FN354 Unit 1 Introductory Concepts PDF

FN354 Dr. A. Wetter Unit 1 – Introductory Concepts Unit 1a: Nutrients and chemicals in foods Learning Objectives: at the end of this discussion, students wi...

FN354 Dr. A. Wetter Unit 1 – Introductory Concepts Unit 1a: Nutrients and chemicals in foods Learning Objectives: at the end of this discussion, students will 1. List the major classes of nutrients and their principal functions. 2. Explain how the body obtains energy from macronutrients and what it uses energy to do. 3. Compare and contrast nutrients and phytochemicals. 4. Identify food sources of nutrients, phytochemicals, and energy 5. Explain how chronic diseases differ from acute conditions in their cause, development, and resolution. 6. Identify food sources of nutrients, phytochemicals, and energy 7. Define the terms that describe the extent to which a nutrient must be ingested. I. Foods provide chemical substances that affect our health and wellbeing A. Nutrients – chemical substances in food that support life 1. Functions 6 classes of nutrients Nutrient Principal function(s) Energy provided Macronutrients “energy-yielding” 1. Carbohydrates (CHO) Provide energy (E) sugars 4 kcals / gram starch 4 kcals / gram fiber 0 kcals 2. Lipids fats Provide E, form body structures 9 kcals / gram cholesterol Form body structures 0 kcals 3. Protein Form body structures 4 kcals / gram Micronutrients 4. Vitamins Regulate metabolism 5. Minerals Regulate metabolism, form body structures 6. Water It’s the essence of life 2. Energy provided by macronutrients a. “burn” nutrients in mitochondria b. aerobically (using oxygen) c. breaking C-C bonds i. produces waste products: CO2 + H2O ii. releases E (measured in calories, kcals) 1. “wasted” as heat 2. captured in ATP to fuel metabolic reactions a. stay alive = fuel biochemical reactions b. move = power mechanical processes c. grow = build body tissue 1 FN354 Dr. A. Wetter B. Food sources of nutrients question on exam - tell me what's wrong with this sentence don't memorize - but explain it carbs milk based products carbs protein milk? no fat protein carbs fat carbs protein both animal and plant protein plant proteins animal protein - fat plant protein - fat protein C. Why do we need to eat nutrients? 1. We are nutrients What happens if the body is lacking a nutrient? 2. We use and lose them every day What happens if our diet is lacking a nutrient? 3. We get them from foods a. essential b. nonessential c. conditionally essential 2 FN354 Dr. A. Wetter D. Phytochemicals – non-nutrient substances 1. not needed for short-term survival 2. 5,000-10,000 different phytochemicals in the diet 3. promote long term health; reduce risk of chronic diseases (CVD, cancer) a. childhood diseases of aging b. managed, not cured c. generate most health care costs, disability, suffering in the US 4. act on many biological processes that are associated with chronic diseases and aging a. lower blood pressure, decrease blood clotting, and reduce inflammation b. alter hormonal function, detoxifying enzyme action, and DNA repair c. have antibacterial and antiviral actions d. act as antioxidants – protect against free radicals and oxidative damage (cartoon) Do reading assignment and study guide before the next video lecture. 3 FN354 Dr. A. Wetter Unit 1b: Healthy diets Learning Objectives: at the end of this discussion, students will 1. Understand the role of foods in providing nutrients and 2. Define a healthy diet in terms of what it achieves and the pattern foods that achieve these outcomes. 3. Describe effective strategies for making nutrient dense food choices. Published by National Academy of II. Dietary recommendations Sciences. http://www.nap.edu A. Nutrient-based recommendations = DRI’s Dietary Reference Intakes: The Essential Reading: pages 31-36 Guide to Nutrient Requirements (2006) What’s the connection between the DRI’s and My Plate / Dietary Guidelines? B. Food-based recommendations pattern of food intake 1. Technically, a healthy diet (Dietary Guidelines 2020 https://www.dietaryguidelines.gov/) processed foods make you fat a. is adequate in all nutrients because they are unhealthy? --- combines info with info already covered -- its not the only thing that actually makes you fat. b. reduces chronic disease risk / promotes life-long health definition - pattern of food intake functions - adequate nutrients for life long health types - there are many types of dieting 2. Which diet is “best” for meeting nutrient needs and promoting life-long health? a. no research evidence exists b. many dietary patterns emphasize a theme of healthful eating that allows for variations i. minimally processed foods is decisively associated with health promotion and disease prevention ii. foods of plant origin minimally processed foods close to nature predominantly plants having to see where these two components come from Katz and Meller. Annu Rev Public Health. 