. messy)



A manufacturing process in which trans fats are made


Purposes of hydrogenation (2)

1. To transform liquid (oil) into a harder fat. This can be for spreadability and used in baking (vegetable shortening).
2. To enhance the shelf-life of processed foods. Hard fat doesn't go rancid as fast as oil does.



When fatty acid cells are oxidized. It will smell and taste gross.


The process of fat hydrogenation (2)

1. Start with oil (e.g veg oil)
2. Add lots of heat and pressure:
a) fully hydrogenated: ...-C-C-C-C-C-C-... (hard like butter)
b) partially hydrogenated: ...-C-C-C-C-C=C-...(spreadable like margarine.)


Tans Fatty Acids (TFAs)

A category of fatty acids formed during hydrogenation


Where 'Cis' and 'Trans' Bonds come from

1. most naturally occurring f.a. have 'cis' double bonds
2. hydrogenation produces 'trans' double bonds.
***these are similar to saturated fats


Food Sources of Trans Fat

. c) Vegetable oil shortening
e.g. peanut butter, most process grain products, pastry, batters, and anything deep-fried


Where are most TFAs coming from?

Baked foods: 32%, fast foods: 13%, snack foods: 9%, margarine and shortening 9% etc.


Concerns with TFAs (2)

1. Significant contributor to coronary heart disease because TFAs raise LDL (bad) and lower HDL (good)
2. Canadians have the highest intake in the world


Canadian Trans Fat Task Force (2006-2009)

Limited TFA to ,2% of total fat in margarine and ,5% of fat in all other foods. However, eliminating TFAs is expensive.



Enzymatic process of food breakdown to their smallest absorbable units (e.g fatty acids, amino acids, and glucose)



Transfer of digested food components across the absorptive surface of GI Tract into vascular (blood) and lymphatic systems.



Various pathways that nutrients take following the previous 2 steps, either to be stored or to be used to make other molecules in the body.


How is fat Digested and Absorbed (7)

1. Trigylcerides from food enter the small intestine
2. Bile acids enter the small intestines and disperse fat into smaller droplets (emulsification)
3. Lipases break down fat (sometimes some are missed)
4. Formation of micelles
5. F.a.'s and monoglycerides will be absorbed into intestinal wall (mucosa)
a) If f.a. < 12C then absorbed into portal vein
b) If f.a. > 14C then reformation of triglyceride will be packaged into chylomicron and enters the lymph system which eventually enters the vascular system at the thoracic duct
6. Bile acids will be reabsorbed/ recycled


Bile Acids (3)

1. Made from cholesterol in the liver (non-essential)
2. Required for... a) fat emulsification b)formation of micelles
3. Amounts of bile acids required each day are much larger than the amount our liver must synthesize. Therefore reabsorption is very efficient (may cycle 3-5x per meal and that would is not recycled is lost in feces)


Summary: with more soluble fibre.. (3)

1. Less cholesterol absorption
2. Less bile acid reabsorption: forces liver to make more bile acids from cholesterol ('denovo' cholesterol synthesis) or easier to take up ready source of cholesterol from blood in order to make more bile acids for digestion)
3. Result: decrease in total blood cholesterol levels


Lipoproteins Function

Transport fat molecules around body via the vascular and lymph systems (blood or lymph). Only in the body, NOT made from food.
-Every lipoprotein is comprise of some of these elements
a) triglyceride
b) cholesterol
c) phospholipids
d) protein
-These serve as identification cards to help attach a lipoprotein to its target tissue


Risk of Coronary heart Disease (CHD) if..

< 1.03mmol/L of HDL or >3.36mmol/L of LDL


Chylomicrons (3)

-carry fat from the intestine to the lymph then to the blood to drop off the fatty acids at the adipose/ muscle
-present in the blood only after meals (2-10hrs to clear out)
- blood taken for cholesterol must be down when fasting



made in the liver to carry fats (TG) that were formed from excess dietary carbs and proteins in the liver to take out to fat stores, it becomes LDL


LDL ('bad' cholesterol- only if blood levels are high)

Circulates blood and delivers cholesterol to all body tissues. Should return to liver for disposal when it is done. However, not taken up by liver if the liver already is well-supplied with cholesterol. Therefore LDL levels will be high.


HDL ('good' cholesterol- reverse of cholesterol transport0

Is make in the liver to pick up unneeded cholesterol from tissues and turn it for disposal in the liver.


What is the 'total' blood (or serum) cholesterol?

