Nutrition Notes PDF

Chapter 10 Learning Objectives: 1. Describe the uses of energy by the body and explain the concept of energy balance 2. Identify factors that influence body weight 3. Discuss BMI calculations/use to determine whether a person’s weight is healthy 4. Describe ways to measure body composit...

Chapter 10 Learning Objectives: 1. Describe the uses of energy by the body and explain the concept of energy balance 2. Identify factors that influence body weight 3. Discuss BMI calculations/use to determine whether a person’s weight is healthy 4. Describe ways to measure body composition. Which are most reliable, and least expensive? Describe acceptable percent body fat ranges for males and females 5. List major health risks associated with excess body fat. Which individuals need more body fat? 6. Discuss the specifics of a long-term weight-loss regimen that is safe and effective. What defines “healthy body weight”? In a starvation diet, how much weight loss is true fat and how much is lean tissue? Define “weight cycling” 7. Evaluate popular weight-reduction diets for safety and long-term effectiveness Cycles of Regained Weight that’s Lost: High % fat mass Low % lean body mass Regulates basal metabolic rate (body at rest- organs functioning) 1. Regular, Vigorous Exercise 3-5x a week 1. Aerobic Exercise- Increases the strength of your heart and lungs 2. Weight lifting/resistance 3. Flexibility/balance (ex. yoga) 2. Healthy diet 1. Low fat, high fiber (complex carbs) Energy Balance: 1. Equilibrium Balance a. Kcal in (diet) vs Kcal out (BMR and exercise) i. Stable, healthy weight that can be maintained 2. Weight loss a. Less Kcal in (diet) vs high Kcal out (exercise and BMR) 3. Underweight (elderly) a. Low Kcal in (diet) vs Kcal out (BMR) There is a safe, recommended rate of weight loss: 1-1.5-2 lbs/week 1 pound lost fat = ~ 3500 Kcal Best case is 75% fat, 25% lean A non healthy diet means 50% fat, 50% lean fat Methods to Assess Healthy Body Composition:  1. BMI Classifications (not useful for athletes) a. Underweight: 30 e. Male weight average: 13-21% f. Female weight average: 23-31% 2. Assessing Body Fat a. Bioelectrical impedance i. Less cost ii. Easy to do b. Skin calipers i. Less cost ii. Easy to do c. Hydrodensitometry or Underwater Weighing d. DEXA (Dual Energy X-Ray Absorption)- X-ray e. Bod Pods 3. Waist Circumference a. (Waist in inches)/ (hip in inches) i. M > 1 is high risk ii. F > 0.9 Central (abdominal) obesity iii. Ups your risk for chronic disease iv. Visceral, android The focus should be on prevention and then maintaining weight Diet Fuels: 1. Carbs break down to glucose (4 kcal/g) 2. Triglycerides break down into glycerol and fatty acids (9 kcal/g) 3. Proteins break down into amino acids a. Fuel is a low-priority BMR- Basal Metabolic Rate Body at rest Total Energy Expenditure (EE) BMR (50-65%) Physical Activity Kcal is a rough estimate Anabolic: To build-up Energy required Example: Glucose to glycogen to liver Catabolic: Breakdown Digestion Factors that influence metabolic rate: Lean body mass (LBM) Body surface area Males don’t always have higher BMR than females The older we get the lower our BMR gets ○ Maintain exercise to counter that Hunger vs Appetite: Appetite: Psychological “want to eat” Hunger is Physicological Hunger is regulated by the hypothalamus in the brain Physiological Factors: If the stomach is full it stimulates stretch receptors Blood glucose rises CCK (Cholecystokinin)- In the stomach in the presence of fat Ghrelin- Hormone secreted by the stomach that raises the appetite and lowers the total EE Leptin- Hormones secreted by fat cells which lowers appetite (appetite is increased by EE) Satiety: Feeling of fullness, increased fibers, and nutrient-dense foods Genetics (Nature): Hormones Enzymes BMR ○ Increases as you increase your lean body mass Brain chemistry *Identical twins adopted at birth (different environments) have adult body weights within 5 lbs of each other Environment (Nurture): Healthy lifestyle choices 1. Regular vigorous exercise 2. A healthy diet lowers fat and raises fibers 3. Set Point: Maintenance- The point or place of weight where we tend to stabilize  If people gain above it, they tend to lose If people are below it (weight loss), they tend to regain it 4. Behavior Modification: Altering the environment to reduce over-eating Slow down eating and take at least 20 minutes Only a concern when they are overweight Be mindful of eating (sit down at the table and socialize) Lower easy access to food (avoid family-style eating) Use small plates 5. Motivation/Attitude: Response to food cues Cognitive restructuring Modeling