35:83;2014 no rigorous, long-term studies compare these diets without direct comparison, any claims of superiority over others are exaggerated 4  FN354 Dr. A. Wetter 3. MyPlate models healthy eating in practice WHAT IS THE HEALTHY EATING THEME THEY HAVE IN COMMON?? a. variety veggies and protein - animal and plant Rx 'perfect' super foods, meatless vegan - dont want to be told what to do cuz this is for everyone b. balance slightly more servings of some groups than others -- a bit more veggies than fruit and a bit more grains than high protein foods. be able to talk this out to c. plant-based = mostly plants someone else is not plant only - mostly plants but does not mean there is no meat or something else in the diet. animal protein is half of protein and dairy has meats from things so everything else is plant- based on the MyPlate d. minimally processed 2020-2025 Dietary Guidelines applied in MyPlate DRIS Dietary Guidlines an My Plate A variety of vegetables from all of the subgroups—dark green, red and nutrient rec's Know these --------------------------------> orange, legumes (beans and peas), starchy, and other dietary food patterns that meet nutrient rec's Fruits, especially whole fruits Grains, at least half of which are whole grains every five years the Fat-free or low-fat dairy (milk, yogurt, cheese) and/or fortified soy beverages restrictions are updated, add new research on dietary A variety of protein foods, including seafood, lean meats and poultry, eggs, patterns, nutrient status, and health legumes (beans and peas), and nuts, seeds, and soy products Dietary Guidelines Book for Oils (vegetable fats) Americans Limit saturated fats and trans fats, added sugars, and sodium Helpful tools: MyPlate and the nutrition facts on the https://www.dietaryguidelines.gov/current-dietary-guidelines containers your re eating https://www.choosemyplate.gov/ Enduring understanding: there is no one perfect, ideal combination of foods; no top 10 foods; no superfoods 4. Why food instead of pills and potions? a. food is more than chemicals: culture, identity, pleasure, nurturing, etc. sustains our soul, identity, culture, faith, etc. RDA/AI levels = nutrient intake through foods - less risk of UL - non-nutrient substances that promote health b. recommended nutrient intakes (RDA, AI) stem from studies on food intake iron recommendation - how much iron do we need to eat through foods --- dont want to eat too much nutrient - easiest way to pack into TOO MUCH is through pills. there is a high risk of upper level ---- food will give you a better path to the needs - not through pills c. safer than relying on supplements d. phytochemicals Do not have to memorize quotes - be able to take them in ““The complex mixture of nutrients and phytochemicals [in foods] cannot be replicated by a dietary supplement.” Which Sources of Flavonoids: Complex Diets or Dietary Supplements? Egert and Rimbach. Adv. Nutr. 2:8;2011 “Because plant-based foods are complex mixtures of bioactive compounds, information on the potential health effects of individual phytochemicals is linked to information on the health effects of foods that contain those phytochemicals.” Linus Pauling Institute https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals Is the health outcome related to the: foods or nutrient or 5 phytochemical  FN354 Dr. A. Wetter 5. obtaining adequate nutrients within a calorie intake for a heathy weight Be able to explain what a healthy diet is a. nutrient density nutrient / x on the exams -- MyPlate etc. concept of density - describing using two measurements - Nutrient density is nutrient per Processed foods something. 'make you fat' because they are unhealthy -- tell why that is FALSE Side bar: energy (E) balance empty calorie foods: foods that provide cals, but have few to no nutrients negative E balance ▪ use more kcals than eat ▪ break down body tissue (fat, CHO, protein) for E positive E balance ▪ eat more kcals than use ▪ store extra kcals as body tissue (fat, CHO, protein) food processing is unavoidable b. 3 strategies for making nutrient dense food choices i. Minimize ultra-processed foods 15% empty calorie foods Group 1-3 is 85% is the majority of our diet sweet and salty snacks Food processing is margarines unavoidable sweets, bakery, grain product energy bars milk/fruit/ cocoa drinks instant soups, canned, bottled in noodles, desserts brine, salted, or preprepared ready sugared nuts or to heat products seeds. cured or poultry/fish smoked meats and nuggets or sticks fish, cheese, and homemade bread 57% of calories come from the ultra processed foods 6  FN354 Dr. A. Wetter know how to explain a nutrient