Final Flashcards
(127 cards)
1
Q
History of Vitamin Deficiencies - Vitamin D
A
- 1880-1920, 90% of children in parts of Europe and in Boston had rickets (industrialization era)
- smoke from coal burning fires absorbed much of UV of sunlight which was needed to produce vitamin D in the skin
- in 1921: discovered that if you exposed children to UV light, symptoms of rickets disappeared
2
Q
History of Vitamin Deficiencies - Thiamin
A
Beri Beri
- First medical link to this deficiency was made by Japanese doctor who observed symptoms in Japanese navy crew who only ate polished white rice but not in crew who ate meat, barley and beans
- POLISHED RICE with husk, bran and germ removed = strips nutrients
- Fatigue with complications affecting cardiovascular, nervous, muscular and GI symptoms
3
Q
History of Vitamin Deficiencies - Niacin
A
Pellagra
- Three D’s: dermatitis, diarrhea, dementia
- early 1900s in southestearn USA, cotton economy failed and people ate corn as a staple
- Niacin in corn is tightly bound and not very available for absorption
- 3 million cases, 100k death in 1907-1940 USA
4
Q
Vitamin A Deficiency
A
- Leading cause of preventable childhood blindness and increases risk of death from common childhood illness (e.g., diarrhea)
- Night blindness is one of the first signs
5
Q
Vitamin A precursor & derivative
A
Beta-Carotene (precursor to vitamin A - plan foods)
- Dark green vegetables
- Deep orange fruits and vegetables
- No upper tolerable limit but high intakes may turn skin yellow0orange
Retinol (pre-formed Vitamin A - animal foods)
- Animal products with fat (meat, fish, etc.)
- Vitamin A derivative (retinoids) used in some acne medications (dangerous for developing fetus - miscarriage, severe birth defects, death). Avoid getting pregnant for 4 weeks after use.
6
Q
Goiter
A
- Iodine deficiency
- Iodine is an element that is needed for production of thyroid hormone
- If deficient, leads to hypothyroidism = weight gain, inability to tolerate cold, fatigue
- Can lead to intellectual disabilities in children if mother was deficient during pregnancy
- ~30% of the world’s population remains at risk for iodine deficiency
7
Q
Water-Soluble Vitamins
A
- The B vitamins and vitamin C
- Due to water solubility, they “wash out” of the body in one - several days
1. Except for B12 as it can be stored up to one year in the liver
2. This does not make them safe in toxic in high doses (Vitamin B6, niacin and C can be toxic in high doses, megadoses stress the kidney) - Water soluble vitamins are easily destroyed during food storage and preparation
8
Q
Minimizing Nutrient Losses
A
- Refrigerate fruits & vegetables
- Reduce contact with air to minimze oxidation
- Wash fruits & vegetables before cutting
- Steam or stir-fry vegetables to minimize cooking losses & avoid high temperature for a long time
9
Q
Folate & Deficiency
A
Folate (natural form), Folic Acid (synthetic form)
- Leafy green vegetables
- Legumes
- Liver
- Lentils
- Fortified grain products
most common food source is enriched or fortified food products
synthetic folic acid more bioavailable than naturally occurring food folate
Deficiency symptoms
1. Lack of folate reduces DNA stability
–> folate deficiency induces and accelerates carinogenesis
–> structure of cell’s genetic material becomes disrupted –> accumulate abnormalities –> cancer
2. Heart Health
–> lack of folate causes homocysteine to accumulate in blood
–> high homocysteine –> heart attacks, strokes
3. Fetal Health
–> ALmost complete absence of spinal cord & brain deformities (neural tube defects) in babies born to mothers consuming adequate folate
–> most common are spina bifida (treatable) and anencephaly (fatal - portion of brain and skull missing)
–> intakes: 400 ug all females, 600 ug pregnant, 4mg previous neural tube defect
10
Q
Vitamin C
A
1. Antioxidant
- protects tissues from oxidative stress
- oxidative stress is caused by free radicals that are produced in response to normal metabolism using oxygen; UV radiation; air pollution; tobacoo smoke
- over time lead to increased risk of cancer, heart disease and arthritis
- Vitamin C along with vitamin E and other phytochemical found in fruits and vegetables neutralize free radicals
2. Cofactor in collagen formation
- helps form collagen - fibrous structural protein of connective tissues (bones, teeth, blood vessels, wounds)
- assists in preventing bruising - with vit. C deficiency tissue hemorrhage or bleeding is a major symptoms
- collagen precursor molecule + vitamin C will cause collagen to hydroxylated –> scar strength
3. Cofactor in other reactions
- conversion of tryptophan –> seratonin (controls mood) & norepi (increase HR)
- fatty acid transport into mitochondria for energy metabolism
- making of hormones (e.g. thyroxine)
4. in stress
- adrenal glands contain more vitamin C than anyother organ
- released with stress hormones during stress reaction
- stresses: infections, burns, toxic heavy metals, chronic aspirin, barbiturates (sedatives), oral contraceptives (also B6, B12, folate), cigarette smoking
5. Role in common cold
- 1 g/day of vitamin C led to 1 day shorter cold & reduced severity of symptoms (by 23%)
- vitamin C reduces blood histamine but at a dose of 2g daily for 2 wks
body’s need: 10 mg prevent scurvy
DRI: females 75 mg/d; males 90 mg/d
excess: nausea, diarrhea, abdominal cramps, excessive gas
11
Q
Vitamin D
A
1. Bone growth
- raises blood concentrations of Ca & phosphorus
–> increase abroption from intestine & reabsorption from kidneys & mobilization from bones into blood
2. Cancer
- recent research suggest that breat, prostate and colon cancer decreased with increased vitamin D
3. MS; rhematoid arthritis
- living higher than 37 degrees latitude increases MS risk > 100%
- 400 IU supplement decrease risk by 40%
12
Q
Vitamin D synthesis & activation
A
Production in the skin needs 10-15 min sunlight (UVB) on arms & face 2-3x per wk (dark pigment may require up to 3hr)
- food sources
1. fortified dairy foods
2. fortified margarine
3. FIsh oils
4. Egg yolk
* fluid milk is most reliable source*
13
Q
Reduced production of vitamin D
A
- North america 6 months no vitamin D production, 4 months no production at the equator
1) 7o years and older - vitamin D production is only 30% of younger adults
2) institutionalized individuals at high risk
3) sunscreen - reduce or block vit. D synthesis but not completely
15 min exposure early morning or late afternoon without sunscreen produces all that is required for a day
DRI for adults is 600IU; for those >70 it is 800IU - tough to get from food so it is recommended to get supplement but fish oils contain the most espeically cod liver oil
14
Q
Phytochemicals
B
A
- Biologically active compounds of plants believed to confer resistance to chronic disease
in plants - Give pigmentation and flavor
- promote chemical reactions/used in metabolism
- protect them from bacteria, fungi, animals and environmental oxidants
- None of the phytochemicals are essential
- deficiency symptoms are not observed
- many have protective and antioxidants properties that make them useful to our tissues (via antioxidant or anti-inflammatory effects)
- others are toxic to us
In humans
- many phytochemicals may protect us from cancer, heart disease, high BP, other chronic diseases
- the correct balance of phytochemicals is unknown but to get adequate levels we need. to follow the advice in Canada’s Food Guide and eat a variety of foods
15
Q
Formation of free radicals
A
UV light, Inflammation, Metabolism, Air Pollution + UV, ionizing radiation, smoking all cause DNA damage
16
Q
How phytochemicals work
A
antioxidant: protect cells against oxidative damage & reduce risk of developing certain types of cancer. Phytochemicals with antioxidant activity: allyl sulfides (onions, garlic), carotenoids (carrots, tomatoes), flavonoids (berries), polyphenols (tea graps)
hormonal action: isoflavones, found in soy, imitate human estrogens and help to reduce menopausal symptoms and osteoporosis
stimulation of enzymes: indoles (found in cabbage and broccoli) stimulate enzymes that make estrogen less effective and could reduce the risk for breast cancer
interference with DNA replication: saponins found in beans interfere with the replication of cell DNA, thereby preventing the multiplication of cancer cells. Capasaicin, found in hot peppers, protects DNA from carcinogens
physical action: some phytochemicals bind physically to cell walls thereby preventing the adhesions of pathogens to human cell walls. Proanthocyanidins are responsible for the anti-adhesion properties of cranberry. Consumption of cranberries will reduce risk of urinary tract infections and will improve dental health.
