Inhoud
Hoofdstuk 1: relatie tussen voeding en gezondheid ............................................................................... 7
Nutritionele situatie → gezondheidsconsequenties ........................................................................... 7
Optimale voeding ............................................................................................................................ 7
Ondervoeding .................................................................................................................................. 7
Overvoeding .................................................................................................................................... 7
Malnutritie....................................................................................................................................... 8
Grafieken ............................................................................................................................................. 8
Doden .............................................................................................................................................. 8
Risicofactoren .................................................................................................................................. 8
Link tussen dieet en gezondheidsuitkomsten ..................................................................................... 8
Intermediaire biologische mechanismen → risico op cardiovasculaire aandoeningen ................. 9
Chronisch tekort aan vitamine A (insufficiëntie) ............................................................................. 9
Reactievermogen op voedingsgebied ............................................................................................. 9
Grafiek ........................................................................................................................................... 10
Onderliggende drijfveren van verbeterde nutritionele status ...................................................... 10
Hoofdstuk 2: lichaamssamenstelling ..................................................................................................... 12
Niveaus .............................................................................................................................................. 12
Modellen ........................................................................................................................................... 12
Twee compartimenten model ....................................................................................................... 12
Drie compartimenten model ......................................................................................................... 12
Bepalen van lichaamssamenstelling.................................................................................................. 13
Directe methode ........................................................................................................................... 13
Indirecte methode ......................................................................................................................... 13
Dubbel indirecte methode ............................................................................................................ 15
Hoofdstuk 3: energiebalans .................................................................................................................. 18
Waarom eten we? ............................................................................................................................. 18
Waar halen we onze energie? ....................................................................................................... 18
Voeding en energie ........................................................................................................................... 18
Basaalmetabolisme ....................................................................................................................... 18
Fysieke activiteit ............................................................................................................................ 19
Thermogenese ............................................................................................................................... 19
Energiebalans van de mens ............................................................................................................... 19
1
, Verzadiging .................................................................................................................................... 20
Neuro-endocrien systeem ............................................................................................................. 20
Aanpassingen van energie-inname aan energie-uitgave .............................................................. 21
Energie-equivalentie van gewichtsverandering ............................................................................ 21
Hoofdstuk 4: energie uit balans ............................................................................................................ 23
Overgewicht ...................................................................................................................................... 23
Inleiding ......................................................................................................................................... 23
Fysiologie ....................................................................................................................................... 23
Voeding.......................................................................................................................................... 23
Psychologie .................................................................................................................................... 24
Fysieke activiteit ............................................................................................................................ 24
Aanpak van overgewicht/obesitas .................................................................................................... 24
Gewichtsverlies door dieet en fysieke activiteit ........................................................................... 24
Bedoeling van dieet ....................................................................................................................... 24
Behandeling ................................................................................................................................... 24
Conservatieve methode ................................................................................................................ 24
Impact van gewichtsverlies ....................................................................................................... 25
Vergelijking andere diëten ........................................................................................................ 25
Verschil in samenstelling ........................................................................................................... 25
Periodiek vasten ........................................................................................................................ 26
Fysieke activiteit ........................................................................................................................ 26
Gedragstherapie ........................................................................................................................ 26
Bariatrische chirurgie (weight + medicine) ................................................................................... 26
Nutritionele complicaties na bariatrische chirurgie .................................................................. 27