dense food Fiber Unenriched white flour vit E Enriched white flour Zn Whole grain flour Mg vit B6 Folate Robiflavin Thiamin ** ultraprocessing also Niacin reduces phytochemicals Iron content 0 10 20 30 40 50 60 70 80 90 100 % of nutrients relative to whole-grain bread ii. Choose reduced-fat foods of animal origin (lean meats and dairy) iii. Choose mostly plant foods (minimally processed, of course) Foods of plant origin ▪ nutrients and phytochemicals provides nutrients plus phytochemicals -- fresh fruits and veggies, canned, cooked, fruit and veggie juice- dry fruits as well ▪ water and fiber: increase fullness without kcals add bulk provide no calories What rlly makes us fat - do prcoessed foods make you fat no they do not eating more calories than your body wants to handle is why people get fat over eating 7 less function and physcial activity eating more calories per minute the taste you want to continue to happen FN354 Dr. A. Wetter Unit 1c: Diet and health status Learning Objectives: at the end of this discussion, students will 1. Define deficiency and toxicity diseases in terms of the severity or cause of disease. 2. Explain why self-diagnosis and self-treatment of a nutrition-related health condition is not advised. 3. Describe how protective and risk factors interact to determine the occurrence of a chronic disease. 4. Explain the role of genetics in the risk for chronic conditions and why it is unlikely that we will be able to have “genetic tests” for CVD, diabetes, obesity, dementia, and other chronic conditions. 5. Consider the social contextual factors that enhance or limit people’s ability to make healthy lifestyle choices, including food choices. 6. Define the 3 main types of research study design used to understand the relationship between diet and health. 7. Identify one advantage and one disadvantage to each type of research study design. 8. Explain how while “everyone is different” we can also draw meaningful information from research studies to help individuals. I. Health conditions of nutrient status A. Type 1. deficiency 2. toxicity 3. Severity of disease a. overt b. subclinical 4. Cause of disease a. primary b. secondary B. Assessing nutritional status – figuring out if someone has a nutrient deficiency or toxicity condition 1. Professional clinical assessment is important a. symptoms b. cause is not obvious 8 FN354 Dr. A. Wetter II. Health conditions related to diet A. Nutrition / dietary advice for treating or managing diagnosed diseases 1. Only RDs and MDs can legal provide medical nutrition therapy 2. It is your personal and professional ethical responsibility to a. understand your profession’s scope of practice b. act within that scope of practice (see NASM article at end of outline) B. Nutrition / dietary advice for health promotion and disease prevention 1. Many health and other professionals 2. dietary advice to enhance lifelong health a. youth – normal growth and development, maximize health-span b. adults – maximize health-span C. Social ecological model for health 1. Risk and protective factors a. within the individual – biology, genetics, behaviors, attitudes, beliefs, etc. b. outside of the individual – social, institutional, societal, and political environments 9 FN354 Dr. A. Wetter 2. most factors are inter-related a. some co-occur (intersectionality) b. some are risk/protective factors for other factors (one leads to another) 3. proximal (direct) vs distant (indirect) influence 4. easily measured and well-studied vs difficult to measure and new knowledge 5. modifiable vs non-modifiable 6. What about genetics? The way we live our lives influences whether our risky genes express themselves or not. This concept, termed epigenetics, refers to the environmental modification of genetic risk. Yes, we may have genes that predispose us to cardiovascular disease, but when, how and to what extent those genes express themselves is highly influenced by lifestyle. https://www.acsm.org/acsm-blog Mythbusting | Genetics and Heart Disease Beth A. Taylor, Ph.D., FACSM | Jan. 29, 2020 7. Social determinants of health (SDoH) and health equity Health equity is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. https://health.gov/healthypeople/priority-areas/social-determinants-health https://www.countyhealthrankings.org/sites/default/files/media/image/resources/CHR Rmodel.png 10 FN354 Dr. A. Wetter III. Research: the scientific basis for dietary recommendations A. Why is research important? B. Different types of research studies – what do they tell us? 1. Epidemiological studies 2. Animal and cellular studies 3. Human studies: gold standard = placebo controlled clinical trial C. The realities about research results 1. Can we control for everything? 2. What does “statistically significant” mean? ▪ p