Carbohydrates and Whole Grains
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Questions and Answers

What is the primary purpose of Front-of-Package (FOP) labeling?

  • To provide comprehensive ingredient lists
  • To calculate calories in a food product
  • To indicate allergen information
  • To flag high levels of sodium, saturated fat, and sugars (correct)

    • Reduced fat products contain no fat at all.

    False

    What does the Canadian Healthy Eating Index (CHEI) measure?

    The quality of the dietary pattern according to the Canada Food Guide.

    The process of breaking food down so it can be absorbed by the body is called __________.

    <p>digestion</p> Signup and view all the answers

    Match the digestive secretions with their functions:

    <p>Mucus = Moistens and lubricates the GI tract Enzymes = Speed up chemical reactions Saliva = Begins the digestion of carbohydrates Bile = Aids in fat digestion</p> Signup and view all the answers

    Which of the following is a common method for estimating food availability for a population?

    <p>Food disappearance surveys</p> Signup and view all the answers

    The GI tract plays no role in immune function.

    <p>False</p> Signup and view all the answers

    What is the average CHEI score for Canadians?

    <p>58.8%</p> Signup and view all the answers

    What is the primary function of lysozyme found in saliva?

    <p>Protects teeth from bacteria</p> Signup and view all the answers

    The large intestine plays a significant role in the digestion of food.

    <p>False</p> Signup and view all the answers

    What is the role of the hepatic portal vein in nutrient absorption?

    <p>It transports blood from the GI tract to the liver.</p> Signup and view all the answers

    The main energy currency of the cell is called ______.

    <p>ATP</p> Signup and view all the answers

    Match the following digestive problems with their definitions:

    <p>Heartburn = Burning sensation due to acid reflux GERD = Chronic condition where stomach acid frequently flows back Ulcers = Sores that develop on the lining of the stomach or intestines Vomiting = Involuntary expulsion of stomach contents</p> Signup and view all the answers

    What protects the intestines during fat digestion?

    <p>Lacteals</p> Signup and view all the answers

    Catabolic pathways are responsible for storing energy in food molecules.

    <p>False</p> Signup and view all the answers

    What type of nutrition is provided when an individual cannot eat by mouth?

    <p>Enteral or Total Parenteral Nutrition (TPN)</p> Signup and view all the answers

    Which of the following best describes prebiotics?

    <p>Dietary fibers that feed gut bacteria.</p> Signup and view all the answers

    Probiotics can help in promoting the growth of harmful bacteria in the gut.

    <p>False</p> Signup and view all the answers

    What is the primary energy source for red blood cells?

    <p>Glucose</p> Signup and view all the answers

    Lactose is made up of glucose and _____

    <p>galactose</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Probiotics = Beneficial microorganisms for gut health Synbiotics = Combination of probiotics and prebiotics Prebiotics = Dietary fibers that nourish probiotics Postbiotics = Metabolites produced by probiotics</p> Signup and view all the answers

    What is the process called that generates energy from glucose?

    <p>Cellular respiration</p> Signup and view all the answers

    Whole grains primarily consist of the endosperm, which lacks fiber and vitamins.

    <p>False</p> Signup and view all the answers

    What is the health impact of consuming whole grains?

    <p>Lowers risk of chronic diseases like coronary heart disease, diabetes, and colorectal cancer.</p> Signup and view all the answers

    When carbohydrate intake is low, glucose can be produced via _____ using glycogen.

    <p>gluconeogenesis</p> Signup and view all the answers

    Which of the following can be a source of dietary fiber that supports gut health?

    <p>Leafy greens</p> Signup and view all the answers

    What is the recommended drink of choice according to the new Canadian food guide?

    <p>Water</p> Signup and view all the answers

    The new Canadian food guide combines the previous meat and dairy groups into one grouping.

    <p>True</p> Signup and view all the answers

    What are the primary food groupings in the new Canadian food guide?

    <p>Fruits and vegetables, protein, and grains.</p> Signup and view all the answers

    The old food guide was known for being __________ and straightforward.

    <p>basic</p> Signup and view all the answers

    Match each nutrient to its function from dairy products:

    <p>Protein = High quality and regulates appetite Fat = Delivers fat-soluble vitamins CHO (Carbohydrates) = Provides lactose</p> Signup and view all the answers

    What concern has been raised about the removal of the dairy food group in the new Canadian food guide?

    <p>Calcium intake</p> Signup and view all the answers

    The ingredient list on food labels must include artificial additives at the end of the list.

    <p>False</p> Signup and view all the answers

    According to the new Canadian food guide, how should individuals approach food marketing?

    <p>They should be aware of food marketing.</p> Signup and view all the answers

    What is the primary end product of glucose breakdown in the presence of oxygen?

    <p>Acetyl-CoA</p> Signup and view all the answers

    The Krebs cycle produces carbon dioxide, water, and ATP.

    <p>True</p> Signup and view all the answers

    How many grams of carbohydrates are recommended daily for adults?

    <p>130 grams</p> Signup and view all the answers

    Sucrose is made up of _____ and _____ together.

    <p>Glucose, Fructose</p> Signup and view all the answers

    Match the carbohydrate types with their definitions:

    <p>Monosaccharides = Single sugar units Disaccharides = Two sugar units linked together Oligosaccharides = Short chains of sugar units Polysaccharides = Long chains of sugar units</p> Signup and view all the answers

    What does FOP labeling aim to help consumers identify?

    <p>Foods high in nutrients of public health interest</p> Signup and view all the answers

    The average Canadian Healthy Eating Index (CHEI) score is above 70%.

    <p>False</p> Signup and view all the answers

    What are the two processes involved in the digestive system?

    <p>Digestion and absorption</p> Signup and view all the answers

    The GI tract consists of several hollow tubes, including the stomach and __________.

    <p>intestine</p> Signup and view all the answers

    Match the following digestive secretions with their primary functions:

    <p>Mucus = Moistens and protects the GI Tract Enzymes = Speeds up chemical reactions in digestion Saliva = Aids in the initial breakdown of food Bile = Emulsifies fats for digestion</p> Signup and view all the answers

    What role does the GI tract play in immune function?

    <p>It limits the absorption of toxins and pathogens</p> Signup and view all the answers

    Digestive enzymes change their chemical structure after catalyzing reactions.

    <p>False</p> Signup and view all the answers

    What is the term for the amount of time it takes for food to pass through the GI tract?

    <p>Transit time</p> Signup and view all the answers

    Which cell types are found in the immune system in the GI tract?

    <p>Lymphocytes and Antibodies</p> Signup and view all the answers

    The large intestine plays a significant role in the digestion of food.

    <p>False</p> Signup and view all the answers

    What hormone is triggered when food enters the stomach to regulate digestive secretions?

    <p>gastrin</p> Signup and view all the answers

    The ______ is responsible for absorbing triglycerides into the lymphatic system.

    <p>lacteal</p> Signup and view all the answers

    What is the primary role of salivary amylase in digestion?

    <p>Starts carbohydrate digestion</p> Signup and view all the answers

    Match the nutrient transport methods with their descriptions:

    <p>Enteral feeding = Nutrition provided through a tube to the gastrointestinal tract TPN = Nutrition provided intravenously Absorption via lacteals = Transport of fat into the lymphatic system Hepatic portal vein = Transports blood from the GI tract to the liver</p> Signup and view all the answers

    Catabolic pathways are responsible for storing energy in food molecules.

    <p>False</p> Signup and view all the answers

    What are the three main parts of cellular respiration?

    <p>Glycolysis, Citric Acid Cycle, Electron Transport Chain</p> Signup and view all the answers

    What is the standard protein requirement for adults per kilogram of body weight?

    <p>0.8 g/kg/day</p> Signup and view all the answers

    All proteins are considered complete proteins.

    <p>False</p> Signup and view all the answers

    What is Kwashiorkor?

