Nutrition Module 5

  1. Benefits of physical activity
    • improved stamina and strength
    • weight management
    • increased flexibility
    • improved blood glucose control
    • stress control
    • improved self image
    • increased cardiovascular function
    • lower blood pressure
    • reduced cancer risk
    • improved immune function
    • slowing of aging
  2. Physical fitness
    • the ability to perform moderate to vigorous activity without excess fatigue
    • studies have proven that moderate levels of fitness can reduce risk of many diseases
  3. Fitness in regards to nutrition
    • your nutritional status and intake can have a + or - effect on your physical performance
    • its never too late to start eating healthy
    • a malnourished athlete cant perform at their peak ability
    • as your fitness level increases, the type of fuel used by the muscles changes
    • improved fitness= increased utilization of fat for muscle fuel
  4. Healthy People 2020 objectives to get people moving
    • reduce the # of adults who dont do physical activity in their leisure time
    • double the # of adults who exercise 30 min or more a day
    • increase the # of adults who participate in some type of resistance exercise to build muscle and endurance 
    • however-people still sedentary
  5. Starting exercise
    • many of us want to start an exercise program, but may be overwhelmed with choices and our lack of knowledge about exercise
    • even after starting an exercise program, good intentions go by the wayside and our motivations dwindle after only several months
  6. Steps to establishing a fitness routine and sticking to it for the rest of your life
    • find activities that you enjoy and vary your routines
    • grab an exercise buddy to help make you accountable
    • start slowly
    • set specific goals and reward yourself once you achieve those goals
    • remember the focus is on disease prevention and maintenance of flexibility and balance as we age
  7. Where should you start in regards to exercising
    • incorporating 30 min of activity into your daily routine is a good place to begin
    • those 30 min can be broken into shorter segements throughout the day- walk to a coworkers desk, take the stairs, do a brisk walk at lunch
    • once you are comfortable with this activity level, it is time to add another 30 min to the day and increase the intensity of the workout
    • if you have not been physically active, are a man over the age of 40 or a woman over 50, have a history of hypertension, diabetes or cardiovascular disease, it is wise to check with your doc prior to initiating any activity
  8. 3 components to any fitness program
    • aerobic workout
    • stretching and flexibility
    • strength training
  9. aerobic workout
    • should be performed 20-60min 5 days per week
    • goal is to increase your heart rate to the target zone
    • for beginner exercisers your goal is to reach 60% of your max heart rate and as your fitness level increases, youre heartbeat should be closer to the upper level of the target zone
    • with any type of aerobic activity, the goal is to build endurance, which increases the ability to deliver oxygen throughout the body
    • all aerobic workouts should start with 5-10 min stretching and low intensity exercises to warm up the muscles
    • following the work out a cool down of 5-10 min should also occur
  10. Stretching and flexibility
    • stretching allows for flexibility
    • stretching important for everyday things, lifting to get something out of a high place
    • stretching and resistance exercises should be done several times per week
  11. Strength training
    • resistance exercises are most imporatnat because as we age we lose muscle and it is often replaced with fat
    • adding weight training, pilates, pushups, or yoga 2-3x per week will tone your figure, increase your muscle and improve your balance and flexibility
    • In addition, the increase in muscle tissue will increase your BMR and you will burn calories more efficiently
  12. finding your target zone for heart rate
    • first find your maximum heart rate by subtracting your age from 220
    • ie: 220-25= 195
    • the target zone is 60%-90% of your max heart rate
    • ie: 195*.6=117, 195*.9=175.5 my target zone is 117-175.5BPM
  13. Measuring your heart rate
    count your pulse for 10sec and multiply by 6
  14. What supplies energy to the muscles?
    energy from plants + ADP +Phosphate = ATP
  15. ATP
    • Adenosine Triphosphate
    • the 1st source of energy for the cells
    • following digestion, energy is released from food and it reacts with ADP and phosphate to make ATP
  16. Energy sources used by the body
    • ATP
    • Pcr
    • Carbohydrates
    • glycogen
    • fat
    • protein
  17. ATP Storage
    • our resting muscles can store enough ATP to do work for 2-4 seconds
    • this requires no oxygen (an anaerobic activity)
    • as soon as the ATP in the cells begins to be used, a compound called phosphocreatine (PCr) is broken down
  18. Pcr
    • Phosphocreatine
    • broken down as soon as ATP in the cells begins to be used 
    • broken down into phosphate and creatine to form more ATP
    • Pcr can maintain muscle contractions for ~10 sec
    • most activities that use Pcr are fast quick bursts of energy (ie- bench pressing, jumping, throwing, sprinting)
  19. Carbohydrate use for work (1st way they are used)
    • for events lasting 30sec to 3min the body uses carbs under anaerobic conditions
    • this is a quick source of energy for an activity like sprinting 400m or hurdles
  20. Why can you only use carbs anaerobically for energy for 30sec to 3min
    your body cant rely on anaerobic glucose breakdown for long due to the release of lactic acid- a byproduct of the glucose breakdown that can lead to muscle fatigue
  21. Carbohydrate use for work (second way they are used)
    • for events lasting 2min to 3hours, glucose breakdown under aerobic conditions occurs
    • energy is released more slowly 
