Nutrition PDF

Need to know Required number of servings and Description of what a serving is Old food guide gives you what you need to eat instead of the portions and such and the old guide being more user friendly. Old food guide is very basic and straightforward. The new canada food guide has food grouping frui...

Need to know Required number of servings and Description of what a serving is Old food guide gives you what you need to eat instead of the portions and such and the old guide being more user friendly. Old food guide is very basic and straightforward. The new canada food guide has food grouping fruit and vegetable, protein grouping (milk and meat), and grains grouping. The difference between the 2 is that in the new guide the meats and dairy groups in the old guide are now one grouping. New Food Guide Healthy Eating Recommendations be mindful of eating habits, cook more often, enjoy food, eat with others, use labels, limit high sodium sugars foods or saturated fats, be aware of food marketing. Make water your drink of choice Eat plenty of fruits and vegetables, whole grains Choose protein foods that come from plants Limit processed foods Pay attention to eating behaviors Concerns with the new canadian food guide Some plant proteins concerns Dairy food group taken out/put into protein food grouping. Calcium? Advice for breastfed infants Nutrient requirements for specific groups of peoples Amounts of food recommended are vague No recommendations for specific people in new guide Dairy Food Group Important nutrients from dairy Protein ○ High quality ○ Unique regulators of appetite and metabolism Fat Delivers fat soluble vitamins Contains CLA Slows GE and provides prolonged satiety CHO Lactose Need to know about the CFG Number of servings recommended for adults 19-50 years(old CFG) What a serving size is(old CFG) Healthy eating recommendations promoted by new CFG Possible problems with the new CFG Food Labels Labels must contain ○ Name of product  ○ Weight ○ Date by which should be sold ○ Name of manufacturer, packager or distributor ○ List of ingredients ○ Nutrition facts table Ingredients List ○ All items must be listed ○ Highest weighted items come first ○ additives , food colors, and flavorings must be listed ○ New change:sugar based ingredients in brackets Nutrition Table Serving size Number of kcalories preserving Total amount of fat and amounts of saturated fat, trans fat, and cholesterol per serving Total amount of carbs and amount of fiber per serving Amount of protein per serving Amount of nutrients per serving Use to include vitamins A and C, calcium, iron but now includes calcium, iron and potassium while containing measurements of each nutrient and the updated % daily values are listed Reduced: Nutritionally altered product contains 25% less of a nutrient or of energy than the regular or reference product. Synonyms include “less”, “lower” and “light”, example reduced in fat FOP Nutrition Labeling FOP Labeling will provide symbol based nutrition informations that flags when a food product has high levels of sodium, saturated fat and/or sugars. FOP labeling will help consumers quickly and easily identify foods high in nutrients of public health interests Monitoring Food Supply Food disappearance surveys ○ A means of estimating the food available to a population and identifying trends in diets Additional Information Needed to Assess Nutritional Health Anthropometric measurements, such as height and weight Medical history and physical exams Laboratory measurements Canadian Health Eating Index The Canadian Healthy Eating Index (CHEI) scores a diet by measuring the quality of the dietary pattern according to the Canada Food Guide A score of 100% meas that individual meets the recommended servings for all food groups The average CHEI score for Canadaians is 58.8%  Chapter 3: Digestion, Absorption, and Metabolism Lecture 1: Overview of the digestive tract, enzymes, and hormones Digestion and Absorption Atoms to Molecules to Cells and Tissue to form a Organ to an Organ System which all makes up an Organism. Overview of Digestive System Digestion: process of breaking food down so it can be absorbed the body Absorption: process of taking substance into body GI Tract: hollow tubes consisting of pharynx, esophagus, stomach,small intestine large intestine and anus Transit Time: amount of time for food to pass GI Tract Feces: excretion of unabsorbed food, bacteria and dead cells Digestive Secretions Mucus ○ Viscous material produced by goblet cells: mucus moistens, lubricates and protects GI Tract Enzymes ○ Protein molecules that speed up chemical reactions; enzymes are not changed during reactions Digestive Enzymes Table 3.2 Enzyme Functions Need to Know GI Tracts Role in Immune Function The GI Tract limits the absorption of toxins and disease causing organisms. Some cells of the immune system are present in the GI Tract ○ Phagocytes ○ Lymphocytes ○ Antibodies Lecture 2: Digestion and Absorption Digestion and Absorption: Mouth Saliva ○ Moistens ○ Helps taste ○ Starts Digestion: Salivary amylase ○ Protect Teeth: Lysozyme Chewing ○ Breaks food into small pieces, increasing surface area for digestive enzymes Digestion and Absorption Pharynx and Epiglottis Digestion and Absorption: Esophagus When you digest fat in large amounts they are put into high low micron and are to big to enter the capillary so they enter the lacteal How the Brain is Involved in Digestion Stretch receptors get full and send a message to the brain to say we do not need anymore which triggers the hormone gastrin when food enters the stomach and regulates the digestive secretions The Gallbladder, liver, and the pancreas are involved in digestion and