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Depo > oyjhg12 > Flashcards

oyjhg12 Flashcards

1
Q

Learning Objective:
Describe using examples the link between nutrition and health

A

There’s a clear link between diet and health outcomes (i.e. teenager that went blind from only eating chips/fries)

  • Impact of malnutrition on health (i.e. low kcal intake, macro-decifiencies and micro-nutrient deficiencies
  • Impact of over-nutrition on health (excess intake of micro/macro nutritents and/or kcal)
  • Food-based strategies for prevention and management of chronic disease
  • Based on scientific evidence: in-vitro, in-vivo, animal studies, clinical (human) trials, case studies, population studies, epidemiological studies.

Also consider:
* Disease
* Dietary patterns
* Global accessibility of foods

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2
Q

Learning Objective:
Define: nutrients, six classes of nutrients, essential and non- essential nutrients, energy, non-nutrients

A
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3
Q

Learning Objective:
Define and list the “six classes of nutrients”

A
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4
Q

Learning Objective:
Define “essential and non- essential nutrients”

A
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5
Q

Learning Objective:
Define “energy”

A
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6
Q

Learning Objective:
Calculate the energy yielded from nutrients

A
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7
Q

Learning Objective:
Explain the components of Dietary Reference Intakes

A
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8
Q

Learning Objective:
Describe the six principles of diet planning

A
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9
Q

Learning Objective:

Apply “Eating Well with Canada’s Food Guide,
food labels, and claims”

A
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10
Q

Define “nutrition”

A

Nutrition is the science of foods and the nutrients in foods; and the actions of nutrients within the body
* Also the social, economic, cultural, and psychological implications of foods and eating

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11
Q

What are the 6 major nutrition problems affecting the greatest portion of the world population

A
  1. Childhood underweight (protein/energy malnutrition = leads to low food consumption/protein intake = impaired physical and brain development)
  2. Suboptimal breastfeeding (infant may not be getting enough milk/time for eating breastmilk; maternal diet is deficient which impairs breastmilk nutrition for infants)
  3. Vitamin A deficiency (Immune function, eye vision
  4. Zinc deficiency (growth, development, metabolism and immune function,
  5. Iron deficiency (anemia, hemoglobin and myoglobin and oxygen transport in the body)
  6. Iodine deficiency (physical and mental development, general metabolism and metabolic rate (and immunity) - regulated by thyroid glad and iodine metabolism)
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12
Q

Lecture 1 Participation Q:

What do you think the vitamin deficiency was that led to the blindness of a teenager who only ate chips and french fries?

A

Micro:
* vitamins and minerals (affecting cellular pathways)

Which ones?
* Vitamin A - for vision (Retanol)

Others
* Zinc - growth, development, immunity
* Iron - for anemia and other cell functions (hemo and myoglobin)
* Iodine - regulated by thyroid, general metabolism and immune function

Patient also had: skin legions and anemia

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13
Q

Which parts of the world have unacceptably high undernutrition (underweight, stunting and wasting)?

A
  1. South-East Asia
  2. Eastern Mediterranean
  3. Africa

Often areas of low income as well as high chronic disease and infectious disease.

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14
Q

Explain what the WHO “Millenial Development Goals” to “Sustainability Development Goals”?

A

Look at slide

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15
Q

Summarize the six Global Nutrition Targets

A

Targets:

  1. 40% reduction in stunted children under 5 years of age
  2. 50% reduction of anemia in women of reproductive age
  3. 30% reduction in low birth weight (anemia and general malnutrition)
  4. No increase in childhood overweight (especially in countries with the “double burden” - malnutrition AND obesity
    **50% increase in the rate of exclusive breastfeeding in the first six months* if infant’s life
  5. 5% reduction and maintenance of childhood wasting
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16
Q

Define “non-communicable disease”?

A

AKA Chronic Diseases - those that are NOT infectious; develop over an extended peroid of time

(i.e. cancer, diabetes, cardiovascular disease, respiratory disease, mental health, oral health problems, and obesity)

~75% of global deaths

Prevent by: diet and exercise, screening early, etc

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17
Q

Define “communicable diseases?”

A

Chronic and infectious diseases (i.e COVID, SARS, tuberculosis, malaria, etc)

~50% in prevalence and promotion of deaths globally

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18
Q

Which four non-communicable diseases make up 80% of global deaths?