    <p>A pure protein deficiency condition characterized by a bloated abdomen.</p> Signup and view all the answers

    The condition caused by a deficiency of both protein and energy is known as __________.

    <p>Protein-energy malnutrition</p> Signup and view all the answers

    Match the following protein sources with their type:

    <p>Eggs = Animal protein Lentils = Plant protein Quinoa = Complete protein Peanuts = Incomplete protein</p> Signup and view all the answers

    Which of the following athletes would have the highest protein requirement?

    <p>Strength athletes</p> Signup and view all the answers

    Protein excess can lead to kidney strain.

    <p>True</p> Signup and view all the answers

    What dietary suffix does a vegetarian who eliminates all animal products use?

    <p>Vegan</p> Signup and view all the answers

    Plant proteins are often lower in __________ but higher in __________ compared to animal proteins.

    <p>protein quality; fiber</p> Signup and view all the answers

    Match the following food allergens with their types:

    <p>Peanuts = Legume Milk = Dairy Eggs = Poultry Wheat = Grain</p> Signup and view all the answers

    Which metabolic condition is associated with the inability to properly digest phenylalanine?

    <p>Phenylketonuria (PKU)</p> Signup and view all the answers

    High protein diets can help in weight loss without any potential negative effects.

    <p>False</p> Signup and view all the answers

    What are limiting amino acids?

    <p>Amino acids that are missing or low in relation to dietary essential amino acids.</p> Signup and view all the answers

    Individuals with __________ may experience anaphylaxis due to food allergies.

    <p>food allergies</p> Signup and view all the answers

    What is NOT a health claim associated with vitamin K?

    <p>Hair growth</p> Signup and view all the answers

    Vitamin K deficiency is common in adults.

    <p>False</p> Signup and view all the answers

    Name one health benefit of phytochemicals.

    <p>Health promotion or disease prevention.</p> Signup and view all the answers

    Vitamin K is important for maintaining __________ health.

    <p>vessel</p> Signup and view all the answers

    Match the phytochemical types with their examples:

    <p>Carotenoids = Beta-carotene Flavonoids = Blueberries Indoles and alliums = Garlic Phytoestrogens = Soy</p> Signup and view all the answers

    What is the primary end product of glucose breakdown in the presence of oxygen?

    <p>Acetyl-CoA</p> Signup and view all the answers

    The Krebs cycle produces ATP, carbon dioxide, and electrons.

    <p>True</p> Signup and view all the answers

    What is the recommended daily intake of carbohydrates for adults in grams?

    <p>130 grams</p> Signup and view all the answers

    Sucrose is made up of _____ and _____ together.

    <p>Glucose, Fructose</p> Signup and view all the answers

    Match the types of carbohydrates with their definitions:

    <p>Monosaccharides = Simple sugars like glucose and fructose Disaccharides = Sugars formed from two monosaccharides Complex Carbohydrates = Polysaccharides like starch and fiber Dietary Fiber = Non-digestible carbohydrates that aid in digestive health</p> Signup and view all the answers

    What is the primary function of lactase?

    <p>To digest lactose in milk</p> Signup and view all the answers

    Whole grains do not contain the bran and germ layers.

    <p>False</p> Signup and view all the answers

    What are prebiotics?

    <p>Dietary fibers that feed gut bacteria</p> Signup and view all the answers

    Carbohydrates contain __________ kcal/g of energy.

    <p>4</p> Signup and view all the answers

    Match the following types of grains with their characteristics:

    <p>Whole grains = Contain bran, germ, and endosperm Refined grains = Mainly consist of endosperm and starch Enriched grains = Nutrients are added back after processing</p> Signup and view all the answers

    Which carbohydrate type is primarily used by the brain for energy?

    <p>Glucose</p> Signup and view all the answers

    Postbiotics are the live microorganisms that confer health benefits.

    <p>False</p> Signup and view all the answers

    What is gluconeogenesis?

    <p>The process of producing glucose from non-carbohydrate sources</p> Signup and view all the answers

    Lactose is composed of glucose and __________.

    <p>galactose</p> Signup and view all the answers

    What do synbiotics consist of?

    <p>A combination of probiotics and prebiotics</p> Signup and view all the answers

    What is considered obesity based on BMI?

    <p>BMI over 30</p> Signup and view all the answers

    Basal metabolic rate (BMR) represents the energy expended during physical activity.

    <p>False</p> Signup and view all the answers

    What does the respiratory quotient (RQ) measure?

    <p>The ratio of carbon dioxide produced to oxygen consumed.</p> Signup and view all the answers

    An environment that promotes weight gain by encouraging overeating is called __________.

    <p>obesogenic</p> Signup and view all the answers

    Match the following hormones to their functions:

    <p>Leptin = Reduces food intake and increases energy expenditure Ghrelin = Stimulates food intake and reduces energy expenditure CCK = Reduces food intake after protein/fat ingestion GLP-1 = Promotes insulin secretion and reduces appetite</p> Signup and view all the answers

    Which of the following factors affects basal metabolic rate (BMR)?

    <p>Amount of lean tissue</p> Signup and view all the answers

    Individuals with higher muscle mass typically have a lower BMR.

    <p>False</p> Signup and view all the answers

    What is the thermic effect of food (TEF)?

    <p>The energy expended to digest and process food.</p> Signup and view all the answers

    A BMI of 25 to 29 kg/m2 classifies an individual as __________.

    <p>overweight</p> Signup and view all the answers

    Match each type of fat patterning with its description:

    <p>Apple-shaped = Increased risk for chronic disease Pear-shaped = No significant increased risk for chronic diseases Visceral = Fat around internal organs Subcutaneous = Fat located under the skin</p> Signup and view all the answers

    What is a possible effect of the mutation of the ob gene?

    <p>Reduced levels of leptin</p> Signup and view all the answers

    Intermittent fasting has shown significant differences in weight loss compared to traditional three meals daily.

    <p>False</p> Signup and view all the answers

    What is the preferred dietary approach for positive weight loss?

    <p>Negative energy balance through healthy eating and exercise.</p> Signup and view all the answers

    Obesity genes code for proteins involved in the regulation of __________ and energy expenditure.

    <p>food intake</p> Signup and view all the answers

    Match obesogenic strategies to their descriptions:

    <p>Promote physical activity = Encourages movement and exercise Watch portion sizes = Helps manage caloric intake Cut down on high kcal foods = Reduces energy consumption Don't get too hungry = Prevents overeating and binge eating</p> Signup and view all the answers

    What is the main role of insulin in regulating blood glucose levels?

    <p>Facilitate glucose uptake by tissues</p> Signup and view all the answers

    Type 2 diabetes is characterized by an autoimmune response that destroys insulin-secreting cells.

    <p>False</p> Signup and view all the answers

    What is Acetyl-CoA a breakdown product of?

    <p>Fatty acids and ketogenic amino acids</p> Signup and view all the answers

    The __________ is a ranking of how food affects glycemic response.

    <p>Glycemic Index</p> Signup and view all the answers

    Match the following types of diabetes with their characteristics:

    <p>Gestational Diabetes = Develops during pregnancy Type 1 Diabetes = Autoimmune destruction of insulin-producing cells Type 2 Diabetes = Decreased sensitivity to insulin Diabetes = Major health issue affecting millions in Canada</p> Signup and view all the answers

    Which macronutrient distribution is recommended for dietary fat intake?

    <p>20-35%</p> Signup and view all the answers

    High sugar intake is linked to obesity, diabetes, and metabolic diseases.

    <p>True</p> Signup and view all the answers

    What effect does the intake of n-3 polyunsaturated fatty acids have on cardiovascular health?

    <p>Protective against CVD</p> Signup and view all the answers

    Dietary cholesterol does not directly correlate to __________ levels in most healthy individuals.

