REVIEW FOR FINAL

2 Nutritional Health Status Desirable Nutritional Status Undernutrition – Subclinical deficiency – Clinical deficiency Overnutrition – Toxicities – Excesses of energy nutrients-obesity

EARs and RDAs EARs – Only set for nutrients that have functional markers – Meets needs for 50% population group RDAs – Based on EARs – Meet 97-98% population group – Prevent deficiency and chronic disease

AIs and ULs AIs – Insufficient data for an EAR – Estimate of average nutrient intake that appears to maintain a defined nutritional state (bone health) – Ideally meets more than RDA Uls – Based on chronic intake of nutrients that are not likely to cause adverse effects in almost all individuals – Based on nutrient intake from all sources – Exceptions: niacin, magnesium, zinc and nickel are only nonfood sources

EERs and AMDRs EERs – Average daily caloric need for each life stage group AMDRs – Range of intake, as a percentage of energy (for example fat is % of kcal) – Values are for Carbohydrates, Fat, Protein and Essential fatty acids

Nutrient Density Divide the amount of the nutrient per serving by the recommended amount Divide the calories in a serving by daily caloric need Compare the two “Empty calorie foods”

Energy Density Comparison of a food’s caloric content per gram weight of the food High energy density foods (>4 kcal/g) – Graham crackers, potato chips, peanuts, bacon Low energy density foods (<0.6 kcal/g) – Lettuce, strawberries, grapefruit, carrots

8 Fat Metabolism Carbohydrates aid fat metabolism by providing enough of key substrates to keep the citric acid cycle going Ketogenesis – Ketone bodies formed by incomplete fatty acid oxidation Ketosis in Diabetes Mellitus Ketosis in Semistarvation or Fasting or No carbohydrates in diet

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10 Vitamin E Functions Antioxidant (also C and carotenoids) Reduces oxidative stress from free radical damage Vitamin E is a “chain breaking antioxidant”

11 Vitamin A Retinoids Active form: preformed Vitamin A Retinal, retinol and retinoic acid Dietary sources: liver, fish oils, fortified dairy products and eggs Caroteinoids Provitamins-can be converted to Vitamin A Dietary sources: dark green and yellow orange vegetables and fruits

12 Potassium Foods (beans, potato, dairy, fruits, vegetables) Needs – AI is 4700 mg – Average intake below this Function: intercellular cation so same functions as sodium except that it decreases calcium excretion Deficiency – Hypokalemia (low blood potassium) can lead to irregular heartbeat – Usually from urinary losses UL – Hyperkalemia (high blood potassium) with poor kidney function

Match the deficiency with the anemia Vitamin E Folate Vitamin B12 Iron Copper Megaloblastic Microcytic Hemolytic 13 *** See book for summary

Successful Weight Management: Lessons from The National Weight Control Registry Registry members have lost an average of 66 pounds and kept it off for 5.5 years –90% exercise, on average, about 1 hour per day. –62% watch less than 10 hours of TV per week. –78% eat breakfast every day. –75% weigh them self at least once a week.

Preventing CVD (limit) Total fat 20-35% total calories Saturated fat < 7 % total calories Trans fat low Polyunsaturated < 10% total calories Monounsaturated < 20% total calories Cholesterol < 200 mg daily 15

Preventing CVD (emphasize) Include 2 grams plant stanols/sterols Soluble fiber g Eat fatty fish 2x/week Keep body weight at a healthy level Increase physical activity Do things to increase your HDL (exercise) Eat foods that prevent oxidation 16

17 Two Essential Fatty Acids Alpha-linolenic (3) Polyunsaturated Major source of Omega 3 fatty acids in foods Used to make EPA and DHA and Eichosanoids Linoleic (6) Polyunsaturated Major source of Omega 6 fatty acids in foods Used to make Arachidonic acid, and Eicosanoids

Two Essential Fatty Acids Alpha-linolenic Cold water fish (salmon, tuna, sardines), walnuts, flax, canola oil Reduces inflammation, thins blood, and reduces plasma triglycerides Linoleic Beef, poultry, safflower oil, sunflower oil, corn oil, mayonaise Regulates blood pressure, can increase blood clotting and inflammation 18

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20 Recommended Intakes of Protein Equilibrium – Protein intake equals protein losses Positive Nitrogen Balance – Protein intake exceeds protein losses Negative Nitrogen Balance – Protein losses exceed protein intake

Calcium supplements Calcium carbonate (HCl-food) and calcium citrate Who should take which? When should you take it? How much should you take? Interactions – Zinc, iron, and magnesium 21

Calcium Absorption Slightly more efficient in upper SI (more acidic) Things that influence absorption: – Food source – Vitamin D needed – Efficiency increases during times of need – Full stomach – Age – Fiber, oxalate, phosphorus, polyphenols (tea) 22