17
Q
Oxidative damage & repair
A
damage: normal cell –> free radicals that damage all components of cell become embedded –> more severe oxidative stress can cause cell death
repairStable molecule –> electron stolen —> Free radial + Antioxidant —> electron returned –> stable molecule
18
Q
Food vs. phytochemical pill
A
- in large doses, phytochemicals may be toxic
- Up to 10,000 phytochemicals identified. Cannot all be isolated and put into supplement
- Health benefits are associated with foods and often not supplements
- many supplements are untested and some phytochemicals supplements may actually harm health (e.g. beta-carotene)
19
Q
Harmful Plant Components
A
Solanine: when potatoes are exposed to light, they turn green = natural defense against insects eating them (bitter) - diarrhea, vomiting, headache, paralysis
Aflatoxins: from Aspergillus fungi growing on nuts/peanuts, dried foods, grains, and spices, which can cause liver cancer with chronic exposure. Testing done by CFIA. Discard nuts/peanuts that look moldy, discolored or shriveled
Oxalic acid: from spinach, turnip greens, rhybabrb, and other foods can bind to calcium and irritate the stomach; cause kidney stones
Phytates: found in whole grains and legumes - bind minerals (iron and zinc); cooking, baking, sprouting, fermentation can reduce phytates
20
Q
Food Biotechnology Methods
A
1. Selective breeding: selectively breeding crops and animals for centuries. e.g., wild corn = 5 kernals/stalk, super-sweet corn, leaner animals, chickens used to lay 10-15 eggs/year and now they lay 300 eggs/year
2. Genetic Engineering: modifying genetic material of living cells so they produce new substance sor perform new functions - insert gene from one organism into another
21
Q
Benefits of Food Biotechnology
A
1. Extended Shelf Life:
- tomatoes stay firm & ripe longer
- “antisense” (mirror image) gene
- binds to native gene and prevents ysnthesis of softening protein
- harvested at more flavorful, nutritious vine-ripe stage
2. Efficient Food Processing
- Renin-coagulate milk in heese production
- traditionally from calf stomach
- today mass produced in bacteria save time, money and space
3 Biopharming
- use animals and plants to produce drugs
- Cow produce vaccine in milk
- use bananas to make edible vaccine
- hydroponically grow tomato plants to secrete desired protein through roots in water
4. Improved Nutrient Composition
- soybeans: upgrade protein quality
- canola: increase monounsaturated fatty acids
- golden rice: genes from daffodil and bacteria to make beta-carotene. One cup could supply 50% of the RDA of vitamin A of an adult
5. Genetically Assisted Agriculture
- 90-95% of canola crops in Canada are GM to withstand herbicides (not just for food)
- farmer can spray whole field, kill weeds and not harm canola
- Canada=soy, corn, canola, sugar beets, alfalfa (imports = USA squash and 80% Hawaiin papayas)
- hypoallergenic peanuts are being researched
22
Q
main issues of concern for human health
A
1. Allergencity: in principle, transfer of genes from commonly allergenci organisms to non-allergic organisms is discouraged in the science of GM. No allergic effects have been found relative to GM foods currently on the market.
2. Gene transfer: Gene transfer from GM foods to cells of body or to bacteria in GI tract is of concern if the transferred genetic material adversely affects human health (e.g. antibiotic resistance genes)
3. Outcrossing: migration of geneses from GM plants into conventional crops. Cases reported where GM crops approved for animal feed or industrial use were detected at low levels in the products in tended for human consumtion. Several countries have adopted strategies t oreduce mixing, inducing clear separation of fields within which GM crops and conventional crops are grown.
23
Q
LEADING CAUSE OF DEATH IN CANADA (CANCER)
A
MALES: Lung, colon & rectum, and prostate
FEMALES: breast, lung, colon & rectum
24
Q
Cancer formation
A
1. Initiation: carinogen -> permanent genetic change in a cell (carrier mutation until its death)
2. Promotion: compounds cause the initiated cells to divide and accumulate- large number of daughter cells with the mutation
3. Progression: transformation from benign tumor to neoplasm, cells can undergo further mutations with metastatic potential
4. Metastasis: invade surrounding tissues and/or spread
25
Factors affecting cancer development
**A. Genetic factors:** affects risk
**B. Immune factors**: ineffective immune system may not recongize tumor as foreign
- aging decreases immune function
- immunosuppressive drugs and viral infections
- Cancer more common in older people, half of all cancers are in people over 70
**C.Environmental Factors**: exposure to radiation & sun, water & air pollution, smoking, lack of PA
- carcinogens damage cellular DNA and alter genetic material
**D. Dietary Factors**:
- Carcinogens initiate cancer
- some pesticides at high doses are carcinogenic
- nitrosamines are strong carcinogens
- naturally occuring or formed during processing (alcohol like beer and scotch, or processed meats like ham, bacon, deli meats, hot dogs in the stomach nitrates added as preservatives can combine with aimines to form nitrosamines
- linked to stomach, esophagus, liver and bladder cancer
**E. Dietary Factors - promoters**:
- accelerate tumor development once intitiating step has occurred - "lag time" of 10-30 years
- excess dietary fat by contributing to obesity
- omega-6 fatty acids promoters in some animals
- **Specifically fat**: fat can oxidize at high cooking temperatures (restaurant deep frying) and may produce oxidative stress in body. MORE important is time, oils become oxidized over time so buy small bottles and if it smells off then throw away. Fat stimulates bile secretion and bacteria can convert bile to cancer causing compounds
**F. Dietary Factors - Anti promoters**"
- high fruits and vegetables decrease cancer risk
- fiber protective against colon cancer
- phytochemicals (cruciferous vegetables)
26
Carinogen calsses
Group 1: carinogenic to humans
Group 2A; Probably carcinogenic to humans
Group 2B: Possibly carcinogenic to humans
Group 3: Unclassifiable as to carcinogenicity in humans
Group 4: Probably not carcinogenic to humans
27
Recommendations to reduce cancer risk
**1. Choose diet rich in a variety of plan-based foods**
- >7 servings of whole grains, legumes, starchy vegetables
- 5-10 servings of other vegetables and fruit
- limit processed foods and refined sugar
**2. Maintain healthy weight and be active**
- Avoid under and overweight
- 1 horu of exercise daily
**3. Drink alcohol in moderation if at all**
- for cancer prevention, it's best not to drink alcohol
**4. Select foods low in fat and salt**
- limit fatty goods especially of animal origin