    • this is fuel used for endurance type activity such as cross country meets or long distance swimming
    • the aerobic breakdown of carbs yeilds 95% of the body's ATP needs
  22. Carbohydrates used for work (Where does the glucose used for ATP come from)
    • for activities lasting less than 30 min, your muscles rely on glycogen stored in the muscles for fuel
    • for events more than 1hr, the glucose in th blood comes from glycogen stored in the liver
  23. Depletion of stored glycogen for energy
    • glycogen from the muscles and liver is converted to glucose to use for work
    • as these stores are depleted, fatigue and a decline in mental function occurs- this is called bonking in cycling or hitting the wall in marathons
    • this depletion can be adverted by consuming 30-60g of carbs per hour for events lasting more than an hour
    • youre using quick sources of energy- ATP, blood glucose, very quickly. Once that supply starts ot run you you start to make pcr to make more ATP (everything still anaerobic). then you rely on carbs on aerobic conditions using stores since youve used the available blood glucose
  24. Fat as an energy source
    fat is an important energy source for activities lasting more than 20min that are performed at a low or moderate rate such as weight lifting, hiking, or a fast walk
  25. Proteins as a fuel source
    • protein is a minor fuel source for the muscle compared to carbs and fat
    • protein is primarily utilized during endurance events as glycogen stores in the muscle are depleted
  26. Does protein build muscle?
    • contrary to popular belief, protein intake does not build muscle- resistance through strength training or exercise increases muscle mass
    • ads promoting high protein bars and drinks are aimed at weightlifters, but the primary fuels for this exercise are Pcr and carbs
    • the typical North American Diet provides adequate amounts of protein and supplements are not necessary
    • However: consuming foods high in carb and moderate in protein enhances the muscle building effect of a weight training activity
  27. What is one thing you can do to benefit your muscles
    drinking an 8oz glass of milk after strength training
  28. Optimal nutrition for athletic performance
    entails consumption of adequate energy and nutrient needs, maintaining appropriate body composition, promoting optimal recovery following exercise, and maintaining proper hydration
  29. How to determine if you are taking in adequate calories to support your energy needs
    consume a mix of carbs, protein and fat daily
  30. How much of your total calorie intake should come from carbs
    • about 60%
    • minimum of 5g perk kg should be eaten daily
    • for endurance athletes, activiteis greater than an hour eat 7-10g carb per kg
  31. Carbohydrate loading
    • carbs are needed to prevent fatigue, and enough must be ingested for storage in the liver and muscle
    • endurance athletes have found carb loading helps maximize their muscle glycogen load
    • % of cal from carbs are increased to about 70% while decreasing exercise around eating so you can store the carb
    • this only works for activity over an hour and the athlete needs to practice this prior to the event- if you do it the day of your muscles may not react well (feel heavier- affecting performance)- carb load a week before the event
  32. Does carb loading actually work?
    • yes
    • if you have an untrained muscle (you dont workout) you can hold 13g carb per 100g muscle. an athelete with trained muscle hods 32g carb per 100g muscle. If you load, the trained muscel increases to 35-40g carb per 100g muscle
  33. Carb loading side effects
    • muscle stiffness and heaviness due to excess water storage in the muscles
    • so if youre gonna carb load, practice it first
  34. How much fat should be in our diet
    • fat should make up about 35% of the calorie intake
    • the major source should be mono unsaturated fatty acids
    • rich fatty foods can slow absorption so the day before an event, limit fat to allow for optimal performance
  35. How much protein should be in the diet?
    • most adulst require .8g/kg 
    • for athletes, up to 1g/kg
    • for weight lifters, strength trainers, up to 1.2g/kg
  36. Is more protein better?
    • no
    • its not the protein that builds muscle, its the exercise
    • also- excess protein can negatively affect your workout
    • if you take in too much it causes increased urine production which could cause dehydration and fatigue and therefore negative performance outcome
  37. Calorie need variation
    • calorie needs vary depending on the athletic fitness of the person and the type of event they are training for
    • no matter what youre training for, maintaining an appropriate weight for your height and age is important
  38. How many calories does physical activity use
    moderate physical activity requires 5-8cal per min
  39. Ways to monitor caloric intake
    • food diary: record everything and enter it into a nutrient analysis profile
    • use commercial websites or apps: these track calories and set healthy goals and it is then easy to compare your intake to standards and the recommended amounts
    • combine variety, proportionality and moderation
    • measure your fat % and compare it to standards
  40. Desirable body fat %s
    • Male: 8-24%
    • Female: 20-35%
    • Male Athlete: 5-18%
    • Femal Athlete: 17-28%
  41. Vitamins and minerals for athletes
    Athletes can meet requirements for most vitamins and minerals without supplements with some exceptions
  42. Vitamins and minerals that athletes need to look out for
    • B complex and rich antioxidants: athletes that must watch weight (wrestlers, ballerinas etc) are at risk for deficiencies of these
    • Iron and calcium: are of concern for vegetarian female athletes. an anemic will have a negatively impacted performance
    • calcium: important for muscle function and strong bones. female athletes especially need to watch this
  43. Importance of calcium throughout life
