Clinical Nutrition

  1. This fat is found in abundance in red meat and dairy.  It raises cholesterol (associated with high risk of coronary heart disease)
    Saturated Fat
  2. This fat is found in vegetables oils and fish; it reduces cholesterol.
    Polyunsaturated Fat
  3. Obesity is a major risk factor for several diseases;  what are these diseases?
    • Type II Diabetes
    • Coronary Heart Disease (CHD)
    • Breast / Colon / Kidney / Esophageal Cancer
  4. What occurs in the refining process of carbohydrates?
    The process removes many vitamins, minerals and fibers.

    Refined carbs such as white bread and white rice can be very quickly broken down to glucose.
  5. High consumption of red meat has been associated with increased risk of what conditions?
    • Coronary Heart Disease (CHD)
    • Type II Diabetes
    • Colon Cancer
  6. Eggs are high in cholesterol, but consumption does not appear to have adverse effects on Coronary Heart Disease (CHD) risk, except for what condition?
  7. Men / Women who consume large amounts of dairy products experienced an increased risk of what condition?
    • Men - Prostate Cancer
    • Women - Ovarian Cancer
  8. Which vitamin is considered the most toxic of all vitamins?
    Vitamin A
  9. The main function of ____________ in the body is to furnish the body with energy.
  10. _______ serves as the essential energy source, is commonly known as blood sugar or dextrose. Most cells depend on _______ for their fuel, and the cells of the brain and the rest of the nervous system depend almost exclusively on _______ for  their energy. The body can obtain _______ from carbohydrates.
  11. ________ is the sweetest, occurs naturally in honey and fruits, and is added to many foods in the form of High-________ corn syrup. High-________ corn syrup is the predominant sweetner used in processed foods today and it is mostly ________ and glucose.
  12. _______ is fructose and glucose combined. It is refined from sugarcane and sugar beets, tastes sweet, and is readily available; also know as table sugar or white sugar.
  13. Storage form of glucose in the animal body.
    Composed of highly branced chains of glucose.
    Provides a rapid relase of energy when needed.
    The body stores much of its glucose as ________ in the liver and muscles.
    After a meal, as blood glucose rises, the pancreas releases the hormone insulin which signals the body's tissues to take up surplus glucose. Muscle and liver cells use some of this excess glucose to build ________. The muscles hoard two-thirds of the body's total ________ and use it just for themsleves during physical activity.  The brain stores a tiny fraction of the total, thought to provide an emergency glucose reserve able to fuel the brain for an hour or two in severe glucose deprivation.  The liver stores the remainder and released blood glucose in the circulation for the brain and other tissue when the supply remains low.
  14. Storage form of glucose in plants.
    Found in grains, tubers, and legumes.
    Long and straight or branched chain of hundreds of glucose units linked together.
  15. Overdose of Vitamins C and / or E can cause what?
  16. This form of carbohydrate is easy for the body to break down.
    • Starch
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  17. This form of carbohydrate cannot be broken down by the body.
    • Cellulose
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  18. ______ provide structure in stems, trunks, roots, leaves, and skins of plants; are found in all plants derived foods; are composed of a variety of monosaccharides and other carbohydrate derivatives; the sugar units are held by bonds that human digestive enzymes cannot break.
    • Fibers
    • *slows glucose absorption and regulates the passage of food through the GI Tract
    • *Fiber containing foods and other slowly digested foods prolong the presence of food in the digestive tract, thus providing greater satiety and diminishing the insulin response, which can help with weight control. In contrast, the rapid absorption of glucose from a high-glycemic diet seems to increase the risk of heart disease and promote overeating in some overweight people.
  19. Dissolves in water.
    Form gels.
    Easily digested by bacteria in the large intestine (fermentable).
    Commonly found in barley, fruits, legumes, oats, and vegetables.
    Associated with lower risks of chronic disease.
    • Soluble Fibers
    • *they can hang on to bile salts and cholesterol with water, as well as toxins; which halts putrifaction
  20. Do not dissolve in water.
    Do not form gels.
    Are less readily fermented.
    _________ ______ such as cellulose and many hemicelluloses are found in the outer layers of whole grains (bran), the strings of celery, the hulls of seeds, and he skins of corn kernels. These fibers retain their structure and rough texture ever after hours of cooking.
    Aid the digestive system by easing elimination.
    Insoluble Fibers
  21. What are the symptoms of Lactose Intolerance?
    • Bloating
    • Abdominal Discomfort
    • Diarrhea
    • Causes Lactase Deficiency
  22. This hormone moves glucose into the cells.
    After a meal, as blood glucose rises, β-cells of the pancreas respond by secreting _______ into the blood.
  23. This hormone brings glucose out of storage.
    When blood glucose falls (as occurs between meals), other special cells of the pancreas respond by secreting ________ into the blood. ________ raises blood glucose  by signaling the liver to dismantle its glycogen stores and release glucose into the blood for use by all the other body cells.