absorption The large intestine does not participate in digestion Large intestine contains colon and rectum Large intestine absorbs water and some vitamins and minerals Microflora have an important role After triglycerides are absorbed they are absorbed into the lacteals of the lymphatic system and then metabolized to provide energy Lecture 3: Common digestive problems, nutrient transport and metabolism, elimination of wastes Know Heartburn, Gastreoesphagel reflux disease (GERD) and ulcers as well as vomiting Alternate Feeding Methods If an individual cannot take adequate food or fluid by mouth ○ Enteral or tube feeding ○ TPN: Total Parenteral Nutrition Which of the following statements is true about the cardiovascular system's role in absorption of nutrients? Answer: the hepatic portal vein transports blood from the GI tract to the liver Metabolism of Nutrients Metabolic pathways are a series of reactions needed to transform food into a final product that can be used by 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 Need to be familiar with 3 main parts of cellular respiration and key metabolites 1.Formation of Acetyl-CoA. glucose is broken down with the presence of oxygen forming acetyl-CoA, Fatty acids and amino acids can be broken down into acetyl CoA aswell. 2.Krebs Cycle. Acetyl CoA goes into the krebs cycle which forms electrons, CO2, and ATP 3. The electron transport chain. Out of everything the krebs cycle gives out the electron chain takes it and forms water. Multiple ways of getting rid of waste such as Digestive system, Respiratory system, Circulatory system, Integumentary system (Skin), and the Urinary system Chapter 4 Types of CHO, dietary fibre and lactose intolerance How much Carbs? 130 grams/day (RDA), Acceptable Macronutrient Distribution Range is 45-65% of daily calorie intake How to calculate % energy from carbs by Dividing energy from carb by total energy and multiply by 100 to express as percent Kcalories from carb divided by total kcalories then multiply by 100 Simple carbohydrates ○ Include monosaccharides and disaccharides (“Simple Sugars”) ○ Can be naturally present in food ○ Can be added to foods at the table or during manufacturing Complex Carbohydrates ○ Include oligosaccharides and polysaccharides ○ Dietary sources include starch and fibre ○ Our bodies also synthesize complex carbohydrates as a form of energy storage (Glycogen) Monosaccharides to know, Glucose, Galactose, Fructose Disaccharides to know, Glucose and Fructose together is Sucrose. Glucose and Galactose together is Lactose The enzyme lactase is needed to digest lactose, the sugar found in milk ○ If lactose is not digested in the small intestine, it passes through to the large intestine ○ Undigested lactose in the small intestine can cause cramping, abdominal distention, and diarrhea Whole grains vs Refined grains Whole or unrefined grains contain  ○ Bran Layers Good source of fibre and vitamins ○ Germ Good source of vegetable oils and vitamin E ○ Endosperm Contains starch and some protein Refind grains separate grain layers Retain mainly endosperm and starch (no germ) Enriched is adding nutrients to food that wasn't there before Impact of whole grains on health Brings down ○ All cause mortality ○ Coronary Heart Disease Incidence ○ Stroke Incidence ○ Type 2 diabetes ○ Colorectal Cancer Whole vs Refined Carbs Key Definitions: Whole Grain Stamp, Different numbers on every product. Guarantee: a half serving or more of whole grain Basic stamp ○ Mix of whole and refined grains ok at least 8g (½ serving) of whole grain 100% stamp ○ No refined grain and at least 16g (1 serving) of whole grain Probiotics and Prebiotics Industrialization is altering the human gut microbiome Probiotics are beneficial gut bacteria that ferment dietary fibres and prebiotics Prebiotics are dietary fibres from grains, beans or leafy greens that feed your gut bacteria Postbiotics are byproducts or metabolites produced by protics that are believed to support whole body wellness Live microorganisms that when administered in adequate amounts confer a health benefit to the host Change gut health with prebiotics Indigestible CHOs ○ Fermentable fibre that supports health Examples ○ Oligosaccharides like inulin, fructo and soybean Promotes probiotic growth ○ Selectively enhances the growth of beneficial bacteria (especially Bifidobacteria) in the colon Synbiotics are combination of probiotics and prebiotics  Probiotics, Synbiotics, and Prebiotics make up gut microbiota which makes up Postbiotics Role of CHOs, Diabetes, GI, and dental caries The Role of Carbohydrates Energy ○ 4kcal/g ○ Energy for daily activities: carbs and fat ○ Some cells prefer glucose for energy Red blood cells use only glucose Brain and nervous system rely on primarily on glucose Cellular Respiration To generate energy, glucose is metabolized through cellular respiration Cellular respiration produces ATP, a form of energy Gluconeogenesis When carbs is low glucose can be attained by breaking down liver or muscle glycogen then going to the blood increasing blood glucose levels,amino acids are used to produce glucose. This happens mainly in the liver and kidney its a process where we can reduce glucose from proteins. The Breakdown products of fatty acids and ketogenic amino acids is Acetyl-CoA Regulating Blood Glucose Insulin ○ Secreted by the pancreas in response to a rise in blood glucose ○ Helps glucose move from blood into many tissues Glucagon ○ Secreted by the pancreas in response to a declining glucose ○ It signals the liver that glucose needs to be released (from glycogen) or made (from amino acids) Diabetes Diabetes ○ Major health problem in canada ○ Canadian Diabetes Asociation 3 million