- limit red meat to 3 portions per week
- modewst amount of vegetable oil
- limit salted foods and table salt (salt-preserved foods damage stomach lining)
**5. Prepare and store foods safely**
- do not eat charred food
- consume meat/fish grilled in direct flame only occasionally
**6. do not smoke or use tobacco in any form**
**7. Charring/Burning**
- do not burn food when cooking by any method and removed charred portions
- marinating meats can help reduce carcinogen formation
- COntinuously turning meat over rather than leaving it without flipping on high heat
- trim the fat
- lower the temperature (low and slow) indirect heat methods like stewing, steaming or poaching produce less than frying and grilling
28
Charring and Burning
- Charring, burning, or grilling meat, poultry and fish over high temperatures causes chemicals to form that are mutagenic (damage dna)
- HCAs form when amino acids, sugars, creatine in muscle meats react at high temperature
- PAHs form when fat or juices from meat grilled over a heated surface or open fire drip onto the surface or fire and cause flames and smoke. Smoke contains the PAHs and that sticks to the surface of the meat. Also formed during smoking of food
- well done more than rare/medium
- high temp (grilling, pan fry) or cooked longer
29
Factors associated with site specific cancers
**1. Stomach**: salt preserved foods; possibly grilling and BBQ-ing
**2. Colorectal**: saturated fat, red meat, alcohol; possibly grilling
**3. Liver**: alcohol, hep B
**4. Lung**: smoking, possibly alcohol, saturated fat, cholesterol
**5. Breast**: obesity, early puberty, alcohol; possibly meat and fat
**6. Prostate**: high fat intake (espeically from meat)
30
Minerals & Health
- minerals are components of body structures and play key roles in regulation of body processes
- deficiency disease occur when too little 1 or more of the 15 essential minerals is provided; overdoses occur when too much is provided
- inadequate intakes are associated with chronic disorders like osteoporosis, iron deficiency, and hypertension
31
Minerals in a 60kg human body
**Major Minerals**: The major minerals are those present in amounts larger than 5 g (a teaspoon). A pound is about 454g; thus only calcium and phosphorus appear in amounts larger than a pound
- Calcium: 1150 g
- Phosphorus: 600 g
- Potassium: 210 g
- Sulfur: 150 g
- Sodium: 90g
- Cholride: 90g
- Mg: 30g
**Trace Minerals**: there are more than a dozen trace minerals, although only size are shown here
- Iron: 2.4g
- Zinc: 2.0g
- Copper: 0.09g
- Manganese: 0.02
- Iodine: 0.02
- Selenium: 0.02
32
Mineral Charge
- Charge (+/-) allows minerals to combine with minerals of opposite charge to form stable compounds
- these become part of bones, teeth, cartilage and tissues
- in body fluids, charged minerals are a source of electrical power to stimulate muscle to contract and nerves to react
- mineral charge is related to many other functions (helps maintain an adequate amount of water in the body, assists in neutralizing acidic or basic body fluids, mineral are components of proteins and enzymes)
33
Calcium
**found in**
- milk and milk products
- fish bones
- tofu
- greens (kale and bok choy)
- legumes
- 99% is stores in our bones and teeth, ~1% is in blood, muscle and other fluids
**important for**
- muscle contraction
- blood clotting
- cell membrane integrity
- nerve conduction
- strong bones and teeth
34
Bioavailability of calcium
- Oxalic acid, found in spinach, beets, celery, pecans, peanuts, tea and cocoa, can bind to calcium and form an insoluble complex that is excreted in the feces
- Phytates, found in whole grain, legumes, and nuts can bind to calcium to form an insolumble complex thereby decreasing absorption of calcium
- DRIs are based on Calcium found in the food. Greater consideration needed if all from plant foods because lower absorption
- **look at picture of absorption & Nutriotious non-dairy alternative picture**
35
Calcium supplements
3 major types sold:
**1. Purified calcium**
- carbonate (most common: best with meals), citrate (good for elderly: doesn't require gastric acid), gluconate, alctate or phosphate
**2. Calcium mixtures**
- magnesium, vitamin D, zinc
**3. Powdered calcium**
- Caution: bone meal, oyster shell, dolomite
*iron chelates with calcium so don't take these supplements at the same time*
36
Osteoporosis
| if
- if insufficient calcium, phosphorus or vitamin D
- peak bone mass occurs at ~30 yeras of age, after bone loss starts to outpace bone deposititon *diagram look*
- at menopauss, surge of calcium out of the bones
- less bone mass at birth will increase chance of osteporosis
- bone loss and most common types of bone fractures in women include spinal vertebrae, hip, wrist or forearm fractures
37
Osteoporosis risk factors
Sex hormones. Abnormal absence of menstrual periods (amenorrhea), low estrogen level (menopause), and low testosterone level in men can bring on osteoporosis.
Anorexia nervosa. ...
Calcium and vitamin D intake. ...
Medication use. ...
Lifestyle. ...
Cigarette smoking. ...
Alcohol intake
38
iron
**found in**
- liver
- beef
- prune juice
- dried fruit
- beans & lentils
- cereal (cream of what, oatmeal, dry cereal)
**characteristics**
- Most is stored in hemoglobin (oxygen transport protein in RBC)
- small amounts are stored in myoglobin (storage/transport of oxygen in muscle cells)
- many enzymnes require iron to function
- high amounts of iron are toxic
**enough iron**
- 16-18mg for men and 15mg for women
- WOmen have to consume ~2500 calories per day to obtain 15mg
- Selection of good sources of iron is needed it women are to get enough
- Most iron in plants poorly absorbed due to tight binding to oxalate, phytate and tannins
- **vitamin C** can increase non-heme iron absorption and even reverse the inhibiting effect of substances such as tea and calcium/phosphate
- Decrease iron absorption: tea, coffee, calcium and phosphorus, phytate, tannins and fiber
- heme iron not affected much by oother foods/compounds eaten in the same meal
39
Heme and Non-heme iron
- only foods derived from animal flesh provide heme but they laos contain nonheme iron
- All the iron in foods derived from plants is nonheme iron
- heme accounts for about 10% of average daily iron intake, but 35% is absorbed
40
Causes of iron deficiency
- about 5% of Canadians but 20-25% worldwide have iron deficiency
- low intake
- blood loss through: menstruation, injury, surgey, ulcers, blood donation
**symptoms of iron deficiency anemia**
Being pale or having yellow "sallow" skin.
Unexplained fatigue or lack of energy.
Shortness of breath or chest pain, especially with activity.
Unexplained generalized weakness.
Rapid heartbeat.
Pounding or "whooshing" in the ears.
