HNFE Exam 1 Study Guide PDF

Exam 1 Study Guide CHAPTER 1 - Intro Know the difference between hunger and appetite ○ Hunger : physical and biological drive to eat controlled by internal mechanisms ○ Appetite : psychological drive to eat Know the energy density of macromolecules ○ carbs/...

Exam 1 Study Guide CHAPTER 1 - Intro Know the difference between hunger and appetite ○ Hunger : physical and biological drive to eat controlled by internal mechanisms ○ Appetite : psychological drive to eat Know the energy density of macromolecules ○ carbs/proteins - 4Kcal/g of energy ○ Lipids - 9 Kcal/g of energy ○ Alcohol - 7 Kcal/g of energy Be able to convert between grams and kcals and vice versa- bring a calculator to the exam ○ GRAMS TO KCALS ○ Multiply each macronutrient by number of calories/gram ○ Add the calories from all three macronutrients ○ Divide the calories from each nutrient by the total number of calories in the meal ○ Double check work - add to get to 100% 42 grams carbs, 35 grams protein, 10 grams fat 42 x 4 = 168 calories, 35 x 4 = 140 calories, 10 x 9 = 90 calories 168 + 140 + 90 = 398 calories 168/398 = 42.2%, 140/398 = 35.2%, 90/398 = 22.6% 42.2% + 35.2% + 22.6% = 100% ○ KCALS to GRAMS ○ Determine how many calories each macronutrient percentage is providing ○ Divide the calories from each nutrient by the calories/gram each macronutrient provides ○ Find _____ weight in kg ○ Determine how many grams/kg body weight ____ is consuming 155 lbs, 20% carbs, 50% protein, 30% fat, new diet of 1200 cals 1200 x 0.2 = 240, 1200 x 0.5 = 600, 1200 x 0.3 = 360 240/4 = 60, 600/4 = 150, 360/9 = 40 155 lbs/2.2 kg = 70.5 kg Total grams of protein / weight in kg, 150/70.5 = 2.12 grams/kg Be able to determine the % of each macronutrient when given total Kcals and grams ○ 1200 Kcals, 60 gram carbs, 150 gram protein, 40 gram fat 60 x 4 = 240, 150 x 4 = 600, 40 x 9 = 360 240/1200 = 20%, 600/1200 = 50%, 360/1200 = 30% Be able to convert between inches and cm or m, and pounds and kg ○ 1 in = 2.54 cm ○ 1 cm = 0.39 in ○ 1 m = 39.37 in ○ 1 kg = 2.2 lbs Be able to calculate someone’s BMI ○ Weight in kg and height in meters***  ○ 1 inch = 0.0254 meters*** ○ 1 pound = 0.453592 kg ○ Height in inches x 0.0254 = ___ meters ○ Weight in lbs x 0.453592 = ___ kg ○ BMI : kg/(M)^2 = ___ kg/m^2 Know the 5 steps of evidence-based practice ○ Ask a well designed research question ○ Acquire evidence (papers) ○ Appraise & interpret ○ Apply the evidence to your practice ○ Evaluate the effects of implementation Know the numbers of the 4 BMI categories ○ Underweight = less than 18.50 ○ Normal range = 18.50 - 24.99 ○ Overweight = greater than or equal to 25 ○ Obese = greater than or equal to 30 Be able to define energy dense foods and nutrient dense foods and calculate them when given kcals and grams ○ Energy dense - ratio content to weight ○ Nutrient dense - ratio of nutrient content to calorie content Know the food components to limit- specifically the amount ○ Limit added sugars to less than 10% of daily calories ○ Limit saturated fat to less than 10% of daily calories ○ Limit sodium to less than 2300 mg/day ○ Limit alcohol to moderate consumption Women - 1 drink per day Men - 2 drinks per day Know the PA guidelines for children and adults ○ Children : Aerobic - 60+ minutes per day, vigorous intensity physical activity 3 days a week Muscle strengthening - apart of the 60 minutes per day, at least 3 days a week Bone strengthening - as part of 60 minutes per day, at least 3 days a week ○ Adults : At least 150 to 300 minutes a week of moderate-intensity At least 75 to 150 minutes a week of vigorous-intensity aerobic physical activity Be able to define moderate intensity exercise and vigorous intensity exercise based on %max HR. Be able to calculate ○ Moderate-intensity exercise - physical activity that increases a person’s heart rate to 64-76% maximum