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Domain 2 > Nutrition and Supporting Sciences > Flashcards

Nutrition and Supporting Sciences Flashcards

1
Q

Cellular oxidation

A

Enzymes: proteins, organic catalysts that control reaction

Coenzymes: enzyme activators, include some vitamins (pantothenic acid, thiamin, riboflavin, niacin are needed for energy production)

Substrate: substance upon which enzymes work

Cofactor: assists enzymes minerals

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2
Q

Calorimetry

A

Carb alone: 1
Protein alone: 0.82
Fat alone: 0.7
Mixed intake: 0.85

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3
Q

Carb: order of sweetness

A

fructose, invert sugar, sucrose, glucose, sorbitol, manniol, galactose, maltose, lactose

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4
Q

Protein: amino acids

A

sulferous: cysteine, cystine, methionine

Essential: threonine, valine, tryptophan, isoleucine, leucine, lysine, phenylalanine, methionine, histidine (TV, TILL PMH)

Soybeans low in methionine

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5
Q

Fat: unsaturated

A

Most polyunsaturated: safflower
Omega-6 (linoleic):
if it replaces CHO: lower LDL, higher HDL
if it replaces sat fat: lower total chol, lower HDL

Omega-3 (linolenic):
EPA & DHA

the location of the first double bond, counted from the MEHTYL end of the fatty acid is designated by the omega sign

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6
Q

Fat: hydrogrenation

A

process of adding hydrogen to unsat fatty acids to increase saturation and stability

trans fatty acids: hydrogens are across from each other, pack as tightly as SFA in membranes, intake can influence membrane fluidity and could be harmful to cell function, found in milk fat, margarines, shortenings, frying fats

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7
Q

Types of fat

A

Sat: coconut oil, palm kernel oil, cocoa butter, butter, palm oil, canola (medium-chain are SFAs between 6 and 12 carbons naturally found in milk fat, coconut oil, and palm kernel oil)

Mono-unsat: olive, canola, peanut, sunflower, coconut (MCT source)

Poly-unsat: safflower, corn, soybean, cottonseed, sunflower, palm kernel

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8
Q

Fat: function

A

energy, insulation, padding, depresses gastric secretion so delays emptying

Has less oxygen more carbon than carbohydrate so provides more energy (more carbon atoms for oxidation)

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9
Q

Winterized oil

A

salad dressings, won’t crystalize when cold

corn, soy and cottonseed oils are winterized, NOT olive ol

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10
Q

Vitamin A (fat sol)

A

PROPERTIES: toxic level 10k IU
FUNCTION: skin, vision
SOURCES: yellow, orange fruits, dark leafy green veg, cantaloupe, fish, liver, carrots, fortified skim milk, apricots, sweet potato
DEFICIENCIES: nyctalopia (reversible night blindness), xeropthalmia (permanent corneal damage), hyperkaratosis

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11
Q

Vitamin D (fat sol)

A

PROPERTIES: cholesterol is precursor
FUNCTION: D3 cholecalciferol to D2, ca & protein metabolism
SOURCES: sunlight, egg yolk, fortified milk
DEFICIENCIES: rickets, osteomalacia (adult rickets)

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12
Q

Vitamin E (fat sol)

A

PROPERTIES: one of the least toxic vitamins
FUNCTION: antioxidant
SOURCES: veg oils (cottonseed), whole grains, green vegetables, almonds
DEFICIENCIES: hemolytic anemia

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13
Q

Vitamin K (fat sol)

A

PROPERTIES: synthesized by bacteria in lower intestinal tract
FUNCTION: forms prothrombin in liver, aids blood clotting
SOURCES: spinach, kale, broccoli, green, leafy vegetables
DEFICIENCIES: hemorrhage, affected by mineral oil, antibiotics and anticoagulants

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14
Q

Vitamin B1 (Thiamin)

A

PROPERTIES: lost as temp or pH rises, heat stable in acid
FUNCTION: oxidation of CHO (incr CHO incr needs), metabolism of pyruvate)
SOURCES: grains, wheat germ, pork, liver
DEFICIENCIES: beriberi, muscle weakness, foot drop, memory loss, tachycardia (low erythrocyte transketolase, high plasma pyruvate)

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15
Q

Vitamin B2 (Riboflavin)

A

PROPERTIES: lost in UV light
FUNCTION: energy release from protein, RBC production
SOURCES: lier, kidney, meat, milk
DEFICIENCIES: cheilosis (cracked lips), stomatitis (mouth corner cracks), magenta tongue

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16
Q

Vitamin B3 (Niacin)

A

PROPERTIES: tryptophan is precursor, essential in all cell metabolism
FUNCTION: metabolism of CHO, protein, fat
SOURCES: protein, peanuts, RTE cereals, chicken, rice, yeast, milk
DEFICIENCIES: pellagra, dermatitis, diarrhea, dementia, beefy bright red tongue, symmetrical pigmented rash in sun