TC-LDL+HDL+VLDL (mmol/L everywhere, mg/dL in the US)
Conversion: mg/dL= 38.67=mmol/L


Lipoproteins: Link to CHD (3)

-There is a correlation between the number of CHD deaths and the serum cholesterol that a person has
-200mg/dL or 5.2 mmol/L is the cut off point
- A 1% mg/dL drop in TC means a 2% lower risk of CHD **she stressed this a lot



It is a slow gradual accumulation of cholesterol-rich plaque found in the arteries. It lower flood flow (occlusion) "hardening of the arteries." Usually takes decades, no symptoms or obvious ways to measure it.



When damage to advanced arterial plaque causes a platelet-rich blood clot formation. This is called a Myocardial Infraction (MI) or a heart attack.


Atherosclerosis: Early Stages

Patients will present with high amounts of LDL from diets which are high in saturated and trans fat. From ages 8-12+ LDL becomes oxidized and will look foreign to the immune system.


How LDL becomes oxLDL

-high in saturated and trans fat
-high in dietary cholesterol


Stages before a heart attack

Atherosclerosis > 'injury' > Thrombosis


Steps in reducing/ eliminating CHD (4)

1. Soluble Fibre (to keep LDL low)
2. Antioxidants (to keep LDL from being oxidized)
-get these from the diet and NOT from tablets
3. Injury Prevention (avoid toxins, stay physically active)
4. Fish Oils (EPA) (shown to lower platelet aggregation)


Role LDL in CHD

If not taken up by the liver, LDL will accumulate in artery. LDL > oxLDL which attracts macrophages (immune cells)
The oxLDL being taken up by immune cells into the arterial wall ultimately leads to Atherosclerosis.


Level of HDL in CHD

Raises blood levels which means that high amounts cholesterol can be removed from tissues for disposal in the liver. This is considered to be 'reverse' cholesterol transport which = less plaque buildup


How to increase HDL levels? (6)

1. Exercise (aerobic)
2. Avoid dietary supplements promising to rais HDL
3. Lose eight (only if truly overweight)
-10 pounds lost = HDL increase by 2mg/dL
4. Limit refined carbs and sugars (they lead to metabolic syndrome which lowers HDL an raises TG)
5. Don't smoke (it lowers LDL)
6. Moderate alcohol intake


How saturated fats influence blood lipoprotein levels (TC, Blood LDL, Blood HDL, and examples)

-Raises TC
-Raises LDL
-Does nothing to HDL
-Can be found in fatty meats, full fat dairy, coconut oils, and palm oils


How polyunsaturated fatty acids (linoleum and alpha-linolenic acid) influence blood lipoprotein levels (TC, Blood LDL, and Blood HDL)

-Lowers TC
-Lowers LDL
-Lowers HDL


How monounsaturated fatty acids (oleic acid) influence blood lipoprotein levels (TC, Blood LDL, and Blood HDL)

-Lowers TC
-Lowers LDL
-Does nothing to HDL


How trans fats influence blood lipoprotein levels (TC, Blood LDL, Blood HDL, and examples)

- Raises TC
- Raises LDL
- Lowers HDL
- margarines and shortening


How oxidization occurs membranes or in oil

In cell membranes or in oil: double bonds in fatty acids are vulnerable to a free radical attack. A free radical steals an electron from a PUFA making it an oxidized fat.


LDL oxidization (LDL, HDL, chylomicron, VLDL. They all have triglycerides, PL, proteins, and cholesterol)

LDL: Cholesterol rich.
-Elevated in liver stops taking back the LDL from the blood.
-As long as LDL is regularly cleared from the blood by the liver oxidization is low.
-If free radical comes and takes an electron then it will be oxidized



Naturally occurring: vitamins C, E, B-carotene, SE, Fe, and minerals.


