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NTRN 363 > Midterm Review > Flashcards

Midterm Review Flashcards

(103 cards)

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1
Q

What are the key concepts to remember when applying DRI’s?

A

-Intended for use with healthy people
-Apply to all sources of a nutrient
-Apply to usual intake

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2
Q

List 5 factors that affect the dietary requirements of a nutrient in humans

A

-Dietary factors(chemical form of nutrient +processing)
-Host factors (Age, sex, genetics)
-Physiological states (growth, pregnancy, lactation, aging)
-Pathological states (metabolic disease, trauma)
-Environmental factors( physical and biological)
-Social(dietary habits, physical activity)

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3
Q

Define Minimum requirement

A

-The least amount of a nutrient needed to prevent clinical symptoms or support a defined biochemical response

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4
Q

What are the indicators of adequacy?

A

-growth
-clinical signs and symptoms
-biochemical measures (blood levels, enzyme activity, urinary excretion)
-balance studies

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5
Q

What are the criterion for indicators of adequacy?

A

-May be deemed the most appropriate to determine the risk that an individual will become deficient
- May relate to maintaining a desirable level of function
-Reducing the risk of chronic disease and concept of optimal body pools/stores

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6
Q

What does DRI stand for?

A

-Dietary reference intake

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7
Q

What is EAR?

A

Estimated Average Requirement; the avg daily intake value that is estimated to meet the requirement, as defined by a specific indicator of adequacy in 50% of healthy individuals in a life stage or gender group. Not a recommended intake.

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8
Q

What is RDA?

A

The avg. daily dietary intake level that is sufficient to meet the requirements of nearly all healthy individuals in a life stage or gender group

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9
Q

What is AI?

A

-adequate intake
-Used when there is insufficient data to establish the EAR and RDA
-Value based on observed or experimentally determined estimates of the average nutrient intake that appears to maintain a defined nutriture in a group of healthy people

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10
Q

What is UL?

A

-The maximal level of chronic daily intake unlikely to pose adverse health risks to almost all in life stage or gender group

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11
Q

What does ND stand for?

A

-Not determinable

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12
Q

What is EER?

A

-Estimated energy requirement; Avg. Daily energy intake predicted to maintain energy balance. Based on age, sex, weight, heigh and PA level

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13
Q

What is AMDR?

A

-Acceptable macronutrient distribution range; Range of intake for energy yielding macronutrients that are with decreased risk of chronic disease

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14
Q

What are DVs?

A

Daily Values; set of nutrient standards used on nutrition facts panel and are based on RDI’s and DRVs

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15
Q

What are the three types of research?

A

-Experimental/ Interventional: Clinical Trials
- Epidemiological/ Observational: Observations based on individuals or populations of people
-Pre-clinical/ Basic research: cells, chemistry, animal models.

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16
Q

What are the two main types of human research studies?

A

-Clinical trials: prove cause and effect relationships
-Epidemiological research: Suggest associations and observe a group’s behavior to suggest a relationship

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17
Q

What makes a good Clinical Trial?

A

-Double blind
-Defined research question
-Specific study population
-controlled conditions
-pre-determined outcome measures

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18
Q

What is the gold standard for a clinical trial?

A

-Radomized, Placebo controlled, double blind

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19
Q

What are Epidemiological studies?

A

Observational study that can not prove cause and effect but suggest relationships. Frequently use questionnaires to obtain data.

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20
Q

What are the three types of observational studies?

A

Cross sectional study: Identify feature of population
-Case-control study: Compare risks in two groups
- Cohort study: Identify causes that lead to a certain endpoint

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21
Q

Define incidence

A

number of new cases of a disease

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22
Q

Define prevalence:

A

number of cases of a disease existing in a given population at a specific time

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23
Q

Define Baseline characteristics

A

data collected at the beginning of the trial for both Tx and control groups

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24
Q

Define Adverse Events

A

unfavorable, unintended consequences as a result of the study; participants may discontinue the trial

