Nutrition Module 1

• The science that links food to health and disease
• studies the ingestion, digestion, absorption, transport and excretion of food substances
• impacts us from birth to death

it is relatively new and still changing every year

• moms nutrition affects growth in womb
• chidrens nutrition affects growth, health, academic function

• athletic performance, academic performance, growth
• ie Calcium = bone structure

• Good nutrition can help prevent negative effects of aging
• the choices you make today will influence your health and longevity later too

• Cancer
• Diabetes
• Hypertension
• Cardiovascular Disease
• Arthritis
• Obesity
• Osteoporosis

• Poor nutrition can cause disease
• disease can cause loss of appetite which can lead to inadequate nutritional intake

• Restaurants: are they serving healthy food
• Manufacturers: what are they putting in our food
• How are people determining calories/serving sizes?

• marketing strategies
• promotion of fads and unhealthy foods
• celebrities backing certain products and fad diets

• What is recommended today may not be healthy later
• ie: vitamin E was recommended by cardiologists 8 years ago for heart health. Now, it has been found that vitamin E in large levels is bad for the heart

• Physical Health
• Intellectual Health
• Emotional Health
• Social Health
• Spiritual Health

• The ability of the body to perform physically to allow survival
• depends on available nutrients (ie vitamins are required for hormones, calcium for bone formation)
• involves what we need to take in to keep the body healthy

• the ability to learn and adapt
• involves healthy brain and central nervous system
• lack of nutrients can impact this 
• -> ie iron= anemia (physical) but then impairs your ability to think and affects the CNS

• involves the ability to express or supress certain emotions
• relies on hormones, which vitamins are needed to make
• if blood sugar drops you can become angry,lethargic- affecting physical and emotional performance

• the ability to interact with others
• almost all social events are centered around foods (funerals, parties, get togethers)

• the purpose for human existance
• religions and cultural practices often restrict certain foods

• food provides energy in the form of calories
• nutrients are substances found in food that are involved in building and maintaining body parts, metabolic reactions, and processes

• help produce the energy you get
• 6 different types- food is a mixture of many types but is classified by which nutrient is the most abundant
• ie a bagel is a carb bc its mostly carbs

undestanding nutrition allows us to make wise food choices that will prevent disease

many factors, but mainly physiological and psychological factors play a large role in appetite, hunger and satiety

• Hunger: an internal drive, a physiological drive. something that occurs naturally in the body. Often unpleasant such as stomach gurgling or upset. Blood sugar levels drop, stomach churns
• Appetite: an external drive that encourages us to go out and eat food. it is a psychological response. related to pleasant sensations associated with food. ie you walk into a room not thinking about food then smell a delicious dinner and then you think you need to eat. 

both control our desire to eat

• smell
• sight
• the environment
• psychological issues
• social situations
• all these can trigger us to eat

• Fullness/satisfaction
• as digestion occurs, and nurients are absorbed into the blood, blood glucose levels shift and the feeding center in the hypothalamus slows down and satiety center becomes activated

• Plays a large role in hunger and satiety
• if you havent eaten and blood sugar decreases the feeding center in the hyp becomes activated. when the blood sug level increases the satiety center in the hyp is activated
• it is constantly processing signals from many nerves to regulate our food intake
• if the hyp is damaged by an accident/drugs/annorism etc the regulation of hunger and satiety can be lost

• GI tract: stomach regulates weight and satiety.
• Hormones: balance hunger and satiety

• stomach expands when eating (we can only hold 4 cups food)
• as it expands our desire to eat declines
• ie buffet: by the second trip, you are much more selective on what you want where as at the beginning it all looks good
• gi tract uses nerves to communicate w/ brain no more food

survey buffet and take small protions of high fiber and water foods- by choosing less food to start youre less likely to overreat

hormones are compounds secreted into the blood by cells that impact the function of another type of cell

• grelin (most important)
• endorphins
• neuropeptide Y

• seratonin
• cholecystokinin (cck)
• leptin (most important)