Headache, especially with activity
*in infants and children, deficiency anemia may cause irreversible impairment in mental development*
41
Iron overdose
- 10k people per year
- overdoses of iron supplements are a leading cause of accidental poisoning in young children
- keep out of reach of children
- alcohol can increase iron absorption
- iron toxicity causes liver damage, diabetes and heart failure
42
sodium and potassium
**check diagram**
43
hypertension and sodium
**hypertension leads to heart disease, kidney disease, strokes and declines in brain function, poor circulation in legs, sudden death**
- Normal BP <120/80
- "Silent Killer"
- People with overweight 6x greater risk of having hypertension
- the higher your BP, the higher your risk of health problems. (Someone with BP of 135/85 is twice as likely to have a heart attack or stroke as someone with a BP of 115/75)
44
What are supplements?
- Vitamins and minerals
– Probiotics
– Herbal remedies
– Homeopathic medicines
– Traditional medicines such as traditional Chinese
medicines
– Other products like amino acids and essential fatty acids
45
How & when to take multivitamin pill
- with a meal
- USP label (U.S. Pharmacopeia)
- the **USP** dietary supplement verification program is a voluntary program open to manufacturerrs of dietary supplement finished products from around the world
- A manufacturer may choose to manufacture a supplemet/drug product to the pharmacopoeial standard (e.g. USP) or to the manufacturer/s own standard and label the product as a house standard (e.g. manufacturer's name standard)
- contains the ingredients listed on the label, in the declared potency and amounts
- does not contain harmful levels pf s[ecofoed cpmta,omamts (e.g. lead and mercury, microbes, pesticides, or other contaminants)
- will break down and release into the body within a specifed amount of time
- Has been made according to FDA current good manufacturing and monitoring processes, and that the supplement will be manufactured with consistent quality from batch to batch
46
Single vitamins or minerals (iron, calcium, vitamin E, vitamin C)
**Iron:**
- with meal or glass of juice
- avoid taking with tea or coffee
- if anemic, not at the same time as Ca
**Calcium**:
- calcium carbonate with a meal
- divide large doses
- Ca+ vitamin D good idea in winter if no multivitamin is taken
**Vitamin E**:
- nantural more rapidly absorbed and maintained in tissue
- about 2x as potent
**Vitamin C**:
- Natural and synthetic have equal potency
- pills, foods or rose-hip extracts = same
47
Herbal Supplements
- considereed natural & therefore healthier and safer
- for a specific condition or general health
- may have health benefits
- lacking well-controlled research studies
- short-term and long-term risks and benefits
- some have hazardous side effects
- may interact with some prescription medications and over the counter drugs
- e.g. garlic increases blood thinning activities of anti-inflammatory drugs and vitaminn E
- advise docotr, pharmacist of all herb use
- take herbs only for short periods
- follow label instructions
- if unusual side effects, stop use immediately
- do not take in place of conventional medicien for chronic conditions
- not for children under 12, pregnant or lactating women, kidney or liver damage, immunocompromised, or undergoing surgey
- How are herbal supplements regulated?
- classified as dietary supplements not drugs
- no vigorous testing by Health Canada or FDA
- test done by Consumer Lab found 25% of 30 brands of ginkgo biloba (e.g.
for memory loss) didn’t have expected levels of active ingredient
- 25% of 260 Asian herbal products had high heavy metal contamination
Legislation now requires natural health products to have a natural
product number (NPN). Safe, effective and high quality (documents
submitted by company)
Database: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen-
prod/lnhpd-bdpsnh-eng.php
Responsibility still lies with the consumer to be informe
Chapparal - liver damage
Comfrey - liver damage
Ephedra/ma huang - rapid heartbeat, heart attack
Germander - liver damage
Lobelia - breathing problems, rapid heartbeat, coma, death
Magnolia/stephania - kidney damage
Willow bark - Reye’s syndrome in children (brain & liver damage)
Wormwood - nerve damage, arm/leg numbness, delirium, paralysis
Yohimbe - anxiety, paralysis, GI problems, psychosis
Kombucha - liver toxicity
“When kombucha is sold in a raw (unpasteurized) form the live microbes may continue to ferment creating
product risk. This may occur at the point of processing or with consumer mishandling when product is left
unrefrigerated. Acidosis from excess acid can occur in persons with underlying medical conditions, in
particular metabolic issues such as diabetes. Ethanol values in excess of 0.5% can also be of concern to
toddlers and infants, and no alcohol is recommended during pregnancy.” BCCDC
48
Example of a common supplement (Creatine)
- increases bioavailability of phosphocreatine in muscle cells
- faster resynthesis of ATP (fuel for cellular processes)
- brief high intensity exercise
- body can synthesize PCr from amino acids
- vegetarians may have lower PCr stores...therefore may benefit more from supplementation
- ~0.3 g/jg/day of CR monohydrate for 5-7 days followed by 3-5 g/day thereafter to maintain elevated stores
**safety concerns have historically included**
- kidney and liver cuntion
- suppress natural creatine synthesis
- promote dehydration and muscle cramping
- muscle injury
**no evidence from well-controlled studies (up to 5 years) to support any of these concerns**
49
For any supplement consider:
**1. No expert body of nutrition experts recommends routine use of supplements**
- do agree some people benefit from supplements
- at or below the RDA (Recommended Daily Allowance) is considered safe
**2. Food is more than the sum of its nutrients**
- more than micro and macronutrients
- fiber and phytochemicals
**3. Taking supplements of single nutrients in large doses may have detrimental effects on nutritional status and health**
- e.g. beta carotene and supplements increased the risk of which cancer?
**4. Vary substantially in quality**
- Ca not dissolving
- Garlic not containing active ingredient
**5. Focusing on supplements can take attention away from improving lifestyle**
- false sense of security
50
Water Balance
~ 60 % of adult body is water
51
Daily Fluid Recommendations
- varies depending on diet, activity, temperature, and humidity
- adult who expends 2000 kcal/d needs about 7-11 cups/day of fluid
- Aim for 1.0-1.5 ml/kcal expended
52
Foods contain water
- Beverages are 85-100% water
- Fruits and vegetables 75-90%
- Meats are 50-70%
- Water in foods contributes to our fluid intake
- 31% of intake from plain water
- 44% from other beverages
- 25% from foods
53
Factors that increase water needs
1. Diseases that disturb water balance, such as diabetes
2. Exercise
3. Forced air environments, such as airplanes or sealed buildings
4. Heated environments/hot weather
5. Increased dietary fiber, protein, salt or sugar
6. Drugs & medications (diuretics – alcohol, caffeine)
7. Pregnancy or breastfeeding
8. Prolonged diarrhea, vomiting or fever
9. Surgery, blood loss, or burns
10. Very young or old age (smaller body mass makes minor changes in hydration more serious; elderly sense of thirst reduced)
54
Fluid losses
- Heat = sweat losses of 1-2 L/hr exercising in heat
- Cold = cold induced diuresis (cold weather induced need to urinate) increases fluid loss
- dehydration reduces ability to dissipate heat causing increase body temp
- dehydration >2% body mass leads to significant reductions in endurance exercise performance
Temperature (ºC) Litres lost per hour
-5 **0.6 - 1.4**
+10 **1.2 - 1.5**
+20 **1.6 - 2.5**
+30 **2.0 - 2.8**
55
Water toxicity
- Rare
- High intake leads to: Hyponatremia (low sodium in the blood), exxcessive water accumulation in the brain and lungs, confusion, severe headache, nausea, vomiting, seizure, coma and death
- Water intoxication has occurred in: endurance athltes who consume too mcuh water, infants give too much water or over-diluted formula, patients with psychiatric disorders taking medications that produce cravings for water
56
Fluid Replacement
* 500 ml -------------------------2 hours before exercise
* 150-300 ml -------------------every 20 minutes during exercise
* exercise < 60 min ---------water is best replacement
* exercise > 60 min ---------dilute glucose & electrolyte solutions
**1. Volume**
- small volume, regular interval to prevent bloating
**2. Temperature**
- cool (5-10 degrees) to maximize ingestion
**3. Composition**
- >10% CHO may inhibit gastric emptying resulting in
diarrhea, nausea, cramping
* 6-10% glucose or sucrose absorbed rapidly and provide
energy for prolonged exercise
57
Bottled Water
* **Mineral water**: taken from underground reservoirs
between layers of rock. Contains dissolved minerals
from the rock.