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25
Define Hazard
the risk (probablility) of some outcome over the whole trial period
26
Define endpoint:
the primary goal of the trial (most important outcome) often measured at a pre-determiend time
27
What does p<0.05 mean?
-Less than a 5% chance that the outcome is due to random variations
28
Define relative risk
ratio of incidents in exposed group to incidents in non-exposed group
29
Define adjusted relative risk
accounts for variables (age, race,gender, family, history, presence of diseases)
30
Define odds ratio
ratio of calculated odds of an event happening in exposed group to incidents in non-exposed group
31
Define meta-analysis
pooling data from several studies that address a set of related research
32
What are monosaccharides?
-1 sugar unit (glucose, fructose, galactose)
33
What are dissaccharides?
2 sugar units (sucrose, lactose maltose)
34
What are oliosaccharides?
3-10 sugar units (raffinose, stachyose)
35
What are polysaccharides?
more than 10 sugar units (starch, glycogen)
36
What are sugar alcohols?
Reduction: changes carbonyl to hydroxyl group (eg alcohol forms of glucose and fructose)
37
The term sugar is traditionally used to describe..
-mono- and dissacharides
38
What does it mean for a sugar to intrinsic and extrinsic
-Intrinsic: naturally occurring (Lactose in milk, fructose in sugars) -Extrinsic: added to foods (white, brown and raw sugars, corn and maple syrup)
39
Starches consist of….
-<1000 to many thousands of alpha linked glucose units (ex. Amylose and Amylopectin)
40
Is the amount of dietary carbohydrates known or unknown?
Unknown. AMDR: 45-65% to total kcals
41
RDA for carbohydrates
RDA for CHO is set at a minimum amount required to prevent ketosis. 130 g/d based on the avg. minimum amount of glucose utilized by the brain
42
What is ketosis?
When glucose production/availibility is below the complete energy requirements of the brain. The liver produces ketone bodies (alternative fuel for the brain)
43
What is dietary fiber?
Non-digestible CHO and lignin that are naturally occurring in plants (i.e. intact and intrinsic in plants)
44
What is functional fiber?
Isolated, extracted or synthetic nondigestible CHO that have beneficial physiological effects in humans
45
Examples of dietary fibers
cellulose, hemicellulose, lignin, B-glucans, fructans, resistant starches
46
Example of functional fibers
cellulose, lignin, fructans, chitin, polydextrose, resistant dextrins
47
What is resistant starch (RS)
-not digested by human intestinal enzymes -passes to colon, fermented by bacteria into short chain fatty acids (SCFA)
48
What are the types of RS (Resistant Starch)
-RS1: Naturally occuring, plant cells walls, inaccessible to amylase (e.g. legumes, unprocessed whole grains, seeds) -RS2: Naturally occurring, starch inaccessible to enzymes d/t starch conformation (e.g. green banana, raw potato) -RS3: Produced during processing or manufactured, Amylose prone, to retrogradation(H-bonding between amylose untis) eg. rice and potatoes -RS4: synthetically produced, man-made(eg. actisar(RS modified tapioca)
49
Fibers are classified by..
Their solubility in water, ability to form viscous solutions and degree of fermentation
50
What are the properties of Viscous/soluble fiber
Dissolve in water, high water holding capacity, higher viscosity, gel forming in gut, dely gastric emptying, dely nutrient absorption, increase/lengthen transit time of intestinal contents, stool softening, highly fermentable
51
What are the properties of non-viscous. Insoluble fiber
doesn’t dissolve in water, lower water holding capacity, do not have property of viscosity, goes through GI tract unchanged, increase fecal bulk and frequency, decrease/shorten transit time via irritation of gut mucosa, less/insignificant fermentation
52
Solubility does/does not always predict physiological effects/ functional properties of fiber
-does not
53
What are sources of soluble dietary fiber?
-e.g pectins,gums, -oats, rye, barley -legumes (beans, peas,soybeans) -some fruits and fruit juices (prune juice, plums, berries, insides of apples and pears) -some vegetables(broccoli, carrots, artichoke) -some root vegetable (sweet potatoes, onion (skins are insoluble fiber))
54
What are sources of insoluble fiber?
-e.g Cellulose and lignin -Wheat and corn bran -nuts and seeds -potato skins -some fruits (avocado, bananas) -some vegetables( green beans, cauliflower, zucchini, celery)
55
What is the fiber AI? What is mean intake of fiber in the US?
25-38g/d - 17g/d
56
What are the effects of dietary fiber in the human colon?
-inc. Fecal weight/fecal bulk -inc. Frequency of defecation -changes in transit time (*varies) -dilutes colon contents -adsorbs organic/inorganic substances -detoxification -decreased dehydroxylation of bile acids
57