• secreted by adipose tissue, alerts the brain to turn off feeding center and activate satiety
• if someone has a leptin level that remains elevated for a period of time, it interferes with the hunger-satiety balance
• high leptin levels leads to lower leptin sensitivity, obese people can have higher leptin levels

produced by the stomach, stimulates feeding center in the brain

• eating without being hungry is appetite
• food choices are a reflection of who you are
• who you are is determined by- genetics, family eating patterns, religion, health, etc
• there are 4 external forces that affect our eating habits

• Sensory forces
• Cognitive factors
• Environmental factors
• Health status

• flavor, texture (soft, crunchy, slimy), taste (most important)
• taste preferences are often genetic
• smell- gives food appeal, if you have a cold food doesnt taste as good
• kids may prefer crunchy where old person with dentures may need soft
• color- makes food more pleasing and healthy- you want to eat the rainbow
• moisture and temp

• Sweet
• Sour
• Bitter
• Salty
• Umami (meat)

• habits- routines can be tied to food choices- can be learned during early childhood from parents
• comfort foods
• Advertising
• social factors

100

• early experiences expose us to maky foods that we relate back to that good experience and people. memories related to theose foods stick with us, relieve stress, give us security and make us feel better
• negative feelings occur with this too- ie kara hates meatloaf bc puking
• genders have diff  comf foods- girls- ice cream and chocolate (sweet foods); male- meat/potatoes

• has largest effect on children
• the most popular foods advertised are often unhealthy
• uses toys/color
• govt is restricting ads targeted to kids due to growing childhood obesity

• food is always at social events
• parents control what we eat til school then peers have an impact
• time: how much time do we have for food prep/shopping? we may turn to frozen or microwavable food (today many cant cook from scratch)
• nutritional value

• types of food we choose can be determined by our stage in the life cycle, health status, educational background, socioeconomic status
• read food labels to make healthy choices

involves:economics, lifestyle, culture, environment

families with higher income dont always eat healthier, might eat out more or get higher cost processed foods

• nuclear family vs single parent vs single career vs elderly- all lead different lifestyles and eat different foods
• time, convenience, income all influence the lifestyle and therefore food choice

• can define our attitude towards food and is one of the heaviest influences
• food can have symbolic meaning related to family tradition, social status, experiences, customs, and health
• the culture that we're raised in can determine food preferences
• in many cultures, meals are related to social interaction - ie in USA eat a 30 min dinner whereas in europe its longer, you savor food and connect with family/friends

• where do you live and what food options do you have around you
• people in rural or inner city areas may not have a grocery store- they may eat from gas stations/convenience stores
• location and climate can affect food costs and therefore influence our choices

• How healthy are we, how well are we aging
• as we age or acquire disease, there are different restrictions that arrive (someone with poor dental hygene who had all teeth removed can t chew)
• as we age we loose taste sensitivity
• medications also make food not taste as good which can affect health status
• age in the life cycle and gender affect health status (teen girls dont drink milk bc they dont want calories- drink diet cola but 50 years later they may have undeveloped bones- osteoporosis)

• taste
• texture 
• this is in relation to our personal preferences
• most of us dont read labels or think about how food will affect our health

• energy or tissue synthesis
• every food has a variety of nutrients in different amounts

• 1. Promote growth and development
• 2. Maitenance of tissue, cells and bones
• 3. Fuels us for physical work and metabolic processes
• 4. Regulation of various body processes that occur every day
• 5. Fufill the true purpose of eating- nourishing our bodies

• cannot be made by the body, we have to get it from our diet
• there are 45 essential nutrients for human growth development and maitenence to occur

• Macronutrients: body needs large amounts of it
• Micronutrients: body only needs small amounts
• Organic compounds: contain both carbon and hydrogen
• Inorganic compounds/substances: dont contain carbon

nutrients are either macro or micro AND inorganic or organic

a deficiency occurs

• 6 classes
• the 6 classes serve 3 functions
• 1. can be used for calories to meet energy needs
• 2. to regulate body processes
• 3. help with structure, growth and maitenence