* **Spring water:** taken from springs that form pools or
streams.
*** Sparkling water:** carbonated water (true seltzers are
naturally carbonated but sparkling is usually
commercial addition of pressurized CO2 ).
* Estimated that ~45% of bottled water is (purified)
bottled tap water.
58
Single gene defects
**- Hundreds of diseases related to single gene defects**
- PKU (phenylketonuria)
- cystic fibrosis
- sickle cell anemia
- hemochromatosis
- **most diseases are combination of multiple genes & environment**
59
Polygenic defects
**1. Heart Disease**
- High cholesterol diets cause plaque in some people
- low folate and vegetable diets at higher risk
**2. Cancer**
- differs by site
- endometrial (environment = 90%)
- stomach (72% environment)
- Prostate (42% environment)
**3. Hypertension**
- salt sensitivity = eating too much salt usually increases BP but not in everyone
- salt sensistive or salt resistant
**4. Obesity**
- over 120 genes associated with development
60
Celiac Disease
- An autoimmune disease that damages small intestine
- People with celiac disease have an immune reaction to a protein gluten
- Gluten is wheat, barely and rye
- when people with celiac disease consume gluten, immune system attacks and destroys villi
**Genetic Link**
- Celiac disease occurs in genetically predisposed people
- HLA genes (human leukocyte antigen)
- Responsible for how immune system distinguishes between body's proteins and foreing proteins
- ~99% of people with celiac and 60% with non-celiac gluten sensitivtiy have **DQ2 or DQ8** risk version of HLA (but 30% of general population have risk version so development of disease is dependent on combination of risk variants)
61
Symptoms of Celiac Disease
- GI symptoms (diarrhea, loose stools, dyspepsia, flatulence, growth stunting in children, chronic abdominal pain, vomiting, chronic constipation, distended abdomen, anorexia, weight loss.
- Dermatitis, elevated liver, hepatitis, iron deficiency anemia, arthralgia, arthritis, ostepenia, osteoporosis, bone fractures, recurring headaches, preiopheral neuropathy, epilepsy, seqizures....
62
# [](http://)
Types of Celiac Disease
**Classical**: signs malabsorption, including diarrhea, steatorrhea (pale, foul smelling, fatty stools) weight loss or growth failure in children
**non-classical**: mild GI systems without clear signs of malabsorption or may ahve seemingly unrelated symptoms
**Silent**: Patients do not complain of any symptoms but still experience villous atrophy damage to their small intestine
63
# Celiac Disease
Prevalence and Diagnosis
~1% of Canadaian population
- Genetic component: if 1st degree relative have celiac disease, 1 in 10 chance family member will develop it
Many people go undiagnosed but testing involves:
- Blood test: tTG-IgA and must be on gluten containing diet
- small intestine biopsy
- Genetic screening
Commonly misdiagnosed as:
- IBC or Crohn's
64
Non-Celiac Gluten Sensitivity
Developing symptoms when they consume gluten-containing foods and feel better on a gluten free diet but do NOT have celiac disease
- No biomarkers for diagnosis
- autoantibodies (TTG, EMA, DGP) are absent
- No villous atrophy
- Other compounds in wheat, barley and rye may trigger symptoms (e.g. amylaze/trypsin inhibitors or fermentable carbohydrates)
65
Nutrigenomics
The study of how genes and diet interact. to increase or decrease someone's risk for disease
- Gene x Environment interactions
- Play a role in "personalized nutrition"
66
Food Selection
- food preferences largely learned
- 80 genes that help taste bitter foods
- some are highly sensitive
- vegetables taste bitter --> eat less
67
Future
- individualized dietary prescriptions
- complete profile with genetic risks, gut microbiota profiles, etc
68
Canada's PA Guidelines
**Adults**:
- 150 min of moderate to vigorous physical activity per week (bouts of 10 min or more)
- 2 sessions of strength-training per week
**Children**:
- 60 minute of moderate to vigorous physical activity everyday
- vigorous at least 3 days per week
- activities that strengthen muscle and bone 3 days per week
69
Fuel Sources at Rest and During Exercise
- At rest: 85% from fat, 10% from CHO, 5% from protein
- During exercise: 1. muscle glycogen, 2. body glucose, 3. plasma fatty acids, 4. intramuscular triglycerides
- Extent of conteribution depends on intesnity and duration of exercise, level of exercise training, initial muscle glycogen stores, supplementation with CHO during exercise. Usually with higher intensity, carbohydrate energy will go up, fat will go down.
70
Energy Systems
**ATP-Phosphocreatine System**
- immediate energy source
- short term, explosive power activities up to 10 sec
**Lactic acid system**
- anaerobic breakdown of glucose to lactic acid (glycolysis)
- any intense effort lasting up to 2 min
**Oxygen System**
- after 2 min during low to moderate intensity exercise
- glycogen provides 6-70% of fuel during first 20 min of low to moderate intensity exercise
- after 20 min fat increasingly used
71
Fatigue - "Hitting the Wall"
- Depletion of muscle and liver glycogen levels --> extreme fatigue
- some carbohydrate is needed by muscles to generate energy from fat breakdown
- water and glucose ingestion at point of fatigue may prolong exercise but severe limitations exist for high level of energy production needed for exercise
- inability to maintain current level of activity; pereption of effort greatly increased
72
Carbohydrate Needs
**Light Exercise**: low intensity or skill-based activities need 3-5g/kg BW of CHO intake
**Moderate Exercise**: Moderate exercise program (e.g. 1hr/day) need 5-7g/kg BW of CHO intake (e.g. team sport)
**High Exercise**: Endurance program (e.g. 1-3 hr/d mod-high-intensity exercise) need 6-10 g/kg BW
**Very High Exercise**: Extreme commitment (e.g., 4-5 hr/d mod-high-intensity exercise) needs 8-12 g/kg BW
73
Carbohydrate Pre, During, Post-Exercise
**1-4 h pre-exercise:** 1-4 g/kg BW
**under 1h pre-exercise**: if desired, a small amount of easily digested CHO in an amount and form the athlete prefers
**During exercise**: Team sports: 30-60 g/h. Endurance: depends on duration, up to 90 g/h
**Under 8 hours to recover**: 1-1.2 g/kg/h for 4 hours
**Over 8 hours to recover**: Daily fueling plan adequate to restore muscle glycogen
74
Dietary Protein
- **Timing of protein intake: ** studies suggest that increases in strength and muscle mass greatest with immediate post-exercise provision of protein
- **Amount of protein**: No further performance benefits with >1.62 g protein/day with 95% CI (1.03-2.20 g pro/kg/d)
75
Pre-competition nutrition
- Maximize muscle and liver glycogen endurance
- goals of pre-competition meal:
- 1. Stomach should be relatively empty at start of competition
- 2. Minimize Gi distress
- 3. Avoid hunger, lightheadedness or fatigue
- 4. Adequate fuel (carbohydrate) in blood and muscles
- 5. Adequate amount of body water
76
Practical considerations of pre-competition meal
**3-4 hours before competition: solid meal**
– CHO rich with minimal fiber, fat, and protein which can cause GI distress
during exercise
– Avoid gas formers and bulky foods like bran.