heart rate  ○ Vigorous-intensity - physical activity that increases a person’s heart rate to 77-95% maximum heart rate Know how to determine one’s max HR (220-age) ○ 220-age : 220-18 = 198 ○ Moderate-intensity 198 x.64 = 126.72 198 x.76 = 150.48 ○ Vigorous-intensity 198 x.77 = 152.46 198 x.95 = 188.1 Malnutrition - can be overnutrition or undernutrition Know the ABCDEs of nutritional status ○ Anthropometric - height, weight, % body fat, body circumference ○ Biochemical - concentration of nutrients/nutrient byproducts in blood, urine, & feces ○ Clinical assessment - physical evidence (high BP), skin, eyes, & tongue; hair loss, sense of touch, ability to walk ○ Dietary assessment - DIR or 24 hour recall, dietary intake assessment ○ Environmental assessment - medical history, social history, family health history, education level, economic status Know the definitions of RDA, AI, EER, UL, and CDRR ○ Recommended Daily Allowance (RDA) - daily amount of a nutrient that will meet the needs of 97% in a particular age & gender group (MINIMUM) Water has no RDA ○ Adequate Intake (AI) - when there isn’t enough information to make an RDA. Standard is based on the amount that appears to be maintaining health in healthy people ○ Estimated Energy Requirement (EER) - For calorie needs, the RDA is set higher for most people. The EER is for the average person and should be tailored based on more information How many kcals people should be taking in ○ Tolerable Upper Limit (UL) - highest amount of a nutrient unlikely to cause adverse health effects ○ Chronic Disease Risk Reduction Intakes (CDRR) - values set after correlations with intakes and disease Sodium- the CDRR is set at 2300 mg max a day to reduce the risk of hypertension Know the functions of the organelles in the cell ○ Mitochondria Respiratory center of the cell - contains the TCA cycle & electron transport chain (aerobic metabolism) Part of a network ○ Nucleus Most cells contain 1  Skeletal muscle has many RBCs have none Contains nuclear pores for chemical communication Stores DNA DNA is condensed into chromosomes DNA is our genetic blueprint which is read by the enzyme RNA Polymerase and produces mRNA ○ RER & SER SER - synthesis of phospholipids, cholesterol, steroids, TAGs & glycogen, stores CA++ RER - proteins made at fixed ribosomes on the RER are released into the cisternae of the ER ○ Golgi apparatus Modifies and packages proteins for secretion Produces lysosomes ○ Lysosomes Produced by the golgi apparatus Fuses with damaged organelles to break them down - breaks down unused proteins Fuses with endosomes to destroy bacteria or other debris that enters the cell Autolysis - internal digestion of the cell ○ Peroxisomes Break down very long chain FAs Detoxify harmful chemicals Produce H2O2 Know the functions of the organ systems in the body ○ Integumentary Major organs Skin Hair Sweat glands Nails Functions Protects against environmental hazards Helps regulate body temperature Provides sensory information Produces vitamin D ○ Skeletal Major organs Bones Cartilages Associated ligaments Bone marrow  Functions Provides support and protection for other tissues Stores calcium and other minerals Forms blood cells ○ Muscular Major organs Skeletal muscles and associated tendons Functions Provides movement Provides protection and support for other tissues Generates heat that maintains body temperature ○ Nervous Major organs Brain Spinal cord Peripheral nerves Sense organs Functions Directs immediate responses to stimuli Coordinates or moderates activities of other organ systems Provides and interprets sensory information about external conditions ○ Endocrine Major organs Pituitary gland Thyroid gland Pancreas Adrenal glands Gonads Endocrine tissues in other systems Functions Directs long-term changes in the activities of other organ systems Adjusts metabolic activity and energy