Ondervoeding .................................................................................................................................... 27
Vormen .......................................................................................................................................... 27
Soorten tgv starvation ................................................................................................................... 27
Effect en metabole veranderingen van langdurig vasten en ziekte/trauma ................................ 28
Een onderschat probleem? ........................................................................................................... 28
Risicogroepen ................................................................................................................................ 29
Oorzaken van malnutritie en ondervoeding ................................................................................. 29
Gevolgen van ondervoeding.......................................................................................................... 29
Behandelingsaanpak...................................................................................................................... 30
Voedingsadvies bij ondervoeding ................................................................................................. 30
2
, Refeeding syndroom (vermijden!) ................................................................................................ 30
Hoofdstuk 5: voedingsaanbevelingen ................................................................................................... 31
3 basisconcepten ............................................................................................................................... 31
Voedingsaanbevelingen .................................................................................................................... 31
Optimal nutrition ........................................................................................................................... 31
Grafiek ........................................................................................................................................... 32
Andere voedingsaanbevelingen .................................................................................................... 32
Bepaling voedingsaanbevelingen .................................................................................................. 32
Beperking....................................................................................................................................... 32
Karakteristieken............................................................................................................................. 33
Doel ............................................................................................................................................... 33
Hoofdstuk 6: koolhydraten (KH) ............................................................................................................ 34
Indeling .............................................................................................................................................. 34
Verteerbaarheid ............................................................................................................................ 35
Bronnen ............................................................................................................................................. 35
Spijsvertering ..................................................................................................................................... 37
Rol ...................................................................................................................................................... 37
Eigenschappen voedingsvezels ..................................................................................................... 38
Bloedsuikerspiegel......................................................................................................................... 38
Glycemische respons ......................................................................................................................... 38
Beïnvloedende voedingsfactoren.................................................................................................. 39
Glycemische lading (GL) ................................................................................................................ 39
Aanbevelingen ................................................................................................................................... 39
Vezelrijke voeding ......................................................................................................................... 39
Gezondheidsaspecten ....................................................................................................................... 40
Schema’s........................................................................................................................................ 40
Normale conversie van fructose ................................................................................................... 41
De novo lipogenese is een mineure pathway na fructoseconsumptie ......................................... 41
Speciale koolhydraten ....................................................................................................................... 41
Intensieve zoetstoffen ................................................................................................................... 41
Andere KH-gerelateerde componenten ........................................................................................ 41
Hoofdstuk 7: lipiden .............................................................................................................................. 42
Indeling .............................................................................................................................................. 42
Bronnen ............................................................................................................................................. 43
3
, Vertering en absorptie ...................................................................................................................... 44
Transport van lipiden ........................................................................................................................ 44
Exogene pathway .......................................................................................................................... 45
Endogene pathway ........................................................................................................................ 45
Chylomicronen .............................................................................................................................. 45
Lipidensynthese in de lever ........................................................................................................... 45
VLDL ............................................................................................................................................... 45
LDL ................................................................................................................................................. 45
HDL ................................................................................................................................................ 45
Transport van vrije vetzuren ............................................................................................................. 46
Rol ...................................................................................................................................................... 46