    <p>LDL-C</p> Signup and view all the answers

    Match the following lipoproteins with their functions:

    <p>Chylomicrons = Transport dietary fat from the intestines VLDLs = Transport lipids synthesized in the liver LDLs = Transport cholesterol to the body HDLs = Transport cholesterol from tissues to the liver</p> Signup and view all the answers

    What is a common symptom of Type 1 diabetes?

    <p>Frequent urination</p> Signup and view all the answers

    The keto diet is primarily focused on increasing carbohydrate intake.

    <p>False</p> Signup and view all the answers

    What are the two essential fatty acids mentioned, and their daily intake recommendations?

    <p>Linoleic acid and Alpha-linolenic acid; 12-17g (LA) and 1.1-1.6g (ALA)</p> Signup and view all the answers

    Alcohol provides __________ calories per gram.

    <p>7</p> Signup and view all the answers

    What is a potential risk of a high-carb diet according to the text?

    <p>Increase in blood insulin levels</p> Signup and view all the answers

    Trans fats from hydrogenated oils are protective against cardiovascular disease.

    <p>False</p> Signup and view all the answers

    Study Notes

    Carbohydrates

    • Glucose and galactose form lactose
    • Lactase is the enzyme needed to digest lactose
    • Undigested lactose in the small intestine can cause cramping, abdominal distention, and diarrhea

    Whole Grains vs. Refined Grains

    • Whole grains contain bran, germ, and endosperm
    • Bran provides fiber and vitamins
    • Germ contains vegetable oils and vitamin E
    • Endosperm contains starch and some protein
    • Refined grains contain only the endosperm
    • Enriched grains are refined grains that have added nutrients

    The Health Benefits of Whole Grains

    • Reduce risk of all-cause mortality
    • Reduce risk of coronary heart disease
    • Reduce risk of stroke
    • Reduce risk of type 2 diabetes
    • Reduce risk of colorectal cancer

    Whole Grain Stamp

    • The "Basic Stamp" indicates a mix of whole and refined grains, with at least 8g of whole grain per half serving
    • The "100% Stamp" signifies no refined grains and at least 16g of whole grain per serving

    Probiotics, Prebiotics, and Postbiotics

    • Probiotics are beneficial gut bacteria that ferment dietary fiber and prebiotics
    • Prebiotics are dietary fibers that feed gut bacteria
    • Postbiotics are the byproducts of probiotics
    • Synbiotics are a combination of probiotics and prebiotics

    The Role of Carbohydrates in the Body

    • Carbohydrates provide energy (4kcal/g)
    • Some cells rely primarily on glucose for energy, including:
    • Red blood cells
    • Brain and nervous system

    Gluconeogenesis

    • The process of producing glucose from other sources when carbohydrate intake is low
      • The liver and muscle glycogen are broken down and released into the blood
      • Amino acids can be used to produce glucose

    FOP Nutrition Labeling

    • Food product labeling with symbols that indicate high levels of sodium, saturated fat, and/or sugars
    • Helps consumers identify foods high in nutrients of public health concern

    Food Disappearance Surveys

    • Assess the food available to a population
    • Identify trends in diets

    The Canadian Healthy Eating Index (CHEI)

    • Measures the quality of a diet according to the Canada Food Guide
    • A score of 100% indicates that an individual meets the recommended servings for all food groups
    • The average CHEI score for Canadians is 58.8%

    Digestion and Absorption

    • Digestion is the process of breaking down food for absorption
    • Absorption is the process of taking substances into the body
    • The GI tract is a hollow tube that includes:
      • Pharynx
      • Esophagus
      • Stomach
      • Small intestine
      • Large intestine
      • Anus
    • Transit time is the time it takes for food to pass through the GI tract
    • Feces are the excretion of unabsorbed food, bacteria, and dead cells

    Digestive Secretions

    • Mucus is a viscous substance produced by goblet cells that moistens, lubricates, and protects the GI tract
    • Enzymes are protein molecules that speed up chemical reactions, they are not changed during reactions

    The GI Tract's Role in Immune Function

    • The GI tract limits the absorption of toxins and disease-causing organisms
    • Immune cells present in the GI tract include:
      • Phagocytes
      • Lymphocytes
      • Antibodies

    Digestion and Absorption in the Mouth

    • Saliva:
      • Moistens food
      • Helps with taste
      • Starts digestion through salivary amylase
      • Protects teeth through lysozyme
    • Chewing:
      • Breaks food into smaller pieces, which increases surface area for digestive enzymes

    Digestion and Absorption in the Pharynx and Epiglottis

    • The pharynx is the passageway for food and air
    • The epiglottis covers the trachea during swallowing to prevent food from entering the lungs

    Digestion and Absorption in the Esophagus

    • The esophagus is a muscular tube that moves food from the pharynx to the stomach

    Digestion and Absorption in the Stomach

    • Gastric juices contain:
      • Hydrochloric acid
      • Pepsinogen (which converts to pepsin)
      • Mucus
    • The stomach mixes food with gastric juices
    • The stomach releases chyme (partially digested food) into the small intestine

    Digestion and Absorption in the Small Intestine

    • The small intestine is the primary site of nutrient absorption
    • The small intestine has three segments:
      • Duodenum
      • Jejunum
      • Ileum
    • The small intestine secretes:
      • Pancreatic juice
      • Bile
    • The small intestine contains villi and microvilli, which increase surface area for absorption
    • Nutrients are absorbed into the bloodstream or the lymphatic system

    Digestion and Absorption in the Large Intestine

    • The large intestine absorbs water and some vitamins and minerals
    • Microflora play an important role in the large intestine

    Triglyceride Absorption

    • Triglycerides are absorbed into the lacteals of the lymphatic system
    • They are metabolized for energy

    Common Digestive Problems

    • Heartburn, gastresophageal reflux disease (GERD), and ulcers

    Alternative Feeding Methods

    • Enteral or tube feeding
    • TPN: Total Parenteral Nutrition

    The Cardiovascular System and Nutrient Absorption

    • The hepatic portal vein transports blood from the GI tract to the liver

    Nutrient Metabolism

    • Metabolic pathways transform food into its final usage form for the body
    • Catabolic pathways release energy trapped in chemical bonds
    • Energy from catabolic reactions is converted into ATP
    • ATP is the energy currency of the cell

    Cellular Respiration

    • The process for generating energy from glucose
    • Cellular respiration involves three main parts:
      • Formation of Acetyl-CoA
      • The Krebs Cycle
      • The electron transport chain

    Old Food Guide

    • Provided information on what to eat but lacked specific portion sizes.
    • Emphasized basic and straightforward guidelines for healthy eating.
    • Featured food groups like fruit and vegetables, protein (milk, meat), and grains.

    New Canada Food Guide

    • Combines the meat and dairy groups from the old guide into one protein grouping.
    • Focuses on healthy eating habits, such as cooking more and eating with others.
    • Encourages mindful eating, using labels, and limiting processed foods high in sodium, sugars, or saturated fats.
    • Emphasizes drinking water as the preferred beverage choice.

    Concerns with the New Canadian Food Guide

    • Questions arise regarding the adequacy of plant protein sources.
    • The removal of the dairy group and its inclusion in the protein grouping raises concerns about calcium intake and recommendations for breastfed infants.
    • Lack of specific nutrient requirements for different populations.
    • Vague food recommendations, lacking specific serving sizes.
    • Absence of personalized recommendations for specific individuals.

    Dairy Food Group

    • Offers essential nutrients like protein, fat, and carbohydrates.
    • High-quality protein aids in appetite and metabolism regulation.
    • Fat delivers fat-soluble vitamins and contains conjugated linoleic acid (CLA).
    • CLA slows gastric emptying and promotes prolonged satiety.
    • Carbohydrates include lactose.

    Canada Food Guide (Older Version)

    • Provides recommended serving sizes for adults aged 19-50 years.
    • Defines serving size for each food group.