    • Calcium is needed for normal muscle function and strong bones
    • think a bank- you can make regular deposits or withdrawls- bones are always being broken down and rebuilt
    • from birth to mid 20s: calcium deposits are made to your bones and bone mass increases
    • after your mid 20s: the deposits slow and eventually stop. bone turnover is still ocurring, but you cant build more, your just trying to maintain your current bone, after his bone maintenance relies on adequate calcium intake
    • many young ppl restrict dairy in favor of diet soda to help weight loss- leads to bone mass decrease
  44. Female athletes and fat
    • female athletes may have minimal fat stores, which can lead to cessation of menstration resulting in thinning bones and increased risk of stress fractures
    • the bone loss is irreversable and can lead to osteoporosis
  45. Female Athlete Triad
    • the combination of disordered eating, low BMI, osteoporosis, and loss of periods combined with excess physical training is Female Athlete Triad
    • it is important that coaches are aware of the risk and encourage their female athetes to make wise and healthy nutrition choices while maintaining an appropriate weight.
  46. Why is water needed by the body
    • to regulate temp and help you stay cool
    • allows for cooling, temp regulation, transport of waste products  and increased blood volume
  47. Fluid levels required per day
    • 9-11 cups for the average adult
    • athletes will require more to prevent dehydration and for performance
    • each individual will have different fluid requirements
  48. What determines an individuals fluid requirements?
    • body size
    • ability to sweat
    • level of activity
    • duration of the exercise they are doing
  49. Fluid loss when exercising
    • it is important to determine how much fluid is lost through sweat per each hour of activity
    • weighing one's self before, during and afterthe activity can be used to determine the fluid loss
    • water loss >3% of your body weight: can not only affect your performance but can lead to several potentially fatal conditions (heat exhaustion, heat cramps and heat stroke)
    • if weight change cant be checked, your urine can also be a good indicator of your hydration status
  50. Urine determining hydration
    • a well hydrated individual has clear to pale yellow urine
    • dark yellow urine is an indicator that you are at risk for dehydration
  51. Preventing dehydration
    • consume 2.5-3 cups of water for each pound lost during or after the event
    • it is also beneficial to drink 1 ½ to 2 ½ cups of fluid 2 - 3 hours before the event
  52. Drinks that can help you stay hydrated
    • water
    • juice
    • cofee
    • tea
    • sports drinks
    • note coffee and tea have caffeine which can have a diuretic effect, but the effects are minimal if limited to less than 3 cups in 24 hours
  53. Caffenated beverages
    • coffee and tea have caffeine which can have a diuretic effect, but the effects are minimal if limited to less than 3 cups in 24 hours
    • there are some beverages that are being marketed for athletes to improve performance through the use of caffeine.
    • Caffeine containing energy drinks not recommended to hydrate athletes
    • While caffeine can improve performance it can also have negative side effects such as shakiness, nervousness and anxiety.
  54. Conditions related to dehydration
    • heat exhaustion
    • heat cramps
    • heat stroke
  55. Heat exhaustion
    • can occur when temps and humidity are high
    • as humidity rises, sweat becomes an inefficient way to keep the body cool
    • symptoms: profuse sweating, dizzines, nausea/vomiting, muscle weakness, fatigue and skin flushing
    • if someone appears to be suffering from this: move them to a cool place, encourage them to drink fluids and sponge them with cool water.
  56. Heat cramps
    • occur when fluids are replaced but sodium levels in the body are low
    • exercising over long periods in high temps can lead to painful contractions of the skeletal muscle
    • prevention: moderation of actiivty and adequate salt an fluid intake
  57. Heatstroke
    • the most serious condition related to dehydration
    • occurs when the body's internal temperature reaches 104 degrees as the body's cooling capacity fails and sweating stops
    • symptoms: hot dry skin, fainting, confusion, poor coordination and seizures
    • without immediate treatment, coma or death will result
    • during hot humid weather, athletes should be monitoring their weight, replacing lost fluids and limiting their activity during the hottest parts of the day
    • several highschool, college and adult professional atheletes die each year form this
  58. are sports beverages necessary?
    • it depends on the type and length of the activity being done
    • For athletes participating in enduracne events lasting longer than 60 mins, these beverages may be helpful.
    • water is the best choice for events up to 60 min
  59. sports drinks vs water
    water allows for cooling, transport of waste products  and increased blood volume but does not replace electrolytes lost through sweat- sports drinks can
  60. Sports drinks
    • sports drinks such as gatoradepowerade and all sport contain carbs, sodium and potassium.
    • ----> these carbs provide glucose for the muscle, increase thirst and help the prodcut taste good which encourages consumption
  61. Ergogenic acids
    • a mechanical, nutritional, psychological or physiological substance or treatment intended to improve performance
    • being used by athletes to enhance performance
    • depending on the nature of the acid, they may not be so harmless
    • ergogenic: means work producing. 
    • ie: vitamins and minerals, energy bars, sports drinks and products that are meal replacements like ensure or boost
    • some are banned in competition and considered dangerous
  62. examples of dangerous ergogenic acids
    • these are banned in competitions
    • anabolic steroids
    • growth hormones
    • GHB
    • blood doping