• Carbohydrates (CHO): organic macronutrients
• Protein: organic macronutrient
• Fat: organic macronutrient
• Vitamins: organic micronutrients
• minerals: inorganic micronutrients
• Water: inorganic macronutrient

• Carbs: 4kcal/g
• Protein: 4kcal/g
• Fat: 9kcal/g

Bonus: Alcohol 7kcal/g

• aka CHOs bc they are composed of carbon hydrogen and oxygen
• function: primary source of energy
• can be complex or simple
• found in grains, vegetables, fruits, dairy and legumes (beans/peas)

• simple: sucrose and fructose
• complex: starches and sugars (ie fibers)
• eventually carbs are broken down into glucose no matter what, but complex carbs take longer to break down
• the glucose will provide a source of energy for us

• also composed of carbon, hydrogen, and oxygen but also (unlike carbs) contain nitrogen
• made up of amino acids coming together
• function: structure and regulation for blood, body cells, enzymes and immune function; secondary function is an energy source
• found in meat, dairy products, legumes, vegetables and grains

• made of carbon, hydrogen, and oxygen
• a very dense form of energy
• 2x as much energy from fat than carb and protein
• function: excellent energy source, important for structure and regulation as well
• found in multiple categories
• found in fat of meat and oils, and those are found mostly in meat and dairy products
• no fat in fruit or veggies, its in some grains depending on how processed they are

found in the form of triglycerides (fats in oils), cholesterol and phospholipids

• made of carbon and hydrogen, but with other elements as well
• function: important for growth, maitenence and body functions, and needed to enable our bodies chemical reactions
• found in all food groups
• 2 classifications

• 1. Fat soluble Vitamins: A D E K
• 2. Water soluble Vitamins: B vitamin complex, C

• can be divided into macrominerals or microminerals
• simple inorganic substances
• electrolytes are a type of mineral
• function: structure and regulation for growth and maitenance
• found in all food groups

• minerals that the body needs in relatively large quantities
• there are 16 of these minerals

• the remaining minerals are only needed in small amounts
• these are often referred to as trace minerals

minerals that conduct electricity

• made of hydrogen and oxygen
• has no calories
• 60% of us is water
• functions: a solvent, a lubricant, transports nutrients and waste, helps with temperature regulation and with chemical processes
• found in beverages but in food as well (ie 1 cup watermelon= 1cup water)

• the main reason we eat is for energy (the ability to do work) 
• the energy in food (calorie) is chemical, but our bodies can convert that energy to electrical, mechanical or heat energy
• all body functions and actions require energy
• 3 of the 6 classes of nutrients are energy sources

• carbs
• protein
• fat

foods are usually a combination of multiple energy sources

• Another way to get energy 
• 7kcal/g
• not an essential nutrient because it provides nothing besides calories

• building: energy used to build new compounds that our bodies need
• muscular movement: mechanical energy needed for us to do work
• nerve transmission: electrical energy needed for this
• maintain balance within cells: ion balance

• kilocalories
• 1 kcal is the amount of heat required to raise the temperature of 1kg of water 1C, so you are measuring how much heat is given off
• scientists can burn food to see how much energy potential is in it
• they found that the energy in food is determined by its composition of carb, protein and fat`

multiply the g of each nutrient by the conversion rate and add up all the calories for the total calories

provides key to how healthy the food is (we want to stay within the recommended percentages of each nutrient daily)

find all the # of calories and then divide the cal of each nutrient by the total calories in the food and multiply by 100

• 10%-35% of calories should come from protein
• 45%-65% of calories should come from carbs
• 20%-35% of calories should come from fat

• 2000
• also keep percentages within the guidelines

2,000 or 2,500

• fat: 20-35%
• 2,000 x .2= 400cal
• 2,000 x .35= 700cal
• 400-700 cal/day
• 400cal/9cal= 44.4g
• 700cal/9cal= 77.8
• 44.4-77.8g per day