What are the benefits of fiber fermentation?
-Production of hydrogen, methane, carbodioxide, SCFAs (butyrate,propionate,acetate) -dec. pH in colonic lumen -inc. Microbial growth (act as substrates) -stimulates healthy gut microflora -modulates immune function -protects against inflammation -serves as an energy source for colon cells (butyrate) -stimulates water and electrolyte absorption( can assist in tx of diarrhea)
58
Overall, dietary fiber promotes…
-digestive health through its modulation of laxation, fermentation and effects on gut microbiota
59
What is a low FODMAP diet and who would it be recommended for?
-FODMAP; fermentable oligo, di-, and monosaccharides+polyols(fructose,lactose.sugar alcohols,fructans) -poorly absorbed causes gas production, bloating, abdominal pain and changing in bacterial populations=changes in motility -Sometimes recommended for people with IBS
60
What is Inflammatory Bowel Disease (IBD)
-progessive, autoimmune,chronic inflammatory disease of the GI tract that often leads to irreversible damage.
61
What are the two types of IBD?
-Chron’s -involves any port of GI tract (most common in ileum and colon) -Ulcertaive colitis- involves large intestine (colon or rectum) Symptoms: diarrhea. Bloody stools, abdominal pain, fever. Fatigue, weight loss
62
What is diverticular disease?
-Movement of material through the colon is stimulated in part by the presence of reside or bulk -With chronic insufficient bulk, stronger contractions are need to propel the smaller mass forward for excretion -chronic force can lead to formation of diverticula, herniation of the mucosal layer of the colon wall, diverticulosis -diverticulitus results if the diverticula become inflamed -symptoms abdominal pain, bloating, alternating constipation and diarrhea
63
Management of diverticular disease
-high fiber diet -bulk can prevent formation of more diverticula
64
What was Dr. Denis Burkitt- Origin of dietary fiber hypothesis
-Well established relationsips between high dietary fiber intake and lower risk of chronic disease
65
What type of hormone is insulin?
-anabolic hormone
66
What are the major metabolic effects of insulin in glucose metabolism?
-Stimulates glucose uptake into muscle and adipose cells -inhibits hepatic glucose production -stimulates glycogen synthesis and inhibits glycogenolysis
67
What are the consequences of insulin deficiency in glucose metabolism?
Hyperglycemia: osmotic diuresis and dehydration
68
What are the major metabolic effects of insulin in lipid metabolism?
-Inhibits lipolysis (breakdown of TGs) in adipose tissue -Stimulates lipogenesis (synthesis of TGs)
69
What are the consequences of insulin deficiency in lipid metabolism?
-Elevated FFA levels
70
What are the major metabolic effects of insulin in ketone metabolism?
inhibits ketogenesis (process by which ketone bodies are produced as a result of fatty acid breakdown)
71
What are the consequences of insulin deficiency in ketone metabolism ?
-ketoacidosis
72
What are the major metabolic effects of insulin in protein metabolism?
-Stimulates AA uptake and protein synthesis -Inihibits proteolysis (protein breakdown)
73
What are the consequences of insulin deficiency in protein metabolism?
-muscle wasting
74
What is Type 1 diabetes Mellitus (DM)
-insulin-dependent diabetes mellitus (IDDM); juvenile onset -Results from the failure of pancreatic B-cells to produce insulin, leading to insulin deficiency -Caused by genetic defects in B-cell function, insulin processing/action OR autoimmune destruction of B-cells
75
What is type 2 diabetes Mellitus (DM)
-noninsulin-dependent (NIDDM)”adult onset” but teens and children can develop -characterized by insulin resistance couples with relative insulin deficiency -commonly coexists with obesity
76
What are the short-term (acute) complications with diabetes
-Hypoglycemia…coma…death -ketosis…high ketone bodies in blood; acidic, dec. pH -diabetic ketoacidosis…dehydration/electrolyte depletion.. Coma…death
77
What are the long term complications with diabetes
Cardiovascular disease (stroke) -Nepthropathy (kidney failure) -Reniopathy ( vision loss/blindness) -Neuropathy(nerves.. infection/amputation)
78
What is the link between fiber and diabetes?
Fiber slows the absorption of glucose which causes decrease in postprandial glucose and dec. insulin response -Overall benefits on long-term glucose control; prevention and management of diabetes
79
What is the glycemic index?
A classification system used to quantify the relative BG response to foods containing CHO
80
What is Cardiovascular Disease?
CVD is an umbrella term used to describe disease of the heart and blood vessels. -Ex. Coronary heart disease, cerebrovasular disease, peripheral arterial disease, aortic aneuryms. Congenital heart disease, cardiac dysrhythmias, hypertensive heart disease, heart failure