**Under an hour** before competition: small or liquid
– Many athletes do well with 25-30 g of CHO
– Research shows even if “rebound hypoglycemia” occurs, it does not impact
performance
77
Ideas for Foods to Consume 1-4 hours before & 30-60 minutes before exercise.
**1-4 Hours Before**
- Peanut butter and honey on crackers
- Fruit and yogurt smoothie
- low-fat cottage cheese
- yogurt+granola+fruit
- chicken on a whole weat bun
**30-60 minutes before**
- Piece of fruit
- whoole grain crackers
- sports gel, sports bar
- fruit puree pouch like applesauce
78
Sports bars
- good source of carbohydrate, some fat and protein
- no magical qualities but are convenient
- should be used as a substitue for pre comp meal not a long term basis to replace normal eating patterns
79
Eating during competition
- Generally not needed but depends on event
- CHO ---> additional energy supply
- Water --> temperature regulation
- **endurance sports**
- <30 minutes no CHO needed
- 30-75 minutes then small amounts including mouth rinse (rapidly oxidized e.g., glucose, sucrose, maltodextrin)
- 1-2h then up to 30 g/h (rapidly oxidized e.g., glucose, sucrose, maltodextrin)
- 2-3h then up to 60 g/h (rapidly oxidized e.g.. glucose, sucrose, maltodextrin)
- >2.5h then up to 90 g/h (multiple transportable CHO - 2:1 glucose:fructose)
- Team sports usually >1h so 30-60 g/h
80
Post competition
- **endurance** sports need complex COH in daily diet
- immediately post exercise simple sugars help restore muscle glycogen and adding some protein may enhance storage (ratio of 3:1)
- in general, balanced diet will restore nutritional status after hard physical training
- Resistance training focus on protein
81
Infant Health Weight
**low birth weight = < 2.5 kg (5 1/2 lbs)**
**preterm = < 37 weeks of pregnancy**
- the lowest mortality rates occur among infants weighing 3,000 to 3,5000 (6.6 to 7.7 lb)
82
Critical Periods
- Critical period: time when cells of a tissue or organ are genetically programmed to multiply
- Critical so cannot correct for deficiency in cells alter
- nutrients required for cell/tissue development must be available during specific time intervals if missing then developing tissue has fewer cells, forms abnormally or functions poorly (e.g. cleft palate from too much vit A)
- Critical Periods of development diagram** Lecture 20**
83
Development origins hypothesis
**Dutch Hunger Winter (1944-1945)**
- 4.5 million people affected
- if women were exposed to famine during pregnancy:
- 1. lower birth weight
- 2. offsrping had an increased risk of diabetes and obesity as adults
- increased susceptibility to chronic disease is "programmed" by energy or nutrient imbalances during pregnancy
- fetal tissues in critical periods make adaptations to cope with poor nutrient supply
- adaptations produce changes in structure and function of tissues (permanent or long-lasting effect)
84
weight gain in pregnancy
- typically depends on woman's weight entering pregnancy
- **underweight**: 28 to 40 pounds
- **Normal weight**: 24 to 35 pounds
- **Overweight**: 15 to 25 pounds
- **obesity**: 15 to 20 pounds
- women carrying twins typically gains 37 to 54 pounds
- weight gained should be gradual and consistent, from a high-quality diet
85
NUTRITION During Pregnancy
**A. Calories**
1st trimester = +0 kcal/d
2nd trimester = +340 kcal/d
3rd trimester = +450 kcal/d
**B. Other Nutrients**
- choose nutrient dense foods
- espeically folate, iron, calcium
86
Folate in pregnancy
- deficiency assocaited with fetal growth fialure and malformation and neural tube defects
- adequate folate early in pregnancy reduces neural tube defects
- 600 ug folate is needed daily before (neural tube forms before 30 days after conception) and during pregnancy
87
Vitamin A during pregnancy
- Too little = poor fetal growth
- too much = fetal malformations (facial features and heart)
- intake of 10k-15k IU of retinol daily is too much
- limit vitamin A to ~5000 IU/day and take no vitamin A-containing medications
- Beta-carotene, a precursor to vitamin A is not harmful
88
Calcium during pregnancy
- needed for mineralization of bones in fetus
- supplied by mother's diet and calcium in long bones of mother's body
- low calcium intake means greater calcium losses from maternal bones during pregnancy - is this Ca regained after delivery?
89
Alcohol and pregnancy
- Fetal alcohol syndrome premanent condition
- no amount of alcohol is absolutely safe
- to prevent women should not drink during pregnancy or when trying to get pregnant
90
Vitamin D during pregnancy
Lack = compromises fetal growth and development
- Vegan women may be at greater risk because vitamin D is naturally found in animal products
- 600 IU is officially recommended for pregnancy and should not exceed 4000 IU
91
Iron during pregnancy
- most common deficiency in pregnant women
- **Neonatal Risks**: low birth weight, small for gestational age, fetal distress, preterm birth
- DRI =27 mg/day during pregnancy
- **Offspring risks**: memory/processing disorders, intellectual disability, iron deficiency
- **Maternal Risk**: preterm labor, placental abruption, severe postpartum hemorrhage, presclampsia, hysterectomy, maternal shock, increased ICU admission, maternal death
92
Vitamins and Minerals In Pregnancy
- Iron and folate are the only supplements recommended for all pregnant women
- multivitamin-mineral pills are recommended for women who do not consume an adequate diet and for high-risk categories, such as twins, heavy cigarette smokers, and those with alcohol or drug abuse