    The FDA has little control over these supplements and their safety and their effectiveness is questionable

    still, many athletes take the chance hoping they will gain a competitive edge
  63. Why do we eat?
    • simple answer: to nourish our bodies and provide sustenance
    • the true reason involves psychological, social, genetic, environmental and cultural influences determine our daily food choices
  64. What can food be a symbol for
    • pleasure: releases endorphins
    • love and comfort: helps with stress
    • struggle: parents trying to get children to eat
  65. food choices as an infant
    • as an infant we begin to associate food with pleasure as endorphins
    • endorphins: natural body tranquilizers, are released as part of the feeding response
  66. eating as we age
    • as we age, different memories are associated with food
    • thoughts of safety and warmth come to mind when you smell moms chicken cooking and the memories linger even after you don't see her anymore
    • for many, food is a simbol of love and comfort and individuals will sometimes turn to it to handle stress
  67. Meal time as a struggle
    • parents attempt to bribe or reward their children in an attempt to get them to eat
    • “If you finish your dinner I will let you have a piece of cake”
  68. Cultural influences that affect our choices
    • European countries: meal time is a celebration of good food and family time. families spend time around table eating and talking
    • USA:meal time is limited and the option of a drive through for fast food is readily available.
  69. The media influencing our food choices
    • television, billboards, magazines and the World Wide Web often advertise mixed messages 
    • food ads are big business and companies spend billions to market food to target audiences
    • fat and sugary food is the most abundant its ever been
    • media sends mixed messages bc it markets this crappy food and then the ideal body type
    • negative thoughts regarding overweight and obesity start early in life due to the media
  70. Average model vs average female
    • avg model: 5ft 11 and 117lbs
    • long legs, wide shoulders, thin waist
    • avg female: 5ft4 140lbs
    • does not have model's physique and no amount of dieting or exercise will acheive it
  71. social descrimination
    many feel that descrimination against the overweight and obese is the last acceptable form of discrimination
  72. advertising messages
    • paint overweight as lazy, ugly weak, or lacking willpower
    • paint thin with hardworking, beautiful, strong and self disciplined
    • this leads to people unrealistically wanting to acheive the ideal body type- this can lead to eating disorders
  73. Body preferences
    • there really is no ideal body
    • men: prefer the more curvy figure. If asked what an ideal woman's weight should be they usually say about 10lbs more than what a woman would say her weight should be
    • women: more critical of themselves, and media helps promote these doubts to women as young as 7
  74. negative effects of body perception
    • emotional stress
    • social pressure
  75. Causes of eating disorders
    • very complex and different for each person
    • you cant assume you know the cause of a persons disorder- they must be diagnosed and treated on an individual basis
  76. Disordered eating
    • a short term change in normal eating patterns that comes from a stressful event, illness or desire to change physical appearance
    • if this goes long term it may cause physical or psychological issues
    • usually begins with the goal of weight loss or calorie restriction but then progresses until signs of eating disorder is seen
  77. Issues that can result from long term disordered eating
    • excessive food restriction
    • binging
    • purging
    • weight fluctuation
    • can interfere with daily activities