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17
Q

Vitamin B9 (Folate)

A

PROPERTIES: PABA precursor
FUNCTION: DNA synthesis, forms RBC, prevents neural tube defects
SOURCES: fortified dry cereal, liver, kidney, green leafy veg, citrus fruits, lentils, beans
DEFICIENCIES: megaloblastic microcytic anemia, fatigue, irritability, dyspnea

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18
Q

Vitamin B6 (Pyridoxine)

A

PROPERTIES:
FUNCTION: coenzyme in amino acid metabolism (incr protein need incr B6)
SOURCES: meat, wheat, corn, yeast, pork, liver, RTE cereals
DEFICIENCIES: seizures, anemia, dermatitis, glossitis, peripheral neuropathy

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19
Q

Vitamin B12 (Cyanocobalamin)

A

PROPERTIES: contains cobalt, bound by IF in gastric juice
FUNCTION: coenzyme in protein synthesis, forms RBC
SOURCES: liver, meat, milk, kidney, eggs, fish, cheese
DEFICIENCIES: macrocytic megaloblastic anemia, pernicious anemia, due to lack of IF after surgery

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20
Q

B5 (Pantothenic acid)

A

PROPERTIES:
FUNCTION: Coenzyme A- energy synthesis of fatty acids
SOURCES: animal foods, grains, legumes
DEFICIENCIES: rare, parasthesia in feet

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21
Q

Vitamin C (ascorbic acid)

A

PROPERTIES: most easily destroyed, structure like glucose, needs acid pH, destroyed by heat, alkaline, oxidation
FUNCTION: changes proline into hydroxyproline into collagen, wound healing, aids iron absorption
SOURCES: citrus fruits, potatoes, papaya, dark green & yellow veg
DEFICIENCIES: scurvy, poor wound healing, bleeding gums, petechiae

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22
Q

Vitamin B7 (Biotin)

A

PROPERTIES: synthesized by intestinal bacteria
FUNCTION: coenzyme in fatty acid synthesis, conerts pyruvate to oxaloacetate in GNG
SOURCES: liver, kidney, egg yolk, yeast
DEFICIENCIES: muscle pain, dermatitis, glossitis

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23
Q

Myo-inositol

A

PROPERTIES: in plants as phytic acid
FUNCTION: binds calcium, zinc, iron membrane structure
SOURCES: outer husks of cereal, leafy green veg
DEFICIENCIES:

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24
Q

Calcium

A

PROPERTIES: most abundant mineral, regulated by PTH, absorption aided by vit D, acid, lactose, calcitonin lowers serum ca by inhibiting bone resorption
FUNCTION: blood clotting, cardiac function, nerve transmission, smooth muscle contractility
SOURCES: dairy products, leafy vegetables, legumes
DEFICIENCIES: hypocalcemia leads to tetany

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25
Q

Phosphorus

A

PROPERTIES: second most abundant mineral, part of DNA, RNA, ATP
FUNCTION: phospholipids transpot fat through lymph and blood; bone and teeth
SOURCES: meat, milk, poultry eggs, fish, cheese
DEFICIENCIES: rare

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26
Q

Iron

A

PROPERTIES: trace mineral, part of Hgb, food in ferric form, absorbable as ferrous, stored as ferritin
FUNCTION: oxygen transport
SOURCES: heme iron= animal foods, meat, fish, poultry; non-heme= cereals, veg, poorly absorbed; gastric juice and vit C aid absorption; calcium absorbed if oxalates are present (eggs, tea, milk, cheese do not help)
DEFICIENCIES: pale tongue, fatigue, anemia, spoon-shaped nails, pale conjunctivae (mucous membranes lining eyelid)

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27
Q

Magnesium

A

PROPERTIES: part of chlorophyll, 50% in bone, 50% in cells
FUNCTION: protein and fatty acid synthesis, stabilizes structure of ATP, high protein, calcium, vit D incr needs
SOURCES: most foods, milk, bread
DEFICIENCIES: rare, tremors

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28
Q

Zinc

A

PROPERTIES: trace mineral, excess leads to copper or iron deficiency
FUNCTION: incr taste acuity, enhances insulin action, stabilizes DNA, RNA, cell division
SOURCES: meat, liver, eggs, fish, phytates and copper decr absorption
DEFICIENCIES: reduced immune function, alopecia, poor wound healing, hypogeusia

29
Q

Iodine

A

PROPERTIES: trace mineral
FUNCTION:
SOURCES: seafood, iodized salts
DEFICIENCIES: goiter

30
Q

Fluoride

A

PROPERTIES: trace mineral
FUNCTION: teeth, bones
SOURCES: soil, water
DEFICIENCIES: dental caries