    Food Labels

    • Required components: product name, weight, best-before date, manufacturer or distributor information, ingredient list, nutrition facts table.
    • Ingredients listed in descending order of weight.
    • Additives, food colors, and flavorings must be included. Sugar-based ingredients now listed in brackets.
    • Nutrition facts table provides serving size, calories, total fat, saturated fat, trans fat, cholesterol, total carbohydrates, fiber, protein, and essential nutrients (calcium, iron, and potassium).
    • % Daily Values are included.
    • "Reduced" label: Nutritionally altered products with 25% lower nutrients or energy than the regular or reference product.

    FOP (Front-of-Package) Labeling

    • Utilizes symbols to indicate foods high in sodium, saturated fat, and/or sugars.
    • Aids consumers in quickly identifying foods high in nutrients of public health concern.

    Monitoring Food Supply

    • Food disappearance surveys estimate food availability to a population and track dietary trends.

    Additional Information to Assess Nutritional Health

    • Anthropometric measurements (e.g., height and weight).
    • Medical history and physical examinations.
    • Laboratory measurements.

    Canadian Health Eating Index (CHEI)

    • Scores diets based on alignment with the Canada Food Guide recommendations.
    • A score of 100% indicates meeting recommended servings across all food groups.
    • Average CHEI score for Canadians is 58.8%.

    Digestion and Absorption

    • Digestion: Breaking down food into absorbable components.
    • Absorption: Taking substances into the body.
    • GI Tract: Includes pharynx, esophagus, stomach, small intestine, large intestine, and anus.
    • Transit Time: Time for food to travel through the GI Tract.
    • Feces: Excreted unabsorbed food, bacteria, and dead cells.

    Digestive Secretions

    • Mucus: Viscous material from goblet cells, lubricating, moistening, and protecting the GI Tract.
    • Enzymes: Protein molecules that accelerate chemical reactions without undergoing changes themselves.

    GI Tract's Immune Function

    • Limits absorption of toxins and pathogens.
    • Contains immune cells such as:
      • Phagocytes
      • Lymphocytes
      • Antibodies

    Digestion and Absorption: Mouth

    • Saliva:
      • Moistens
      • Aids taste
      • Starts digestion (salivary amylase)
      • Protects teeth (lysozyme)
    • Chewing breaks food into smaller pieces, increasing surface area for enzyme action.

    Digestion and Absorption: Pharynx & Epiglottis

    • Function in swallowing and preventing food from entering the trachea.

    Digestion and Absorption: Esophagus

    • Transports food from the pharynx to the stomach.

    Digestion and Absorption: Stomach

    • Aids in digestion through:
      • Gastric juice
      • Mixing action
      • Peristalsis
      • Absorption of some nutrients

    Digestion and Absorption: Small Intestine

    • Primary site of digestion and absorption.
    • Receives digestive secretions from the pancreas and gallbladder.
    • Absorbs nutrients into blood and lymph.

    Digestion and Absorption: Large Intestine

    • Primarily absorbs water and some vitamins and minerals.
    • Contains the colon and rectum.
    • Microflora play a crucial role in digestion.

    Digestive System: How the Brain is Involved

    • Stretch receptors in the stomach signal fullness to the brain, regulating appetite.
    • The brain triggers the release of the hormone gastrin, which regulates digestive secretions.

    Gallbladder, Liver, and Pancreas

    • Play vital roles in digestion and absorption:
      • Gallbladder: Stores and releases bile.
      • Liver: Produces bile and plays a role in nutrient metabolism.
      • Pancreas: Secretes digestive enzymes and hormones.

    Triglyceride Absorption

    • Triglycerides are absorbed into the lacteals of the lymphatic system and then metabolized for energy.

    Common Digestive Problems

    • Heartburn: Burning sensation in the chest due to stomach acid reflux.
    • Gastroesophageal Reflux Disease (GERD): Chronic heartburn.
    • Ulcers: Sores in the lining of the stomach or duodenum.
    • Vomiting: Expulsion of stomach contents.

    Alternate Feeding Methods

    • Enteral or Tube Feeding: When individuals cannot consume adequate food or fluids orally.
    • TPN (Total Parenteral Nutrition): Intravenous nutrition for individuals unable to digest or absorb nutrients.
    • Cardiovascular System and Nutrient Absorption
      • The hepatic portal vein carries blood from the GI tract to the liver.

    Metabolism of Nutrients

    • Metabolic pathways: Series of reactions converting food into usable products.
    • Catabolic pathways: Release energy trapped in chemical bonds.
    • ATP: The energy currency of cells, produced by catabolic reactions.
    • Cellular Respiration: Three main parts:
      • Formation of Acetyl-CoA: Glucose is broken down into Acetyl-CoA. Fatty acids and amino acids can also produce Acetyl-CoA.
      • Krebs Cycle: Acetyl-CoA enters the Krebs cycle, producing electrons, CO2, and ATP.
      • Electron Transport Chain: Takes electrons from the Krebs cycle to produce water, generating the majority of ATP.

    Waste Elimination

    • Waste products are eliminated through:
      • Digestive system (feces)
      • Respiratory system (CO2)
      • Circulatory system
      • Integumentary system (skin)
      • Urinary system

    Carbohydrates

    • Recommended Daily Allowance (RDA): 130 grams/day.
    • Acceptable Macronutrient Distribution Range (AMDR): 45-65% of daily calorie intake.
    • Calculation of % Energy from Carbs: Divide the energy from carbohydrates by the total energy intake and multiply by 100.

    Carbohydrate Types

    • Simple Carbohydrates:
      • Monosaccharides and disaccharides.
      • Commonly known as "simple sugars".
      • Can be naturally present or added to foods.
    • Complex Carbohydrates:
      • Oligosaccharides and polysaccharides.
      • Includes starch and fiber.
      • The body also synthesizes complex carbohydrates (e.g., glycogen) for energy storage.

    Carbohydrate Monosaccharides

    • Glucose: The primary energy source for the body.
    • Galactose: Found in milk and dairy products.
    • Fructose: Found in fruits and honey.

    Carbohydrate Disaccharides

    • Sucrose: Composed of glucose and fructose.

    Protein

    • Protein Turnover: Approximately 0.2-0.4% of body protein turns over daily.
    • Protein Requirements: Enough to replace losses and sustain turnover, support growth in children, and meet demands of pregnancy, lactation, and stress.

    Protein Requirements (DRIs)

    • Recommended Dietary Allowance (RDA): 0.8 grams per kilogram of body weight per day.
    • Acceptable Macronutrient Distribution Range (AMDR): 10-35% of total calories.

    Increased Protein Requirements

    • Infants and Children: Extra protein for growth.
    • Pregnancy: Extra protein for blood volume expansion, uterine and breast enlargement, placenta development, and fetal growth.
    • Lactation: Extra protein for breast milk production.
    • Extreme Stress: Higher protein requirements.
    • Athletes:
      • Endurance athletes: 1.2-1.4 grams per kilogram of body weight per day.
      • Strength athletes: 1.2-1.7 grams per kilogram of body weight per day.

    Protein Deficiency

    • Protein-energy malnutrition (PEM): Includes pure protein deficiency or combined protein and energy deficiency.
    • Kwashiorkor: Pure protein deficiency.
      • Bloated abdomen due to fat and fluid accumulation in the liver.
    • Marasmus: Energy deficiency.
      • Emaciation and ketosis are possible.

    Protein Excess

    • Kidney Strain: Increased workload on kidneys.
    • Dehydration: Possible if not enough water is consumed.
    • Bone Health Concerns: Not conclusively proven.
    • Increased CVD and Cancer Risk: Potential for increased risk in some studies.
    • Digestive Issues: Constipation or diarrhea.
    • Nutrient Imbalance: Increased intake of one nutrient may lead to insufficient intake of others.
    • Weight Gain: Excess protein can contribute to calorie surplus.