use by the body Controls many structural and functional changes during development ○ Cardiovascular Major organs Heart Blood Blood vessels Functions Distributes blood cells, water, and dissolved materials including nutrients, waste products, oxygen, and carbon dioxide Distributes heat and assists in control of body temperature ○ Lymphatic Major organs Spleen Thymus Lymphatic vessels Lymph nodes Tonsils Functions Defends against infection and disease Returns tissue fluids to the bloodstream ○ Respiratory Major organs Nasal cavities Sinuses Larynx Trachea Bronchi Lungs Alveoli Functions Delivers air to alveoli (sites in lungs where gas exchange occurs) Provides oxygen to bloodstream Removes carbon dioxide from bloodstream Produces sounds for communication ○ Digestive Major organs Teeth Tongue Pharynx Esophagus Stomach Small intestine Large intestine Liver Gallbladder Pancreas Functions Processes and digests food Absorbs and conserves water Absorbs nutrients Stores energy reserves ○ Urinary Major organs Kidneys  Ureters Urinary bladder Urethra Functions Excretes waste products from the blood Controls water balance by regulating volume of urine produced Stores urine prior to voluntary elimination Regulates blood ion concentrations and pH ○ Male reproductive Male major organs Testes Epididymides Ductus deferentia Seminal vesicles Penis Scrotum Functions Produces male sex cells (sperm), seminal fluids, and hormones Sexual intercourse ○ Female reproductive Female major organs Ovaries Uterine tubes Uterus Vagina Labia Clitoris Mammary glands Functions Produces female sex cells (oocytes) and hormones Supports developing embryo from conception to delivery Provides milk to nourish newborn infant Sexual intercourse Know the functions of the hormones important for nutrition ○ Growth hormone Produced by pituitary gland Promotes protein synthesis and growth Increases use of fat as fuel ○ Thyroid hormone Produced by thyroid gland Regulates metabolic rate, growth, and development ○ Epinephrine and norepinephrine Produced by adrenal glands Increase blood glucose  Increase metabolic rate during times of stress ○ Cholecystokinin Produced by small intestine and brain Regulates the movement of food through the GI tract and stimulates the release of bile and pancreatic juice into the small intestine ○ 1,25-dihydroxyvitamin D3 Calcitriol; produced by skin and activated in liver and kidneys Regulates blood calcium level ○ Insulin and glucagon Produced by pancreas Regulate blood glucose level ○ Ghrelin Produced by stomach cells Helps to regulate energy intake and body weight to stimulating hunger ○ Leptin Produced by adipose tissue Helps to regulate energy intake and body weight by reducing hunger ○ Secretin Bicarbonate release from the pancreas ○ Gastrin Gastric motility; stomach enzyme release Know the underlined digestive enzymes, the macronutrient that they digest, and where they work ○ Mouth Salivary amylase- begins the digestion of carbohydrates Lingual lipase- begins the digestion of lipids ○ Stomach - contains gastric pits (cell life 3-7 days, then sheds) Parietal cells HCL & intrinsic factor ○ Low pH kills pathogens, denatures proteins, breaks down plant cell walls & animal CT, activation of pepsinogen to pepsin Chief cells ○ Pepsinogen - begins digestion of protein ○ Gastric lipase - continues digestion of lipids G cells (mostly in pylorus) ○ Gastrin - stimulates product release by the chief cells & parietal cells ; and gastric motility P/D1 cells (mostly in fundus) ○ Ghrelin - initiates hunger Antagonist to leptin, signals satiety ○ Small intestine Pancreatic Alpha amylase from the pancreas - continues carbohydrate digestion  Pancreatic lipase - finishes lipid digestion Trypsin, chymotrypsin, elastase, carboxypeptidase A & B - from pancreas as proenzymes continues protein digestion Brush border enzymes finish the digestion of carbs & proteins Sucrase, maltase, isomaltase, and lactase ○ Finishes carbohydrates digestion Aminopeptidase, tripeptidase, dipeptidyl peptidase ○ Finishes amino acid (protein) digestion Enteropeptidase - cleaves trypsinogen to trypsin (from pancreas) Hormones CCK : pancreatic enzyme release & gallbladder contraction Secretin : bicarbonate release from the pancreas Gastrin - gastric motility; stomach enzyme release Be able to define the 4 types of gut bacteria ○ Probiotics - foods that can contain live microorganisms that will become part of the gut microbe population ○ Prebiotics - substances that increase the growth of probiotic microorganisms ○ Synbiotics - contain both probiotics and prebiotics ○ Postbiotics - metabolic products of probiotic microorganisms Be able to define epigenetics and nutritional genomics ○ Epigenetics - changes to gene expression without changing DNA code ○ Nutritional genomics - interactions between genetics and nutrition Know the carbohydrate and fiber recommendations ○ 45-65% of Kcalc should be from carbohydrates ○ Half should be whole grains ○ RDA is 130 grams - everyone should get at least this many a day ○ 25 for women for fiber ○ 38 for men for fiber Know the 3 monosaccharides, 3 disaccharides and what they are made of ○ Monosaccharides - simplest Glucose - comes from starches & sucrose (rice, spaghetti) Fructose - comes from fruit; most is converted to glucose Galactose - comes from lactose in dairy products; most is converted to glucose Glucose can be converted to galactose to make milk in lactating mothers ○ Disaccharides - two monosaccharides Maltose, sucrose, lactose Sucrose - natural sweetener found in sugar kane, sugar beets, honey, and maple sugar Lactose - milk sugar Maltose - 2 glucose joined together Know the difference between amylose and amylopectin, and glycogen ○ Polysaccharide  Amylose - 15-20% of cereal grain, potatoes, other vegetables Amylopectin - branch points broken down by isomaltase (glycogen has more branches) Broken down more readily → can raise blood sugar faster 80-85% of cereal grains, potatoes, and other vegetables Know the difference between soluble and insoluble fiber ○ Soluble fiber (viscous) - Pectins, gums, mucilages Found in beans, oats, oat bran, & some fruits and veggies Readily fermented by bacteria in the Ll to form short-chain fatty acids Attracts water to feces- stool softener Reduces blood cholesterol - inhibits absorption of cholesterol & bile in the Ll, body has to remove circulating cholesterol to produce new bile acids Controls blood glucose ○ Insoluble fiber (non-fermentable) Found in wheat bran, nuts, fruit skins, and some veggies Speeds up transit time in the Gl- natural laxative Provides bulk to feces Know the carbohydrate digestion enzymes ○ Salivary amylase - in mouth, chops up polysaccharides ○ Pancreatic alpha amylase in small intestine continues the digestion of polysaccharide ○ Four brush border enzymes finish digestion Maltase - cleaves the bond between 2 glucoses Isomaltase - cleaves bonds of limit dextrins Sucrase - cleaves sucrose to produce fructose and glucose Lactase - cleaves lactose to produce galactose and glucose Know the functions of insulin and glucagon ○ Insulin - released from the pancreas after eating when blood glucose rises ○ Stimulates storage pathways Glycogen synthesis Protein synthesis TAG synthesis ○ Glucagon - released from the pancreas in between meals when blood drops ○ Stimulates break-down pathways Know the criteria for diabetes diagnosis ○ Defined by an elevated blood glucose level - all forms are characterized by a defect in insulin production or inability to use insulin Type I - autoimmune disease Symptoms : increased thirst, frequent urination, dry mouth, extreme hunger, unexplained weight loss, fatigue, blurry vision, sores that are sore to heal  Diabetic ketoacidosis - cells can’t take in