  24. This hormone acts quickly to bring glucose out of storage during times of stress.
    Epinephrine (secreted by the adrenal medulla)
  25. This hormone is synthesized from cholesterol by the adrenal cortex.
  26. In ________, blood glucose surges after a meal and remains above normal levels because insulin is either inadequate or ineffective.
    The diagnosis of ________ is based primarily on plasma glucose levels.
    Symptoms include polyuria, dehydration, polydipsia, blurred vision, increased infections, weight loss, polyphagia and fatigue.
  27. This type of diabetes is the less common type, the pancreas fails to make insulin due to destruction of the pancreatic β-cells.
    • Type I Diabetes / IDDM / Juvenile-onset
    • *Some research suggests that in genetically susceptible people, certain viruses activate the immune system to attack and destroy cells in the pancreas as if they were foreign.
  28. This type of diabetes is the more common type where muscle, fat, liver cells fail to respond to insulin and this form of diabetes is frequently asymptomatic. The primary defect in ______ diabetes is insulin resistance, a reduced sensitivity to insulin in muscle, adipose, and liver cells. To compensate, the pancreas secretes larger amounts of insulin, and plasma insulin concentrations can rise to abnormally high levels (hyperinsulinemia). Over time, the pancreas becomes less able to compensate for cells' reduced sensitivity to insulin, and hyperglycemia worsens.  The high demand for insulin can eventually exhaust the β-cells of the pancreas and lead to impaired insulin secretion and reduced palsma insulin concentrations. ______ diabetes is therefore associated both with insulin resistance and with relative insulin deficiency.
    Type II Diabetes / NIDDM / Adult-onset
  29. What are chronic complications associated with Diabetes?
    • Macrovascular (i.e. CVD, peripheral vascular disease)
    • Microvascular (i.e. retinopathy, nephropathy, diabetic neuropathy)
  30. This refers to how quickly glucose is absorbed after a person eats, how high blood glucose rises and how quickly it returns to normal.
    Glycemic Response
  31. This is a method of classifying foods according to their potential to raise blood glucose.
    Glycemic Index
  32. Insulin resistance is a central feature of _________ ________, a group of disorders that substantially increase the risk of developing cardiovascular disease (CVD).
    _________ ________ is a cluster of at least three of the following:
    -insulin resistance
    -reduced HDL cholesterol levels
    Metabolic Syndrome
  33. This hormone improves insulin sensitivity.
    • Adiponectin
    • *Obesity causes reduced secretion this hormone
  34. This hormone increases insulin resistance.
    • Resistin
    • *Obesity causes and increased secretion of this hormone
    • *Insulin resistance intereres with vasoconstriction / dilation, therefore increasing blood pressure
  35. This is a marker of inflammation linked to an incrased risk of CVD.
    • C-reactive protein
    • *The obese often have elevated levels of this
  36. This term refers to the pancreas secreting larger amounts of insulin, and plasma insulin concentrations can rise to abnormally high levels, to compensate for a reduced sensitivity to insulin.
    • Hyperinsulinemia
    • *promotes reabsorption of sodium by the kidneys, resulting in fluid retention and increased blood volume resulting in increased blood pressure
  37. As a result of obesity, adipose cells are less responseive to insulin and release more fatty acids into the bloodstream. At the same time, they are less able to extract and store triglycerides from chylomicrons and VLDL. To keep up with the greater influx of fatty acids, the liver must accelerate its production of VLDL, and ___________________ develops.
  38. What are the consquences of Metabolic Syndrome?
    • Increased risk of CVD
    • Accelerating Atherosclerosis
    • Increased levels of fibrinogen (promotes clotting)
  39. What are the recommendations for patients with Metabolic Syndrome?
    • Dietary Management
    • Physical Exercise
    • *both can improve insulin resistance, blood pressure, and blood lipid levels
  40. What are the health effects of starch and fibers?
    • Reduce Heart Disease Risk - by lowering blood cholesterol
    • Reduces Risk of Type II Diabetes - by slowing down the absorption of glucose
    • Enhances Health of GI Tract - by easing stool passage
    • Promote Weight Control through less Kcal's per bite - low in fat and added sugars, creates a sense of full and delaying hunger
  41. The class of nutrients known as ______ include triglycerides (fats and oils), phospholipids, and sterols.
  42. _________ fatty acids carry the maximum possible number of hydrogen atoms. When most of the fatty acids are _________  it is called a _________ fat.
  43. _____1_____ fatty acids lack hydrogen atoms that have at least one double bond. The double bond is considered the point of _____2______.
    • 1: Unsaturated
    • 2: point of unsaturation
  44. ____ lack two hydrogen atoms and have one double bond.
    Olive oil is a rich source of ____, but animal fats also contain substantial amounts of these fatty acids.
    There is no requirement for ____ in the diet since they can be created within the body.
    ____ have no effect on plasma cholesterol.
    • MUFA (Monounsaturated Fatty Acids)
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  45. ____ lack four or more hydrogen atoms and have at least two or more double bonds.
    • PUFA (Polyunsaturated Fatty Acids)
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  46. Peanut oils have a good balance of _________ & ___________ fatty acids.
