NR 228 NUTRITION, HEALTH AND WELLNESS WK 1-4 CONCEPT REVIEW

NR 228 NUTRITION, HEALTH AND WELLNESS WK 1-4 CONCEPT REVIEW Units 1-4 Concept Review Concepts: 1. Discuss the role that nutrition plays in health promotion. • Promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights. • Consume a variety of nutrient-dense foods within and across the food groups, especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk products, and lean meats and other protein sources. • Limit the intake of saturated and trans fats, cholesterol, added sugars, sodium (salt), and alcohol. • Limit caloric intake to meet caloric needs. 2. Discuss the dietary implications and examples of primary, secondary, and tertiary prevention. • Primary: prevention. Low fat, high fiber (plant based) diet. • Secondary: screening. Reducing certain nutrients, such as sodium. • Tertiary: already have the disease trying to treat it. Diets should match the disease the Pt has. 3. Explain what health literacy means and how it relates to health promotion. • The ability to acquire and comprehend basic health concepts such as nutrition and apply them to one’s own health decisions. • Cultural, social, and individual factors 4. Describe the six known essential nutrients • Carbs: glucose • Proteins: Amino acids: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine • Lipids (Fats): Linoleic acid, linolenic acid • Minerals: Major minerals: calcium, phosphorus, sodium, potassium, sulfur, chlorine, magnesium. Trace minerals: chromium, cobalt, copper, fluorine, iodine, iron, manganese, selenium, zinc 5. Explain the difference between essential and non-essential nutrients. • Essential: we have to get from foods • Non-essential: our body makes on its own 6. Identify the kilocalorie per gram for the following and be able to calculate the kcal in food: • Proteins: 4 • Carbohydrates: 4 • Fats: 9 • Alcohol: 7 7. Explain Dietary Reference Intakes (DRI’s) and explain why they are used. • Planning meals for large groups, such as the military • Creating dietary standards for governmental food assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) • Interpreting food consumption information on individuals and populations 8. Define the following: • EAR: the amount of a nutrient needed to meet the basic requirements of half the individuals in a specific group; the basis for setting the RDAs • RDA: the level of nutrient intake sufficient to meet the needs of almost all healthy individuals of a life stage and gender group • AI: the approximate level of an average nutrient intake, determined by observation of or experimentation with a particular group or population that appears to maintain good health • UL: the level of nutrient intake that should not be exceeded to prevent adverse health risks (an example of this is Vit D) • AMDRs: intake range for an energy source associated with reducing chronic disease risk while supplying adequate essential nutrients 9. Differentiate between the terms undernutrition and malnutrition. • Undernutrition is the consumption of not enough energy or nutrients in comparison with DRI values. This means either not eating enough food to take in all the essential nutrients or eating enough food for energy but choosing foods that lack certain nutrients • Malnutrition is a condition resulting from an imbalanced nutrient and/or energy intake. Malnutrition is both undernutrition and overnutrition—consumption of too few nutrients or too low an energy intake and excess nutrient or energy consumption. 10. Apply the concepts of self-efficacy and locus of control to positive nutrition lifestyle. • Self-efficacy is our perception of our ability to have power over our lives and behaviors. Positive self-efficacy means believing that personal behaviors can be changed and one has control over one's life. Negative self-efficacy refers to feeling as if one is powerless, with little control over circumstances. A sense of positive self-efficacy is essential to attaining and then maintaining nutrition lifestyles for optimum heajk=V85 09 • lth. These strategies may be applicable in our own life situations and are useful for our clients as they, too, strive for enhanced self-efficacy. • Locus of control is the perception of one's ability to control life events and experiences. Having an internal locus of control means feeling as if you can influence the forces with which you come into contact. You have an inner sense of your ability to guide life events. An external locus of control is defined as the perception that you are not able to control what happens to you and that outside forces have power over what you experience. 