Week 14 Notes - Nutrition.pdf

Nutritional Diseases Introduction Too much, too little  Millions of people in developing nations starve;  Millions of people in the developed world struggle to avoid extra calories and their consequences.  The diet in the U.S. is high in fat, calories, salt, and refined sugar...

Nutritional Diseases Introduction Too much, too little  Millions of people in developing nations starve;  Millions of people in the developed world struggle to avoid extra calories and their consequences.  The diet in the U.S. is high in fat, calories, salt, and refined sugar (fast food diet)  Both a lack of nutrition and overnutrition present with major health issues A healthy diet includes:  Energy, as carbohydrates, fats, and proteins  Essential (and non-essential) amino acids fatty acids  Vitamins and minerals  Water Malnutrition Primary malnutrition is when one or all components are missing from the diet Secondary malnutrition results from malabsorption, impaired storage, excess loss or increased metabolic requirements Causes of malnutrition  Lack of nutrients or access to them  Poverty  Chronic Alcoholism  Acute or Chronic illness  Self-imposed restrictions  Ignorance / lack of education Evaluation:  body mass index (BMI), weight in kilograms divided by height in meters squared). o A BMI less than 16 kg/m is considered malnutrition 2 o normal range 18.5 to 25 kg/m. 2  a child whose weight falls to less than 80% of normal (provided in standard tables) is considered malnourished.  evaluation of fat stores (thickness of skin folds), muscle mass (reduced circumference of mid-arm), and serum proteins (albumin and transferrin levels Severe Acute malnutrition / AKA protein energy malnutrition  Greatly reduced weight/height ratio  16 million children affected worldwide  Full-range of syndromes resulting from inadequate diets; two forms of severe malnutrition are: Dr M Hossu Notes 199  Marasmus- diet lacks calories mainly  growth retardation  loss of muscle mass  loss of subcutaneous fat Kwashiorkor- diet lacks proteins mainly  Common in Africa and Southeast Asia  Results in hypoalbuminemia and generalized edema  Skin lesion  Hair changes  Fatty liver  Listlessness  Defects in Immunity Vitamins Overview  small molecular nutrients needed in small amounts (essential, can’t be produced in the human body, (except Vit D and possibly B12 by microbiome)  Multiple function: coenzymes (Bs, K), hormones –like / growth factors (D,A), antioxidants (C,E)  13 essential vitamins  Four are fat soluble (A,D,E,K; need carriers in blood, need bile/bile salt for absorption)  Nine are water soluble: excess excreted in urine – to be taken in small repeated doses  Fat soluble vitamins may be poorly absorbed in fat malabsorption disorders  Some vitamins may become toxic if accumulated in excess  Deficiency of a single vitamin is uncommon (in modern world), many are due to secondary deficiencies (malabsorption, impaired storage, excess loss or increased metabolic requirements) Minerals  Inorganic elements required in different amounts (major=macro & micro)  Cannot be destroyed [same like toxic elements] o used as ions (electrolytes) and mostly as organic salts or compounds (e.g. Ca lactate versus carbonate, heme versus Fe2O3)  Identified as essential: K, Cl, Na, Ca, P, Mg, Fe, Zn, Mn, Cu, I, Cr, Mo, Se, Co. o [*] for board purposes ONLY, textbooks still list F as a nutrient beneficial for cavity prevention and “stronger” bones.  Influence body fluids (osmotic pressure), assist in chemical reactions, and are part of the body structure, messengers, electrical homeostasis.  [mn] Electrical and mechanical homeostasis (tone) is interconnected with ALL life processes, and it is directly affected by non-pharmaceutical therapies including chiropractic. Mineral support/balance is mandatory for these therapies to be effective! Dr M Hossu Notes 200  Obesity a state of increased body weight, caused by adipose tissue accumulation, that is of sufficient magnitude to produce adverse health effects.  Charts, body measurements, BMI  Body mass index (BMI) is the most commonly used. o BMI =(mass (aka weight) in kg)/(height in m)2, = kg/m2 Mechanisms: Parallel circuits  Peripheral:  Adiponectin: “burn fat” signal (i.e. hormone) secreted by the adipocyte  anti-diabetic, anti-atherogenic, cardioprotective, anti-inflammatory  possible +/- antiproliferative  Central:  Anabolic & catabolic  Insulin and Leptin can modulate both [“energy deposits are full”]  Insulin = high blood sugar (→ to be absorbed into cells)  Leptin (mostly from adipocytes) = high reserves of triglycerides  Ghrelin = hunger  Peptide YY = satiety  Effectors  Organic (endocrine, autonomic)  Behavioral  NPY: anxiolytic, analgesic, & increased fat deposits Causes: Multifactorial:  Intake of too many calories  Lack of exercise: career, transportation, fast food option, environment  Parental influences: children of obese parents have ~ 70% chances of becoming obese (versus 20% in the other children)  Pregnancy at later age  Lack of sleep  Gut microbiome dysbiosis (reduced diversity)  Eating and behavioral disorder  Stimulation of reward circuits: food additives, gut hormones, autonomic NS Incidence: increasing Effects: multiple; classified as a risk factor in: hypertension, ischemic heart disease, heart failure, thromboembolism, diabetes, hyperinsulinemia, infertility, cancers of uterus, cervix, breast, prostate, colon, esophagus; asthma, obstructive sleep apnea, fatty liver, GERD, gall stones, migraines, stroke, dementia, osteoarthritis, gout. Dr M Hossu Notes 201