glucose, so fatty acids are the primary energy source. Excess lipolysis/beta oxidation produces excess acetyl CoA which combine to form ketones (especially important for the brain) Type II - usually tied to obesity & inactivity Symptoms : may have some of the above or none Gestational - during pregnancy Other- genetic defects, injury, drug0induced Pre-diabetes - elevated blood glucose in response to a high carbohydrate meal (impaired glucose tolerance) Elevated blood glucose in the fasting state known as impaired fasting glucose Those with pre diabetics are at a high risk of developing diabetes DIAGNOSIS Fasting blood glucose ○ Pre-diabetes : 100 mg/dl to 125 mg/dl ○ Normal : < 100 mg/dl ○ Diabetes on two separate tests : > 126 mg/dl Hemoglobin A1c - tests average blood glucose over 2-3 months ○ Normal : 4-5.6% ○ Pre-diabetes : 5.7-6.4% ○ Diabetes on two separate tests : > 6.5% Know the difference between glycemic index and glycemic load ○ Glycemic index - ratio of blood glucose in response to a food compared to a reference food like white bread (quality of food) ○ Glycemic load - measures both quality and quantity taken in during a meal Know the lipid recommendations ○ 2020 Dietary Guidelines for Americans : 20-35% of Kcals of fat intake (no minimum) ○ No RDA (our bodies can go on without intaking any fat) ○ Omega 6 Men - 17 grams Women - 12 gram ○ Omega 3 Men - 1.6 grams Women - 1.1 grams ○ AHA Recommendations : 5-6% of Kcals come from saturated fats Limiting trans fat By limiting trans and saturated fat, we can limit cholesterol Know the types of fatty acids- saturated, unsaturated, MUFAs, PUFAs, trans-fats, Omegas ○ Saturated - no carbon to carbon double bonds (solid at room temp) ○ Unsaturated - one or more double bonds (liquid at room temp)  One double bond - monounsaturated (MUFA) Two or more double bonds - polyunsaturated (PUFA) Polyunsaturated fats - break into Omega-6 and Omega-3 (essential fatty acid) Omega-6 - Linoleic acid → DHA or EPA Omega-3 - Alpha-linolenic acid → arachidonic acid Know the glycerolipids, phospholipids, and cholesterol ○ Glycerolipids - mono-, di-, tri-esters of glycerol and fatty acids Most fatty acids are found as glycerolipids ○ Phospholipids - Contains phosphate group Glycerol core structure ○ Sterols / steroids - cholesterol (common example) Know the digestive enzymes for lipids ○ Lingual lipase - begins to remove 1 FA from TAGs in the mouth ○ Gastric lipase - cleaves some more FAs off ○ Pancreatic lipase - continues the removal of FAs Can get access to TAGs only when lipid droplets are emulsified by bile Know how they are transported in the blood- major lipoprotein in a fasted state and major one in a fed state ○ Know the 4 different types of lipoproteins and their characteristics- size and biggest constituent ○ VLDLs Made in the liver Major lipoprotein circulating in fasted state Delivers TAGs to adipose tissue ○ LDLs Formed from VLDL when TAGs are gone Transports cholesterol for use by cells in the periphery-known as bad cholesterol Saturated fat has shown to increase LDLs ○ HDLs Known as good cholesterol transporter because it removes cholesterol from peripheral cells and returns it to the liver where much converted to bile acids- known as reverse cholesterol transport or excreted Know the non-modifiable and modifiable risk factors for CVD ○ Non-modifiable Age - men 45+, women 55+ Sex - males higher at risk than females Heredity - cardiovascular disease in the family, African-American, Mexican-American, American-Indian, or native Hawaiian ○ Modifiable  Smoking and vaping (makes blood more likely to clot), for women- combination of smoking and oral contraceptive use High blood pressure - systolic blood pressure (130+) and diastolic blood pressure (80+) show hypertension High cholesterol - LDL, HDL, and triglycerides, elevated LDL, Inactivity - being sedentary, regular exercise