Voeding.......................................................................................................................................... 46
Aanbevelingen ................................................................................................................................... 46
Gezondheidsaspecten ....................................................................................................................... 47
Cardiovasculaire aandoeningen .................................................................................................... 47
Kanker............................................................................................................................................ 47
Cholesterol .................................................................................................................................... 47
Hoofdstuk 8: eiwitten ............................................................................................................................ 48
Indeling .............................................................................................................................................. 48
Vertering en absorptie ...................................................................................................................... 49
Absorptie ....................................................................................................................................... 50
Verteerbaarheid ............................................................................................................................ 50
Kwaliteit van proteïnen ..................................................................................................................... 50
AZ-samenstelling ........................................................................................................................... 50
Biologische beschikbaarheid ......................................................................................................... 51
Methoden voor de evaluatie van de eiwitkwaliteit ...................................................................... 51
Rol ...................................................................................................................................................... 52
Aminozuurmetabolisme .................................................................................................................... 52
Synthese van lichaamseiwitten ..................................................................................................... 52
Alternatieven voor aminozuur -N.................................................................................................. 53
Degradatie ..................................................................................................................................... 53
Behoud van lichaamseiwitten ........................................................................................................... 53
Eiwitreserve ................................................................................................................................... 53
Aminozuurpool .............................................................................................................................. 53
4
, Eiwit-turnover................................................................................................................................ 54
Stikstofbalans ................................................................................................................................ 54
Aanbevelingen ................................................................................................................................... 54
Gezondheidsaspecten ....................................................................................................................... 54
Hoofdstuk 9: gezondheidspromotie en preventie ................................................................................ 56
Preventie ........................................................................................................................................... 56
Doelen ........................................................................................................................................... 56
Fasen van ziekte (piramide)........................................................................................................... 56
Food labelling ................................................................................................................................ 57
Food provision ............................................................................................................................... 57
Food price – taks ........................................................................................................................... 57
Food policies .................................................................................................................................. 57
Gedragsverandering en omgeving ................................................................................................ 57
Hoofdstuk 10: micronutriënten............................................................................................................. 59
Mineralen en spoorelementen.......................................................................................................... 59
Homeostatische regeling ............................................................................................................... 59
Indeling .......................................................................................................................................... 59
Mineralen in voeding..................................................................................................................... 60
Tekort of teveel aan mineralen ..................................................................................................... 60
Natrium.......................................................................................................................................... 60
Calcium .......................................................................................................................................... 61
Fosfor ............................................................................................................................................. 62
Kalium ............................................................................................................................................ 62
Chloor ............................................................................................................................................ 62
Zwavel............................................................................................................................................ 63
Magnesium .................................................................................................................................... 63
IJzer ................................................................................................................................................ 64
Zink ................................................................................................................................................ 66
Jodium ........................................................................................................................................... 66
Selenium ........................................................................................................................................ 67