    Phenylketonuria (PKU)

    • Inherited condition due to a defective gene.
    • Individuals with PKU cannot properly metabolize phenylalanine.
    • Aspartame (sugar substitute) contains phenylalanine.

    Protein Allergies

    • Triggered by undigested protein absorption.
    • Common allergens include:
      • Milk
      • Eggs
      • Nuts
      • Wheat
      • Soy
      • Fish
      • Shellfish
      • Peanuts
    • Anaphylaxis: A severe, rapid allergic reaction.

    Food Allergy Labeling

    • Allergens must appear on labels in three ways:
      • Listed in the ingredient list.
      • Identified within a parenthetical statement.
      • Using the word "contains".
    • Health Canada has published a guide on food allergies.

    Plant Proteins

    • Eat protein foods "choose protein foods that come from plants more often."
    • Sources of protein: Dairy, eggs, fish, meat, poultry, grains, legumes, nuts, and seeds.

    Health Benefits of Plant Proteins

    • Reduced CVD, T2D, and high blood pressure risk:
      • Whole grains, fruits, vegetables, nuts, and legumes are associated with these benefits.
    • Increased CVD and T2D risk with animal products:
      • Red and processed meats are associated with increased risk.

    Protein in Food

    • Protein content depends on the quantity of protein and its quality in the food.
    • Quantity: Aim for 10-35% of daily calories from protein.
    • 0.8 grams per kilogram of body weight per day.

    Protein Quality

    • Measure of how well a food's protein provides essential amino acids (EAAs).

    Protein Quality Factors

    • Limiting Amino Acids: Missing or insufficient in relation to dietary EAAs.
    • Complete Protein: Contains all EAAs in the right proportions.
    • Incomplete Protein: Lacks one or more EAAs.

    Additional Determinants of Protein Quality

    • Digestibility: Amount of ingested protein absorbed
    • Bioavailability: Efficiency of nutrient absorption
    • Food Processing: Can impact protein quality
    • Health and Life Cycle Factors: Disease or life stage can influence protein needs

    Protein Quality Classification

    • High Protein Quality: Provides all EAAs in sufficient amounts.
    • Low Protein Quality: May lack or have insufficient amounts of EAAs.

    Plant Protein Concerns

    • Adults: Higher intakes needed to meet protein requirements.
    • Older Adults: More protein needed due to increased protein turnover.
    • Macronutrient Balance: High plant protein intake may affect other macronutrient balance.
    • Reduced B12, Iron, Omega-3 Fats, Vitamin D, and Calcium: Potential deficiency if not sufficient dietary sources are included.
    • Lower Digestibility: High fiber, phytic acid, and oxalates can interfere with digestion and absorption of protein and minerals.
    • Incomplete Protein: May limit the body's ability to utilize protein.
    • Reduced Protein Synthesis: May impact muscle growth, recovery, and health in athletes and older adults.

    Plant Protein Take Away

    • Plant proteins provide health benefits. Aim for at least 1/3 of protein intake from plant sources.
    • Higher intakes of plant protein are needed to meet protein requirements.
    • Pay attention to nutrient intake.
    • Animal protein: Generally higher in protein quality, fat, and B vitamins.
    • Plant protein: Generally lower in protein quality, fat, and higher in fiber and antioxidants.
    • Complementary proteins: Combine different plant protein sources to create more nutritionally complete meals.

    Vegetarian Diets

    • Varies in inclusiveness:
      • Semi-Vegetarian: Restricts certain red meats, fish, or poultry.
      • Pescetarian: Excludes all animal flesh, except for fish.
      • Lacto-ovo Vegetarian: Excludes all animal flesh but includes eggs and dairy.
      • Lacto Vegetarian: Excludes all animal flesh and eggs, but includes dairy.
      • Vegan: Eliminates all animal products.

    Vegetarian Diet Take Away

    • Include more plant proteins in your diet.
    • Pay attention to nutrient intake.
    • Animal protein: Higher in protein quality, fat, and B vitamins.
    • Plant protein: Lower in protein quality, fat, and higher in fiber and antioxidants.
    • Complementary proteins: Combine various plant protein sources to create nutritionally balanced meals.

    Energy Balance and Weight Management

    • Energy Balance: Energy consumed equals energy expended.
    • Weight Management: Achieving and maintaining a healthy weight.

    Obesity Health Risks

    • Obesity is a risk factor for various chronic diseases.
    • Increased risk associated with obesity:
      • Heart disease
      • Type 2 diabetes
      • Some cancers
      • Stroke
      • Osteoarthritis
      • Sleep apnea
      • Gallstones
      • Fatty Liver Disease
      • Mental health disorders
      • Pregnancy complications

    Energy Balance

    • Energy Intake: The calories consumed from food and beverages.
    • Energy Expenditure: Calories used for daily activities.
      • Basal Metabolic Rate (BMR): Calories burned at rest.
      • Physical Activity: Calories burned through exercise and daily movement.
      • Thermic Effect of Food (TEF): Calories needed to digest and process food.
    • Weight Changes:
      • Weight Gain: Energy intake is greater than energy expenditure.
      • Weight Loss: Energy expenditure is greater than energy intake.
      • Weight Maintenance: Energy intake is equal to energy expenditure.

    Factors Affecting Energy Expenditure

    • Age: BMR slows down with age.
    • Gender: Men have a higher BMR than women.
    • Body Composition: Lean muscle mass burns more calories than fat mass.
    • Genetics: Can influence metabolic rate and body composition.
    • Hormones: Some hormones can influence appetite and metabolism.
    • Medications: Some medications can impact metabolism.

    Healthy Weight Management Strategies

    • Balanced Diet: Focus on a variety of nutrient-rich foods.
    • Regular Physical Activity: Aim for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week.
    • Portion Control: Be mindful of serving sizes.
    • Mindful Eating: Pay attention to hunger and fullness cues.
    • Limit Processed Foods and Sugary Drinks: These contribute to excess calories and lack nutritional value.
    • Hydrate Adequately: Water can help you feel full and supports metabolism.

    Weight Management Take Away

    • Energy balance is key to weight management.
    • There are both environmental and genetic factors that influence weight.
    • A healthy lifestyle with balanced nutrition and regular physical activity is essential for sustainable weight management.

    Factors Contributing to Obesity

    • Environmental Factors:
      • Increased portion sizes and availability of calorie-dense foods:
      • Sedentary lifestyles: Less physical activity.
      • Marketing and advertising for unhealthy foods:
      • Accessibility of fast food and convenience foods:
    • Genetic and Biological Factors:
      • Genetics: Inherited predisposition to obesity.
      • Hormones: Disruptions in hormone regulation.
      • Metabolism: Individual differences in metabolism.
      • Body Composition: Individuals with a higher percentage of body fat may be more prone to obesity.

    Obesity Prevention and Treatment

    • Early Intervention: Identify and address obesity risk factors in childhood.
    • Lifestyle Changes:
      • Diet: Adopt a balanced and healthy diet with portion control.
      • Physical Activity: Implement regular physical activity.
      • Behavioral Therapy: Address underlying behaviors related to eating habits.
    • Medications: For some individuals, medications may be prescribed to aid in weight loss.
    • Surgery: In certain cases, bariatric surgery can be an option for severe obesity.

    Obesity Take Away

    • Obesity is a complex issue with multiple contributing factors.
    • Prevention and treatment require a multidisciplinary approach.
    • Lifestyle modifications are essential for sustainable weight management.

    Energy Metabolism

    • Glucose is broken down in the presence of oxygen to form Acetyl-CoA.
    • Fatty acids and amino acids can also be broken down into Acetyl-CoA.
    • Acetyl-CoA enters the Krebs cycle, producing electrons, CO2, and ATP.
    • The electron transport chain utilizes the electrons from the Krebs cycle to produce water.
    • Waste elimination occurs through the digestive, respiratory, circulatory, integumentary (skin), and urinary systems.