    professoinal help is required for an eating disorder
  78. Progression of disordered eating
    Healthy attitudes --> transition period --> disordered eating
  79. Healthy attitudes (start)
    • someone who has a healthy weight, they weigh what they should for their height and activity level
    • have healthy eating habits
    • they exercise
    • they have body image acceptance-they overall feel pretty good about themselves

    but somewhere along the line there is a stress or a trigger that will move them towards the transition period
  80. Transition Period
    • Occurs when a stress or trigger occurs to someone in the healthy attitudes category (ie- they put on a little weight and someone comments on it)
    • you may start to see
    • -> increased exercise (it may become a compulsion where they need to exercise all the time
    • -> steroid use (men) to build up muscle 
    • -> yoyo dieting
    • -> compulsive eating- large quantities of food eaten at one time
    • -> theres a preoccupation with weight (they weigh themselves 3+ times a day)
    • -> fasting or eating very small amounts
    • -> feeling very dissatisfied with their body image

    if the issues aren't addressed and treated this will lead to disordered eating
  81. Disordered Eating (in the transition)
    • you have a distorted body image- you view your body one way whereas people actually see you in a different light
    • may have laxative abuse
    • adonis complex (males)- trying to become thin but muscular
    • a variety of eating disorders will manifest
  82. Types of disordered eating
    • Anorexia Nervosa
    • Bulimia Nervosa
    • Binge-Eating Disorder

    Recently, psychologists have petitioned to add night eating syndrom to the list

    people can have one or a combination of these types
  83. Eating disorder occurrence
    • over 5mil north Americans have one type 
    • females outnumber males 5:1
  84. Nervosa
    • associated with anorexia and bulimia 
    • means an attitude of disgust with one's body
    • this typically can begin in the teenage or early adult years
    • The Diagnostic and Statistical Manual of Mental Disorders outlines the criteria used to diagnosis eating disorders
  85. Characteristics shared by anorexia nervosa and bulimia nervosa
    an individual can suffer from both or have parts of each of these 2 disorders

    • no simple cause or treatment for the disorder
    • not exclusively a food issue- may be related to lack of coping mechanism and dysfuncitonal relationships. food is just something they can control
    • there is a genetic component
    • sometimes there are other issues like depression, anxiety and substance abuse
    • can cause serious health risks including death (this one is true for all 3 types)
  86. Anorexia Nervosa
    • anorexia: means denial of appetite
    • the person starves themselves
  87. characteristics of anorexia nervosa
    • extreme weight loss: mainly due to starvation
    • a fear of becoming obese: whether realistic or not, the person sees themselves as much larger than they are
    • a distorted body image: they dont see themselves as others do
  88. Who suffers from anorexia
    • most of the people suffering from it are adolescent females who are not happy with the normal body changes that come with puberty
    • however, children as young as 7 have been hospitalized with anorexia
    • it was once thought to happen to middle and upper class white girls, but is now seen among all ethnic groups
  89. Behavior of the anorexic individual
    • they are competitive, controlling and obsessive
    • the desire to lose weight stems from their feelongs of hopelessness in human relations, conflict in family, evaluation of self worth in terms of self control (the more self control i have the more worthy i am), social stress and life changes (because life changes take away their control)
    • through strict discipline and self denial of food they feel empowered and in control. Dieting or control over food becomes their focus.
    • rituals involving food and excessive exercise and calorie counting are also common
  90. Anorexia warning signs
    • distorted body image: which leads to low self esteem and abnormal eating habits
    • wearing baggy clothes
    • frequent weighing themselves
    • they will go to extremes to avoid eating (ie- mom wants you to eat breakfast. you make toast and eggs and leave the crumbs and remenants so it looks like you ate but throw it out)
    • spend a great amount of time talking about or making food and watching others eat but they wont eat it
    • they are overcritical of themselves or others. 
    • they may withdraw from friends or family
    • there is an intense fear of becoming fat- even a small weight gain can cause panic
  91. Physical concerns that go along with being anorexic
    • nutrient deficiencies can lead to physical and psychological problems
    • Brain: Depression and confusion often pair with anorexia
    • Hair: is often brittle and thin due to low protein/zinc
    • Skin: yellow color, bruises easily
    • Heart: slow heart rate and low bp, heart disease
    • Blood: Anemic from lack of iron
    • Kidneys: kidney stones may develop, as the nutrient deficiencies get worse they can get kidney failure
    • Intestines: Constipation from not enough fiber
    • Body Fluids: abnormal mineral metabolism from low potassium, magnesium, sodium
    • Hormones: Menstruation stops
    • Immune system: impaired