Koper ............................................................................................................................................. 68
Fluor............................................................................................................................................... 68
Vitaminen .......................................................................................................................................... 68
Eigenschappen............................................................................................................................... 69
5
, Indeling .......................................................................................................................................... 69
Functies ......................................................................................................................................... 69
Voeding.......................................................................................................................................... 69
Vetoplosbare vitaminen .................................................................................................................... 70
Vitamine A: retinoïden .................................................................................................................. 70
Vitamine D ..................................................................................................................................... 72
Vitamine E ..................................................................................................................................... 73
Vitamine K ..................................................................................................................................... 73
Wateroplosbare vitaminen ............................................................................................................... 74
Vitamine B-groep........................................................................................................................... 74
Vitamine B1: thiamine ................................................................................................................... 74
Vitamine B2: riboflavine ................................................................................................................ 75
Vitamine B3: niacine...................................................................................................................... 75
Vitamine B5: pantotheenzuur ....................................................................................................... 75
Vitamine B6: pyridoxine ................................................................................................................ 76
Vitamine B8: biotine ...................................................................................................................... 76
Vitamine B11: foliumzuur .............................................................................................................. 77
Vitamine B12: cobalamine ............................................................................................................ 77
Vitamine C : ascorbinezuur............................................................................................................ 77
Supplementen ............................................................................................................................... 78
Geïntegreerde rol van micronutriënten ............................................................................................ 79
Cofactor ......................................................................................................................................... 79
Hart- en bloedvatensysteem ......................................................................................................... 80
Stucturele rol van micronutriënten ............................................................................................... 80
6
, Samenvatting voeding
Hoofdstuk 1: relatie tussen voeding en gezondheid
Nutritie = complex veelzijdig wetenschappelijk domein dat aangeeft hoe stoffen in voedingsmiddelen
zorgen voor essentiële voeding voor behoud van leven
- Voeding wordt geproduceerd en getransporteerd
- Maaltijden bereiden en consumeren
o Textuur
o Smaak
o Metabolisme in het lichaam
- Cellulair, moleculair… niveau, maar ook sociale aspecten → als het niet in de smaak valt bij
de consument, dan heeft het geen nut
Nutritionele situatie → gezondheidsconsequenties
Optimale voeding
- Nutritionele situatie
o Voedselzekerheid
o Gebalanceerd dieet
- Gezondheidsconsequenties
o Gezond
o Normale ontwikkeling
o Hoge levenskwaliteit
Ondervoeding
- Nutritionele situatie
o Voedselonzekerheid
o Armoede
o Politiek onstabiele omgeving
o Oorlog
- Gezondheidsconsequenties
o Verminderde fysieke en mentale ontwikkeling
o Aangetast immuunsysteem
o Stijging in infectieziekten
o Vicieuze cirkel: ondervoeding – onderontwikkeling – armoede
Overvoeding
- Nutritionele situatie
o Overconsumptie van voeding
o Lage fysieke activiteit
o Roken, stress, alcohol
- Gezondheidsconsequenties
o Obesitas
7
, o Metabool syndroom
o Cardiovasculaire aandoeningen
o Diabetes type II
o Bepaalde vormen van kanker
Malnutritie
- Nutritionele situatie (combinatie overvoeding en ondervoeding)
o Voedselzekerheid → overvloed aan aantrekkelijk, ongezonder voedsel → teveel aan
macronutriënten en tekort aan micronutriënten
- Gezondheidsconsequenties
o Stijging in infectieziekten, kanker, cardiovasculaire aandoeningen
Grafieken
Doden
- Aantal doden wereldwijd tgv bepaalde aandoeningen
o Borstvoeding → vaste voeding (die niet alle voedingsstoffen bevat)
o Tumoren
o Musculoskeletale aandoeningen (spiermassa is gerelateerd aan voeding)
o Op jonge leeftijd veel aandacht besteden aan voeding om op latere leeftijd de
positieve effecten hiervan te zien
- Verschillende aandoeningen
o Alzheimer
o Ischemische hartaandoeningen (tgv O2-tekort)
o Prematuren
▪ Ischemische hartaandoeningen
▪ Longkanker
▪ Cerebrovasculaire aandoeningen
Risicofactoren
- Tabak
- Verhoogde bloeddruk
- Alcohol
- Diëten
- Hoge BMI (disbalans door overvoeding)
- Cholesterol (LDL = slecht, HDL = goed)
- Malnutritie (België)
o Tekort aan granen
o Tekort aan groeten
Link tussen dieet en gezondheidsuitkomsten
1. Blootstelling → klinische uitkomst (direct)
2. Blootstelling → voorspelling van klinische uitkomst → klinische uitkomst (indirect)
3. Blootstelling → mogelijke voorspelling van klinische uitkomst → klinische uitkomst (indirect)
4. Blootstelling → indicaties van blootstelling → direct naar klinische uitkomst OF via
voorspelling van klinische uitkomst OF via mogelijke voorspelling van klinische uitkomst
8
, Intermediaire biologische mechanismen → risico op cardiovasculaire aandoeningen
- Lipiden niveaus
o LDL-cholesterol
o HDL-cholesterol
o Triglyceriden
o Lipoproteïne A
- Bloeddruk
- Trombose
- Hartritme
- Endothele functie
- Systemische inflammatie
o Vaak voorkomen bij obesitas
- Insulinesensitiviteit
- Oxidatieve stress
- Homocysteïne niveau
Chronisch tekort aan vitamine A (insufficiëntie)
1. Uitputting vit A in weefsels
2. Metabole en genetische malfunctie
3. Metaplasie (celdifferentiatie abnormaal)
Verminderde groei
Anemie (slechte interactie met Fe)
Verminderde immuniteit
4. Nachtblindheid
5. Xeroftalmie
Reactievermogen op voedingsgebied
- Geen reactievermogen (geen mogelijkheid om te compenseren door supplementen)
o Sikkelcelanemie
o Osteoporose
▪ Niet genezen door vit A of vit D toe te dienen, wel ondersteuning
o Kanker
▪ Meer succes bij chemotherapie indien persoon niet ondervoed is
- Reactievermogen (mogelijkheid om te compenseren door supplementen, volgorde van meer
naar minder mogelijk van boven naar onder)
o Anemie
o Vitamine deficiëntie
o Mineralen deficiëntie
o Toxiciteit
o Laag gewicht bij geboorte