    Carbohydrates

    • Recommended Daily Allowance (RDA) for carbohydrates is 130 grams per day.
    • Acceptable Macronutrient Distribution Range (AMDR) is 45% to 65% of daily calorie intake.
    • To calculate the percentage of energy from carbohydrates, divide the energy from carbohydrates by total energy and multiply by 100.

    Simple Carbohydrates

    • Include monosaccharides and disaccharides.
    • Naturally present in some foods.
    • Can be added to foods at the table or during manufacturing.

    Complex Carbohydrates

    • Include oligosaccharides and polysaccharides.
    • Dietary sources include starch and fiber.
    • Our bodies synthesize complex carbohydrates as a form of energy storage (Glycogen).

    Monosaccharides

    • Glucose, Galactose, Fructose

    Disaccharides

    • Sucrose: Glucose + Fructose
    • Lactose: Glucose + Galactose

    Lactose Intolerance

    • The enzyme lactase is required to digest lactose.
    • Undigested lactose in the small intestine can cause cramping, bloating, and diarrhea.

    Whole Grains vs. Refined Grains

    • Whole grains contain bran, germ, and endosperm.
    • Refined grains primarily retain endosperm and starch.
    • Enrichment adds nutrients back to foods that were lost during processing.

    Health Benefits of Whole Grains

    • Reduced risk of:
      • All-cause mortality
      • Coronary Heart Disease
      • Stroke
      • Type 2 Diabetes
      • Colorectal Cancer

    Whole Grain Stamp

    • Basic Stamp: Indicates at least 8 grams (½ serving) of whole grain.
    • 100% Stamp: Indicates no refined grains and at least 16 grams (1 serving) of whole grain.

    Probiotics, Prebiotics, and Postbiotics

    • Industrialization is altering the human gut microbiome.
    • Probiotics are beneficial gut bacteria that ferment dietary fibers and prebiotics.
    • Prebiotics are dietary fibers from grains, beans, or leafy greens that feed gut bacteria.
    • Postbiotics are byproducts or metabolites produced by probiotics.
    • Live microorganisms that, when administered in adequate amounts, confer a health benefit to the host.

    Prebiotics

    • Indigestible carbohydrates that support gut health.
    • Examples include inulin, fructans, and soy oligosaccharides.
    • Promote probiotic growth, specifically Bifidobacteria in the colon.

    Synbiotics

    • Combinations of probiotics and prebiotics.

    Gut Microbiota

    • Probiotics, synbiotics, and prebiotics contribute to the gut microbiota.
    • Gut microbiota produces postbiotics.

    Role of Carbohydrates

    • Energy source (4 kcal/g).
    • Provides energy for daily activities alongside fat.
    • Some cells prefer glucose for energy, including red blood cells and the brain and nervous system.

    Cellular Respiration

    • Glucose is metabolized through cellular respiration to generate energy (ATP).

    Gluconeogenesis

    • When carbohydrate intake is low, glucose can be produced from:
      • Breakdown of liver or muscle glycogen.
      • Amino acids.### Gluconeogenesis
    • Glucose can be synthesized from proteins in the liver and kidneys.
    • Fatty acids and ketogenic amino acids breakdown into Acetyl-CoA.

    Blood Glucose Regulation

    • Insulin is secreted by the pancreas in response to high blood glucose.
    • Insulin facilitates glucose transportation from blood into various tissues.
    • Glucagon is secreted by the pancreas in response to low blood glucose.
    • Glucagon signals the liver to release stored glucose (from glycogen) or synthesize new glucose (from amino acids).

    Diabetes

    • Diabetes is a prevalent health condition in Canada.
    • The Canadian Diabetes Association estimates 3 million Canadians have diabetes, with a projected increase to 3.7 million by 2020.
    • Diabetes is a significant contributor to blindness, renal failure, and non-traumatic lower limb amputations.

    Gestational Diabetes

    • Gestational diabetes (GDM) develops during pregnancy.
    • Women with GDM have a greater risk of developing diabetes later in life.

    Type 1 Diabetes

    • Type 1 diabetes is an autoimmune disease.
    • The body's immune system destroys insulin-producing cells, halting insulin production.

    Type 2 Diabetes

    • Muscle, liver, and fat cells become less sensitive to insulin in type 2 diabetes.
    • Insulin production is diminished.
    • The incidence of type 2 diabetes is increasing among younger individuals.

    Diabetes Symptoms

    • Common symptoms include excessive thirst, frequent urination, blurred vision, and weight loss (especially in type 1 diabetes).

    Diabetes Treatment

    • The main objective is to maintain blood glucose levels within the normal range.
    • Treatment focuses on consistent healthy eating, regular physical activity, and medication (insulin or oral medications) when necessary.

    Glycemic Index

    • The glycemic response measures how quickly and how high blood glucose rises after carbohydrate consumption.
    • The Glycemic Index (GI) ranks foods based on their effect on the glycemic response.

    Dietary Treatments for Diabetes

    • Foods with a high GI quickly elevate blood glucose levels.
    • Foods with a low GI raise blood glucose levels more slowly. Low GI foods are advantageous for individuals with diabetes.
    • Many low GI foods are high in fiber and may reduce the risk of heart disease and colon cancer.

    Carbohydrates and Dental Caries

    • Dental caries (cavities) develop when bacteria accumulate in plaque, which forms when bacteria metabolize carbohydrates and produce acid.
    • This acid erodes tooth enamel and underlying structures.

    Low Carb Diet/Keto, Sugar, Sweeteners

    Low Carb Diet

    • Foods rich in carbohydrates stimulate insulin release.
    • Insulin promotes energy storage, primarily as fat.
    • Low carb diets reduce insulin release and increase ketone production.
    • Ketones can suppress appetite.

    Keto Diet

    • The ketogenic diet prioritizes fat (75%) over protein (20%) and carbohydrates (5%).

    Benefits of Keto Diet

    • May be beneficial for conditions such as epilepsy, metabolic diseases (type 2 diabetes, chronic inflammation, hypertension), and brain disorders (Parkinson's, Alzheimer's, multiple sclerosis, sleep disorders, autism, and brain cancer).

    Concerns with Keto Diet

    • Potential nutrient deficiencies.
    • Keto flu, a common side effect.
    • Difficulty maintaining long-term adherence.
    • Uncertain long-term health implications.
    • Challenges returning to a normal diet.
    • Potential negative impact on gut health.
    • May increase cholesterol levels and cardiovascular disease risk in some individuals.

    Carbohydrates and Heart Disease

    • Diets high in sugar and refined carbohydrates can elevate blood lipid levels, increasing heart disease risk.
    • Consuming diets rich in whole grains has been linked to a reduced risk of heart disease.

    Simple Sugars

    • Excessive simple sugar intake is associated with obesity, diabetes, and other metabolic diseases due to increased total calorie intake.
    • High fructose consumption can:
      • Elevate blood triglycerides.
      • Increase insulin resistance (pre-diabetes).
      • Contribute to higher body weight in children.

    Aspartame

    • Aspartame may be a possible human carcinogen.
    • Aspartame is strictly regulated in Canada under the Food and Drug Act regulations.
    • There is no conclusive evidence that aspartame poses a health hazard.
    • It is recommended to seek healthier alternatives, such as other artificial sweeteners, or increase water and other healthy beverage consumption.

    Lipids

    • Lipids are a chemical name for fat.
    • This category includes fatty acids, triglycerides, phospholipids, and sterols.
    • Lipids are often referred to as fats or oils.

    Functions of Lipids

    • Provide stored energy.
    • Insulate the body against temperature changes.
    • Protect internal organs from physical shock.
    • Lubricate body surfaces, such as mucous membranes in the eyes.

