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Philosophy on nutrition
natural is better
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basic science on nutrition
biochemistry, physiology
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what is the hierarchy of research evidence? (lowest to highest)
animal research/labroratory studies, editorials/opinions, case reports, case series, case-control studies, cohort studies, randomized controlled trials, systematic review
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what do observational studies find?
associatios between behaviors and health
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what are examples of observational studies?
case-control, cross-sectional, cohort
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what do intervention studies look at?
effects of treatments
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what is an example of an intervention study?
clinical trials
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what disease is most affected by increased BMI?
diabetes
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what data do you collect to evaluate weight?
- BMI
- waist circumference
- history
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when is weight loss recommended?
- BMI= 30 or more
- health risk and a BMI of 25-30
- health risk and big waist circummference
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what are the genetic factors causing an obesity epidemic?
- fat storage to avoid starvation
- obese body type
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what are the environmental factors leading to an obesity epidemic?
- high fat and sugar foods available everywhere
- sedentary lifestyles
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what are the behavioral/psychological problems causing an obesity epidemic?
- eating habits not associated with appetite
- eating because of emotions/stress
- psychological disorders causing overeating
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most fat is what?
fatty acids
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what makes up 95% of dietary lipids?
triglycerides
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healthy fats are?
unsaturated= mono and cis-poly
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polyunsaturated fats consist of what 2 groups?
omega-3 and omega-6
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what are unhealthy fats?
saturated and trans-unsaturated
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how are trans-unsaturated fats made?
from partial hydrogenation
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what fat has the highest saturated fat?
coconut oil
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what fat is highest in monounsaturated fat?
olive oil
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what fat is highest in polyunsaturated fats?
chia seed oil
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what fat is highest in omega-3 fats?
chia seed oil
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what fat is highest in omega-6 fats?
safflower oil
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what fat is highest in trans-fats?
stick soy bean oil margarine
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chylomicrons
- produced by the intestinal cells
- delivers dietary triglycerides to adipose and muscle via lipoprotein lipase in the capillaries
- problems are uncommon
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chylomicron remnant
- leftover fats from chylomicron
- delivers dietary cholesterol to the liver via receptor mediated uptake
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VLDL
- produced by the liver
- contains endogenous cholesterol and triglycerides
- delivers triglycerides and adipose to muscle via lipoprotein lipase
- problems are common
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IDL
- leftover of VLDL
- contains endogenous cholesterol
- either taken up into liver by receptor or turned into LDL
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LDL
- develops from IDL
- delivers cholesterol to tissues or is taken up by the liver
- abnormalities are common since numbers are raised by trans and saturated fats
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HDL
- empty HDL secreted by the liverruns around collecting cholesterol from tissues and other lipoproteins and returns it to the liver
- low levens commonly found (bad)
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healthy level of LDL
below 130
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healthy level of HDL
above 40
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healthy level of triglycerides
below 150
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sources of liver cholesterol
- dietary (chylomicron remnants)
- de novo synthesis
- HDLs, LDLs, IDLs
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how cholesterol leaves the liver
- VLDL synthesis
- free cholesterol in bile
- converted to bile acids/salts
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roles of the liver
- takes up cholesterol from chylomicron remnant
- dietary glucose -> triglycerides
- makes VLDL and HLD
- regulates de novo cholesterol and biliary disposal
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diet is calculated by:
% carbohydrates + % fat + % protein
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effect of mono and polyunsaturated fats on cholesterol levels
decreased LDL, increased HDL
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effects of saturated fats on cholesterol levels
increases LDL and HDL
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effects of trans fats on cholesterol levels
increased LDL
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effects of substituting a carb with a good fat
- stabilizes total cholesterol and LDL level
- increases HDL levels
- decreases triglyceride levels
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effects of substituting a saturated fat with a good fat
- decreased LDL level
- stabelizes HDL and triglyceride levels
- decreases risk of thrombosis
- decreases risk of cardiac arrhythmia
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sources of monounsaturated fats
- olive oil
- canola oil
- nuts
- avocado
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sources of omega-6 fats
vegetable oils
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what type of fat increases your risk of heart disease?
trans fats
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diets allowing what type of fats show a decrease in vascular disease
healthy fats
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is there a correlation between overall fat and cancer?
no
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there is an increased/decreased risk of breast cancer from eating what fats?