Canadians have diabetes This number will increase to 3.7 million by 2020 ○ Leading cause of blindness, renal failure, nontraumatic lower limb amputation Gestational ○ First onset in pregnancy ○ Women with GDM at greater risk for developing diabetes later in life Type 1 Diabetes ○ Autoimmune disease:body's own immune system destroys insulin-secreting cells. Insulin is no longer made Type 2 Diabetes  ○ Muscle, liver and fat cells have decreased sensitivity to insulin ○ Decreased insulin production ○ Incidence increasing in younger kids Diabetes Symptoms Immediate Symptoms ○ Excessive thirst ○ Frequent urination ○ Blurred vision ○ Weight loss (Especially type 1) Diabetes Treatment The goal ○ Keep blood glucose levels within normal ranges Treatment ○ Consistent healthy diet and regular physical activity Medication need ○ Insulin or oral meds Glycemic Index Glycemic Response ○ How quickly and how high blood glucose rises after carbs are consumed Glycemic Index ○ Is a ranking of how food affects the glycemic response Diet Treatments for Diabetes Glycemic Index ○ A foods ability to raise blood glucose levels ○ High GI foods raise blood glucose quickly ○ Low GI foods raise blood glucose more slowly Better for people with diabetes Most are higher in fibre May reduce risk of heart diseases, colon cancer Carbohydrates and Dental Caries Dental caries ○ Bacteria form plaque if plaque not removed by brushing/flossing ○ Plaque formed when bacteria metabolize Carbs and produce acid ○ Acid dissolves tooth enamel and underlying structures Low Carb Diet/Keto, Sugar, Sweeteners Low Carb Diet The rationale ○ Foods high in carbs stimulate the release of insulin Insulin promotes energy storage mostly from fat The more insulin you release, the more fat you store Low carb diets cause less insulin to be released and more ketone production ○ Ketones help suppress the appetite Diet Type Protein Carb Fat AMDR 10-35% 45-65% 20-35% Low carb diet 40% 10% 50% Keto diet 20% 5% 75% Keto Diet Benefits Epilepsy ○ Brain disorders such as parkinsons, alzheimers, multiple sclerosis, sleep disorders, autism, and even brain cancer, anything in the nervous system Metabolic disease ie type 2 diabetes, chronic inflammation, HTN Concerns with Keto Diet Nutrient Deficiencies Keto flu Adherence Long term of keto diet on health Return to normal eating Gut health May increase cholesterol levels and CVD risk in some people Carbohydrates and Heart Disease High in sugar/refined carbohydrates raise blood lipid levels and can increase in heart disease risk Diets high in whole grains have been found to reduce the risk of heart disease Simple Sugars Sugars related to obesity, diabetes and other metabolic disease via increases in total kcal intakes Fructose of high intakes ○ Increase blood TG ○ Increased insulin resistance (pre-diabetes) ○ Associated with higher body weight in children Aspartame Aspartame may be a possible carcinogen to humans Carefully regulated in Canada by food and drug act regulations ○ No evidence that it poses a health hazard Recommendations ○ Seek healthier alternatives: ie other artificial sweeteners, drink more water/other health beverages Chapter 5 Lipids Types and functions of lipids including fatty acid, essential fatty acids, PUFAs Lipids Chemical name for fat Includes fatty acids, triglycerides, phospholipids, sterols Often names as fats/oils Functions Types and functions of lipids including: TGs, phospholipids, sterols Triglycerides Triglycerides ○ The major form of lipid in food and in the body ○ Consists of three fatty acids tails attached to one glycerol backbone Provide stored energy Insulate the body from temp changes Protect internal organs from physical shock Lubricate body surfaces, such as the mucous membranes of the eyes Phospholipids Phosphoglyceride ○ A type of phospholipid Glycerol with two fatty acids and one phosphoric acid Phospholipids ○ Lipids attached to a phosphate Are amphiphilic Act as emulsifiers Synthesized in the body but are a small part of the diet as well Sterols Sterols ○ Type of lipid found in plants and animals Cholesterol is a type of sterol found only in animals Eating plant sterols can help reduce blood cholesterol levels Cholesterol Used to make several hormones (including estrogen and testosterone) Allows cell membranes to remain appropriately fluid at a wide range of temperatures Lecture 3 Recommendations for fat intake, fat absorption and transport, CVD risk factors, atherosclerosis Recommended Fat Intake Acceptable Macronutrient Distribution Range (AMDR): 20-35% of total calories should come from fat(NEED TO KNOW) Essential fatty acids: ○ Linoleic acid: 12g (women) to 17g (men) per day ○ Alpha-linolenic acid: 1.1g (women) to 1.6g (men) ○ Ratio of LA:ALA should be between 5:1 to 10:1 Fat absorption and transport: lipoproteins Lipoproteins ○ Transport structures created by combining lipids, phospholipids, and protein Transport triglycerides, cholesterol and fat-soluble vitamins from the small intestine and stored lipids from the liver Lipoproteins and their function Chylomicrons ○ Transport dietary fat from intestine tissues VLDLS ○ Very low-density lipoproteins; transports lipids (mainly TGs) synthesized in the body to tissues LDLs (low density) ○ Transports cholesterol to body “bad cholesterol” HDL (high density lipoprotein) ○ Transports cholesterol from tissues to the liver “good cholesterol” Fat and cardiovascular disease Cardiovascular disease (CVD) ○ Dysfunction of the heart or blood vessels Can result in heart attack or stroke Main cause: atherosclerosis Slow and progressive development The type of fat in our diet can contribute to our protect against CVD Risk factors for CVD ○ Intra-abdominal adiposity ○ 