81
What is the most common form of CVD?
-Coronary heart disease (CHD)
82
What usually causes Coronary heart disease? (CHD)
Usually caused by atherosclerosis. Narrowing of the lumen of an artery due to accumulation of plaque, obstructed blood flow. Can lead to high blood pressure. Angina, ischemia, myocardial infarction or stroke.
83
What is the main risk factor for coronary heart disease?
High LDL cholesterol >160 mg/dl
84
What is the AI for fiber intake?
Based on the prevention of CHD 38g/d (men) and 25 g/d (women) -Clinical trials show inc. in dietary fiber causes dec. in blood lipids -The impact of dietary fiber on the advent of CHD occurs across a wide range of intake and therefore EAR/RDA can’t be set
85
What is the summary conclusion of effects of fiber in the GI tract on parameters related to energy regulation/weight control
-The beneficial effects of fiber on energy regulation were seen with soluble and insoluble fiber, and when using foods naturally high in fiber or fiber supplements
86
What is the summary of fiber and potential link to weight regulation
-Fiber-rich foods/ a fiber-rich meal: -Typically less energy dense, induces bilk and inc. viscosity(depends on type, changes gut microbial composition, produces short-chain fatty acids(trigger relase of gut hormones), promotes feeling of satiety, affect energy intake during meal or delay the return of hunger following a meal -High fiber intake may help with maintaining a healthy weight by reducing food/calorie intake -not just one mechanism; likely multiple
87
Nutrition can/can not promote or inhibit cancer development and progression
-can
88
Summarize fiber and the potential link to colon cancer
-inc. Fecal bulk, dilutes carcinogens, toxins, tumor promoters -dec. Transit time, dec, exposure/contact to mutagens -bind primary bile acids; promotes excretion, limits conversion to carcinogenic secondary BA -fermentation produces volatile SCFA, anti-carcinogenic properties, inc, bacterial growth, inactivate toxins, limit uptake in NH3
89
Is the effect of fiber on cancer clear or unclear based on research?
-unclear
90
How does fat function?
-Fat stored as TG is a main source of fuel for the body -aids in absorption of fat-soluble vitamins and cartenoids -cell signaling; structural components of cell membranes
91
What does dietary fat mainly consist of?
-Mainly consists of triglycerides (95%) -Sterols and phospholipids(5%)
92
What are MUFAs
-Cis monounsaturated fatty acids
93
What are PUFAs
-Cis polyunsaturated fatty acids
94
How to read to Omega system: 20: 5 w 3
-20= chain size # of C atoms -5= number of double bonds w= symbol for double bond 3- position of the first double bond
95
Cholesterol plays a vital role in..
the synthesis of vital compounds
96
What are the major sources of dietary cholesterol
-eggs (yolk) -dairy products (milk, cheese, icecream, butter) -beef, pork, poultry -fish, shellfish(shrimp) -organ meats (liver, kidney)
97
What are the sources of sterols from plants?
Naturally occurring: fruits, vegetables, nuts, seeds, legumes, vegetable oils Fortified foods: Margarine, granola bars, juice, cereal products Supplements: capsules and tablets
98
What are the major sources of dietary saturated fatty acids?
-Dairy products, beef, pork, poultry -Coconut oil, palm kernel oil, palm oil, cocoa butter
99
What are the main traditional nutritional factors that raise serum LDL cholesterol
-Saturated fatty acids -Trans fatty acids -Dietary cholesterol
100
What is the connection between n-3 PUFAs and cognitive decline/dementia
-n-3 PUFAs have anti inflammatory and cardiovascular protective effects -n-3 PUFAs may improve the composition of cell membranes -n-3 PUFAs may be neuroprotective -may help preserve brain function
101
What is the MIND diet
-Mediterranean-DASH Intervention for Neurodegenerative Delay -Attributed to improved cognitive thinking and lowering the risk/ slowing the progression of Alzheimer -Combines two dietary approaches to emphasize: natural plant based foods, increased consumption of berries and green leafy vegetables, limited intake of animal based and saturated fat foods -15 dietary components: Brain healthy-green, leafy veg. Other veg. Nuts, berries, beans, whole grains, fish, poultry, olive oil, wine Unhealthy: red meats, butter, stick margarine, cheese, pastries, sweets, fried and fast foods.
102
What are the theoretical concerns with long term use of n-3 fatty acids
-suppression of immune response -excessive bleeding and risk of hemorrhagic stroke -oxidative damage to various tissues -solid research is lacking on adverse effects, No UL is set of n-3 fatty acids
103
What are the potential issues with fish/fish oil consumption
-nausea -certain types of fish are high in methyl-mercury -mercury toxicity

NTRN 363 (2 decks)

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