improves insulin action Excess body fat - especially around waist causes increased LDL, insulin resistance, and inflammation Diabetes - guarantees development of cardiovascular disease, insulin increases cholesterol synthesis, increase LDL Be able to calculate the protein requirement for someone if given their weight ○ RDA is 0.8g per Kg body weight 111/2.2 = 50.455, 50.455x0.8 = 40.354 Know the 4 levels of a protein’s structure- what leads to these conformations ○ Dipeptides - two amino acids ○ Tripeptides - three amino acids ○ Oligopeptides - 4-9 amino acids ○ Polypeptides - greater than 10 amino acids ○ Primary - single polypeptide chain of AAs ○ Secondary - hydrogen bonding produces alpha helices or beta sheets ○ Tertiary - results from hydrophobic and hydrophilic interactions of R groups & disulfide bonds ○ Quaternary - multiple tertiary polypeptide structures coming together to form 1 protein Know the difference between complete, incomplete and complementary proteins ○ Know complementary protein combinations Know all the enzymes that break down proteins, including enteropeptidase ○ Pancreatic proteases chop up oligopeptides at specific AAs ○ Enteropeptidase - converts trypsinogen to trypsin (stimulated for release by chyme) Know the essential amino acids ○ Phenylalanine ○ Valine ○ Tryptophan ○ Threonine ○ Isoleucine ○ Methionine ○ Histidine ○ Arginine - essential for infants ○ Leucine ○ Lysine Know how transcription and translation work ○ Transcription  Reading of the DNA code and producing a blueprint in the form of mRNA to produce a protein Gene activation begins when the promoter region of the gene is available for RNA polymerase to bind ○ Translation Know the types of body fat distribution ○ Upper body - apple Related to insulin-resistance, fatty liver, high blood lipids & heart disease Fat is released and enters portal circulation directly to the liver High testosterone, alcohol, & smoking encourage upper body density Women after menopause can develop upper body because decrease in estrogen ○ Lower body - pear Know the healthy W-H ratios ○ Waist to hip ratio Waist should be less than hip Women 35 in Know the principle behind the skinfold test and the accuracy rate ○ Principle - amount of subcutaneous fat is proportional to a person’s total fat ○ Assuming good technique and the proper equations, accuracy is within + or - 3.5 Know the theory behind the BIA and what can erroneously affect the reading the most ○ Procedure that mathematically predicts FFM from (Height2/R) R = bioelectrical resistance impedance in ohms ○ Theory - lean tissue is more electrically conductive than fat tissue because of greater electrolyte content ○ Fat tissue gives greater resistance and impedance Know the 5 parts of energy expenditure and their definitions ○ 24-EE = RMR + TEF + TEE + TED (+ NEAT) 24-EE = 24 hour energy expenditure Measured by direct calorimetry or indirect calorimetry RMR = resting metabolic rate Determined by your fat free mass, RMR declines with advancing age, largely due to decreases in fat-free mass TEF = thermic effect of food TEE = thermic effect of exercise TED = thermic effect of disease and injury NEAT = refers to fidgeting-like activities; adaptive thermogenesis  Know behavior modification strategies ○ Set realistic goals ○ Mindful eating ○ Chain breaking ○ Stimulus control ○ Cognitive restructuring ○ Contingency management ○ Self-monitoring ○ Plan for relapses and get back on track ○ Social support system Harris-benedict equation ○ Females : 655.096 + 9.563W + 1.850S - 4.676A 655.096 + 9.563 (50.45) + 1.850(157.48) - 4.676(18) 655.096 + 482.45 + 291.338 - 84.168 (1.2) 1,613 ○ Males : 66.473 + 13.752W + 5.003S - 6.755S W = weight in kg A = age in years S = stature (height) in cm ○ 10W + 6.25S - 5A - 161 = RMR ○ 10(50.45) + 6.25(157.48) - 5(18) - 161 ○ 504.5 + 984.25 - 90 - 161 = 1,237.75 (1.2) ○ 1,485