11. What is “MyPlate”? Know the plans for school age children and adults, including portion sizes 12. Apply the concepts of variety, proportionality, moderation, and activity to food intake. • Variety: Eat foods from all food groups and subgroups. • Proportionality: Eat more of some foods (fruits, vegetables, whole grains, fat-free or low-fat milk products) and less of others (foods high in saturated or trans fats, added sugars, cholesterol, salt, and alcohol). • Moderation: Choose types of foods that limit intake of saturated or trans fats, added sugars, cholesterol, salt, and alcohol. • Activity: Be physically active every day. 13. Identify nutrients that Americans eat too few of and too much of. • The American public consumes insufficient amounts of certain nutrients, such as vitamin D, calcium, potassium, and dietary fiber, but an excess of solid fats and added sugars (SoFAS), refined grains, sodium, and saturated fat. This combination has resulted in an excessive energy intake that has led to a majority of Americans' being overweight or obese 14. Recognize general dietary implications of Mediterranean, Latin American, and African Diet Pyramids. • Look at Chp. 2 pg. 23 15. Apply nutrition concepts to Nutrition Facts labels and interpret the information given on food labels. 16. Understand the goals of Healthy People 2020. • Reduce chronic diseases and maintain healthy body weight • Eat a wide good group (healthy) • Limit fats, cholesterol, sugars, sodium, and alcohol • Limit calorie intake 17. Apply food descriptor labels to food choices. • Free- Contains only a tiny or insignificant amount of fat, cholesterol, sodium, sugar, and/or calories. For example, a “fat-free” product contains less than 0.5 g of fat per serving. • Low- “Low” in fat, saturated fat, cholesterol, sodium, and/or calories; can be eaten fairly often without exceeding dietary guidelines. So, “low in fat” means no more than 3 g of fat per serving. • Lean- Contains less than 10 g of fat, 4 g of saturated fat, and 95 mg of cholesterol per serving. “Lean” is not as lean as “low.” “Lean” and “extra lean” are US Department of Agriculture terms for use on meat and poultry products. • Extra Lean- Contains less than 5 g of fat, 2 g of saturated fat, and 95 mg of cholesterol per serving. Although “extra lean” is leaner than “lean,” it is still not as lean as “low.” • Reduced, Less, Fewer- Contains 25% less of a nutrient or calories. For example, hot dogs might be labeled “25% less fat than our regular hot dogs.” • Light/Lite- Contains one third fewer calories or one half the fat of the original. “Light in sodium” means a product with one half the usual sodium. • More- Contains at least 10% more of the daily value of a vitamin, mineral, or fiber than the usual single serving. • Good Source of - Contains 10% to 19% of the daily value for a particular vitamin, mineral, or fiber in a single serving. 18. Describe the functions of the organs, hormones, and enzymes involved in digestion, absorption, metabolism, and elimination. 19. Define carbohydrate. • Carbohydrates are a convenient and economical source of calories for people throughout the world. Carbohydrates are organic compounds composed of carbon, hydrogen, and oxygen. These compounds consist of simple carbohydrates, such as glucose and sucrose, and complex carbohydrates, which include starch and dietary fiber. Each type of carbohydrate serves a distinct role in nourishing the body. • In addition to serving as an energy source, some carbohydrates are also used as sweetening agents. When carbohydrate sweeteners are found naturally in foods, such as in fruits, they are accompanied by essential nutrients. The sweetness makes eating nutrient-dense foods even more enjoyable. Some carbohydrates also supply dietary fiber. 20. Explain the function of carbohydrates as a nutrient in the body. • Increased levels of complex carbohydrates, particularly dietary fiber, appear to reduce the risk factors associated with chronic diet-related disorders such as heart disease, diabetes, and some cancers. 21. What is the Dietary Reference Intake (DRI) and AMDR for carbohydrates? • The Dietary Reference Intake (DRI) for carbohydrates is 130 g/day for adults between 19 and 30 years of age. The Acceptable Macronutrient Distribution Range (AMDR) for carbohydrates is 45% to 65% of kcal intake per day as primarily complex carbohydrates 22. What are the recommended average daily servings for carbohydrates: be familiar with examples of grains and portion sizes. • 6 ounces of grains (bread, cereal, rice, and pasta), with at least half being whole grains, provide adequate amounts of complex carbohydrates. In general, 1 slice of bread, 1 cup of ready-to-eat cereal, or cup of cooked rice, cooked pasta, or cooked cereal can be considered a 1-ounce equivalent from the Grains Group. 