• no
• some foods are more nutrient dense than others (packed with vitamins, minerals etc)
• other foods may be energy dense but have little nutritional value (ie alcohol)
• it is important to choose nutrient rich foods over empty calorie foods (many calories but no nutritional value)

• the health of a person based on height, weight, blood chemistry, physical exam results, and lifestyle
• important to monitor, as 68% of US adults are overweight or obese and have increased risk of disease
• a person's nutritional status is classified into 3 categories

• southern
• think Paula Deen food

• Desirable nutrition
• Overnutrition
• Undernutrition

• what we hope to be
• you are healthy and eating a variety of foods, getting all essential nutrients
• your risk of chronic disease is lower
• you can also store nutrients for times of need
• this status results from a balanced diet and regular exercise

• increased consumption, usually increased calories, fats, saturated fats and cholesterol (all lead to increased risk of chronic disease)
• these fats are often acquired from oils, shortenings, meat, cheese, and frozen desserts and overtake of these leads to obesity

• no, can be overconsumption of certain nutrients (too much of a certain nutrient can be toxic)
• some minerals (ie vitamin A) have a small window between good amounts and too much
• vit A good for skin, eyes, etc but too much at pregnancy is bad

• Nutrient intake does not meet our nutrient needs
• too little consumption or deficiency of certain nutrient(s)
• as nutrient levels decline, our metabolic processes start to slow down and eventually stop

• initially when were in a state of undernutrition there are no signs or symptoms
• you may not know you have a deficiency at this point

• If a sub-clinical deficiency isnt corrected eventually we will start to see symptoms and signs and a diagnosis is made
• there are many symptoms

• dry/yellow skin (liver disease?)
• spares hair with no shine, losing patches
• dry purple tongue w/ fissures/crevices
• eyes- dull, fissures around eyes/mouth/nostrils

refers to overnutrition or undernutrition

• an inability to obtain food (economics, lack of store, transportation, etc)
• poor utilization of nutrients (ie crohns cant absorb- it goes right through you)
• A diet that lacks certain vitamins/minerals/other nutrients (ie vegans- may be missing iron and b vitamins in animal products)
• poor food quality and/or excess quantity
• many 3rd world countries have inadequate farming and poor food quality. a lot of protein comes from plants
• USA ppl may take in too many calories from poor quality foods
• cerain subpopulations (cancer, drug addict) may be malnourished

• eventually results in failing health related to inadequate or overabundant intake of certain nutrients
• nutrition must be corrected before permanent damage occurs to body

• ABCDE
• A: Anthropometric Measurement
• B: Biochemical Assessment
• C: Clinical Assessment
• D: Dietary Assessment
• E: Environmental Assessment

• body composition
• youll look at someones height, weight skin fold measurements, or other method to determine fat%
• for infants- view head circumference to ensure proper growth
• anthropometric measurements are compared to standard tables to see how the person measures compared to norm
• can also compare ap measurement over time (esp in kids) to see if growing properly

• measure the nutrients in the uring, blood, and feces
• used for diagnosis of many disorders/diseases as well
• ie checking someones calcium levels if low, could be a predictor of osteoporosis

• looking at a person's appearance
• look at eyes, skin, hair, teeth, blood pressure, mobility
• can tell you a lot
• hair loss- protein/zinc deficiency
• yellow skin- liver disease

• looking at someone's dietary intake- are there any problem areas. get a diet history
• people arent always truthful
• use with the other assessment (ie if someone has high blood pressure [clinical] tell them ways to lower sodium intake)

• review persons living condition, background and history, social and medical history, medication review, family history, marital status, economic status, educational status
• necessary for an overall assessment of who this perosn is and understand how to educate them on health (ie HS dropout vs a doc- talk to them differently)
• can recommend social service agencies to help them acheive optimal nutritional health

• 1950s- developed the food groups to assist in healthy eating
• there were 7 then 4 and today 5
• first food pyramid in 1992- lasted til 2005