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 blood lipid profile ○ High total cholesterol or high LDL cholesterol ○ Low HDL cholesterol or high LDL-C/HDL-C ratio ○ High triglycerides (and high VLDL) Lecture 4 Fats that protect, have a neutral effect or increase CVD risk N-6 polyunsaturated fatty acids Intake of n-6 polyunsaturated FAs are protective against OR may not increase CVD risk  ○ Decreases cholesterol synthesis in liver (which decreases circulating levels of LDL- cholesterol) ○ Dietary sources: oils that are liquid at room temperature (plant and vegetable oils except palm and coconut oil) Intake of n-3 polyunsaturated FAs is protective against CVD risk Decreases blood triglycerides Decreases formation of blood clots Increases HDL-cholesterol Helps maintain a normal heart beat Anti-inflammatory properties Monounsaturated fatty acids Intake of monounsaturated FAs is protective against CVD risk ○ Decreases LDL ○ Dietary sources: olive oil, other vegetable oils, and nuts Trans fatty acids Intake of trans fats from hydrogenated oils is associated with CVD risk ○ Increase LDL-C ○ Decrease HDL-C Natural trans fat is found in foods from ruminant animal and is metabolized differently than trans fat from hydrogenated oils Dietary cholesterol does not equal LDL Only 20-25% of people with high LDL-C find that their LDL-C decreases when they restrict dietary cholesterol Most healthy people 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-C Intake of SFAs is associated with CVD risk ○ Decrease the removal of LDLs from the blood ○ Promote the synthesis of cholesterol in the liver ○ Contribute to the formation of plaques ○ Increases triglyceride levels Saturated fat Food sources matter Dairy sources of SFAs appear to be metabolized differently from other sources Coconut oil and CVD Coconuts have high SFA content High coconut consuming populations appear to have healthy outcomes, lower CVD risk Eating coconut ingredients promoted to be healthy Includes: oil, flesh, milk and water Coconut oil health claims have not been substantiated by controlled human clinical trials Compared to butter, CO may lower CVD risk; but relative to non-SFAs, it does not Many populations with high CO consumption are from tropical regions with non-western diet and lower energy intake With western diet, CO may not be any different than other SFA sources Summary:recommendations Saturated fat should not exceed 10% of energy Polyunsaturated fats (n-6 and n-3 fats) should be around 10% energy Emphasize intake of n-3 fatty acids including DHA and EPA Monounsaturated fats make up the remainder Ingest no trans fat (hydrogenated fat) Dietary Fat and Cancer Risk High fat intakes increase risk N-3 fatty acids reduce risk Conjugated linoleic acid and vaccenic acid Trans fats that are found naturally in our diet (ruminant animals) Chapter 5 Alcohol Lecture 1 Metabolism, Factors affecting blood EtOH, Acute effects Alcohol Alcohol is a class of organic compounds containing hydroxyl groups (-OH) Ethyl alcohol is the ingredient in beer, wine, and liquor Produced by microbial fermentation of carbohydrate Provides 7kcal/g Metabolism of alcohol in the body Quickly absorbed ○ 20% of consumed alcohol is absorbed in the stomach Food slows down the absorption ○ Stomach dilutes EtOH ○ Food slows down gastric emptying Alcohol enters the blood stream quickly Metabolism of EtOH (alcohol) Alcohol can cause dehydration Alcohol lost through lungs used to estimate blood alcohol Metabolized by the liver ○ Alcohol dehydrogenase Products produced promote fat synthesis ○ Microsomal ethanol oxidizing system (MEOS) Reactive oxygen species produced Alcohol Metabolism Alcohol is also metabolized by colon bacterial ADH to yield acetaldehyde - a toxic compound Women have more fat mass and less body water and alcohol is a water soluble component which makes alcohol effect women more Rates of Alcohol Metabolism  About 0.5 oz alcohol/hr Alcohol in blood increases if exceeds the rate of breakdown Rate of breakdown depends on ○ Health, genetics, body composition, gender, age, frequency of alcohol consumption Fasting vs fed state ○ ADH is broken down during fasting Lecture 2 Health risk, benefits, safe consumption Health risks of alcohol use Accident and fatalities Hangover… missed work etc Free radical damage Liver damage Other chronic diseases of kidney and heart, pancreas, cancer, ulcers, sexual dysfunction, and infertility Nutrition concerns with alcohol consumption Fetal alcohol syndrome/fetal alcohol effects Breast feeding ○ Alcohol readily enters breast milk ○ Concentrates within 1 hour of consumption ○ Decreases milk production ○ Flavours milk Alcholism:Chronic effects of alcohol use Nutrient deficiencies ○ Primary malnutrition Alcohol displaces requuired nutrients in the diet ○ Secondary malnutrition damage/inflammation to GI tract alters nutrient absorption, storage, metabolism, and excretion Obesity ○ Abdominal fat ○ EtOH has lower satiety value Long term excessive alcohol consumption generates toxins and free radicals that cause ○ Liver damage Fatty liver, alcoholic hepatitis, cirrhosis, etc ○ Hypertension, heart disease and stroke ○ Increased risk for certain types of cancers ie breast and colon cancers Chapter 6 Proteins and Amino Acids  Lecture 1 Types and synthesis of proteins Amino acids Amino acids aare the building blocks of protein Essential amino acids cannot be synthesized by the human body in sufficient amounts to meet needs Conditionally essential amino acids are essential under certain conditions Transamination When a nonessential amino acid is not available from the diet, it can be made in the body by the process of transamination Protein Shape The shape of a protein