31
Q

Copper

A

PROPERTIES: trace mineral, attached to protein, ceruloplasmin
FUNCTION: Hgb synthesis, aids iron absorption
SOURCES: liver, kidney, shellfish
DEFICIENCIES: Wilson’s disease, rare: microcytic anemia, neutropenia

32
Q

Selenium

A

PROPERTIES: cooperates with vitamin E
FUNCTION: antioxidant, tissue respiration
SOURCES: soil, grains, meat, fish, poultry, dairy
DEFICIENCIES: myalgia, cardiac myopathy

33
Q

Manganese

A

PROPERTIES: trace mineral
FUNCTION: central nervous system
SOURCES: whole grains, legumes, nuts
DEFICIENCIES: unlikely

34
Q

Chromium

A

PROPERTIES: absorption enhanced by vit C, niacin, ultra-trace mineral
FUNCTION: aids insulin action, glucose metabolism
SOURCES: yeasts, oysters, potatoes, liver
DEFICIENCIES: insulin resistance

35
Q

Cobalt

A

PROPERTIES: exists with B12, stored in liver
FUNCTION: maturation of RBCs
SOURCES:
DEFICIENCIES: related to B12 deficiency

36
Q

Sulfur

A

PROPERTIES: part of amino acids, cysteine, methionine
FUNCTION: component of organic molecules
SOURCES: meat, fish, eggs, poultry
DEFICIENCIES:

37
Q

Choline

A

PROPERTIES: component of lecithin
FUNCTION: transports lipids as acetylcholine
SOURCES: fat in eggs, milk, liver, soybeans
DEFICIENCIES: dental caries

38
Q

Nutrients that aid glucose metabolism

A

chromium & zinc

39
Q

As energy expenditure of the body increases, need more of these:

A

thiamin, niacin, riboflavin, pantothenic acid

40
Q

Electrolyte concentration

A

mEq= mg / atomic wt x valence

41
Q

Insensible water loss

A

0.8-1.2 liters / day

42
Q

Electrolytes

A

extracellular: Na (22.99), Ca (40.08), Cl (35.45), HCO3 (61.02)
inracellular: K (39.09), Mg (24.31), P (30.97)

43
Q

Dehydration

A

nausea, dizziness, sunken eyes, fever, hyperventilation, excessive sweating, concentrated urine, dry inelastic skin, incr in solutes (BUN), tachycardia, headache, fatigue, decr appetite, rapid wt loss

serum sodium is the BEST assessment parameter for fluid status. Hypernatremia > 145 mEq/L (> 145 mmol/L) is assoc with dehydration. Hyponatremia is assoc with over-hydration.

44
Q

Acid base balance in the body

A

a change in one side of the buffer brings about a compensatory change in the other sid to maintain balance

RESPIRATORY: carbonic acid (incr H2 CO3 is acidosis; decr H2 CO3 is alkalosis)

METABOLIC: bicarbonate base (decr HCO3, incr H+ is acidosis or ketosis; incr HCO3, decr H+ is alkalosis)

45
Q

Acid base levels

A

pH 7.4
HCO3 (base, kidney): 24-28
pCO2 (acid, lungs): 35-45

46
Q

Pregnancy wt gain guidelines

A

BMI 18.5-24.9: 25-35 lb
BMI <18.5: 28-40 lb
BMI 25-29.9: 15-25 lb
BMI >=30: 11-20 lb

47
Q

At risk pregnancy

A
  • failure to gain 4 lb in last half of pregnancy
  • <16 or >=35 years old
  • pregnant adolescent is high risk and needs iron, calcium and zinc
48
Q

Normal birth wt

A

2500-4000 g

LBW is <5.5lb (<2500 g)

49
Q

Infant calorie needs

A

needs the most calories., protein, water / unit wt

0-6 months: 
cal= EER 520F 570M
prot= RDA 9.1g
H2O= 125-155ml/KG, 1.5ml/kcal
fat= minimum of 30g per day 
7-12 months: 
cal= EER 676F 743M
prot= RDA 11g
H2O= 125-155ml/KG, 1.5ml/kcal
fat= minimum of 30g per day

recommend exclusive breastfeeding for the first 4-6 months, then supplemented by weaning foods for at least up to 12 months (add solids when sitting posture can be sustained and extrusion reflex diminishes)

breast-fed infants need to supplement with 400IU vit D and .25mg fluoride/day after 6 months

50
Q

Infant formula

A

20 cal/ounce; need 2 1/2 oz/lb/day
has more protein and more iron than human milk but lacks antibodies
vit D
recommended iron-fortified formula

51
Q

WHO growth charts

A

1) wt for length/stature (birth-24 months, young children 2-5): detects short term changes in nutritional status
2) stature/length for age (0-24 month, 2-20 yrs): reflects long term nutritional status
3) weight for age (0-24 months, 2-20): not use to classify under/over weight, short term marker of growth
4) BMI for age percentiles (starting age 2): age and sex specific