A
  1. Cancer
  2. Cardiovascular
  3. Chronic respiratory diseases
  4. Diabetes

These are prevented with diet and exercise.

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19
Q

Describe different ways that “Cardiovascular Disease” can affect our health in negative ways?

A

Lesions in blood vessels
Thickening of the blood
Vaso-dialation and constriction that affects the heart

Lesions in brain - cerebral infarction or stroke

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20
Q

Describe different ways that “Diabetes” can affect our health in negative ways?

A

It’s a metabolic disease.

Diabetic Retinopathy (blindness/vision impairment)

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21
Q

Describe different ways that “Obesity” can affect our health in negative ways?

A

Affects 20-40% of demographics

Linked to diet and kcal over-intake and lower physical activity

Endocrine and genetic factors (predisposition)

Brain health

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22
Q

Describe different ways that “Polycystic Ovarian Syndrome” (PCOS) can affect our health in negative ways?

A

Over production of testosterone = develops overweight ness and obesity

May have underlying genetic defect in hormone metabolism

PCOS can also be a predisposition: first intervention is diet and lifestyle intervention

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23
Q

Describe different ways that “Antioxidants, Dietary Fibre and Cancer” can affect our health in positive ways?

A
24
Q

Describe different ways that “Alzheimer’s Disease” can affect our health in positive ways?

A

Genetic susceptibility

25
Q

What are the top 5 leading causes of death globally?

A
  1. Heart Disease
  2. Stroke
  3. Chronic obstructive pulmonary disease
  4. Lower respiratory infections
  5. Neonatal conditions (infection in environment)
26
Q

How did the impact of COVID shift the top 10 leading causes of death?

A

COVID swooped in 6th place of leading deaths in the world (in 2020)

27
Q

What are eight “risk factors for Chronic Disease”?

A
  • Tobacco use
  • Harmful alcohol use
  • High blood pressure
  • Physical inactivity
  • Raised blood cholesterol (and total triglycerides and lipoproteins)
  • Overweight/obesity
  • Unhealthy diet
  • Raised blood glucose
28
Q

Define “metabolism”

A

Process for the use of nutrients

Energy: chemical energy (ATP) aka “energy currency” in its usable form of energy in the body

29
Q

Which pathways is ATP used in?

A

Glycolysis
Krebb’s cycle
Electron-Transport chain (produces ATP)

Muscular use: Actin and myacin and Heart

30
Q

What are four major chemical substances in food?

A

Macronutrients (g daily):
* the energy-eliding nutrients: carbs, fats and proteins

Micronutrients (mg or ug daily)
* vitamins and minerals

Water

Other Essential Nutrients (40+) body cannot synthesize; needs to derive from food

31
Q

What’s the difference between organic and inorganic nutrients?

A

Organic nutrients contain carbon. Inorganic nutrients do not.

32
Q

Define “non-nutrients”

A

compounds or organisms that have biological activity in the body.

Does not have a “recommended dietary intake” value

33
Q

Define “phytochemicals”

A

Considered a “non-nutrient” = Does not have a “recommended dietary intake” value

Non-nutrient compounds derived from plants that have biological activity in the body
* primarily antioxidant function/immune function

34
Q

List 5 major bioactive non-nutrient components of food, their benefits, and which foods they’re sourced from?

A

Allyl compounds (garlic and onion)
* Immunostimulatory
* Anti-microbial
* Anti-neoplastic
* Anti-cardiovascular
* Anti-diabetic

Carotenoids (pigments in plants - yellow to orange to dark green)
* Immunostimulatory
* Anti-neoplastic
* Anti-cardiovascular
*UV protection for skin
*Inhibition of macular degradation (eye/vision health)

Flavonoids (ubiquitous >4000 types; i.e isoflavones in soy)
* Anti-microbial
* Anti-neoplastic
* Anti-cardiovascular

Glucosinolates (brussica family)
* Anti-neoplastic
*Inducing Phase II enzyme systems

Pre/Pro Biotics (whole grains, fermented milk products, meat products, oligosaccharides)
* Gut flora/environment/immunostimulatory

35
Q

Define energy in relation to the Joule

A

International System of Units (SI) uses
Joule = energy used when 1kg is moved 1 m by force of 1 Newton

Newton = work energy

36
Q

Define energy in relation to kilocalorie (kcal)

A

kcal = common measure of energy in food

kcal = Energy used to raise the temp of 1 kg H2O by 1 degree C.

kilocalorie = heat energy (calculating via bomb calorimeter)

In canada: Calorie = kilocalorie

37
Q

How do you convert kcal to kilojoules?