determines its function ○ Connective tissue proteins and collagen are elongated ○ Hemoglobin has a spherical shape Lecture 2 Protein function and requirements Protein Functions Provide structure to individual cells and whole body ○ Parts of a cell membrane, cytosol, organelles ○ Body structures: skin, hair, muscle ○ Collagen:part of bones and teeth Enzymes speed up metabolic reactions Transport proteins move substances in and out of cells Make up the immune system ○ Skin ○ Antibodies How much should we eat? o.2-0.4% of our body protein turns over each day Some proteins is lost every day Protein requirements ○ Enough to replace losses, sustain turnover ○ Provide for growth in children ○ Depends on health status, age, physiological state Protein Requirements DRIs defined through RDAs (0.8g/kg/d) and the AMDR (10-35% of total calories) Infants and children ○ Extra protein needed for growth Pregnancy ○ Extra protein needed for expansion of blood volume, enlargement of uterus and breast, development of placenta, growth of fetus  Lactation ○ Extra protein needed for breast milk Extreme stress ○ Protein requirements are higher Athletes ○ Endurance athletes: 1.2-1.4g/kg/d ○ Strength athletes: 1.2-1.7g/kg/d Lecture 3 Protein deficiency/excess, PKU, allergies Protein Deficiency Protein-energy malnutrition (PEM) ○ Protein deficiency conditions that may include only protein deficiency or protein deficiency plus energy deficiency Kwashiorkor is a pure protein deficiency ○ Due to low protein, high fibre diet for first child when 2nd child is born ○ See bloated abdomen Due to fat and fluid accumulation in liver Protein Deficiency Marasmus is an energy deficiency ○ Emaciation and ketosis possible Protein Excess Kidney strain Dehydration Bone health concerns: not conclusive Increased CVD and cancer risk Digestive issues ○ Constipation, diarrhea Nutrient imbalance Weight gain Proteins that may harm certain individuals: Phenylketonuria PKU is an inherited condition attributed to a defective gene Aspartame, a sugar substitute, contains phenylalanine Protein Allergies Food allergies are triggered when a protein from the diet is absorbed without being completely digested Common allergens ○ Proteins from milk, eggs, nuts, wheat, soy, fish and shellfish and peanuts A rapid severe allergic reaction is called anaphylaxis Labelling for Allergies The 3 ways allergens can appear on the label ○ Listed in the ingredient list ○ Identified in a parenthetical statement  ○ With use of word “contains” Health canada has published a booklet entitled common food allergies: a consumers guide to managing the risks Lecture 4 Plant Proteins Protein Foods Eat protein foods “choose protein foods that come from plants more often” Protein comes from ○ Dairy ○ Eggs ○ Fish ○ Meat ○ Poultry ○ Grains ○ Legumes ○ nuts/seeds Health Benefits of plant proteins Several plant foods associated with reduced CVD, T2D, high blood pressure risk ○ Whole grains, fr/veg, nuts, legumes Certain animal foods associated with increased CVD and T2D risk ○ Red and processed meat Protein in food Protein in food dependent on quantity of protein and the quality of the protein in food Quantity of protein ○ Need 10-35% of kcals as protein ○ 0.8g/kg/day Protein quality Protein quality ○ Measure of how good the protein in a food is at providing the essential amino acids (EAAs) needed by body Protein Quality Factors Limiting Amino Acids ○ Missing or low in relation to dietary essential amino acids Complete protein ○ Contains all essential amino acids in the right proportions Incomplete proteins ○ Lacks one or more essential amino acids Protein quality: Additional Determinants Digestibility ○ How much ingested protein is absorbed Bioavailability ○ Efficient of the limiting essential amino acids  Food processing ○ Impact on protein quality Health and life cycle factors ○ Disease and life stage influence protein needs Protein quality High protein quality Low protein quality Lecture 5 Vegetarian Diets Plant Protein Concerns Protein Quality and Adults (19-50y) ○ High quality (100%): 25% below RDA ○ Good quality (80%): 44% below RDA Protein Quality and older adults (71+y) ○ High quality (100%): 37% below RDA ○ Low quality (60%): 88% below RDA Plant protein concerns Higher intake required to meet protein needs ○ Affect macronutrient balance ○ High intakes associated with lower B12, iron, w-3 fats, Vitamin D and calcium intakes Lower Digestibility ○ High fibre, phytic acid, and oxalates interferes with digestion/absorption of protein and minerals ○ Reduce mineral bioavailability Incomplete protein ○ Limits ability to support body functions Reduced protein synthesis ○ Muscle ○ Athletes ○ Older adults Plant proteins take home message Plant proteins have health benefits ○ Plant protein = ⅓ of protein intake Higher plant protein intakes needed to meet protein requirements ○ B12, iron, w-3 fats, vitamin D, calcium Vegetarianism Types of vegetarians Semi-vegetarian ○ Avoid certain types of red meat, fish or poultry Pescetarians ○ Exclude all animal flesh except for fish  Lacto-ovo vegetarians ○ Eat no animal flesh but do eat eggs and dairy Lacto vegetarians ○ Eat dairy products but no animal flesh nor eggs Vegan ○ Eliminates all animal products Take home message:plant proteins Eat more protein and choose plant proteins more often (this does not have to mean going fully vegan) Animal protein ○ High protein quality, (generally) higher in fat, high in B vitamins and iron Plant protein ○ Lower protein quality, (generally) lower in fat and higher in fibre, high in antioxidants Create more nutritionally balanced plant protein foods using complementarity Chapter 7 Energy Balance and Weight Management Lecture 1 Obesity health risk