o Verminderde weerstand tegen ziekte
o Arthritis
o Diabetes
o Hypertensie
o Hartaandoeningen
9
Hoofdstuk 1: relatie tussen voeding en gezondheid ............................................................................... 7
Nutritionele situatie → gezondheidsconsequenties ........................................................................... 7
Optimale voeding ............................................................................................................................ 7
Ondervoeding .................................................................................................................................. 7
Overvoeding .................................................................................................................................... 7
Malnutritie....................................................................................................................................... 8
Grafieken ............................................................................................................................................. 8
Doden .............................................................................................................................................. 8
Risicofactoren .................................................................................................................................. 8
Link tussen dieet en gezondheidsuitkomsten ..................................................................................... 8
Intermediaire biologische mechanismen → risico op cardiovasculaire aandoeningen ................. 9
Chronisch tekort aan vitamine A (insufficiëntie) ............................................................................. 9
Reactievermogen op voedingsgebied ............................................................................................. 9
Grafiek ........................................................................................................................................... 10
Onderliggende drijfveren van verbeterde nutritionele status ...................................................... 10
Hoofdstuk 2: lichaamssamenstelling ..................................................................................................... 12
Niveaus .............................................................................................................................................. 12
Modellen ........................................................................................................................................... 12
Twee compartimenten model ....................................................................................................... 12
Drie compartimenten model ......................................................................................................... 12
Bepalen van lichaamssamenstelling.................................................................................................. 13
Directe methode ........................................................................................................................... 13
Indirecte methode ......................................................................................................................... 13
Dubbel indirecte methode ............................................................................................................ 15
Hoofdstuk 3: energiebalans .................................................................................................................. 18
Waarom eten we? ............................................................................................................................. 18
Waar halen we onze energie? ....................................................................................................... 18
Voeding en energie ........................................................................................................................... 18
Basaalmetabolisme ....................................................................................................................... 18
Fysieke activiteit ............................................................................................................................ 19
Thermogenese ............................................................................................................................... 19
Energiebalans van de mens ............................................................................................................... 19
1
, Verzadiging .................................................................................................................................... 20
Neuro-endocrien systeem ............................................................................................................. 20
Aanpassingen van energie-inname aan energie-uitgave .............................................................. 21
Energie-equivalentie van gewichtsverandering ............................................................................ 21
Hoofdstuk 4: energie uit balans ............................................................................................................ 23
Overgewicht ...................................................................................................................................... 23
Inleiding ......................................................................................................................................... 23
Fysiologie ....................................................................................................................................... 23
Voeding.......................................................................................................................................... 23
Psychologie .................................................................................................................................... 24
Fysieke activiteit ............................................................................................................................ 24
Aanpak van overgewicht/obesitas .................................................................................................... 24
Gewichtsverlies door dieet en fysieke activiteit ........................................................................... 24
Bedoeling van dieet ....................................................................................................................... 24
Behandeling ................................................................................................................................... 24
Conservatieve methode ................................................................................................................ 24
Impact van gewichtsverlies ....................................................................................................... 25
Vergelijking andere diëten ........................................................................................................ 25
Verschil in samenstelling ........................................................................................................... 25
Periodiek vasten ........................................................................................................................ 26
Fysieke activiteit ........................................................................................................................ 26
Gedragstherapie ........................................................................................................................ 26
Bariatrische chirurgie (weight + medicine) ................................................................................... 26