A

kj = food kcal x 4.2

38
Q

How do we calculate energy from foods?

What are the typical kcal/g of 3 main macronutrients?

A

Fat - 9 kcal/gram (highest)

Carbs - 4 kcal/gram

Protein - 4 kcal/gram

Bonus: Alcohol - 7 kcal/g (often considered “anti-kilocalories”; no other nutrients and uses vitamin B in it’s metabolic pathway

39
Q

Calculation example:

1 cup of fried rice contains: 5g protein, 30g carbohydrate and 11g fat

a) how many kcal in 1 cup of fried rice (energy density)?

b) what is the % of total kcal from each energy-yielding nutrient?

A

Recall base kcal/gram of each:
Fat - 9 kcal/gram (highest)
Carbohydrates (CHO) - 4 kcal/gram
Protein - 4 kcal/gram
—

a)
Protein: 4 kcal/gram X 5g = 20 kcal
CHO: 4 kcal/gram X 30g = 120 kcal
Fat: 9 kcal/gram X 11g = 99 kcal
Total = 239 kcal

b)
Protein: 20 kcal / 239 kcal X 100% = 8.4%
CHO: 120 kcal / 239 kcal X 100% = 50.2%
Fat: 99 kcal / 239 kcal X 100% = 41.4%
Total = 100%

hint: Look at peanut butter sandwich example in Chapter 1-2.

40
Q

Peanut butter sandwich calculation example

A
41
Q

What’s the difference between “low-energy density” and “high-energy density” meals?

A

LOWER ENERGY DENSITY - Eggs, toast, sausage, fruit, grains and small coffee.
This 450-gram breakfast delivers 500 kcalories, for an energy density of 1.1 (500 kcal / 450 g = 1.1 kcal/g).

HIGHER ENERGY DENSITY - Two donuts with a big coffee
This 144-gram breakfast also delivers
500 kcalories, for an energy density of 3.5 (500 kcal /144 g = 3.5 kcal/g).

42
Q

What’s the difference between “low-nutrient density” and “high-nutrient density” meals?

A

High Nutrient Density - Eggs, toast, sausage, fruit, grains and small coffee.
-CHO, Ptn, Lipid -Vitamins, Minerals,
phytochemicals
-Increased satiety -Sustained glucose release (don’t need to eat for hours = slow release and absorption of glucose)

High Nutrient Density = LOWER ENERGY DENSITY

Low Nutrient Density - Two donuts with a big coffee
-low complex CHO, simple sugars -rapid rise blood glucose
-low satiety (high release of simple sugars; rapid rise in blood-glucose; we feel hungry sooner)

Low Nutrient Density = HIGHER ENERGY DENSITY

43
Q

What are 4 nutritional science studies used?

A

1) Lab-based animal studies
2) Lab-based in-vitro studies
3) Human intervention (clinical trials)
4) Case-control studies

These studies are used to allow us to determine nutrient and energy intake to maintain health and preventing toxicity.

Also used in regional studies of deficiencies and toxicity.

44
Q

How do we know what vitamins and minerals are needed? How much?

A

Developed scientific studies help inform this: either deficiency of excess of nutrients…

1) Vitamin A helps Collagen and connective-tissues synthesis

i.e. James Lind (1747) giving sailors citrus to prevent Scurvy and Vitamin C deficiency

2) Excessive folate fortification and increased risk of bowel and prostate cancer.

45
Q

Define “Estimated Average Requirement (EAR)”

A

The avg daily amount of a nutrient to maintain body functions in half (~50%) a specific *healthy** population
“does this specific group meet half of the daily requirements?”