• Protein (used to be called meat)
• Fruits
• Vegetables
• Dairy (used to be milk)
• Grains

changed to MyPyramid- steps to a Healthier You

• goal was to provide advice to prolong life and health and individualize the pyramid
• this pyramid also included exercise for the first time
• band width told you how much to eat rather than going from bottom to top like old pyramid
• despite this, obesity continued to increase

• 1. Personalization: make it to you. your serving size, your needs
• 2. Moderation: any food can be in your diet, but focus on nutrient rich foods, only eat the others occasionally
• 3. Proportionality: portion size- represented by band widths. Focus on grains, fruits, and veggies but also know serving sizes. Also encourages use of scales and visual aids to know how much we're eating
• 4. Variety: eating a rainbow. eat from each food group every day
• 5. Activity: 30-60min activity/day
• 6. Gradual Improvement: small changes should be the focus

• intruduced by USDA in 2011
• Goal: to be easier to understand
• 1/2 fruits and veggies, 1/2 protein and grains
• be physically active your way
• had same messages as my pyramid

• variety, proportionality and moderation
• balance caloric intake- focus on nutrient dense fods

used bc a 2YO has diff needs than a teen, so food plans based on age, gender and activity level

• a diet program
• put in your daily intake and it will analyze your diet for calories and nutrient intake

• cardiovascular disease
• cancer
• obesity
• diabetes

• outlined to help consumers improve their diet choices and lifestyle
• updated every 5 years

• balance our calories with our physical activity- by doing this we can maintain weight
• consume more of certain foods and nutrients- such as fruit, veggie, whole grain, fatfree and lowfat milk and seafood
• consume fewer foods with sodium, trans fats, saturated fats, cholesterol, added sugar and refined grains

• US Dept. of Health and Human Services developled this in 1970s
• updated every 10years
• promotes goals for consumers to meet to increase quality and healthy lives

• Used to plan a healthy diet
• all packaged foods have a label

• Product Name- so you know what you're buying
• Name and Address of the manufacturer
• Amount of product in package- helps with comparison shopping
• Ingredients listed in decending order
• Allergy info (soy, wheat, dairy, nut)

by FDA to ensure manufacturers are meeting standards and that labels are accurate

• required on all packaged foods as well
• key tool to compare nutrients, fats, calories etc among food products

• serving size and calories per serving
• must list- total fat, saturated fats, trans fats, mono unsaturated and polyunsaturated fats, cholesterol, sodium, total carb (including sugars and dietary fiber)

the bigger difference between the total carb amount and the sugars amount= the more nutritious the food is

protein

vitamin A, C, calcium, iron etc

• listed on bottom of nutrition facts
• based on a 2000 or 2500 calorie diet
• tells you how much of each nutrient in g you should eat each day
• if a food gets lots of its calories from fat we should eat it sparingly

• listed in household units (cups, tbsp, etc) so we can measure it
• we may think we are eating correct portions but we may actually be eating 2-3 servings

• Health claim
• preliminary health claim
• nutrient claim
• structure-function claim

• regulated by FDA
• to make a health claim there must be scientific evidence linking the food (or nutrient in the food) to a reduced risk of disease (ie eating a fruit or veggie rich diet reduces cancer risk)
• whole grains important for heart health

• regulated by FDA, but a scientific link has not yet been established
• not many manufacturers use this claim
• if it is used, a statement similar to "this evidence is non conclusive" must appear on the label

• Closely regulated by FDA
• a specific claim is made about a nutrient
• ie reduced fat cheez its
• low sodium soup (sodium must be <140mg)
• low fat is 3g or less per serving

• not FDA approved
• ie product X contains bee pollen, whcih may lower your stress level
• there doesnt have to be any scientific evidence and the claim doesnt have to be valid
• the FDA will only recognize these claims if the product is throught to cause harm to the consumer

a style of eating that meets your nutritional needs and is something you can practice forever