Nutritionele complicaties na bariatrische chirurgie .................................................................. 27
Ondervoeding .................................................................................................................................... 27
Vormen .......................................................................................................................................... 27
Soorten tgv starvation ................................................................................................................... 27
Effect en metabole veranderingen van langdurig vasten en ziekte/trauma ................................ 28
Een onderschat probleem? ........................................................................................................... 28
Risicogroepen ................................................................................................................................ 29
Oorzaken van malnutritie en ondervoeding ................................................................................. 29
Gevolgen van ondervoeding.......................................................................................................... 29
Behandelingsaanpak...................................................................................................................... 30
Voedingsadvies bij ondervoeding ................................................................................................. 30
2
, Refeeding syndroom (vermijden!) ................................................................................................ 30
Hoofdstuk 5: voedingsaanbevelingen ................................................................................................... 31
3 basisconcepten ............................................................................................................................... 31
Voedingsaanbevelingen .................................................................................................................... 31
Optimal nutrition ........................................................................................................................... 31
Grafiek ........................................................................................................................................... 32
Andere voedingsaanbevelingen .................................................................................................... 32
Bepaling voedingsaanbevelingen .................................................................................................. 32
Beperking....................................................................................................................................... 32
Karakteristieken............................................................................................................................. 33
Doel ............................................................................................................................................... 33
Hoofdstuk 6: koolhydraten (KH) ............................................................................................................ 34
Indeling .............................................................................................................................................. 34
Verteerbaarheid ............................................................................................................................ 35
Bronnen ............................................................................................................................................. 35
Spijsvertering ..................................................................................................................................... 37
Rol ...................................................................................................................................................... 37
Eigenschappen voedingsvezels ..................................................................................................... 38
Bloedsuikerspiegel......................................................................................................................... 38
Glycemische respons ......................................................................................................................... 38
Beïnvloedende voedingsfactoren.................................................................................................. 39
Glycemische lading (GL) ................................................................................................................ 39
Aanbevelingen ................................................................................................................................... 39
Vezelrijke voeding ......................................................................................................................... 39
Gezondheidsaspecten ....................................................................................................................... 40
Schema’s........................................................................................................................................ 40
Normale conversie van fructose ................................................................................................... 41
De novo lipogenese is een mineure pathway na fructoseconsumptie ......................................... 41
Speciale koolhydraten ....................................................................................................................... 41
Intensieve zoetstoffen ................................................................................................................... 41
Andere KH-gerelateerde componenten ........................................................................................ 41
Hoofdstuk 7: lipiden .............................................................................................................................. 42
Indeling .............................................................................................................................................. 42
Bronnen ............................................................................................................................................. 43
3
, Vertering en absorptie ...................................................................................................................... 44
Transport van lipiden ........................................................................................................................ 44
Exogene pathway .......................................................................................................................... 45
Endogene pathway ........................................................................................................................ 45
Chylomicronen .............................................................................................................................. 45
Lipidensynthese in de lever ........................................................................................................... 45
VLDL ............................................................................................................................................... 45
LDL ................................................................................................................................................. 45
HDL ................................................................................................................................................ 45
Transport van vrije vetzuren ............................................................................................................. 46