- animal fat (increased)
- olive oil (decreased)
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there is an increased risk of colon cancer from eating what fats?
red meat and processed meats
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gamma-linolenic acid
omega-6
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dihomo-gamma-linolenic acid
- omega-6
- eicosanoid precursor
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arachidonic acid
- omega-6
- eicosanoid precursor
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eicosapentaenoic acid
- omega-3
- eicosanoid precursor
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docosahexaenoic acid
omega-3
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elongase enzymes
add a 2 carbon pair
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desaturase enzymes
inserts a double bond
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what determins which EFAs are found in the body?
- genetics
- diet and supplements
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what is the ratio for EFAs in the western diet?
10:1 favoring omega-6
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what is the ratio for EFAs in a natural diet?
1:1
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are short or long chain EFAs found more commonly in the body?
short chain
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how are most short EFAs provided?
through the diet
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is arachidonic acid production high or low?
low (good thing!)
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is long chain omega-3 production high or low in the body?
low...bad!
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EFA functions
- membrane structure and function
- vision
- nervous system
- eicosanoid synthesis
- gene expression regulation
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how do EFAs assist in membrane structure and function? (which EFA?)
- linoleic acid
- influcence receptor function, membrane permeability, signal transduction, transport proteins
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which EFA helps with vision?
DHA
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which EFA helps with the nervous system?
DHA and AA
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what are the effects of eicosanoid synthesis
- inflammation
- vasoconstriction
- coagulation
- smooth muscle activity
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what are the effects of EFA on gene expression regulation?
- inflammation
- fatty acid metabolism
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what are the precursors to eicosanoids?
DGLA, AA, EPA
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cyclooxygenase produces which eicosanoid?
- prostaglandins
- thromboxanes
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lipoxygenase produce which eicosanoids?
leukotrienes
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eicosanoids produced from DGLA have what effects?
anti-inflammatory
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eicosanoids produced from AA have what effects?
- inflammation
- platelet stickiness
- vasoconstriction/bronchoconstriction
- smooth muscle contraction
- BAD!!!!
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eicosanoids produced from EPA have what effects?
anti-inflammatory
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primary and secondary prevention with omega-3s for vascular disease showed reduced risk of:
- heart attack
- ischemic stroke
- overal mortality
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what is the most likely way to end up with EFA deficiency?
malabsorption
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what are signs of EFA deficiency?
- skin changes
- growth probles
- reduced resistance to infection
- poor healing
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what insufficiency is common?
omega-3
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sources of linoleic acid?
- (omega-6)
- vegetable oils, nuts, seeds
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sources of gamma-linolenic acid?
- (omega-6)
- supplements only!
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sources of dihomo-gamma-linolenic acid?
- (omega 6)
- none available!!
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source of arachadonic acid?
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source of linolenic acid?
- (omega-3)
- flax, walnuts, canola oil, soy bean oil
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sources of EPA and DHA?
- (omega-3)
- oily fish
- supplements
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what safety issues do you need to be concerned about with supplements?
- allergies
- gastrointestinal distress when taking high levels
- anti-clotting effects of fish oils
- drug interactionscontaminants in fish (and fish oils)
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what can you do to limit your amount of contaminants in fish?
- aboid the large, hazardous species
- prepare and cook to remove the fatty residues
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what contaminants are found in fish? what part of the fish are they found in?
- mercury-skin
- polychorinated biphenyls (PCBs) in the fat
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nut intake is shown to do what?
- lower cholesterol
- reduce the risk of heart disease
- reduce the risk of type 2 diabetes
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intake of seeds is show to do what?
- lower inflammatory mediators
- lower cholesterol
- modify hormone function
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what are the main health promoting fat sources?
- natural unprocessed oils
- uncontaminated oily fish and fish oils
- nuts and seeds
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