    Triglycerides

    • Triglycerides are the primary form of lipid in food and the body.
    • They consist of three fatty acid tails attached to a glycerol backbone.

    Phospholipids

    • Phospholipids are lipids attached to a phosphate group.
    • They are amphiphilic, meaning they have both water-loving (hydrophilic) and fat-loving (hydrophobic) properties.
    • Phospholipids act as emulsifiers.
    • They are synthesized in the body but also found in small quantities in the diet.

    Sterols

    • Sterols are a type of lipid present in plants and animals.
    • Cholesterol is a sterol found exclusively in animals.
    • Consuming plant sterols can help lower blood cholesterol levels.

    Cholesterol

    • Cholesterol is used to synthesize various hormones, including estrogen and testosterone.
    • It helps maintain the appropriate fluidity of cell membranes across a wide range of temperatures.
    • The Acceptable Macronutrient Distribution Range (AMDR) recommends that 20-35% of total calories should come from fat.
    • Essential fatty acids include:
      • Linoleic acid (LA): 12g (women) to 17g (men) per day.
      • Alpha-linolenic acid (ALA): 1.1g (women) to 1.6g (men) per day.
    • The LA:ALA ratio should be between 5:1 and 10:1.

    Fat Absorption and Transport: Lipoproteins

    • Lipoproteins are transport structures formed by combining lipids, phospholipids, and protein.
    • They transport triglycerides, cholesterol, and fat-soluble vitamins from the small intestine and stored lipids from the liver.

    Lipoproteins and their Functions

    • Chylomicrons: Transport dietary fat from the intestine to tissues.
    • VLDLs (very low-density lipoproteins): Transport lipids (primarily triglycerides) synthesized in the body to tissues.
    • LDLs (low-density lipoproteins): Transport cholesterol to the body; often referred to as "bad cholesterol."
    • HDLs (high-density lipoproteins): Transport cholesterol from tissues to the liver; often referred to as "good cholesterol."

    Fat and Cardiovascular Disease (CVD)

    • CVD involves dysfunction of the heart or blood vessels.
    • It can lead to heart attacks or strokes.
    • Atherosclerosis is the primary cause of CVD.
    • Atherosclerosis develops slowly and progressively.
    • The type of fat in the diet can contribute to or protect against CVD.

    Risk Factors for CVD

    • Intra-abdominal adiposity (excess fat around the abdomen).
    • High blood pressure.
    • Obesity.
    • Diabetes.
    • Physical inactivity.
    • Smoking.
    • Stress.
    • Age.
    • Gender.
    • Family history (genetics).

    Atherosclerosis

    • An increased risk of atherosclerosis and CVD is associated with an unfavorable blood lipid profile, including:
      • High total cholesterol or high LDL cholesterol.
      • Low HDL cholesterol or a high LDL-C/HDL-C ratio.
      • High triglycerides (and high VLDL).

    Fats that Protect, Have a Neutral Effect, or Increase CVD Risk

    N-6 Polyunsaturated Fatty Acids

    • Intake of n-6 polyunsaturated fatty acids may not increase or may protect against CVD risk.
    • They decrease cholesterol synthesis in the liver, reducing circulating LDL-cholesterol levels.
    • Dietary sources include oils that are liquid at room temperature (plant and vegetable oils, except palm and coconut oil).

    N-3 Polyunsaturated Fatty Acids

    • Intake of n-3 polyunsaturated fatty acids is protective against CVD risk.
    • They decrease blood triglycerides, reduce blood clot formation, increase HDL-cholesterol, help maintain a normal heartbeat, and have anti-inflammatory properties.

    Monounsaturated Fatty Acids

    • Intake of monounsaturated fatty acids is protective against CVD risk.
    • They decrease LDL cholesterol.
    • Dietary sources include olive oil, other vegetable oils, and nuts.

    Trans Fatty Acids

    • Intake of trans fats from hydrogenated oils is associated with CVD risk.
    • They increase LDL cholesterol and decrease HDL cholesterol.
    • Natural trans fats found in ruminant animals are metabolized differently than trans fats from hydrogenated oils.

    Dietary Cholesterol

    • Dietary cholesterol does not directly equate to LDL cholesterol.
    • Only 20-25% of individuals with high LDL-C see a decrease in LDL-C when restricting dietary cholesterol.
    • Most healthy individuals do not need to restrict their intake of dietary cholesterol.

    Saturated Fatty Acids and LDL

    • High saturated fat intake increases the liver's production of LDL cholesterol.
    • Intake of saturated fatty acids is associated with CVD risk.
    • They hinder the removal of LDLs from the blood, promote cholesterol synthesis in the liver, contribute to plaque formation, and elevate triglyceride levels.

    Saturated Fat

    • Food sources matter.
    • Dairy sources of saturated fatty acids appear to be metabolized differently than other sources.

    Coconut Oil and CVD

    • Coconuts are high in saturated fatty acids.
    • Populations with high coconut consumption appear to have healthy outcomes, with a lower CVD risk.
    • Consuming coconut ingredients, such as oil, flesh, milk, and water, has been promoted as healthy.
    • Coconut oil health claims have not been substantiated by controlled human clinical trials.
    • Compared to butter, coconut oil may lower CVD risk, but it does not have the heart-protective benefits of other unsaturated fats.
    • Many populations with high coconut consumption live in tropical regions with non-Western diets and lower energy intake.
    • With a Western diet, coconut oil may not differ significantly from other saturated fat sources.

    Summary: Recommendations for Fat Intake

    • Saturated fat should not exceed 10% of energy intake.
    • Polyunsaturated fats (n-6 and n-3 fats) should be around 10% of energy intake.
    • Emphasis should be placed on n-3 fatty acid intake, including DHA and EPA.
    • Monounsaturated fats should make up the remaining fat intake.
    • Trans fats (hydrogenated fats) should be avoided.

    Dietary Fat and Cancer Risk

    • High fat intake may increase cancer risk.
    • N-3 fatty acids are linked to lower cancer risk.

    Conjugated Linoleic Acid and Vaccenic Acid

    • Trans fats found naturally in the diet (ruminant animals).

    Alcohol

    • Alcohol is a class of organic compounds containing hydroxyl groups (-OH).
    • Ethyl alcohol is the primary ingredient in beer, wine, and liquor.
    • Produced by microbial fermentation of carbohydrates.
    • Provides 7 kcal/g.

    Metabolism of Alcohol in the Body

    • Quickly absorbed, with about 20% absorbed in the stomach.
    • Food slows down absorption by diluting alcohol in the stomach and slowing gastric emptying.
    • Alcohol enters the bloodstream rapidly.

    Metabolism of EtOH (Alcohol)

    • Alcohol can cause dehydration.
    • Alcohol lost through the lungs is used to estimate blood alcohol levels.
    • Alcohol is metabolized by the liver:
      • Alcohol dehydrogenase: Products produced promote fat synthesis.
      • Microsomal ethanol oxidizing system (MEOS): Reactive oxygen species are produced.

    Alcohol Metabolism

    • Colonic bacteria can also metabolize alcohol via ADH, yielding acetaldehyde, a toxic compound.
    • Women have more fat mass and less body water than men, making them more susceptible to the effects of alcohol.

    Rates of Alcohol Metabolism

    • Approximately 0.5 oz of alcohol is metabolized per hour.
    • Blood alcohol levels increase if alcohol intake exceeds the rate of breakdown.
    • The rate of alcohol breakdown varies depending on health, genetics, body composition, gender, age, and frequency of consumption.
    • Fasting vs. fed state: ADH is broken down during fasting.

    Health Risks of Alcohol Use

    • Accidents and fatalities.
    • Hangovers, missed work, etc.
    • Free radical damage.
    • Liver damage.
    • Other chronic diseases including kidney and heart disease, pancreatitis, cancer, ulcers, sexual dysfunction, and infertility.