- 83% of pregnancy women take multiple vitamin and mineral supplements
93
Nutiriton-related concerns
**A.Nausea/morning sickness**
- get up slowly in morning
- eat dry toast or crackers
- chew gum or suck hard candies
- eat small, frequent meals
- avoid foods with offensive odors
- when naueseated do not drink citrus juice, water, milk, coffee, or tea
**B.Constipation and hemorrhoids**
- Fiber, exercise and liquids
**C. Heartburn**
- relax and eat slowly
- eat small, frequent meals
- drink liquids between meals
- avoid spicy or greasy foods
- elevate head while sleeping
- wait an hour after eating before lying down
94
High risk pregnancy factors
1. Maternal weight before pregnancy (over or under-wt)
2. Maternal weight gain during pregnancy
3. Maternal nutrition
4. Socioeconomic status
5. Lifestyle habits (smoking, alcohol, drugs)
6. Age – geriatric pregnancy?
7. Previous pregnancies (number, interval, outcomes, twins)
8. Maternal health (high BP, diabetes, etc.)
95
Exercise during pregnancy
**A. Benefits**
- maintain fitness
- prevent gestational diabetes
- facilitate labor
- reduce stress
**B. Guidelines**
- "low impact" activiteis
- avoid sports with risk of falling or being hit by other people or objects
- prevent excessive high internal temperatures and dehydration
- stay out of saunas, steam rooms and hot tubs
- don't exercise lying on back after 1st trimester
- dont exercise if pain or discomfort
96
Energy needs during infancy
- infants couble birthweight by 4 months
- infants triple birthweight by 1 year
- length increases 50% in first year
- after infancy growth rate declines
- **HR: 120-140 bpm**
- **Respiration rate: 20-40 breaths/min**
- **energy needs: 100 kcal/kg compared to adults need under 40 kcal/kg**
97
Breast milk composition
39% CHO (adults 12%)
55% Fat (adults 30%)
6% protein (adults 58%)
98
Nutritional needs during infancy
**A. Introducing cow's milk**
- 12 months
- before 6 months associated with intestinal bleeding and iron deficiency
**B. introducing solid foods**
- typically at 6 months
- iron fortified cereal first
- pureed vegetables and fruits next
- new recommendations don't dictate an order
- progress to family foods by 12 mnths
99
# Foo
Foods to avoid in first year of life
**choking**: grapes, frankfurter pieces, hard cancy, hard vegetables, meat chunks, nuts and seeds, popcorn, raw vegetables
**allergic reactions**: cow's milk, egg white, fish, seafood, nuts, peanuts, peanut butter, soy protein, wheat products
**foods that may cause other problems:** blueberries, coffee, corn, fruit drinks, honey, prune juice, tea
100
Children's Growth & Weight
- marker of their general nutrition and physical health
- poor growth often due to undernutrition or prolonged disease
- childhood obesity associated with a higher chance of obesity, premature death and disability in adulthood
- **satierty responsiveness**: responsiveness to internal satiety cues
- **food responsiveness**: responsiveness towards external food cues, including the smell and taste of foods
101
Food preferences
- learned and shaped by environment
- humans born with caution toward new foods
- childreen do not initially like strong flavored vegetables, spicy foods or mized foods
102
Food bans
- prohibiting intake of foods strengthens interest in the banned food and boosts consumption later
103
Healthy Eating Habits
* Parents decide what types of food their child should be
offered, decision about how much to eat is left to child
* Born with mechanisms to regulate amount – satiation/satiety
* Often children are trained to override the internal satiety cues
and soon they become dampened and less likely to regulate
body weight appropriately
* Don’t reward or punish children with foods
– e.g. eat when you’re not hungry to reward yourself
104
what to do about picky eaters
* Make one family meal
– Do not offer your child other options or their favorite foods if
he/she refuses the family meal.
* Make sure your child comes to the table hungry
* Avoid distractions like toys and television
* Eat meals at the table as a family.
– Do not offer food while your child is playing, watching television
or walking around.
105
Fast food choose wisely
- Frequent fast food may lead to chronic diseases due to
excess fat & salt, and lack of fruits, vegetables & whole
grains.
* Feeding your child fast food influences lifelong food
preferences.
* Teach moderation
106
Children & Milk
* Children and teens replace milk with soft drinks
* 1/2 of children have low calcium daily
* Children without milk intake have:
– Low calcium intakes
– Lower bone density
– More fractures
– Risk of osteoporosis
* Up to 2 yrs. of age, should drink whole milk (3.25% MF)
107
Growth Spurt
1. Growth Spurt: increased hunger and food intake, body fat gain, height gain and body fat lass.
2. Growth plateau: decreased hunger and food intake
3. Growth spurt: sequence repeats at start of next growth spurt
**adolescent growth spurt**:
* Occurs in girls between 11 and 15 years
* Occurs in boys between 12 and 17 years
* Age of onset varies considerably
* At peak, girls gain 8 kg/yr and boys gain 9 kg/yr
* Gain 50% of adult weight, 25% of adult height, 45% of
bone mass
108
WHO Growth Charts for Canada
- For females and males from 2-19 years of age to compare with norms
- Growth charts consist of graphs of: weight for age and height for age
- **BMI percentile**: below 5th means underweight, above 85th is overweight, above 95th obesity
109
What determines adult height
* Nutrition is the strongest non-genetic factor influencing height
* People grow taller in developed countries
* Good nutrition during pregnancy, and child diet during the
growing years, exercise and freedom from illness support
growth in height
110
Life expentancy and life span + in canada
- life expactancy (avg number of years lived) is lengthened by medical science and nutrition
- life span (maximum number of years) has not increased
- human life span = 120 years
**in Canada life expectancy**:
- Women -83.9 years
- Men - 79.5 years
- Highest BC
Shortest life expectancy is in Central African Republic = 54.36 years
*Longest life expectancy is in Hong Kong = 85.29 years
111
Strategies to slow aging
**A. Healthy habits**
- physiological age may not reflect chronological age
- lifestyle behaviors
1. Sleep
2. Well balanced meals
3. Regular physical activity
4. No smoking
**B. Calorie REstriction**
**1. energy restriction in animals**
- increased life span
- fewer age-related diseases
- 30-50% fewer calories
- aging genes less active
- less oxidative stress
**2. Energy restriction in humans**
Human trials are rare
* Pioneering clinical trial
called Comprehensive
Assessment of Long-term
Effects of Reducing Intake of
Energy (CALERIE).