23. What are refined grains and what does the term “enriched” mean? • Most refined grains are enriched. This means that certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing. Fiber is not added back to enriched grains. Check the ingredient list on refined grain products to make sure that the word “enriched” is included in the grain name. Some food products are made from mixtures of whole grains and refined grains. 24. How much of grain consumption should be whole grains? • You should make at least half of your grains whole grains 25. What enzymes are require to metabolize disaccharides? • Enzymes specific for disaccharides (lactase for lactose, sucrase for sucrose, maltase for maltose) are secreted by the small intestine's brush-border cells, which then hydrolyze disaccharides into monosaccharides. 26. Lactase deficiency is common in what ethnic groups? What symptoms will the patient who has this experience? What are the dietary implications? • The condition is common among Asian/Pacific Islanders (Asian Americans), Africans (African Americans), Hispanics (Hispanic Americans), Latinos, and Native Americans. • Symptoms: When the lactose sits in the large intestine, bacteria begin to ferment the undigested lactose, causing diarrhea, bloating, and increased gas formation. • Depending on the severity of the sensitivity, advice to clients may include additional label reading for lactose-containing foods and medications, especially for clients dealing with conditions such as irritable bowel syndrome. Can tolerate 6-9g of lactose at a time. (Cheese and yogurt are tolerated better) 27. In what form does the liver and muscles store glucose? • Glycogen is carbohydrate energy stored in the liver and in muscles. The amount held in the muscles of an adult is 150 g (600 kcal); 90 g (360 kcal) are stored in the liver. Retrieved as needed for energy, glycogen is quickly broken down by enzymes to produce a surge of energy. The process of converting glucose to glycogen is glycogenesis. 28. What is a normal blood glucose range? • 70-100 29. What gland produces insulin and glucagon and what is their role in the control of blood glucose level? • Insulin, a hormone produced by the beta cells of the islets of Langerhans, lowers blood glucose levels by enhancing the conversion of excess glucose to glycogen through glycogenesis or to fat stored in adipose tissue. Insulin also eases the absorption of glucose into the cells so the use of glucose as energy is increased. • The pancreas produces two hormones with this function: glucagon and somatostatin. • Glucagon stimulates conversion of liver glycogen to glucose, assisting the regulation of glucose levels during the night; somatostatin, secreted from the hypothalamus and pancreas, inhibits the functions of insulin and glucagon. 30. What are the health concerns related to sugar consumption? • The health concerns regarding sugar consumption include nutrient displacement, dental caries, and the related issues of obesity and diabetes. 31. Explain the difference between nutritive and non-nutritive sweeteners. What happens when large amounts of sugar alcohols such as sorbitol are consumed? • Sugar in our food supply may include the following nutritive sweeteners: refined white sugar, brown sugar, dextrose, crystalline fructose, high-fructose corn syrup (HFCS), glucose, corn sweeteners, lactose, concentrated fruit juice, honey, maple syrup, molasses, agave nectar, and reduced energy polyols or sugar alcohols (e.g., sorbitol, mannitol, xylitol) • Alternative sweeteners are non-nutritive substances produced to be sweet-tasting; however, they provide no nutrients and few, if any, kcal. • Some people may experience a laxative effect from a load of sorbitol ≥ 50 g 32. Which non-nutritive sweetener should people with PKU not consume and why? • Should not consume aspartame because their bodies cannot break down excess phenylalanine, resulting in a buildup that causes medical problems. All products containing aspartame have a warning label to alert individuals with PKU. This warning should apply to pregnant women as well. Because the fetus would be exposed to excess phenylalanine before the presence of PKU could be determined, the safest approach is to restrict consumption of aspartame during pregnancy. 33. Apply principles of the glycemic index to dietary choices. • Glycemic index is the ranking of foods according to the level to which a food raises blood glucose levels compared with a reference food such as a 50-g glucose load or white bread containing 50 g carbohydrate. A ranking of 100 is the highest glycemic index level—that is, it raises blood glucose levels the highest. Note the glycemic index rankings of commonly consumed foods listed. 