Stages of Cancer

First there is DNA damage (from UV rays, retro-viruses, and free radicals)
1. Initiation: When DNA damage enters a normal cell body
2. Promotion: assisting division of a damages cell
3. Progression: accumulation of errors and mutating
4. Metastasis: when this spreads


Initiation and Promotion

DNA is damages > free radicals lead to oxidization > this leads to a damaged cell
PUFA > short chain aldehydes


Oxidization Summary (3)

Free Radical Damage:
b) Fat
-LDL > oxLDL > atherosclerosis
-Body cell membranes: PUFA > PUFA + electron (then PROMOTERS) > short chain aldehyde (malondialdehyde)
c) Proteins (cataracts in eyes)


Dietary Cholesterol (5)

1. Structural component of all animal and human cell membranes.
2. Precursor of: a) bile acids b) vitamin D c) steroid hormones
3. Present only in foods of animal origin
4. Body makes cholesterol (not an essential nutrient)
5. Most recent DRI report: Cholesterol consumption as low as reasonable (Last updated September 2002)


Examples of foods containing DIETARY cholesterol

(in order) Eggs, beef, pork, chicken, turkey, shrimp, cheddar cheese, ice creme, and milk


Summary of Dietary Strategies to lower total serum cholesterol in order of effectiveness (3)

1. Lowers total saturated and trans fatty acid intake
2. Raise soluble fibre intake
3. Lower dietary cholesterol intake (step #1 helps with this)


EPA equation



DHA Equation



Fish oils contain?




Originate from phytoplankton, consumed by marine (ocean) fish > also found in lakes therefore EPA and DHA are in lake fish too!


Where did interest in fish oils originate? (3)

In the 1970 scientists noticed that the Greenland Eskimos had:
1. Very high intake of fish and marine mammal blubber
2. They had lower risk of CHD
3. Their blood clotting ability is somewhat lower then others. (they may be likely to have atherosclerosis but they were less likely of developing thrombosis)


Examples of fish that are high in fats

Salmon, Mackeral, Herring, and Sardines


EPA: Potential in Heart Health (5)

1. EPA does NOT work to lower blood cholesterol or LDL
2. Lowers blood levels or serum concentrations of TG
3. Lowers platelet stickiness or reactivity
4. Lowers blood pressure
5. There are 15 others mentioned in text.


Example of Platelet stickiness

Fatty acids arachidonic acid (20:4n-6) converts to an icosanoid (thromboxane A2). If it is a fatty acid then EPA turns to thromboxane A3 which has a more moderate platelet response.


What is the ratio of omega 6's and 3's that humans should be having?

10x the Omega 6s as Omega 3s


What is the ratio of omega 6's and 3's that Canadians are currently having?

17x the Omega 6s as Omega 3s


What is the goal that we should be striving for in regards to Omega 6s and 3s?

To narrow the gap between Omega 6s and 3s. Not to have a lower amount of Omega 6s to Omega 3s.


DHA helps in..?

Retinal development and brain development


Fish oil supplements? (3)

1. Try cod, pickerel, or haddock as they have a less 'fishy' taste.
2. Fish Oil supplements
3. Higher alpha-linolenic


Things to watch out for with fish oil supplements (5)

1. Pure oil: 9kcal/g
2. Full of double bonds (how dedicated was the manufacturer)
3. Contaminants
4. Higher doses are to known to lead to higher risk of bleeding or hemmoragic stroke (blood vessel in the brain bursts)
5. Higher blood sugar in diabetics


Where else does alpha-linoleic acid come from?

walnuts, flax, canola oil, wheat germ, DHA-rich micro-algae, DHA-rich eggs


Alpha-linoleic acid

<5-10% of EPAs come from 18:3n-3. 3% of DHAs come from 18:3n-3 being converted to from EPA to DHA. (This should be double checked..)


Fish and fish oil recommendations from EWCFG and AHA

-2 food guide servings/week
2. AHA
-eat fish 2x/week if healthy
-1g mixed EHA and DHA from doctor supervision
-supplements only if necessary


Way to avoid contaminants in fish (4)

1. Enjoy a variety of fish and seafood
2. Limit intake of 'top of the food chain' fish (shark, swordfish, tuna steak, marlin)
3. Eat fish lower in mercury
4. Tuna (white albacore)


White albacore serving sizes

-women who are or may become pregnant: 4 fg servings/week
-children ages 1-4: 1 fg serving/week
-children ages 5-11: 2 fg servings/week
-Albacore as a main protein source: 10 fg servings/week


What are the health risks of not consuming fish and/or their oils?

Higher amounts of coronary heart problems if there isn't enough fish in the diet. The benefits of eating fish outweigh the costs.


What are the 10 leading causes of death?

cancer, heart disease, and strokes


What are the main cancers found in north american males?

lung, prostate, and colorectal


What are the main cancers found in north american females?

lung, breast, and colorectal


Describe the relationship between fats and cancer (3)

1. Differs around the world
2. Overall mechanisms that link fat and cancer are unknown
3. a) difficulty in separating fat intake from total energy intake b) effects of total fat. Does increase in fat equal an increase in cancer? c) is there effects of different fatty acid types?


