Lecs-10510141019 Flashcards
(83 cards)
1
Q
Is protein deficiency common in the US?
A
No, rare
2
Q
What is most common dietary source of protein in US? How much of dietary protein does it comprise?
A
Animal sources: meat, poultry, seafood, eggs, and dairyMake up 2/3 of dietary protein in the US
3
Q
What is most common dietary source of protein in the world?
A
Plant proteins: grains and veggies
4
Q
What is the correlation btwn economic status and animal foods consumption?
A
W/ increase in economic status → increase in proportion of animal foods consumed
5
Q
What is avg amount of protein consumed/day in US?
A
avg 90grams protein/day>High burden of disease
6
Q
What are nutrients supplied by animal protein foods? Drawbacks?
A
> B vitamins, iron, zinc, calcium>But: low in fiber and can be high in fat
7
Q
What are nutrients supplied by plant protein foods? Drawbacks?
A
> B vitamins, iron, zinc, calcium, FIBER >Less absorbable forms
8
Q
What are amino acids (AAs)?
A
> Building blocks of protein
9
Q
What are essential AAs?
A
AAs that can’t be synthesized by the human body in sufficient amounts to meet needs>Need to include in diet
10
Q
How many AAs in total? How many are essential vs. not?
A
20 amino acids in total: 9 essential and 11 non-essential
11
Q
What are conditional essential AAs?
A
They need to be obtained via the diet when one is sick or in some conditions
12
Q
What is unique about the 11 non-essential AAs?
A
We can convert all 11 non-essential AAs into one another
13
Q
What is a protein?
A
one or more polypeptide chains (many AAs) folded into a three-dimensional shape
14
Q
What determines a protein’s fxn?
A
Its shape determines its fxn
15
Q
What is protein denaturation?
A
alteration in protein’s 3D structure>Results in: normal fxn ceases
16
Q
What are causes of protein denaturation?
A
> Change in pH (e.g. digestion)>Heat (e.g. cooking)>Agitation (e.g. whipping an egg white)
17
Q
What is AA structure?
A
Central carbon atom bound to an H atom –> Amino group (NH2) –> Acid group (C(O)OH) –> R Chain (differs by AA)
18
Q
What is proteins structure?
A
> Peptide bonds: chemical bonds that link AA together>Dipeptide bonds: two AAs>Polypeptides: many AAs
19
Q
How is protein digested and absorbed?
A
> Mouth – Mechanical breakdown via chewing>Stomach – HCL starts chemical digestion>Small intestine»_space;>Active transport into mucosal cell, where dipeptides and tripeptides are broken down into single AAs>AA pass into blood, travel to liver
20
Q
What causes food allergies?
A
Absorbing a protein whole = allergy>Most common allergens = milk, eggs, nuts, wheat, soy, fish and shellfish, and peanuts
21
Q
Anaphylaxis
A
rapid, severe allergic rxn>Life-threatening>Epi-pen – epinephrine is used to treat allergic reactions
22
Q
Amino Acid Pool
A
We don’t store AA, but there are AAs floating in our blood from digestion and mscl breakdown (body proteins)
23
Q
What are AAs used for?
A
> Used for energy, >Synthesis of glucose or fatty acids, >Synthesis of nonprotein molecules that contain nitrogen (e.g. DNA and RNA)
24
Q
Protein Synthesis: Transcription and Translation
A
Nucleus (DNA to mRNA) ⇒ cytosol (mRNA to ribosomes) ⇒ ribosomes (tRNA reads code and synthesizes the protein)
25
What determines proportion of AAs in AA pool?
AA composition of the diet
26
What organ can excess protein consumption damage and why?
Kidneys bc we don't store protein, we excrete it
27
**What are some fxns of protein in the body?**
>Enzymes → speed up metabolic rxns>Transport proteins → move substances in and out of cells>Antibodies → immune system (antigens/foreign bodies)>Contractile proteins → help mscls move, E.g. Actin and myosin >Hormones → chemical messengers, E.g. insulin and glucagon>Regulate fluid and acid-base balance
28
What is US and global impact of protein deficiency?