of parents and coaches Overfeeding ○ Children and infant parents should be responsive to cues of fullness Weight Loss and Maintenance: Small reasonable goals 8-10-12 week classes Should teach people how to eat healthy Reduce the risk of chronic disease Bariatric Surgery: Surgical site of the stomach BMI > 40 Requires a 6-month trial with RDs and RNs on diet and exercise 1. Gastric Bypass Malabosportion 2. Sleeve Gasterectomy 3. Gastric Banding Chapter 11 Learning Objectives: 1. List five health benefits of a physically active lifestyle 2. Differentiate between anaerobic and aerobic use of energy, and identify the advantages and disadvantages of each in the body 3. Refer to the physical activity pyramid: aerobic activity should be done how many times per week and for how long? What about strength exercises? 4. Estimate an athlete’s energy/protein needs. Distinguish between endurance vs strength athletes. Discuss the overall dietary needs to best support physical activity Benefits of Exercise: Lowers stress, anxiety, depression  Raises self-esteem Psychological wellbeing Increases muscle mass (LBM)/ Strength Lowers fat mass (weight control) Weight-bearing exercise Strengthens bones Lowers the risk of osteoporosis Improves joint functions Health benefits ○ Lower blood pressure ○ Improves blood glucose regulation ○ Improves lipid profile (blood, lower cholesterol, lower LDL, HDL) ○ Lower risk of many cancers Physical Activity Pyramid: 1. Aerobic for strengthening the heart and lungs a. Means with air b. Done at a pace that your body can deliver oxygen to the working muscles to meet the needs c. Trained individual athletes are better at aerobic exercise d. Can get bone mass e. In the mitochondria Recommendations: i. Start goal: 3-5x a week, 20-30 minutes ii. End goal: 5-7x a week 60 min iii. One day off 2. Strength/Resistance a. 2-3x a week (8-10 exercises) 3. Flexibility and balance a. Static stretching of large muscle groups Anaerobic: Mean without oxygen Done at a pace where we cannot deliver adequate oxygen to working muscle Can get bone mass Use of Fuels Energy: Carbs AMDR: 45-65% ○ 2-4 fruits ○ 3-5 veggies ○ 6-11 whole grains All of these contain fiber: ○ Lowers and regulates blood glucose Glycolysis (breaking down of glucose)  ○ Turns 6 glucose into 2, 3 carbon, pyruvate molecules ○ Acetyl-CoA is 2 carbons ○ Lactic Acid (muscle fatigue, burning, aching) Fat is used for low to moderate-intensity ○ 20-35% Proteins ○ 10-35% ○ Fuel is a low-priority use of protein Endurance: 1.2 to 1.4 g/kg of protein Strength: 1.2 to 1.7 g/kg of protein RDA Recommendation: 0.8 g/kg for healthy adults Erogenic Acids: Supplemt of substances that enhance exercise performance Caffeine: Fatty acids to muscle jittery Creatine: Higher muscle mass Diet: 1. High complex carbs (AMDR 45-65%) 2. Moderate in protein (15-20%) 3. Low in fat (AMDR 45-65%; 30% or less AHA) Antioxidants: Vitamin E Vitamin C Reduces muscle fatigue and damage Reduces the risk and severity for chronic diseases Fluids: Recommendations: ○ Non-specific: 1 mL/1 kcal ○ 2-3 Liter/day ○ 9-11 cups to avoid mild dehydration Reduces cognitive function  ○ Drink 24 oz of fluids for each pound of body weight lost during exercise Sports Drink: 1 Powerade/Gatorade/Liquid IV Too much can draw water into your intestines which can cause cramping and diarrhea Iron: Avoid sports Calcium: 3 servings/day ○ 8 oz milk ○ 1.5 oz of cheese ○ 6-8 oz yogurt 800 mg for regular adults 1200 mg for pregnant women Chapter 13 Learning Objectives: 1. Identify the range of weight that adult women should gain during pregnancy (distinguish between underweight, healthy, and overweight)- along with extra kcal needed each trimester 2. Identify nutrients that may need to be supplemented during pregnancy 3. Describe the psychological processes involved in lactation and breastfeeding 4. Compare the nutritional composition of infant formula with breast milk/ list the advantages of breastfeeding 5. Explain the rationale for delaying the introduction of solid foods to infants until 4 to 6 months of age. Start with 1st recommended food- discuss the progression of foods and which foods to feed 6. Summarize practical suggestions to encourage healthy eating healthy habits among children 7. Identify at least three major nutrient-related health concerns facing American children and teenagers and how to treat them 8. Identify at least three physiological l changes that occur during the normal aging process 9. Discuss how the aging process can affect an individuals nutrient needs Common Concerns: 1. Nausea a. Anytime not just the first 12 weeks b. Treat with small, frequent meals c. Lower fats d. Dry cereal/ fat 2. Constipation  a. Adequate fluid i. 2-3 liters ii. 9-11, 8 oz cups b. Adequate fiber i. 6-11 whole grains ii. 2-4 fruits iii. 3-5 veggies 3. Heartburn a. GI reflux acid in the stomach b. Small, frequent meals and low-fat help with heartburn 4. Fatigue 5. Normal Edema (feet swell during the last month) Dietary Recommendations: 1. Carbs a. 6-11 whole grains b. 2-4 fruits c. 3-5 veggies d. Higher fiber 2. Protein a. High-lean protein that is high quality b. 4-6 oz meat, chicken, fish, pork 3. Fat a. Should be lower than 30% Prenatal Supplement? 