    eventually: death after the person dwindles down to nothing and the organs are broken down for energy and the person succumbs to infection or heart attack
  92. Guidelines for an anorexia diagnosis (weight)
    body weight less than 85% of the normal for their age, height and gender and a BMI of <17
  93. anorexia treatment
    • usually begins with outpatient therapy involving the patient and a team of medical professionals including a physician, dietitian and a psychologist
    • family members should also be involved bc theres usually some type of family conflict invovled 
    • if the person falls below 75% of standard weight, has other health issues, is suicidal or severe psychological problems they may need to be hospitalized
  94. Anorexia treatment goals
    • first main goal: gain the patients confidence and trust
    • help them recognize that they have an illness: necessary to get them to increase oral intake
    • promote healthy attitude towards food
    • teach them to listen to their own body and eat when they are hungry: these natural ques go away in anorexia
    • A BMI of 20 or more is the longterm goal
    • once proper eating patterns fixed psychological treatment can begin
  95. Anorexia psychological treatment
    • cognitive behavior therapy can be used to help them begin to accept a healthy body weight and address the underlying issues
    • family therapy and self-help groups- can help them develop coping skills and strategies
  96. anorexia average recovery time
    • 7 years
    • success is not always guaranteed
    • patient needs to learn mechanisms to manage any triggers that may cause anorexia to manifest again
  97. Bulimia Nervosa
    • an eating disorder where large quantities of food are consumed in a short period, called a binge
    • Following this binge eating, there is a desire to get rid of the excess calories through laxatives and purging
    • bulimia: means Ox hunger
  98. Characteristics of a bulemic
    • tend to be a normal weight or slightly above normal weight for their height
    • have low self esteem and often have depression
    • gain comfort by turning to food in times of crisis- the disease isnt about the food its about dealing with low self esteem and depression
  99. Bulemic behavior
    • while anorexics are very controlled, bulimics tend to be impulsive and have difficulty controlling their impulses
    • binge eating is often done in secret- making it difficult to diagnose
  100. Criteria for diagnosing bulimia
    • a binge-purge cycle lasting more than 3 months
    • someone is binging and purging at least 2 times per week
  101. Bulimia cycle
    • Starts with rigorous dieting: maybe they are unhappy with their weight or they are trying to handle depression or low self esteem
    • this leads to stress and cravings
    • because of their compulsive tendencies, the stress and cravings lead to binge eatings: they may consume ~3000 calories in one sitting
    • they feel good for a short period of time, but guilt then sets in, leading them to purge
    • the purge leads to more shame and guilt and disgust with themselves, which then leads them to try rigorous dieting again