Dietary factors of fats and cancer (what we do know)

-they account for 30-40% of all cancers
-lower fat diets decrease cancer risk
-higher fibre diets reduce risks of cancer
-higher intake of plant based food reduce the risks of cancer (e.g. cruciferous veggies, fruits, whole grains, legumes)


Dietary lifestyle factors of fats and cancers (what we do know)

-smoking increasing risks
-being physically active decreases risk
-maintaining a healthy body weight decreases risk
-being exposed to hazardous environmental factors increases risk (espestis and farmers lung)


Total fat DRI recommendations from 1990-2002

1990: < or = to 30%
2002: 20-30% (in Japan 10-15% and in the mediterranean 40%)


Saturated DRI recommendations from 1990-2002

1990: < or = to 10%
2002: As low as possible (AHA recommends < or = to 7%)


Trans DRI recommendations from 1990-2002

1990: very little discussion
2002: as low as possible (AHA < or = to 1%)


Monounsaturated fatty acid DRI recommendations from 1990-2002

1990: should comprise the majority of fat intake
2002: stayed the same


Polyunsaturated fats (alpha linoleic and linolenic) DRI recommendations from 1990-2002

1990: < or = to 10% taken together
2002: alpha linoleic (0.6-1.2% of the diet) linoleic (5-10% of the diet) ***this stresses the 10/1 ratio


Naturally occurring oils are...

A combination of all fatty acids, no naturally occurring oil is only 1 type of fatty acid


Summary of the DRI values

EAR (half the pop) -> RDA (98% of healthy pop)
AI (Daily value given if EAR is unknown)
UL: The amount you can have without having any adverse effects


Categories of fats summary

Saturated= <10%
MUFA= Majority of your fat intake
Trans= low as possible



Blood flow


Which is an organic compound?
a) calcium
b) water
c) vitamin C
d) salt

c) vitamin C


Which of the following is NOT closely linked to dietary factors?
a) pneumonia
b) stroke
c) heart disease
d) cancer

a) pneumonia


Which of the following foods is the most 'nutrient dense'?
a) potato
b) onion
c) corn
d) broccoli

d) broccoli


Which of the following is 1 food guide serving?
a) 1 cup fo cooked rice
b) 1 cup of fortified soy beverage
c) 1/2 cups of cooked beans
d) 1 cup of orange juice

b) 1 cup of fortified soy beverage


Which of the following food groups us part of the EWCFG (2007)?
a) breads and cereals
b) milk products
c) fruits and vegetables
d) meat and alt.

d) meat and alt.


Food Groups for EWCFG (2007)

Vegetables and Fruit
Grain Products
Milk and Alternatives
Meat and Alternatives


Cancer risk is attributed to..

40-50% tabacco
30-40% dietary choices
10% genetic reasons


Which of the following is an essential amino acid?
a) glycine
b) methionine
c) alanine
d) glutamine

b) methionine


Highlights from 'trends' in Canadian/North American eating habits

Higher servings of other foods (fats and sugars have gone up)
Lower serving from the four food groups


According to the DRI recommendations, the RDA for vitamin C for men ages 19-30 is 90 mg/day therefore the EAR is 45mg/day? (T/F)



According to the DRI recommendations, the RDA for vitamin C for men ages 19-30 is 90 mg/day therefore a 25 year old man consuming 80mg/day is at risk of scurvy? (T/F)



According to the DRI recommendations, the RDA for vitamin C for men ages 19-30 is 90 mg/day therefore a 29 year old man consuming 120mg/day may develop osmotic diarrhea? (T/F)



Which are legumes and which are nuts?
peanuts, walnuts, pinto beans, pecans, chickpeas, lentils, and almonds

Legumes: peanuts, pinto beans, chick peas, and lentils
Tree nuts: walnuts pecans, and almond


How to tell if there is trans fat in your kitchen?

If the fat percentages do not add up


Which is a product of digestion?
a) triglycerides
b) bile acid
c) free fatty acids
d) lipase

c) free fatty acids


The lipoprotein most enriched in protein is..
b) HDL
c) LDL
d) Chylomicron

b) HDL


Eating a diet rich in _______ may help keep both blood TC and LDL within healthy levels and reduce CHD risk.
a) iron
b) cholesterol
c) 'goog' cholesterol
d) soluble fibres

d) soluble fibres