52
Q

FTT

A

failure to thrive may result from acute or chronic illness, restricted diet, poor appetite, lack of fiber leading to chronic constipation, diminished intake

53
Q

Adult protein requirements

A

RDA
Males >=19 years: 56 g
Females >=19 years: 46 g

54
Q

Exercise needs

A

hydration: 16 oz. water for every 1 lb body weight lost
BEFORE activity: limited research suggests 10ml/kg of a high sodium containing beverage prior to activity that is 1-4 hours long
DURING activity: to maintain hydration, beverages provided in a volume that equals 100% fluid lost during moderate-vigorous activity plus 5.5-15% CHO and 55-164mEq Na

55
Q

Exercise physiology

A

at rest and during normal activities, fats are the primary energy source (80-90%); carb 5-18%, protein 2-5%

during low to moderate intensity aerobic activity (long duration, steady pace and endurance training) fat is a significant energy source

56
Q

Herbal interactions w/ clotting/bleeding

A 
Black cohosh- may cause clotting 
Garlic- reduces clotting time 
Ginger- affects bleeding
Ginkgo biloba- avoid use with warfarin  
Ginseng- avoid with warfarin

Valerian root- avoid with liver disease

57
Q

Bile

A

produced in the liver, stored in the gallbladder, liver stores glycogen and synthesizes glucose

58
Q

Digestion in stomach (chemical)

A

start of proteolysis by protease pepsin and HCL; limited continuation of start hydrolysis by salivary amylase

59
Q

Mechanical digestion

A

acidic chyme enters duodenum, mixes with fluids and bicarbonate ions (from pancreas) which neutralize acid

60
Q

Bacterial digestion

A

large intestine absorbs water, salts, and the vitamins synthesized by bacterial (vit K, B12, thiamin, riboflavin) which are used by GI mucosal cells

bacteria converts malabsorbed CHO and fibers into SCFA (butyrate, propionate, lactate) which stimulate water and sodium absorption in the colon, and provides substrates for energy production; and gases (H2, CO2, N CH4)

61
Q

Enzymes for CHO digestion

A

1) maltase, sucrase (at 30th wk)
2) lactase (at birth)
3) pancreatic amylase (6 months after birth)

62
Q

Sources of glucose

A

dietary, liver glycogen, products of intermediate metabolism (reconversion of lactic acid and pyruvic acid)

1) 100% carbohydate
2) 58% protein - glucogenic amino acids (yield glucose deamination)- alanine the MOST glucogenic
3) 10% fat- glycerol can be converted to glucose

63
Q

Hormones control BG level

A

1) insulin- (lowers BG) BETA cells of pancreas
2) glucagon- (raises BG) ALPHA cells of pancreas
3) glucocorticoids- (raises BG) protein, requires pyridoxine
4) epinephrine- (raises BG) adrenal medulla, stim symp nervous system, liver and muscle glycogenolysis, during catabolic stress
5) growth hormone, ACTH- (raises BG) insulin antagonist

64
Q

Glycolysis + TCA cycle

A

REVIEW image w/ post-it note

65
Q

Protein metabolism

A

pyridoxine is needed for the transport of amino acids

BCAAs: valine, leucine, isoleucine
Exercise releases alanine from muscle protein, it is transported to the liver, deaminated, and converted to glucose. Also during exercise, the oxidation of leucine increases

66
Q

Quality of protein

A

BV- biologic value uses nitrogen balance techniques to determine fraction of absorbed nitrogen retained for growth and maintenance (eggs have BV of 100)

NPU- net protein utilization measures the amount of protein actually used
(N intake - N output) / N intake

Protein digestibility corrected amino acid score (PDCAAS)
represents amino acid score after correcting for digestibility

67
Q

Protein hormonal control

A

1) pituitary growth hormone, thyroid hormone, insulin, testosterone- anabolism
2) adrenal steroids (glucocorticoids) protein catabolism- stimulate gluconeogensis

68
Q

Nutrient transport

A

Active transport: most nutrients (glucose, amino acids, Na, K, Mg, Ca, Fe), sodium pump

69
Q

Factors that aid vitamin and mineral absorption

A
  • A: bile salts, pancreatic lipase, fat
  • D: hydroxylated in the liver, then in kidney, needs bile salts, acidity of chime accompanies Ca, P absorption
  • riboflavin: phosphorus
  • B12: ileum, stomach secretions (HCL, intrinsic factor)
  • iron: HCL, calcium (binds oxalates)
  • folate: zinc-dependent, cleaves polyglutamate to monoglutamate, folic acid in fortified foods and supplements is present as monoglutamate

Domain 2 (4 decks)

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