    excessive exercise can also be a part of this cycle
  102. Physical Effects of Bulimia
    • Brain: depression and anxiety
    • Eyes: broken blood vessels in eyes and face
    • Mouth: Cavities and gum disease, demineralization of the teeth related to erosion from stomach acid, swollen salivary glands
    • Skin: cold and dry, burns on knuckles from vomitting
    • Heart: irregular heart beat and low bp
    • Blood: Anemia
    • Stomach/Esophogus: Ulcers, constant reflux (a change in the acid base balance from vomiting
    • Intestines: Diarrhea (laxative abuse)
    • Body Fluids: Low K, Mg and Na
    • Hormones: Irregular or absent periods
  103. Bulimia treatment
    • As with anorexics- use a team approach
    • first goal: address the binging and decrease the amount of food consumed in a sitting
    • Decreasing the quantitity consumed will decrease purging allowing teeth and esophagus to heal
  104. Psychological Bulimia treatment
    • cognitive behavior therapy is used to help the patient improve their self-esteem and decrease the concern with body weight
    • teach them to cope with stressful situations, controlling impulsive behavior and relearning normal patterns with eating
    • sometimes medication is prescribed for success
  105. Other disorders of eating
    • some individuals suffer from abnormal eating patterns that do not meet the criteria for anorexia nervosa or bulimia
    • these are just classified as general eating disorders or not otherwise specified disorders
    • these include binge eating, night eating and female athlete triad
  106. Binge eating disorder and main characteristic
    • similar to bulimia
    • characterized by binge-eating episodes but no purging
    • first diagnosed in 1994, and a growing problem today
    • more people have this than anorexia or bulemia
    • body image here is not as crucial as in anorexia/bulemia. 
    • Obesity may occur with excess intake but not all binge eaters are overweight
  107. What to look for in binge eating for diagnosis
    • lack of control of whats eaten and how much
    • eating rapidly until feeling uncomfortable
    • eating alone (due to embarrassment)
    • depression/guilt after overeating
    • Compulsive overeating at least two times per week for at least 6 months
  108. How many people have binge eating? and how does it happen
    • ppl at normal or slightly above weight, but early in life they attempted to start diet (commercial weight loss programs) without success and turn to binging
    •  4million diagnosed, but there are many more that suffer and arent diagnosed
    • like other eating disorders, food is just a coping mechanism
    • some come from family/social situations where they cant deal with stress/emotions and binge eating empowers them, but after the euphoria of binge eating subsides, the person deals with guilt, embarrassment and shame
  109. Binge eating disorder treatment
    • like other disorders, professional help recommended
    • key is to help them identify personal needs and express emotions
    • use behavior modification techniques to teach them to relearn hunger cues and normalize eating patterns
    • self help groups and medications may also help
  110. Night eating syndrome
    • occurs in a much smaller proportion of the population
    • 9% of ppl treated in obesity programs have it
    • key sign: at least one third of your calories are consumed after the evening meal
    • the person wakes up at least once during the night and needs to eat before falling back asleep
    • often a lack of hunger in the morning and circadian rhythem out of sync
    • person often has depression
  111. Night eating syndrome treatment
    antidepressents can be beneficial
  112. Female Athlete Triad
    • disordered eating, lack of period, and osteoporosis related to inadequate calcium and VitD intake
    • affects females participating in appearance based or endurance sports such as gymnasts, ballerinas or cross country runners
  113. Female Athlete Triad Treatment
    • gradually increase caloric intake to achieve a normal weight 
    • reduce the preoccupation with food
    • training intensity should be decreased and a normal menstrual cycle should be established.
  114. Undernutrition
    • Results from the lack of adequate food over a period of time to meet one's nutrient needs
    • the most common form of malnutrition among the poor in both developed and underdeveloped countries
    • can lead to numerous deficiency diseases and has a negative impact on the physical and cognitive development of young kids
  115. Food insecurity
    • Although adequate food is grown and harvested to meet the needs of people throughout the world, millions are unable to get enough food for everyone in the family or the quality and variety of the diet are inadequate to meet nutrient needs resulting in malnutrition
    • there might be adequate food but the people dont get it or the nutrient
    • can be a result of poverty, politics or famine
  116. Hunger
    • a painful sensation caused by lack of food
    • most people in developed nations rarely experience true hunger
    • for the less fortunate, hunger can have bad physical consequences
  117. What happens in hunger
    • lack of energy is an initial reaction to inadequate food intake
    • as our food intake declines blood sugar falls
    • brain uses glucose as its primary energy source- without the glucose there is an impaired ability to learn and concentrate
    • when glucose is low there is increased susceptibitily to disease and delayed healing
    • eventually BMR drops, extreme lethargy sets in and you break down muscle to survive
  118. Causes of hunger
    primary cause: poverty in the US in other countries
  119. Subpopulations with increased risk of malnutrition in the USA
    • working poor: they may or may not qualify for food assistance. maybe are working but at a minimal wage job so no assistance
    • living in a food desert: no grocery stores near by, they shop at convenience stores with energy dense foods that aren't nutritious
    • isolated individuals: alcoholics, mentally ill, drug addicts who lack access to food resources
    • homeless: related to limited income and lack of cooking facilities
    • elderly: due to economic difficulties, physical limitations and social isolation
    • children: related to family circumstances, things out of their control
  120. Government funded programs to aid those with limited access to food
    • SNAP: Supplemental Nutrition Assistance Program
    • WIC: Woman, Infant and Children Program
    • CACFP: Child and Adult Care Feeding Program
    • NSLP: National School Lunch Program
  121. SNAP Program
    • Supplemental Nutrition Assisstance Program
    • formerly known as the food stamp program
    • provides access cards to individuals who qualify to extend their food purchasing power
    • they can take the card to grocery stores or even farmers markets
  122. Programs established for children and Seniors
    • Child and Adult Care Feeding Program
    • School Lunch Program (also includes school breakfast program)