Not a problem in US but major cause of early mortality globally
29
What is Protein-Energy Malnutrition (PEM) and 2 types?
>Range of protein deficiency conditions>>Two types: Kwashiorkor and Marasmus
30
What is Kwashiorkor?
pure protein deficiency>Characterized by swollen belly
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What is Marasmus?
energy and protein deficiency>Wasting (same wasting you see w/ AIDS, cancer)>Characterized by depletion of fat stores and wasting of mscl
32
Diets that contain animal protein can result in what?
consuming protein in excess of need
33
What are consequences of excess protein consumption over long periods of time?
>Hydration and kidney fxn issues>>>From need to excrete excess Nitrogen>Bone health issues from loss of calcium in urine>>>High meat diet → excrete more Ca2+ in urine>Kidneystones>Increased risk of heart disease and cancer (red meat)>Increased body fat (excess protein not stored --> converted to fat)>>>Anytime we have extra energy, our body converts it to fatty acids and stores in adipose tissue
34
What comprises "red meat"?
Includes poultry and fish
35
**Why might red meat be related to an increased risk of chronic diseases?**
>GRILLING (any high-dry/high-heat cooking) makes heterocyclic amines (HCA), which appear as blackened surfaces>>>HCA is carcinogenic, acts like nicotine>INCREASE IN BODY WEIGHT>>>Associated w/ cancer risk, e.g. breast, colon, and prostate cancer>Decrease in plant products>Insulin secretion from essential AAs>>>High lvls of Insulin can cause cell damage>Arachidonic acid content (PUFA)
36
What is the implication of excess Nitrogen in the urine (N out > N in)?
Means you're burning up body tissue (protein is seen as N in urine)
37
What is the implication of N in > N out?
Indicated tissue growth!
38
How much protein do adults require by bodyweight?
0.8g/kg bodyweight>Assumption: not excess body fat
39
When do we need more protein?
during periods of growth, pregnancy, and lactation
40
Do we need protein supplements?
>No – unregulated>Amino acid is brought to mscl right after exercise>>>Need INSULIN to get AA into mscl>>>Flavored milk is best to have after exercise
41
What is protein complementation?
Putting together foods to get all your amino acids, e.g. rice + beans>Rice has a lot of Met + Cys but not Lys>Beans have a lot of Lys but not Met + Cys>Combine them and get enough of both
42
Why are we eating more as a population?
>Portion Distortion – portions are larger = more cals
43
How is body weight assessed on popul'n lvl?
Body Mass index (BMI) = Weight in kg/ height in m2>Tells whether overweight [BMI 25 – 29.9] or obese [BMI 30+]
44
Issues with BMI measurement?
>Does not measure fat>Not useful for individuals but for popul’n measures
45
What is energy balance?
energy consumed equals energy expenditure
46
What constitutes an individual's total energy expenditure?
Basal metabolic rate (BMR), physical activity, Thermic effect of food (TEF)
47
What's Basal metabolic rate (BMR)?
energy you need to run your body, equals 60-75% of energy expenditure>Varies by size, body composition, age, gender
48
What are 2 types physical activity?
>Daily, e.g. chores, walking, normal activity>Strucutred, e.g. sports, gym
49
What's the Thermic effect of food (TEF)?
AKA diet-induced thermogenesis>Energy used to digest/absorb food → inherent to food size >On avg = 10% of total energy in food, e.g. if you eat 100 cals you use 10 of those cals to digest food>**We store more energy from smaller amounts of foods** (why snacking causes weight gain)>Non-exercise activity thermogenesis (NEAT) = Overeating and regulating body heat
50
When are body energy stores used or built?