and energy balance Weight Management Terms Energy balance: energy consumed = energy expenditure. Energy is measured in kilocalories (kcal, kcalories, Calories) or kilojoules (kjoules, kJ). Overweight: being too heavy for one’s height or having a BMI of 25–29 kg/m2. Obesity is characterized by excess body fat or a BMI over 30 kg/m2 Energy Balance Energy balance ○ Occurs when energy intake = energy expenditure ○ Energy intake = kcal from food ○ Energy expenditure = kcal expended at rest and during physical activity Calories (kcal) content of food Bomb calorimeter ○ Determines energy of food ○ Measures the heat energy released when a dried food is combusted  Lecture 2 TEE and methods of accessing TEE Energy out: Total Energy Expenditure The three components of total energy expenditure are: ○ Basal metabolic rate (BMR) Basal energy expenditure Resting energy expenditure ○ Thermic effect of food ○ Energy cost of physical activity Energy expenditure Basal metabolic rate (BMR) ○ Energy expended to maintain basal, or resting, functions of the body ○ Highest proportion of total energy expenditure Factors that affect BMR ○ Amount of lean tissue ○ Height, age, gender, fasting ○ Growth (including pregnancy and lactation) ○ Thyroid hormone ○ Some medications Energy out: kcals used by the body Physical activity EE ○ Exercise ○ Non exercise activity thermogenesis Thermic effect of food (TEF) ○ Energy expended to process food Respiratory quotient RQ=VCO2/VO2 RQ values for macronutrients ○ 100% CHO oxidation: RQ=1 ○ 100% fat oxidation: RQ=0.7 ○ 100% protein oxidation: RQ=0.8-0.9 ○ Mixed diet: RQ=0.82 Lecture 3 Body composition and BMI Fat distribution pattern Apple-shaped fat patterning-upper body  ○ Increased risk for chronic disease Pear-shaped fat patterning-lower body ○ No significant increased risk for chronic diseases Visceral versus subcutaneous adipose tissue 1.72m and 77.3 kg Body Mass Index Limitations of the body mass index ○ It is not appropriate for those who are High in muscle mass Under 18 years old (or still growing) Pregnant or breast feeding Over 65 years of age Lecture 4 Genetics, energy regulation Regulation of Energy Balance Obesity genes ○ Code for proteins involved in the regulation of food intake, energy expenditure, or the deposition of body fat Set point theory ○ Proposes that each persons weight stays within a small range (set point) when they are finished growing Short term regulation Ghrelin ○ Produced in stomach; stimulates food intake, reduces EE CCK ○ protein/fat in small intestine stimulate release ○ Reduces food intake GLP-1 ○ Promotes secretion of insulin ○ Used to treat type 2 diabetes ○ Cause weight loss Psychological factors Body and Hormone Factors Leptin is a hormone produced by fat cells that causes reduced food intake, reduced weight, decreased body fat, increased energy expenditure Leptin is controlled by the ob gene Mutation of the ob gene causes reduced levels of leptin leading to increased food intake and reduced energy output Genetic Factors  Thrifty gene theory ○ Proposes that a gene (or genes) causes people to be energetically thrifty ○ Proposes that people with this gene expend less energy than other people and therefore gain weight when food is plentiful ○ A thrifty gene has not yet been identified Contributing Factors for Obesity Adaptive thermogenesis (AT) ○ The change in energy expenditure induced by factors such as changes in ambient temperature and food intake Mechanisms of AT ○ Futile cycling ○ Brown adipose tissue ○ A type of fat tissue that has a greater number of mitochondria than the more common white adipose tissue Lecture 5 Weight Loss Strategies Lifestyle and Rising Obesity Rates Obesogenic environment ○ An environment that promotes weight gain by encouraging overeating and physical inactivity Appetite ○ The desire to consume specific foods that is independent of hunger Positive Weight Loss Strategy Negative energy balance through healthy eating and exercise Exercise/Physical Activity ○ Down appetite ○ Up lean body mass ○ Up well being ○ Up energy output ○ Up fat oxidation Positive Weight Loss Strategy Negative energy balance Promote physical activity ○ Easy to follow and be lifelong Gradual weight loss Promote behavior changes Meet recommended nutrient levels Low in fat, abundant in complex carbohydrates Watch portion sizes  Cut down on high kcal foods Don't get too hungry Promote water intake Obesity Treatment: prescription Medications Weight loss medications ○ May have dangerous side effects ○ Many have been removed from market ○ Should only be used if a person has A BMI of 30 A BMI of 27 and other health risk factors Ozempic Ozempic (semaglutide) and liraglutide (saxenda, Victoza) ○ =glucagon like peptide 1 receptor agonist ○ Mimics actions of GLP-1 Effects ○ Limits ingestion and processing of sugar ○ Regulates appetite and decreases kcal intakes ○ May also lower risk of heart disease, heart attack, stroke and kidney disease Lecture 6 Fad Diets Innefective Unhealthy Weight Loss Strategies Fasting, very low energy diets, Fad diets, Gimmicks “Dieting” and other unhealthy strategies do more harm than good Intermittent Fasting Many variant of IF No difference in weight between IF and having 3 meals daily Concerns ○ Nutrient deficiencies ○ Decreases in metabolic rate ○ Disordered eating Why Innefective? Do not promote life long healthy behaviours ○ Short term weight loss does not equal improved health Restrictive ○ Reduction in lean mass and BMR Health risks ○ Malnutrition Risk of chronic eating disorder Psychological risks  Chapter 8 The Water Soluble Vitamins Lecture 1 Intro to Vitamins Vitamins ans Metabolism Vitamins and minerals ○ Do not directly provide energy to the body ○ Are necessary for obtaining energy from the macronutrients ○ Often functions as coenzymes Vitamins and Coenzyme Function 1. The vitamins combines with a chemical group to form the functional coenzyme 2. The functional coenzyme combines with the incomplete enzyme to form the active enzyme 3. The active enzyme binds to one or more molecules and accelerates the chemical reaction to form one or more new molecules 4. The new molecules are released, and the enzyme and coenzyme (vitamin) can be reused or separated. Fortified and Enriched Foods Fortification ○ Process of adding nutrients to foods Table salt with iodine Milk with vitamin D B vitamins/iron in grains Enrichment ○ Adding nutrients back to foods that have lost nutrients due to processing Vitamin Bioavailability = amount of nutrient absorbed and utilized by the body Influenced by ○ Composition of the diet ○ Body's need Some vitamins absorbed in active provitamin form Lecture 2 Thiamin: Function Coenzyme  ○ Thiamin pyrophosphate (TPP) needed for reactions where CO2 is lost from larger molecules Formation of acetyl-CoA from pyruvate Reactions within citric acid cycle Energy production Production of ribose Acetylcholine synthesis Nerve function Deficiency is called beriberi ○ Results in muscle wasting and nerve damage ○ Neurological symptoms ○ Cardiovascular problems ○ Rare, but seen in chronic alcoholism Sources ○ Whole grains, enriched cereals and breads ○ Pork, organ meats ○ Legumes ○ Nuts ○ Some green leafy vegetables Riboflavin functions Coenzyme forms ○ FAD, FMN FAD ○ Energy production Krebs cycle Breakdown of fatty acids FMN and FAD ○ Electron transport chain to generate ATP Riboflavin deficiency Ariboflavins ○ Inflammation of eyes, lips, mouth, tongue Scaly, greasy skin eruptions Cracking of tissue in corners of mouth Confusion Rarely occurs on its own Riboflavin food sources Dairy products are a good source of riboflavin Plant sources of riboflavin include mushroom, broccoli, asparagus, whole grains, and green, leafy vegetables Animal sources include red meat, poultry, and fish Riboflavin is easily destroyed by heat and exposure to light Niacin Niacin is added to enriched flours in North America  A niacin deficiency disease is pellagra Niacin can be synthesized in the body from the essential amino acid tryptophan if the diet is adequate in tryptophan Two forms of niacin are nicotinic acid and nicotinamide Niacin (B3) Food sources ○ Animal sources ○ Eggs ○ Meat, poultry, and fish ○ Milk and milk products Deficiency=pellegra ○ Symptoms include the 3 D’s dermatitis , diarrhea and dementia Niacin toxicity from overuse of niacin supplements ○ Elevated blood pressure ○ Cardiac arrhythmia ○ Nausea, vomiting ○ Elevated blood sugar levels and impaired liver function Lecture 3 Vitamin B6 Coenzyme form ○ Pyridoxal phosphate Functions ○ Coenzyme for more than 100 enzymes (most in amino acid metabolism) ○ Synthesis of non-essential amino acids via tranamination ○ Metabolism of glucogenic amino acids ○ Synthesis of neurotransmitters Vitamin B6 Deficiency Deficiency symptoms ○ Anemia (microcytic - small cells) ○ Weakness ○ Nervousness ○ Insomnia ○ Decreased immune function ○ Skin lesions Vitamin B6 food sources Sources ○ Meat and fish and poultry ○ Legumes ○ Nuts ○ Enriched cereals and breads ○ Some fruits and vegetables  Vitamin B6 better absorbed from animal foods vs plant foods Folate or Folic Acid Functions Coenzyme form (THF: tetrahydrofolate) important for transferring methyl group between different compounds ○ Folate needed for production and maintenance of new cells for DNA/RNA synthesis ○ Folate needed for synthesis of some amino acids Folate or Folic Acid Deficiency is anmeia (macrocytic anemia) Low folate intake in early pregnancy: increased risk of neural tube defects Low folate intake: increased risk of heart disease and cancer Folate Fortification 1998 folic acid added to white flour, pasta and cornmeal in Canada Rate of neutral tube defects have decreased by 50% in Canada since food fortification Refer to critical thinking section of folic acid fortification in text Sources of Folate in diet Green leafy veggies Oranges Legumes Seeds Organ meats Eggs Enriched flour 400 ug supplement for women wanting ti become pregnant \ Lecture 4 Vitamin B12 (cobalamin) 2 coenzymes ○ Methylcobalamin ○ Adenosylcobalamin Vitamin B12 necessary for the proper absorption of iron in the body Required for nerve functioning ○ Helps form and maintain myelin Required for the synthesis of hemoglobin (in red blood cells) and DNA Breaks down fatty acids with an odd number of carbons High intake of supplemental folic acid ca mask B12 deficiencies Complex absorption Vitamin B12 Deficiency Anemia  ○ Megaloblastic (large immature cells) B12 deficiency causes a 2 degree folate deficiency (B12 needed to covert methyl folate back toi the folate form for DNA synthesis) Decreased immune function Nerve damage and neurological symptoms Due to inability to methylate myelin B12 Deficiancy At risk: elderly, vegans Can occur under these conditions ○ Atrophic gastritis Decreased stomach acid ○ Pernicious anemia Decreased production of intrinsic factor ○ Damage to lower part of small intestine Lecture 5 Other B Vitamins Biotin in the body ○ Coenzyme involved in adding COOH group to other molecules (e.g citric acid cycle, glucose synthesis Pantothenic acid in the body ○ Part of coenzyme A ○ Part of the acyl carrier protein for cholesterol and fatty acid synthesis Vitamin C Functions ○ Collagen synthesis Vitamin C is needed for the activity of enzymes that synthesizes collagen ○ Coenzyme for synthesis of other compounds of other compounds such as hormones, neurotransmmitters, bile acids, and carnitine ○ Helps maintain