Rol ...................................................................................................................................................... 46
Voeding.......................................................................................................................................... 46
Aanbevelingen ................................................................................................................................... 46
Gezondheidsaspecten ....................................................................................................................... 47
Cardiovasculaire aandoeningen .................................................................................................... 47
Kanker............................................................................................................................................ 47
Cholesterol .................................................................................................................................... 47
Hoofdstuk 8: eiwitten ............................................................................................................................ 48
Indeling .............................................................................................................................................. 48
Vertering en absorptie ...................................................................................................................... 49
Absorptie ....................................................................................................................................... 50
Verteerbaarheid ............................................................................................................................ 50
Kwaliteit van proteïnen ..................................................................................................................... 50
AZ-samenstelling ........................................................................................................................... 50
Biologische beschikbaarheid ......................................................................................................... 51
Methoden voor de evaluatie van de eiwitkwaliteit ...................................................................... 51
Rol ...................................................................................................................................................... 52
Aminozuurmetabolisme .................................................................................................................... 52
Synthese van lichaamseiwitten ..................................................................................................... 52
Alternatieven voor aminozuur -N.................................................................................................. 53
Degradatie ..................................................................................................................................... 53
Behoud van lichaamseiwitten ........................................................................................................... 53
Eiwitreserve ................................................................................................................................... 53
Aminozuurpool .............................................................................................................................. 53
4
, Eiwit-turnover................................................................................................................................ 54
Stikstofbalans ................................................................................................................................ 54
Aanbevelingen ................................................................................................................................... 54
Gezondheidsaspecten ....................................................................................................................... 54
Hoofdstuk 9: gezondheidspromotie en preventie ................................................................................ 56
Preventie ........................................................................................................................................... 56
Doelen ........................................................................................................................................... 56
Fasen van ziekte (piramide)........................................................................................................... 56
Food labelling ................................................................................................................................ 57
Food provision ............................................................................................................................... 57
Food price – taks ........................................................................................................................... 57
Food policies .................................................................................................................................. 57
Gedragsverandering en omgeving ................................................................................................ 57
Hoofdstuk 10: micronutriënten............................................................................................................. 59
Mineralen en spoorelementen.......................................................................................................... 59
Homeostatische regeling ............................................................................................................... 59
Indeling .......................................................................................................................................... 59
Mineralen in voeding..................................................................................................................... 60
Tekort of teveel aan mineralen ..................................................................................................... 60
Natrium.......................................................................................................................................... 60
Calcium .......................................................................................................................................... 61
Fosfor ............................................................................................................................................. 62
Kalium ............................................................................................................................................ 62
Chloor ............................................................................................................................................ 62
Zwavel............................................................................................................................................ 63
Magnesium .................................................................................................................................... 63
IJzer ................................................................................................................................................ 64
Zink ................................................................................................................................................ 66
Jodium ........................................................................................................................................... 66
Selenium ........................................................................................................................................ 67