    Nutrition Concerns with Alcohol Consumption

    • Fetal alcohol syndrome/fetal alcohol effects.
    • Breastfeeding:
      • Alcohol readily enters breast milk.
      • It concentrates within 1 hour of consumption.
      • It can decrease milk production and alter milk flavor.

    Alcoholism: Chronic Effects of Alcohol Use

    • Nutrient deficiencies:
      • Primary malnutrition: Alcohol displaces essential nutrients in the diet.
      • Secondary malnutrition: Damage/inflammation to the GI tract impairs nutrient absorption, storage, metabolism, and excretion.
    • Obesity:
      • Abdominal fat deposits.
      • Alcohol has a lower satiety value.
    • Long-term excessive alcohol consumption generates toxins and free radicals, leading to:
      • Liver damage: Fatty liver, alcoholic hepatitis, cirrhosis, etc.
      • Hypertension, heart disease, and stroke.
      • Increased risk of certain cancers, such as breast and colon cancer.

    Proteins and Amino Acids

    • Amino acids are the building blocks of proteins.
    • Essential amino acids cannot be synthesized by the human body in sufficient amounts to meet needs.
    • Conditionally essential amino acids become essential under certain circumstances.
    • Transamination is a process where nonessential amino acids can be synthesized in the body if they are not obtained from the diet.
    • The shape of a protein determines its function.
    • Connective tissue proteins and collagen are elongated, while hemoglobin has a spherical shape.

    Protein Functions:

    • Provide structure to cells and the entire body (cell membranes, cytosol, organelles, skin, hair, muscle, collagen in bones and teeth).
    • Enzymes speed up metabolic reactions.
    • Transport proteins move substances in and out of cells.
    • Form the immune system (skin, antibodies).

    Energy Balance

    • Energy balance occurs when energy intake equals energy expenditure.
    • Energy intake is measured in kcals from food.
    • Energy expenditure is measured in kcals expended at rest and during physical activity.

    Energy Out: Total Energy Expenditure

    • Basal metabolic rate (BMR) is the energy expended to maintain resting body functions.
    • BMR is the highest proportion of total energy expenditure.
    • Thermic effect of food (TEF) is the energy expended to process food.
    • Energy cost of physical activity includes both planned exercise and non-exercise thermogenesis.

    Factors Affecting BMR

    • Lean tissue mass significantly impacts BMR.
    • Height, age, gender, and fasting also influence BMR.
    • Growth, including pregnancy and lactation, increases BMR.
    • Thyroid hormone and certain medications can impact BMR.

    Respiratory Quotient (RQ)

    • RQ is a measure of the ratio of carbon dioxide produced (VCO2) to oxygen consumed (VO2).
    • 100% carbohydrate oxidation yields an RQ of 1.
    • 100% fat oxidation yields an RQ of 0.7.
    • 100% protein oxidation yields an RQ of 0.8-0.9.
    • A mixed diet typically results in an RQ of 0.82.

    Body Composition and BMI

    • Apple-shaped fat patterning, characterized by fat accumulation in the upper body, increases the risk of chronic diseases.
    • Pear-shaped fat patterning, characterized by fat accumulation in the lower body, does not pose a significant risk for chronic diseases.
    • Visceral fat, located around internal organs, is associated with greater health risks compared to subcutaneous fat, which is found under the skin.

    Body Mass Index (BMI)

    • BMI is a measurement of body fat based on height and weight.
    • BMI is not an accurate measure for individuals with high muscle mass, under 18 years old, pregnant or breastfeeding, or over 65 years old.

    Genetics and Energy Regulation

    • Obesity genes code for proteins that regulate food intake, energy expenditure, and fat deposition.
    • The set point theory proposes that each person's weight stays within a specific range (set point) after they finish growing.

    Short-Term Regulation of Energy Balance

    • Ghrelin, produced in the stomach, stimulates food intake and reduces energy expenditure.
    • Cholecystokinin (CCK) is released in response to protein and fat in the small intestine, reducing food intake.
    • Glucagon-like peptide 1 (GLP-1) promotes insulin secretion and has been used to treat type 2 diabetes and cause weight loss.
    • Psychological factors also influence appetite and food intake.

    Body and Hormone Factors

    • Leptin, produced by fat cells, reduces food intake, weight, body fat, and increases energy expenditure.
    • Leptin is regulated by the ob gene.
    • Mutations in the ob gene can lead to reduced leptin levels, resulting in increased food intake and reduced energy output.

    Genetic Factors

    • The thrifty gene theory proposes that certain genes cause individuals to be energetically thrifty, expending less energy and gaining weight easily.
    • This thrifty gene has not yet been identified.

    Contributing Factors to Obesity

    • Adaptive thermogenesis (AT) is a change in energy expenditure induced by factors like temperature and food intake.
    • Mechanisms of AT include futile cycling and brown adipose tissue, which has a greater number of mitochondria compared to white adipose tissue.

    Weight Loss Strategies

    • An obesogenic environment promotes weight gain by encouraging overeating and physical inactivity.
    • Appetite refers to the desire to consume specific foods regardless of hunger.

    Positive Weight Loss Strategies

    • Negative energy balance achieved through healthy eating and exercise.
    • Exercise promotes appetite reduction, increased lean body mass, improved well-being, increased energy output, and promotes fat oxidation.
    • Gradual weight loss and behavioral changes are essential for long-term success.
    • Eating a low-fat, high-complex carbohydrate diet with controlled portion sizes promotes healthy weight management.
    • Staying hydrated and avoiding excessive hunger are crucial.

    Obesity Treatment: Prescription Medications

    • Weight loss medications can have dangerous side effects and many have been removed from the market.
    • Medications should only be considered for individuals with a BMI of 30 or a BMI of 27 with additional health risk factors.

    Ozempic

    • Ozempic (semaglutide) and liraglutide (Saxenda, Victoza) are glucagon-like peptide 1 (GLP-1) receptor agonists.
    • They mimic the actions of GLP-1, limiting sugar ingestion and processing, regulating appetite, and reducing calorie intake.
    • They may also lower the risk of heart disease, heart attack, stroke, and kidney disease.

    Ineffective and Unhealthy Weight Loss Strategies

    • Fasting, very low energy diets, fad diets, and gimmicks are ineffective and potentially harmful.
    • These strategies often cause more harm than good, contributing to nutrient deficiencies, decreased metabolic rate, and disordered eating.
    • Intermittent fasting has not been shown to be more effective than eating three meals daily.

    Intermittent Fasting

    • There are many variations of intermittent fasting.
    • Concerns about intermittent fasting include potential nutrient deficiencies, decreased metabolic rate, and disordered eating.

    Vitamin K

    • Vitamin K is essential for blood coagulation, bone metabolism, and maintaining vessel health.
    • Deficiency is rare due to the injection given to babies at birth.
    • People on blood-thinning medications need to be aware of their vitamin K intake.

    Key Terms

    • Functional foods are similar to conventional foods but provide health benefits beyond basic nutrition.
    • Phytochemicals are health-promoting substances found in plant foods.

    Phytochemicals

    • Carotenoids are yellow-orange pigments like beta-carotene.
    • Flavonoids are blue, red, or yellow pigments like those found in blueberries.
    • Indoles and alliums are sulfur-containing compounds found in garlic and onions.
    • Phytoestrogens are found in soy, flaxseed, and barley.

    Getting More Phytochemicals into Your Diet

    • Eating more fruits and vegetables is crucial.
    • Consuming at least half of your grains as whole grains provides a wider range of phytochemicals.
    • Choosing plant-based proteins increases phytochemical intake.
    • Phytochemical supplements and fortified foods should be used cautiously.
    • Supplements may contain only a fraction of the phytochemicals found in whole foods.
    • There is no guarantee of interaction between different substances in supplements.
    • Doses may be too low or too high to produce biological effects.

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