34. Explain the health effects of dietary fiber. Recognize foods high in fiber. • Dietary fiber consists of substances in plant foods, including carbohydrates and lignin, that for the most part cannot be digested by humans. We do not produce 65digestive juices strong enough to break down the bonds that hold the simple carbohydrates of most plant fibers, so fiber “passes through” our bodies without providing kcal or nutrients. Its texture provides bulk that thickens chyme and eases the work of the GI muscles that regulate movement of the food mass • Foods high in fiber: Baked beans, bran cereals, kidney beans, lentils, navy beans, whole-wheat spaghetti 35. Define lipids and describe the three classifications of lipids. • Lipids are divided into three classifications: fats (or triglycerides), and the fat-related substances phospholipids and sterols. Triglycerides, the largest class of lipids, may be in the form of fats (somewhat solid) or oils (liquids). Approximately 95% of the lipids in foods and in our bodies, are in the triglyceride form of fat. Of the other two lipid classifications, lecithin is the best-known phospholipid, and cholesterol is the best-known sterol. All are organic—composed of carbon, hydrogen, and oxygen—and cannot dissolve in water. 36. What are five food functions of fats? • Source of Energy- Fat is the densest form of stored energy in food and our bodies. This means that gram for gram, food fat — in the form of triglycerides—can produce more than twice the energy in kcal that carbohydrate or protein can. For example, a gram of nearly pure fat (9 kcal), such as butter, provides more than twice the kcal provided by a gram of nearly pure carbohydrate (4 kcal), such as sugar, or a gram of nearly pure protein (4 kcal), such as dried, lean fish. • Palatability- Fat makes food smell and taste good. Deep-fat fried potatoes outrank all other vegetable choices among North Americans. Whether it's bread with butter (or margarine), salad with dressing, or desserts with cream, fat makes foods taste pleasant for many people. For patients who are anorexic because of illness, strategically adding small amounts of fats to meals may increase nutrient intake. • Satiety and Satiation- Fat helps prevent hunger between meals. Fat slows down digestion because of the hormones released in response to its presence in the gastrointestinal (GI) tract, causing us to feel full and satisfied; we call this feeling satiety. Satiation is another, different aspect of fat consumption that occurs during, not after, eating. In contrast to satiety, satiation tends to increase our desire to eat more fatty food, not less. The effect of fat on satiation is likely to be more important than its effect on satiety and may lead to overeating. A satiation that often occurs with the last slice of pizza provides a good example: You want it, you eat it, and half an hour later, you feel too full. • Food Processing- Certain qualities of lipids, besides their nutritional purposes, make them a valuable resource for the processing of foods. The use of processed hydrogenated fats helps keep the fat in food products from turning rancid. Lecithin, a phospholipid, has an extensive role as an emulsifier—a substance that works by being soluble in water and fat at the same time. These functions, which are described in more detail, also increase our overall intake of lipids by allowing their use in numerous processed foods. • Nutrient Source- Some fats contain or transport the fat-soluble nutrients of vitamins A, D, E, and K and the EFAs of linoleic and linolenic fatty acids. These essential fatty acids (EFAs), components of fat triglycerides, are polyunsaturated fatty acids (PUFAs) that cannot be made in the body and must be consumed in the diet. EFAs are necessary materials for making compounds, such as prostaglandins, that regulate many body functions, including blood pressure, blood clotting through platelet aggregation, gastric acid secretions, and muscle secretions. The overall strength of cell membranes depends on EFAs. o Overt symptoms of EFA deficiency include skin lesions and scaliness (eczema) caused by increased permeability, which leads to membrane breakdown throughout the body (Figure 5-1). Inflammation of epithelial tissue and increased susceptibility to infections throughout the body are also possible. Because the minimum amount of EFA required is contained in only about 2 teaspoons of polyunsaturated vegetable oil, deficiencies of EFAs were thought to be rare. However, deficiencies have been noted