  • Dependant on demographics (age, sex, gender, etc.)
  • Based no scientific evidence: nutrient dose studies and epidemiological studies
  • Used for developing/evaluating diets of groups
46
Q

Define “Recommended Dietary Allowances (RDA)”

A

The avg daily amount of nutrient that is adequate to meet the nutrient requirements of all (~98%) healthy people (with no health conditions)

Diatetics caters to the unhealthy population (along with healthy population)

  • RDA is set above EAR to prevent nutrient deficiencies in a wider community
  • Used for assessing individual needs - dependent on demographics and other unique situations (i.e. pregnancy, etc)
47
Q

Define “Adequate Intakes (AI)”

A

The avg daily amount of a nutrient that is estimated to be sufficient to maintain a specific criterion or normal bodily function.
- Educated estimates based on limited evidence (dietary studies may be lacking or variable = demographics, unique metabolism, preexisting conditions, etc)

aka “the adequate amount to maintain biological function per day”

48
Q

Define “Tolerable Upper Intake Levels (UL) or (TUL)”

A

Maximum daily amount of a nutrient that is safe for most of the health population
- prevention of toxicity and adverse health effects
- Usually caused by misuse or over-supplementation

i.e.
- Retinol (vitamin A) is teratogenic (causes birth defects) at >10,000 IU in early pregnancy
- Excess B-carotene causes orange skin but can be a pro-oxidant under specific conditions
- Acute Iron Toxicity could lead to fatigue, dizziness (same as iron deficiency), and vomiting

aka “upper limits to help prevent over intake of certain nutraceuticals and nutrients”

49
Q

How do RDA, AI, EAR, and UL look in an intake graph?

A

Look at it.

50
Q

Define “Acceptable Macronutrient Distribution Ranges (AMDR)”

A

Range of intake for energy-yielding nutrients that provide adequate energy nutrients + reduce risk of developing chronic disease

i.e. AMDR % Total energy Intake
- Carbohydrates = 45-65%
- Fat = 20-35%
- Protein = 10-35%

These are recommendations based on scientific studies. If you go above this, energy is stored as Adipose tissue, body fat, or simply fat is a loose connective tissue composed mostly of adipocytes.

51
Q

How does the ratio change between Carbs, Fats, and Proteins (in relation to AMDR)?

A

Three energy nutrients all contribute to total kcal intake.

If you increase one, the others will lower. If you lower one, the others will accommodate the change to equal a total of 100% intake.

If we go ABOVE 100% intake, then energy is stored as adipose tissue.

Ratios don’t matter, but they are used in research for optimal human health.

52
Q

How do we use “Nutrient Recommendations?” (5 rules)

A
  1. Apply to healthy people
  2. Are not minimal or optimal requirements for all individuals
  3. Meet requirements through diet = variety of foods
  4. Are for “average” daily intake
  5. Each DRI serves a specific purpose to develop or evaluate nutrition programs (adequate intake of macro/micro nutrients for specific people/groups)
53
Q

Define “Nutrition Assessment”

A

Analyzing dietary intake of an individual. Big part of dietetics.

  • Uses dietary reference intakes to assess diet of an individual
  • Completed by: clinician, registered dietitian, nutritionist, nurse practitioner, or other trained healthcare professionals
  • Includes these assessments:
    1) Anthropometric measurements
    20 Biochemical tests
    3) Clinical Examination (eyes, skin, height, other tests ordered (blood-glucose), toxicity or deficiency)
    4) Dietary information
54
Q

Why the focus on nutrition for prevention and intervention of chronic disease?
(5 points)

A
  • Nutrition is a major modifiable determinant of chronic disease
  • Increased prevalence (diet may influence present health AND risk of chronic disease as we age)
  • Increasing portion of population is over 65 yrs (Boomers). Also health of next generations!
  • Significant morbidity, mortality and healthcare costs
    -We do not have a cure for these chronic diseases…. More developmental origins of adult disease and epigenetic.
55
Q

What does the “WHO non-communicable disease and development” graph tell us?

A
  • upward curve slope from fetus –> adult life = accumulated rest of non-communicable disease in adults
  • Rest positively accumulates throughout the lifespan, and disease becomes more prevalent in later (adult) life.
56
Q

Globally, what are the 7 major chronic diseases that are potentially preventable by diet?
(plus 3 bonus)

A

Most preventable:

Alzheimer’s Disease
Cardiovascular Disease
Cancer
Diabetes
Obesity
Dental Disease
Osteoporosis

Bonus”
Inflammatory Bowel Disease
Mental illness
Polycystic Ovary Disease

57
Q

Example: Diet and Cardiovascular Disease - what are the 3 dependants?

A

1) Nutrition targets
2) demographics
3) Food sources/type of diet

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