    Saturated & Unsaturated
  47. Saturated fats are __1__ at room temperature.
    Saturated fats are more resistant to ____2____.
    • 1: solid
    • 2: oxidation (causing rancidity)
  48. Polyunsaturated fats are ___1__ at room temperature.
    Polyunsaturated fats ___2__ easily.
    • 1: liquid (due to the double bonds)
    • 2: spoils (due to the double bonds)
  49. Monounsaturated fat is ____ susceptible to spoilage.
  50. Converts liquid oils into solid fats in the manufacture of shortenings an margarines.
    Protects against oxidation therfore prolonging shelf life.
  51. Dietary trans fatty acids raise _1_ cholesterol an lower _2_ cholesterol in healthy human subjects.
    The concentration of lipoprotein (a) in plasma is directly associated with increased risk for _3_.
    Consumption of trans fatty acids increase the risk of _3_.
    • 1: LDL
    • 2: HDL
    • 3: CHD - coronary heart disease
  52. There is no requirement for ___ in the diet since they can be created within the body.
    The ___ occur mainly in foods of animal origin.
    SFA - saturated fatty acids
  53. These are used as emulsifiers in the food industry.
    Food sources of lecithin include eggs, liver, soybeans, wheat germ and peanuts.
    The body enables transport of lipids across cell membrane.
  54. These are found in plant and animal foods.
    They are the starting material for bile acids, sex hormones, adrenal hormones, and vitamin D.
    They are a structural component of cell membranes.
    They are linked to Atheroschlerosis.
    • Sterols
    • Cholesterol is found in animal foods only (meat, eggs, fish, poultry, dairy products)
  55. ___ is the protein substance of the neruofibrilatory tangles common in Alazheimer's and other neruodegenerative diseases.
    • Tau
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  56. ___ signals gallbladder to release bile
    CCK - cholecystokinin
  57. The largest of the lipoproteins and least dense.
    Transports dietary lipids from the intestines to other locations in the body and get smaller and smaller as cells of the body grab triglycerides from it.
  58. Composed primarily of triglycerides.
    Made by the liver from fatty acids.
    Transport lipids to tissue of body and get smaller and small as cells of the body grab triglycerides form it.
  59. VLDL's, through the processes of the body, eventually become these.
    Composed primarily of cholesterol.
    Transports lipids to all the tissues.
    High levels of ___ are associated with higher risk of heart attack.
  60. Composed primarily of protein
    Transports cholesterol from the cells to the liver for use, recycling or disposal.
    High levels of ___ seem to have a protective effect.
  61. What are factors that can lower LDL and raise HDL?
    • Weight control
    • Replacing trans & saturated fats with mono & polyunsaturated fat in diet
    • Soluble fibers
    • Plant sterols
    • Moderate alcohol consumption
    • Physical activity
    • Niacin
  62. Facilitates cholesterol uptake by the liver and toher tissues, allowing HDL cholesterol to help transport other cholesterol out of the blood plasma.
    Apoprotein A
  63. Found in LDL cholesterol, combines with receptors that bring LDL cholesterol into other cells of the body.
    There is evidence that levels of these are a better indicator of heart disease risk than total cholesterol or LDL.
    Apoprotein B
  64. Assembled in the blood from LDL & ApoA molecules.
    Decreases fibrinolysis, stimulates thrombogenesis.
    High _____ in the blood is a risk factor for CHD, CVD, atherosclerosis, thrombosis, and stroke.
    Niacin and aspirin are two substances know to significantly reduce the levels of _____ in some individuals with high _____.
    Lp(a) - lipoprotein (a)
  65. ___________ is the substrate for out most important hormones: aldosterone, cortisone, estrogen, progesterone, testosterone.
    Elevated blood ___________ is a risk factor for cardiovascular disease.
    ___________ accumulates in the arteries, restricts blood flow and raises blood pressure.
    Saturated fat in the diet raises blood ___________.
  66. _____ is important for the sturctural integrity of cells, anti-oxidation and the production of ATP.
    CoQ10 - Coenzyme Q10
  67. Which grade is better "A" or "B"?
    • apoA - HDL
    • apoB - LDL
  68. What are factors that lower LDL and raise HDL?
    • Weight control
    • Replacing saturated / trans fats with monounsaturated / polyunsaturated fats in the diet
    • Soluble fibers
    • Plant sterols
    • Moderate Alcohol consumption (a shot or 2)
    • Physical Activity
    • Niacin (Raises HDL / Lowers LDL)
  69. Fish is a good source of ___.
    ω−3 / Omega 3
  70. What are the benefits of DGLA?
    decreases inflammation and platelet clotting
  71. What are the benefits of EPA?
    • Decreases Inflammation, platelet clotting, cholesterol
    • Dilates blood vessels
    • activates T-lymphocytes
    • Increases action of insulin
  72. ___  is the key enzyme in prostaglandin synthesis.
    COX - cyclooxygenase
  73. ___________ is the process by which fatty acids, in the form of acyl-CoA, are broken down to generate acetyl-CoA.
Card Set
Clinical Nutrition