in (1) older patients with peripheral vascular disease (a potential complication of diabetes mellitus), (2) patients with fat malabsorption, such as cystic fibrosis, and (3) patients receiving treatment for protein malnutrition with low-fat, high-protein diets. Individuals recovering from serious accidents and burns are also at risk. It is possible that individuals who strive to achieve extremely low dietary fat intake for perceived health reasons or from disordered eating could experience EFA deficiencies 37. What are four physiologic functions of fats? • Stored Energy- Body fat cells contain nearly pure fat, also in the form of triglycerides. This means that a pound of adipose tissue, the storage depot of body fat, could produce about 3500 kcal as energy. Because glucose stored in our bodies as glycogen is stored with water, carbohydrate is a bulkier form of stored energy than body fat. Adipose tissue provides important fuel during illness or times of food restriction and is a major energy source for muscle work. • Organ Protection- Stored fat safely cushions and protects body organs during bumpy activities, such as participating in impact aerobics and snowboarding. • Temperature Regulation- The fat layer just under our skin serves as insulation to regulate body temperature by minimizing the loss of heat. • Insulation- A substance composed largely of fatty tissue, called myelin, covers nerve cells. This covering provides electrical insulation that allows for transmission of nerve impulses. 38. What is the function of phospholipids and sterols and give examples of each. • Phospholipids: Lecithin—carries fat and cholesterol away from plaque deposits in the arteries. o Found in egg yolks, mayo, and cakes • Sterol: provide basic material to make bile, vitamin D, sex hormones, and cells in brain and nerve tissue o The only food sources of cholesterol are animal and include beef, pork (bacon), chicken, luncheon meats, eggs, fish, and dairy products (milk, butter, and cheeses); plant foods do not contain cholesterol. 39. Explain the difference between saturated and unsaturated fats and give examples of each. • A saturated fatty acid has a single-bonded carbon chain that is fully saturated because hydrogen atoms are attached to all available bonding sites. Palmitic acid (16 carbon atoms) (Figure 5-5A), a saturated fatty acid, is contained in meats, butterfat, shortening, and vegetable oils. Other saturated fatty acids are stearic acid (18 carbon atoms), myristic acid (14 carbon atoms), and lauric acid (12 carbon atoms). Additional food sources of saturated fatty acids are primarily animal, including beef, poultry, pork, lamb, luncheon meats, egg yolks, and dairy products (milk, butter, and cheeses); the only major plant sources are palm and coconut oils (often called tropical oils) and cocoa butter. • Unsaturated fatty acid has one or more unsaturated double bonds along the carbon chain. If a carbon chain has only one unsaturated double bond, it is a monounsaturated fatty acid (MUFA), Oleic acid is the main MUFA in foods. Dietary sources include olive oil, peanuts (peanut butter and peanut oil), and canola oil. • If a carbon chain has two or more unsaturated double bonds, it is a polyunsaturated fatty acid (PUFA). Food sources include vegetable oils (corn, safflower, wheat germ, canola, sesame, and sunflower), fish, and margarine 40. What are essential and nonessential fats? 41. Explain how fats are absorbed and metabolized by the body. 42. Know normal cholesterol, LDL, and HDL levels. • Cholesterol: 200 • LDL (bad): 100 • HDL (good): 40 • Triglycerides: 150 43. How many daily grams of fat are recommended for a person with a 2000 calorie daily diet? How is this calculated? • 0.25*2000= 500/9 which = 55g of fat • Multiply that number of kcal by 0.25 for 25% fat intake or by 0.30 for 30% fat intake. • Divide that number by 9, because each gram of fat has 9 kcal. 44. Recognize healthy and unhealthy dietary sources of fats and healthy portion sizes. 45. Describe nitrogen balance, catabolism, and anabolism. • Nitrogen balance: used to determine the protein requirements of the body throughout the life cycle and to assign value to the protein quality of foods to determine their biologic value. • Catabolism is the breakdown of food components into smaller molecular particles, which causes the release of energy as heat and chemical energy. (Glucocorticoids that are enhanced by adrenocorticotropic hormone (ACTH)) • Anabolism is the process of synthesis from which substances are formed, such as new bone or muscle tissue. (Pituitary gland and testosterone) 46. Know the functions of proteins in the body. • Growth and maintenance • Creation of communicators and catalysts • Immune system response • Fluid and electrolyte regulation • Acid-base balance • Transportation 47. Know the enzymes involved in protein digestion. 