>Weight loss = stores are used>Weight gain= stores are built
51
**Extra protein is stored as what?**
AS FAT!>Not stored as mscl or AA but as fat!>>>>(converted to fatty acids and stored in adipose tissue)
52
What is the Hunger-Obesity Paradox?
Says that your chances of being overweight are higher if you’re>Food insecure → associated w/ low-inc>Low-income>Low-education>Minority → associated w/ low-edu, low-inc
53
Define food insecure
For at least some part of the month you don’t know if you will have food at next meal >Most of the time due to financial circumstances
54
What are reasons for the Hunger-Obesity Paradox?
>If you’re food insecure: >>>You may overeat when food is available >>>You may become more efficient at storing fat (survival)i. You’re going through feast and famine all the timeii. Increase activity of lipoprotein lipase? (theory)>>>Erratic eating – you don’t consistently eat the same # of meals a day
55
What is passive overconsumption?
>When you keep eating a food, unaware you’re doing it [taste, cost, convenience]>**Energy density: calories for a weight/volume of food**>>>Higher energy density = high cals for low weight/volume food, e.g. refined grains (“white” pasta, rice, bread), products w/ added sugar/salt/fat-snack foods, candy*LOWER COST → US gov’t subsidizes crops used to make high energy density foods>>>Lower energy density: low cals for a low-weight/volume food, e.g. fruit, veggies, whole grains (have more water/fiber)
56
What are eating disorders?
Diagnostic and Statistical Manual (DSM) IV:>Anorexia Nervosa (AN)>Bulimia Nervosa (BN)>Eating Disorder Not Otherwise Specified (EDNOS)>>>Binge Eating Disorder (BED)
57
About how many women struggle w/ an eating disorder or disordered eating in the U.S.?
1 in 5 women
58
What is DSM-IV diagnostic criterion for Anorexia Nervosa (AN)?
A. Refusal to maintain body weight at or above 85% of expected weight for age + heightB. Intense fear of gaining weight or becoming fat, even though underweightC. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of seriousness of current low weightD. (AMENORRHEA) In post postmenarcheal females: amenorrhea - the absence of at least 3 consecutive menstrual cycles
59
What are the 2 AN subtypes?
>Restricting types>Binge-eating/purging type
60
Restricting Type
(AN subtype)During current episode of AN, no regular binge eating or purging behavior
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Binge-eating/purging type
(AN subtype)During current episode of AN, regular binge eating or purging>DIFFERENTIATED from bulimia bc of presence of a body weight
62
What is DSM-V diagnostic criterion for Anorexia Nervosa (AN)?
A. Persistent restriction of energy intake relative to reqs leading to a significantly low body weight in context of age, sex, developmental trajectory, and physical healthaa. ELIMINATES specificity of below 85% ideal body weightB. Intense fear of gaining weight or becoming fat even though underweight C. Disturbance in the way in which ones body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or the denial of the seriousness of the current low body weight
63
**CHANGES in diagnostic criterion for Anorexia Nervosa (AN) from DSM-IV to DSM-V?**
ELIMINATES objective weight criterion (specificity of below 85% ideal body weight), amenorrhea, and use of the word “refusal”
64
What is DSM-IV diagnostic criterion for Bulimia Nervosa (BN)?
A. Recurrent binge eating (at least 2x/ wk for 3 mos duration)aa. Usually normal weight bc 50% cals are absorbed when consumed, despite purgingB. Recurrent, inappropriate, compulsive behavior to prevent weight gain (e.g. self-induced vomiting, abuse of laxatives, diuretic or other meds, or excessive exercise)C. Persistent overconcern w/ body shape and/or weightD. Absence of Anorexia Nervosa
65
What are the 2 BN subtypes?
>Purging type>Non-purging type
66
Purging type
(BN subtype)self-induced vomiting, laxative abuse, diuretic abuse
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Non-purging type
(BN subtype)Fasting, over-exercise
68
What is DSM-V diagnostic criterion for BN?