immune system ○ Aids in absorption of iron ○ Antioxidant Vitamin C (ascorbate, ascorbic acid) Sources of Vitamin C ○ Fresh fruits and veggies ○ Cooking and light destroys it Deficiency: Scurvy (classical deficiency) ○ Collagen cannot be synthesized and maintained ○ Poor wound healing, bone and joint aches, bone fractures, improperly formed and loose teeth, easy bruising, etc ○ Potential anemia Vitamin C is an Antioxidant  Vitamin C/E selenium protect against oxidative damage from reactive oxygen species ○ Vitamin C donates electrons to neutralize free radicals Reactive oxygen species ○ Environmental factors and from normal phyiological activity ○ Free radicals= reactive oxygen species with an odd number of electrons ○ Ie superoxide, hydrogen peroxide + more react with protein, lipids and DNA which changes the structure/ function of the cell Antioxidants: significance Antioxidants help prevent heart disease and cancer ○ DNA damage can lead to cancer ○ Oxidation of LDL can lead to atherosclerosis Vitamin C Vitamin C may reduce duration and severity of colds Protects against formation of nitrosamines ○ Nitrites converted to nitrosamines in stomach Chapter 9 The Fat Soluble Vitamins Lecture 1 Vitamin A Fat Soluble Vitamins: ADEK Require bile and dietary fat for absorption Omc absorbed, they are transported with fats ○ Through the lymphatic system in chylomicrons Can be stored in body fat Not easily excreted ○ This increases the risk of toxicity with high intakes(from supplements) Vitamin A Animal products/supplements (preformed vitamin A) ○ Retinoids (retinol, retinal,retinoic acid) ○ Efficiently absorbed Plant sources (precursor form) ○ Carotenoids (alpha and beta carotene. Beta cryptoxanthin) ○ Less efficiency absorption ○ Some converted to retinoids in intestines Functions ○ Vision (especially night vision) ○ Gene expression regulating cell differentiation and growth Vitamin A deficiency  Reduces immune function Impaired reproduction and reduced embryonic development Impaired growth ○ Organ system defect ○ Crooked teeth and poor dental health Epithelial tissues become keratinized ○ Hard, dry surface in eye promotes infection Vitamin A toxicity Difficult to develop vit A toxicity through diet ○ Carotenoidosis doesnt equal toxicity ○ High intakes of beta carotene (supps) may be harmful in smokers ○ Birth defects during pregnancy High intake of pre-formed vitamin supplements = toxicity (takes years) Medications made from vitamin A ○ Retin A/Acuutane can cause serious side effects Lecture 2 Vitamin D Vitamin D “sunshine vitamin” Few natural sources Can be toxic at high levels Vitamin D is important for ○ Maintaining calcium and phosphorous in blood ○ Bone health ○ Gene expression ○ Normal functioning of parathyroid gland ○ Regulates immune system ○ Prevents cancer Vitamin D Vitamin D to 1,25-hydroxy D (D3) in kidney 3 target issues ○ Intestine Vit d increases ca absorption ○ Kidney If dietary Ca not available: Vit D, with PTH,increases amount of calcium retained by kidneys ○ Bone If dietary Ca not available: vit D contributes to bone breakdown If dietary Ca available: vit D helps build bone Sources of Vitamin D Sun exposure limitations ○ No sunlight ○ Clothing, pollution, tall buildings  ○ Sunscreen ○ Dark skin pigmentation ○ Reduced skin synthesis Vitamin D deficiency Rickets (kids) ○ Calcium absorption compromised ○ In children = rickets Bone deformities Growth stunting Osteomalacia (adults) ○ Weak bones, increased fracture risks ○ Bone pain and muscle aches Who is at risk in canada ○ Breastfed infants ○ Those who avoid fortified foods ○ People ith kidney failure ○ If completely covered by clothing ○ People with high skin pigmentation ○ Elderly Vitamin D toxicity Unusual through diet; can occur with high supplement intake or over fortification Over supplementation ○ Deposition of calcium in blood vessels kidneys ○ Cardiovascular damage ○ Death Lecture 3 Vitamin E = tocopherol Alpha tocopherol absorption depends on normal fat absorption Functions ○ Antioxidant ○ Protects cell membranes: nerve tissue, RBCs, Immune cells, Lung cells ○ Protection against heavy metals, pollutants ○ Protection for oxidation of LDL Vitamin E deficiency At risk ○ Fat malabsorption ○ Genetic problems with vitamin E metabolism ○ Protein energy malnutrition ○ Premature infants: hemolytic anemia Vitamin E supplements? Claims for ○ Hair growth ○ Sexual potency/fertility ○ Alleviating fatigue ○ immune/athletic performance boosting ○ Heart disease ○ Cancer Vitamin K Named for koagulation; phylloquinone menaquinones Needed for ○ Blood coagulation ○ Proper bone metabolism ○ Maintains vessel health Deficiency is very rare ○ Babies receive vitamin K injection at birth ○ Abnormal blood coagulation ○ People on blood thinning drugs need to be aware of vitamin K intakes Lecture 4 Key Terms Functional foods ○ Similar to conventional food ○ Consumed in typical diet ○ Provide health benefits beyond basic nutrition Phytochemicals ○ Health promoting substances found in plant foods Phytochemicals Carotenoids ○ Yellow-orange; ie beta-carotene Flavonoids ○ Blue, red, or yellow; ie blueberries Indoles and alliums ○ Sulfur containing; ie garlic or onions Phytoestrogens ○ In soy, flaxseed, barley Getting more Phytochemicals into your diet Eat more fruits/vegetables Make half your grains whole  ○ Synergistic effect of nutrients and phytochemicals Bran and germ portion contribute many phytochemicals Choose sources of plant protein Phytochemical supplements, phytochemical-fortified foods with caution ○ May only contain a fraction of the phytochemicals found in foods ○ No interaction between different substances ○ Doses may be too small or too large tp produce biological effects