48. Recognize foods that are high-quality, complete proteins and those that are incomplete. Explain complementary proteins and apply to food sources. • High quality—eggs and human milk • Complete—fish, meat, eggs, tofu, cheese, milk, ice cream, yogurt • Incomplete—cereals, oatmeal, grains (rice, corn, barley, pasta, bread, wheat), legumes (peas, beans, lentils, peanut butter, broccoli, potatoes, leafy green veggies • Complementary— o (Grains + legumes) peanut butter sandwich, tacos with refried beans, rice and beans, split pea soup with croutons, falafel (chickpea balls) on pita bread, lentil soup with rye bread, baked beans with bread, o Grains or legumes + Animal Protein) chili with beans and cornbread, ready-to-eat cereal with skim milk, cheese sandwich, pasta with cheese, rice pudding, French toast, pancakes (made with milk and/or eggs), and tuna casserole 49. Recognize risk factors for malnutrition. • Pregnancy, lactation, infections, chronic diarrhea, toxins, lack of food, child abuse/neglect, eating disorders, drug abuse, social isolation, alcoholism, wars, poverty, socioeconomic status, polluted water, famine, improper farming techniques 50. Describe the difference between primary and secondary vitamin deficiency. • A primary deficiency of a vitamin occurs when the vitamin is not consumed in sufficient amounts to meet physiologic needs. • A secondary deficiency develops when absorption is impaired or excess excretion occurs, limiting bioavailability 52. Discuss the subgroups of Americans who are at risk for vitamin deficiencies. 1. List two distinguishing characteristics of water-soluble and fat-soluble vitamins. 2. Water Soluble Vitamins: Function and food sources Water soluble Major Actions Major Sources Deficiency Vit C Antioxidant, coenzyme, collagen formation, wound healing, iron absorption, hormone synthesis Citrus fruits and juices, and veggies Orange juice, tomatoes Scurcy, decreased iron absorption, bleeding gums Thiamin (B1) Coenzyme energy metabolism; muscle nerve action Meats, grains, legumes Beriberi, headache, weight loss, fatigue Riboflavin (B2) Coenzyme energy metabolism Milk, meats, dark leafy veggies Skin eruptions, cracked lips, red swollen tongue Niacin (B3) Energy metabolism, and glycolysis and tricarboxylic acid (TCA) cycle synthesis Liver, nuts, legumes Pellagra, skin lesions, GI and CNS findings, dementia Pantothenic acid Carb, fat, and protein metabolism Meats, whole grain cereals, dries peas and beans Rare Generalized body system failure Pyridoxine (B6) Cellular function, heme and neurotransmitter synthesis Meats, grains, and legumes Macrocytic anemia, CNS disturbances, poor growth Folate Synthesis of amino acids and hemoglobin, formation or fetal neural tube Liver, green leafy veggies, legumes Megaloblastic anemia, CNS disturbances Cobalamin (B12) Folate activation, RBC maturation, metabolism of fatty acids/amino acids Meats, clams, oysters, eggs, dairy products Pernicious anemia, GI findings, poor muscle coordination, paresthesia of hands/feet Biotin Metabolism of carbohydrate, fat, and protein Liver, kidney, peanut butter, egg yolks, and yeast. Scaly red rash, hair loss, loss of appetite, depression, and glossitis 3. Fat Soluble Vitamins: Function and food sources Fat soluble Major actions Major sources Deficiency A Normal vision, tissue strength, growth and immune system function Orange/yellow fruits and veggies, fatty fish, dairy Apricots, carrots, leafy green veggies Reduced night vision, dry/think corneas, mucosa changes D Maintain serum calcium/phosphorus, aid in bone development Fish, fortifies dairy products, egg yolks, sunlight Low serum calcium, fragile bones, rickets, osteomalcia in adults E Protects vitamin A from oxidation Vegetable oils, grains, nuts, dark green veggies Anemia, edema and skin lesions in infants K Essential for prothrombin synthesis, aids in bone metabolism Green leafy veggies, eggs Increased bleeding times 4. Identify the functions of water in the body. • Provides shape and rigidity to cells • Helps regulate body temperature • Acts as a lubricant • Cushions body tissues • Transports nutrients and waste products • Acts as a solvent • Provides a source of trace minerals • Participates in chemical reactions 5. Describe fluid volume deficit (FVD) and fluid volume excess (FVE): Persons at risk, assessment findings, dietary implications • Look at F&E handout 6. List three factors that may affect the bioavailability of minerals/electrolytes. • Binders • Soil content • Food