A. Recurrent episodes of binge eating characterized by BOTH of the following:aa. Eating in a discrete amount of time (w/i a 2hr period) large amounts of foodab. Sense of lack of control over eating during an episode (i.e. feeling that one cannot stop eating)B. Recurrent, inappropriate compensatory behavior in order to prevent weight gain (e.g. purging)C. The binge eating and compensatory behaviors both occur on avg at least 1x/week for 3 mosD. Self-evaluation is unduly influenced by body shape and weightE. The disturbance does not occur exclusively during episodes of AN
69
**CHANGES in diagnostic criterion for BN from DSM-IV to DSM-V?**
>Reduced frequency of symptom use to 1x/week vs. 2x/wk----- My own observation:>In (B), Changes "compulsive behavior" to "compensatory behavior"
70
What is DSM-V diagnostic criterion for Binge-Eating Disorder (BED)?
A. Recurrent episodes of binge eating. An episode is characterized by:aa. Eating a larger amount of food than normal during a short period of time (w/i any 2 hr period)ab. Lack of control over eating during binge episode (i.e. feeling that one cannot stop eating)B. Binge eating episodes are associated w/ 3+ of the following:ba. Eating until feeling uncomfortably fullbb. Eating large amounts of food when not physically hungrybc. Eating much more rapidly than normalbd. Eating alone bc you're embarrassed by how much you’re eatingbe. Feeling disgusted, depressed, or guilty after overeatingC. Marked distress regarding binge eating is presentD. Binge eating occurs, on avg, 2x/week for 6 mosE. The binge is not associate w/ the regular use of inappropriate compensatory behavior and does not occur exclusively during the course of BN or AN
71
What is The Binge Cycle?
Binge → feel better → feel bad/guilty → want to feel better → binge again → cycles
72
**CHANGES in diagnostic criterion for BED from DSM-IV to DSM-V?**
BED became its own separate category
73
**CHANGES in diagnostic criterion for EDNOS from DSM-IV to DSM-V?**
>Eliminated as a category>Development of OSFED (other specified feeding and eating disorder)>Development of UFED (unspecified feeding and eating disorder)
74
What is OSFED (other specified feeding and eating disorder)?
>Atypical AN (AN features w/o low weight)>BN of low frequency and/or limited duration>BED of low frequency and/or limited duration>Purging disorder>Night eating syndrome
75
What is UFED (unspecified feeding and eating disorder)?
Individuals uncategorized as OSFED or w/ insufficient info to make a diagnosis
76
Purging disorder
recurrent purging behavior to influence shape or weight w/o prior bingeing
77
Night eating syndrome
sleep-wake cycle disturbance, causing very low food intake during the day and very high intake at night >or waking up in the middle of the night to eat
78
What are some risk factors for EDs?
>Genetic: 50-83% of the variance in ED is related to genetics>Social: Societal pressured for thinness>Psychological: anxiety, depression, OCD, trauma>**DIETARY RESTRAINT– one of the predisposing factors for EDs**>Gender (>prevalence in females)>Low self-esteem>Body dissatisfaction
79
What are high-risk popul'ns for EDs?
>Athletes[Female Athlete Triad]>Bariatric (weight loss surgery) candidates>Adolescents
80
Female Athlete Triad
disordered eating, amenorrhea, bone loss>Drop in estrogen + lack kcals = osteoporosis
81
Orthorexia Nervosa
>Fixation on righteous eating>>>Rigid rules about food quality and purity>>>Food choices often become so restricted in variety and calories that health suffers>A more frequent eating disordered behavior in athletes (28%)
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**Dangers of EDs**
EDs have highest mortality rate of any mental illness!!!
83
Complications of EDs
>AN – bradycardia, orthostasis, hypothermia>BN – bradycardia, orthostatis, dry skin>BED – diabetes/pre-diabetes, obesity, altered hormone secretion