    • Both of these established by congress
    • Both provide nutritious meals in congregate settings to help meet 1/3 to 1/2 an individuals daily nutrient needs

    Also, many churches and social organizations run food pantries and soup kitchens for the homeless or anyone in need

    still, no easy fix to the longterm consequences that result from hunger, esp in kids
  123. WIC
    • Women, Infant and Children program
    • for pregnant and lactating women and children up to 5
    • based on income eligibility as well as specific nutritional need
    • provides vouchers that can be taken to grocery stores and farmers markets to buy specific foods pre approved for the program
  124. CACFP
    Child and Adult Care Feeding Program
  125. What factors contribute to undernutrition in the developing world
    • poverty also tied to undernutrition, but there are also many other factors
    • population growth
    • depletion of farmland and water
    • war and political unrest
    • inadequate shelter and sanitation
    • natural disasters
  126. Population growth relating to undernutrition and poverty
    • pop growth can lead to food shortage
    • much of the growth we are seeing now is occurring in the poorest nations in asia, subsaharra africa, and the pacific rim
    • economists estimate we currently have enough food to feed the world, but disparities exist between developed and developing countries, between the rich and poor in one country, and also food distribution in families
    • in some countries the males eat first and females and children gets whats left
    • in some countries the food gets to the country but not to the people
    • currently, its not so much a food shortage but an inequality in food distribution, but if pop grows more at this ace, production may even fall below need
  127. Depletion of farmland and water relating to undernutrition and poverty
    • agriculture production is at its peak in many countries
    • excess demand and poor farming practices and shrinking resources has a negative effect on food production
  128. War and political unrest relating to undernutrition and poverty
    • many areas (africa, republic of congo, ethiopia) are involved in military conflict
    • war leads to increase in poverty, disruption in health care, lack of safe water, shelter and food
    • even when food is available it may not be distributed to the needy due to lack of infrastructure or politics
  129. Inadequate shelter/sanitationrelating to undernutrition and poverty
    • developing countries- impoverished often reside in ghettos and shantytowns
    • result is lack of safe and convenient water, lack of facilities to keep food safe from spoiling, rotting garbage, infestation of insects/rodents, and poor health care
    • children, elderly and immunocompromised are likely to succumb to illness or diarrheal disease
    • WHO estimates 1.1 billion people have unsafe and inadequate water supply
    • 2 billion ppl lack proper sanitation facilities
  130. Natural Disasters relating to undernutrition and poverty
    • Droughts
    • Mudslides
    • Tsunamis
    • Earthquakes
    • Hurricanes
    • all have negative impact through destruction of homes, resources and infrastructure
  131. Reducing undernutrition in developing countries
    • no easy solution
    • more affluent countries provide food and aid, but this is not always in the best interest of the peopl
    • affected countries need to become independent and learn to use their natural resources
    • World food Bank working to implement 3 approaches to counter undernutrition
  132. 3 Approaches by world food bank to counter undernutritions
    • 1. they want countries to increase the diversity of the food supply (a country may be known for a particular food- increase more)
    • 2. fortify food with nutrients
    • 3. Provide nutrient supplementation
  133. Peace Corps
    • working with people in developing nations by providing education, distributing food and supplies, and building structures in order to improve the country's independence
    • education of family planning, techology for production and processing of food, supplementation of food crops, owning land, and water purification can all lead to an independent productive society
  134. Primary causes of malnutrition
    • insufficient food
    • inadequate health care (esp for kids and women)
    • unhealthy living conditions

    • together these lead to poor dietary intake and disease
    • in order to conquer malnutrition, countries must work together to solve these issues and improve their independence and ability to use their own resources
Card Set
Nutrition Module 5
Exam 5