processing, also affected by presence of fiber 7. Know normal serum values for: • Sodium: 135-145 • Potassium: 3.5-5.0 • Magnesium: 1.5-2.5 • Calcium: 8.4-10.5 • Phosphorus: 2.7-4.5 • Chloride: 98-106 • Hemoglobin: 14-18 males, 12-16 females • Hematocrit: 42-52% males, 37-47% females 8. Know factors involved in, persons at risk for alterations in, symptoms of, recommended daily intake, food sources of: • Sodium— mg/day o Table salt; natural in many foods; processed foods • Potassium—4700 mg/day o Unprocessed foods, fruits, vegetables, dairy products, meats, legumes • Calcium— mg/day o Milk (whole, low-fat, skim), milk-based products, green leafy vegetables legumes • Look at F&E handout 9. How are blood calcium levels regulated? • If calcium blood levels get too low: bones release calcium, intestines absorb more calcium, and kidneys retain more calcium • Parathormone is secreted by the parathyroid gland in response to low blood calcium levels. It raises blood calcium levels by stimulating all three ways of providing calcium to body fluids. • Vitamin D has a hormone-like effect as calcitriol and increases blood calcium levels by acting on all three systems. • Calcitonin reacts in response to high blood levels of calcium by lowering both calcium and phosphate in the blood. 10. List several nondairy sources of calcium. • Nondairy sources include green leafy vegetables (broccoli, kale, and mustard greens), small fish with bones (sardines and salmon canned with processed edible bones), legumes, and tofu processed with calcium. 11. List three risk factors for osteoporosis. • Calcium deficiency, white or Asian women, menopause, family history, organ transplantation, alcohol, smoking, caffeine, and sedentary lifestyle 12. How much iron is usually absorbed from food? • Only about 10% to 15% of dietary iron consumed is absorbed; this amount increases up to 20% if body levels are deficient. 13. Recognize foods high in iron. • Heme iron, found in animal sources of meat, fish, and poultry, is more easily absorbed than nonheme iron found in plant foods. • Animal sources of iron also contain nonheme iron in addition to heme iron. Although egg yolks contain iron, the iron in them is not absorbed as well as other heme from other sources. • Nonheme iron plant sources include vegetables, legumes, dried fruits, whole-grain cereals, and enriched grain products, especially iron-fortified dry cereals. 14. What enhances and interferes with the absorption of iron? • Enhances—dietary sources consumed with foods containing vit C (orange juice, cantaloupe) or to cook in cast-iron skillets • Interferes—consumption of foods that contain binders (phytates and oxalates) and tannins (teas and coffee), and antacids. 15. What are food sources of iodine? • Iodized salt, seafood 16. What organ is affected by iodine deficiency? • The thyroid 17. Describe the processes involved in anaerobic and aerobic energy pathways. • For the first minute or two of exertion, oxygen has not arrived at the muscles, and therefore energy must come from anaerobic sources. • After several minutes the aerobic pathway takes over. • However, as the exertion or exercise continues, there is a constant interchange or use of energy sources. The energy source that muscles use during exercise depends on the intensity and length of exercise, the person's fitness level, and the foods eaten. • Short-term, high-intensity activities such as sprinting rely mostly on the anaerobic pathway for energy, and only carbohydrates (primarily from muscle glycogen) can be used. • On the other hand, exercise of low to moderate intensity is supported primarily by the aerobic system, and both carbohydrates and fats are used. • Fats are an important energy source during exercise because, unlike carbohydrates, fatty acids are abundant in the body and their use spares muscle glycogen. 18. Recognize the three factors for estimating daily energy allowances. • Level of activity • Activity factor • Energy expenditure 19. Understand the relative impact of basal metabolic rate, physical activity and thermic effect of food on total energy expenditure. (Pg 164) • BMR: largest contributor to energy expenditure • Physical activity: second largest to energy expenditure • Thermic effect: 20. Calculate BMI for individuals when given weight in pounds and height in inches. • Weight (kg)/ Height (m²) • Weight (lb)/ Height (in²) × 703 Protein requirements for athletes: 1.5-2 g/kg Carbs: 45-65% Fat: 20-35% Protein: 10-35% Hip-to-waist ratio (0.95 to 10 in men; ≤0.8 in women) Waist circumference (40 inches in men; 35 inches in women) Essential body fat: 3-8% males, 12-14% females Water intake: 13 cups males, 9 cups females