* Young and middle-aged adults
randomized into 2 groups
– calorie-restricted diet for 2
years
– usual diet
- **Calorie Restriction Society International**
- - Compared with individuals consuming a typical standard Western
diet, individuals in this group who have been practicing CR for a
mean of 15 years have reduced body fat, markers of
inflammation, and cardiovascular disease (CVD) risk
112
Physiological changes in aging
**1. Body composition**
- lose bone & muscle, increased percent fat
**2. Immune system**
- declines with age
- compromised by nutritional deficiencies
**3. GI tract**
- decreased stomach acidity
- intestinal tract loses strength and elasticity -
constipation
**4. Endocrine**
- hormones increase/decrease (e.g. testosterone,
estrogen)
**5. Tooth loss**
- chewing difficult or painful
- dentures
**6. Sensory losses**
- poor eyesight
- taste sensitivity declines somewhat and
smell declines more
- loss of vision & hearing - social isolation
113
non physiological changes in aging
| q
**1. Psychological**
- depression
- lose appetite and motivation to cook & eat
**2. Economic**
- 20% of people >65 live in poverty
**3. Social**
- malnutrition in those living alone
114
Energy and nutrient needs in odler age
**1. Water**
- total body water decreases with age
- mild fever or hot weather dehydration
**2. Energy**
- needs decline estimated 5% per decade
**3. Protein**
- suggest 1 g/kg BW
- important for immune system & prevent muscle wasting
**4. Vitamins & minerals**
- vitamin B12, vitamin D, calcium, iron
115
Nutrition related diseases in older adults
1**. Cataracts & macular degeneration**
- cataracts = thickening of eye lens
- macular degeneration = deterioration of
center of retina responsible for straight-ahead
vision
- antioxidants may be protective
**2. Arthritis**
* Osteoarthritis = cushioning cartilage in joint breaks down
- prebiotic fiber
* Rheumatoid arthritis = disease of immune system with
painful inflammation of joints
- omega-3, fish oils
**3. Alzheimer’s**
- exploring dietary inflammatory score, whole grains
116
FOOD SAFETY CONCERNS
1. Food borne illnesses
2. Environmental contaminants
3. Naturally occurring toxicants
4. Pesticide residues
5. Food additives
117
Signs of severe food poisoning
- bloody diarrhea
- vomiting so often you can't keep liquids down
- fever higher than 102F
- dehydration
- diarrhea for more than 3 days
118
Causes & consequences of food poisoning
* 250 foodborne illnesses identified
* A day or two of nausea and diarrhea to death within
minutes
* Most severe in people:
– weakened immune systems
– certain chronic illnesses
– pregnant women
– young children
– older persons
* Symptoms of foodborne illness often consist of
abdominal cramps, vomiting, nausea, diarrhea, fever
119
Food borne infections
**HEPATITIS A**
- inflammation of the liver
- fatigue, nausea, dark urine
- primarily spread when person ingests food or water
that is contaminated with the feces of an infected
person
- onset: 2-7 weeks
- Raw or undercooked shellfish
from contaminated waters, raw
produce, contaminated drinking
water (ice)
- MOST prevlanet in developing countries
**GIARDIA (GIARDIA LAMBLIA PARASITE)**
- contaminated water
- diarrhea main symptom (sudden onset explosive
or chronic)
- onset: 1-3 weeks
**LISTERIOSIS (LISTERIA MONOCYTOGENES BACTERIA)**
- hot dogs/deli meat, unpasteurized milk
& soft cheese (feta, Brie, camembert, cream cheese, ricotta)
- mainly gut symptoms and fever but can trigger brain
infection and/or sepsis
- high death rate in fetus and infants
- onset: 3-30 days or longer
Milkshake deaths in August 2023 in Tacoma, Washington
https://www.cnn.com/2023/08/20/us/tacoma-milkshake-listeria-deaths/index.html2008
**SALMONELLA**
- raw or undercooked eggs & meat, raw dairy, F&V (sprouts
and cantaloupe)
- mainly gut symptoms
- onset: 6 hours - 6 days (last 4-7 days)
**e.coli**
- undercooked ground beef, unpasteurized milk,
contaminated water, person to person
- mainly watery bloody diarrhea, cramps
- 15% children and elderly develop hemolytic uremic
syndrome (can be fatal; permanent kidney damage)
- onset: 1-8 days (lasts 5-10 days)
- 2012
Largest food recall in
Canada: 1700 products
120
Food intoxicants
**1. Botulism**
- Clostridium botulinum grows without oxygen
- botulinum toxin is responsible (one of deadliest known toxins)
- canned vegetables and meats; honey (bees pick up spores from
flowers/soil); oils infused with garlic or herbs
- onset: 4-36 hrs
- blurred vision, difficulty speaking, paralysis, can be fatal
- need antitoxin immediately
**2. Staphylococcal toxin**
- tuna, potato and macaroni salads, cream filled pastries, meats &
poultry, egg products
- mainly gut symptoms, mild fever
- onset: 1/2 to 8 hrs (lasts: 24-48 hrs)
121
Food safety
1. Clean, safe kitchen
- hot, soapy water
2. Avoid cross-contamination
3. Keep hot foods hot
- internal cooking temperature to kill
microbes differs for various meats
4. Keep cold foods cold
- refrigerator = 4-6ºC
- freezer = -18 to -20ºC
122
Mad cow disease
* Prion causes this deadly disease
* Small protein that transmits disease when consumed by a similar
species
* Mad cow disease is transferred to humans who eat prion-infected
meat
* Humans develop variant Creutzfeldt-Jakob disease from
contaminated meat
– Symptoms resemble Alzheimer’s but progress much more rapidly
* Inevitably leads to death due to brain damage
* It is now illegal to feed cows any animal parts that
could transmit disease (nerve, bone, intestine).
* Risk of consuming beef from cattle with mad cow
disease is small but possibility exists
123
Mercury Contamination
* Mercury contamination by fungicides, fossil fuel exhaust, smelting
plants, pulp mills, and chemical plants
* Virtually all fish have trace amounts of mercury
- shark, swordfish, bass, lake trout, walleye, chain pickerel (large
game fish) have high levels
* Mercury interferes with fetal brain development, so avoid eating these
fish if pregnant
* Health Canada says pregnant women should avoid shark, tile fish,
swordfish, or king mackerel
* Consumption of fish by adults in general does not appear to pose a
health risk
**bioaccumulation of toxins in the food chain**
124
Other concerns of food contamination
**1. Additives**
- new additive must prove
*effective
*detectable & measurable in product
*safe (large doses to animals)
- must never have caused cancer in animal study or human
experience
*** Intentional additives**
* antimicrobial agents - salt, sugar, potassium sorbate, nitrates
* antioxidants - vitamin C, E, sulfites, BHA & BHT
* color additives - carotenoids, caramel, blue #1 & 2, yellow #5 & 6
* artificial flavors - largest group (MSG)
* texture & stability - gums, pectins, etc.
* nutrient additives -
1. Thiamin, niacin, riboflavin, folate & iron in grain products
2. Iodine in salt
3. Vitamins A & D in milk
4. Vitamin C & calcium in juice
**Indirect additives**
* microwave packaging
- at high temperatures chemicals and microplastics can
migrate into food
- glass or ceramic should be used
- avoid disposable plastic containers
Environ Sci Technol 2023;57(26):9782-9792
125
if 100 people represented the world then
* 60 Asia
* 14 Africa
* 12 Europe
* 8 Latin America and Caribbean
* 5 North America
* 1 Australia and New Zealand
* 1 person would have a college education
* 80 would live in poor housing
* 50 would be malnourished
126
State of health in the world
* What is monitored?
– Number of low birth weight infants
– Prevalence of child underweight
– Rates of breast feeding
– Access to safe drinking water
* Health and nutrition status of developing countries monitored by:
– World Health Organization (WHO)
– United Nations International Children’s Emergency Fund (UNICEF)
– Food and Agriculture Organization (FAO)
127
why does starvation or malnutirition happen?
* Poverty
* Poor and corrupt governments
* Inequitable distribution of the food supply
* Low levels of education
* Discrimination against females
* HIV/AIDS epidemic
* Lack of economic opportunities
* Racism, ethnocentrism
* Low agricultural productivity (natural disasters; use of
agricultural land for biofuel crops)
* Unsafe water