1. Folate a. Folate deficiency increases the risk of neural tube defects (spinal bifida) Dietary Recommendations: i. Green leafy vegetables ii. Orange Juice 2. Iron a. Helps with brain functions Dietary Recommendations: i. Lean meats ii. Poultry iii. Pork iv. Fish v. Beans/legumes vi. Fortified cereals b. Vitamin C and Iron should increase for parental supplements 3. Calcium a. Normal Adult: 3x a day i. 8 oz milk  ii. 1.5 oz cheese iii. 6-8 oz yogurt b. Pregnant women need 4 servings a day Recommended Dietary Recommendations: 1. 1st Trimester a. High Nutrient dense foods b. Should gain 5-6 pounds total 2. 2nd Trimester a. 340 kcal/day b. 1-1.5 pounds a week for a total of 10 pounds 3. 3rd Trimester a. 450 kcal/day b. 1-2 pounds a week for a total for 10-15 pounds Weight Gain During Pregnancy: Underweight: 28-40 pounds gained Healthy weight: 25-35 pounds gained Overweight: 15-25 pounds gained Obese: At least 15 pounds gained Healthy Pregnancy: Exercise daily is good No alcohol (destroys brain cells) No smoking No drugs Gestational Diabetes: Healthy non-excessive weight gain A healthy, balanced diet Hypertension Ctoximal: Higher risk during pregnancy Breastfeeding: Benefits for Infants: ○ Breast-fed babies have better immune systems and decreased sickness ○ Easily digested Less gass Less colic Less spitting up ○ Changes composition over time Hindmilk is higher in fat ○ Better brain and cognitive functions  ○ Lower risk of asthma, obesity, and type 1 diabetes in childhood ○ More convenient ○ Lower cost Benefits for Moms: ○ Lower risk of many cancers, type 2 diabetes ○ More loss of pregnancy weight and fat ○ Less bleeding after delivery ○ More bonding Colostrum: Contains antibodies during the first few days Successful Breastfeeding: Proper technique/ positioning on the breast Frequent feeding: 1012 times in the first 8 weeks How are they getting enough? Gaining weight Loose mustard-colored stools 8-10 wet diapers The breastfeeding diet is the same as the pregnancy diet Growth spurts happen every 6-8 weeks 0-6 months: Breast milk or iron-fortified formula At 4 months, iron-fortified baby cereals in a spoon 6-12 months: Introducing baby foods Around 9 months, soft mashed table foods Sippy cup at 6 months Portion Sizes for 1-10: 1 Tablespoon for every year of age of each food Fostering Positive Eating Behaviors: Picky eaters: ○ Avoid nagging, bribing, or forcing Enjoyable mealtimes- eat all together as a family ○ Should be happy, social occasions ○ Children should help with meal preparation School-Age Children: Compared to younger children, school-aged children: ○ Often skip breakfast  ○ AND eat: More foods away from home Larger food portions More fried foods and soda Parents and caregivers should be concerned about foods eaten away from home and at school Meals should be eaten together as a family whenever possible Physical Activity for Children: Children need at least 60 minutes of moderate-intensity physical activity most days of the week Tips to Improve a Child’s Diet Eat meals together as a family as often as possible Avoid using food as a reward or punishment Keep healthy snacks, such as fat-free or low-fat milk, fresh fruit, and vegetable on hand Encourage the child to eat a nutrient-dense breakfast daily Iron and Calcium Intakes: Iron deficiency during adolescence: ○ Boys may become iron deficient during growth spurt ○ Girls who have heavy menstrual bleeding/poor eating habits may become iron deficient Calcium status is often low ○ Many teens drink soft drinks instead of milk Lifestyle Choices: 1. Healthy Diet 2. Physical Activity- Minimum 60 hours 3. Mental/Spiritual- Lowers stress Elderly: Lower LBM ○ Less strength ○ Lower BMR ○ Lower muscle tone ○ Balance Higher chance for osteoporosis Might have social isolation Might have depression Diet often low in vitamins D and E and potassium ○ Most concerned about Vitamin D Increase that with dairy Tips for Caregivers to Improve Nutrient Intakes of Elderly People: Emphesize nutrient dense-foods in planning menus Have easy-to-prepare nutrient dense foods on hand