Koper ............................................................................................................................................. 68
Fluor............................................................................................................................................... 68
Vitaminen .......................................................................................................................................... 68
Eigenschappen............................................................................................................................... 69
5
, Indeling .......................................................................................................................................... 69
Functies ......................................................................................................................................... 69
Voeding.......................................................................................................................................... 69
Vetoplosbare vitaminen .................................................................................................................... 70
Vitamine A: retinoïden .................................................................................................................. 70
Vitamine D ..................................................................................................................................... 72
Vitamine E ..................................................................................................................................... 73
Vitamine K ..................................................................................................................................... 73
Wateroplosbare vitaminen ............................................................................................................... 74
Vitamine B-groep........................................................................................................................... 74
Vitamine B1: thiamine ................................................................................................................... 74
Vitamine B2: riboflavine ................................................................................................................ 75
Vitamine B3: niacine...................................................................................................................... 75
Vitamine B5: pantotheenzuur ....................................................................................................... 75
Vitamine B6: pyridoxine ................................................................................................................ 76
Vitamine B8: biotine ...................................................................................................................... 76
Vitamine B11: foliumzuur .............................................................................................................. 77
Vitamine B12: cobalamine ............................................................................................................ 77
Vitamine C : ascorbinezuur............................................................................................................ 77
Supplementen ............................................................................................................................... 78
Geïntegreerde rol van micronutriënten ............................................................................................ 79
Cofactor ......................................................................................................................................... 79
Hart- en bloedvatensysteem ......................................................................................................... 80
Stucturele rol van micronutriënten ............................................................................................... 80
6
, Samenvatting voeding
Hoofdstuk 1: relatie tussen voeding en gezondheid
Nutritie = complex veelzijdig wetenschappelijk domein dat aangeeft hoe stoffen in voedingsmiddelen
zorgen voor essentiële voeding voor behoud van leven
- Voeding wordt geproduceerd en getransporteerd
- Maaltijden bereiden en consumeren
o Textuur
o Smaak
o Metabolisme in het lichaam
- Cellulair, moleculair… niveau, maar ook sociale aspecten → als het niet in de smaak valt bij
de consument, dan heeft het geen nut
Nutritionele situatie → gezondheidsconsequenties
Optimale voeding
- Nutritionele situatie
o Voedselzekerheid
o Gebalanceerd dieet
- Gezondheidsconsequenties
o Gezond
o Normale ontwikkeling
o Hoge levenskwaliteit
Ondervoeding
- Nutritionele situatie
o Voedselonzekerheid
o Armoede
o Politiek onstabiele omgeving
o Oorlog
- Gezondheidsconsequenties
o Verminderde fysieke en mentale ontwikkeling
o Aangetast immuunsysteem
o Stijging in infectieziekten
o Vicieuze cirkel: ondervoeding – onderontwikkeling – armoede
Overvoeding
- Nutritionele situatie
o Overconsumptie van voeding
o Lage fysieke activiteit
o Roken, stress, alcohol
- Gezondheidsconsequenties
o Obesitas
7
, o Metabool syndroom
o Cardiovasculaire aandoeningen
o Diabetes type II
o Bepaalde vormen van kanker
Malnutritie
- Nutritionele situatie (combinatie overvoeding en ondervoeding)
o Voedselzekerheid → overvloed aan aantrekkelijk, ongezonder voedsel → teveel aan
macronutriënten en tekort aan micronutriënten
- Gezondheidsconsequenties
o Stijging in infectieziekten, kanker, cardiovasculaire aandoeningen
Grafieken
Doden
- Aantal doden wereldwijd tgv bepaalde aandoeningen
o Borstvoeding → vaste voeding (die niet alle voedingsstoffen bevat)
o Tumoren
o Musculoskeletale aandoeningen (spiermassa is gerelateerd aan voeding)
o Op jonge leeftijd veel aandacht besteden aan voeding om op latere leeftijd de
positieve effecten hiervan te zien
- Verschillende aandoeningen
o Alzheimer
o Ischemische hartaandoeningen (tgv O2-tekort)
o Prematuren
▪ Ischemische hartaandoeningen
▪ Longkanker
▪ Cerebrovasculaire aandoeningen
Risicofactoren
- Tabak
- Verhoogde bloeddruk
- Alcohol
- Diëten
- Hoge BMI (disbalans door overvoeding)
- Cholesterol (LDL = slecht, HDL = goed)
- Malnutritie (België)
o Tekort aan granen
o Tekort aan groeten
Link tussen dieet en gezondheidsuitkomsten
1. Blootstelling → klinische uitkomst (direct)
2. Blootstelling → voorspelling van klinische uitkomst → klinische uitkomst (indirect)
3. Blootstelling → mogelijke voorspelling van klinische uitkomst → klinische uitkomst (indirect)
4. Blootstelling → indicaties van blootstelling → direct naar klinische uitkomst OF via
voorspelling van klinische uitkomst OF via mogelijke voorspelling van klinische uitkomst
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, Intermediaire biologische mechanismen → risico op cardiovasculaire aandoeningen
- Lipiden niveaus
o LDL-cholesterol
o HDL-cholesterol
o Triglyceriden
o Lipoproteïne A
- Bloeddruk
- Trombose
- Hartritme
- Endothele functie
- Systemische inflammatie
o Vaak voorkomen bij obesitas
- Insulinesensitiviteit
- Oxidatieve stress
- Homocysteïne niveau
Chronisch tekort aan vitamine A (insufficiëntie)
1. Uitputting vit A in weefsels
2. Metabole en genetische malfunctie
3. Metaplasie (celdifferentiatie abnormaal)
Verminderde groei
Anemie (slechte interactie met Fe)
Verminderde immuniteit
4. Nachtblindheid
5. Xeroftalmie
Reactievermogen op voedingsgebied
- Geen reactievermogen (geen mogelijkheid om te compenseren door supplementen)
o Sikkelcelanemie
o Osteoporose
▪ Niet genezen door vit A of vit D toe te dienen, wel ondersteuning
o Kanker
▪ Meer succes bij chemotherapie indien persoon niet ondervoed is
- Reactievermogen (mogelijkheid om te compenseren door supplementen, volgorde van meer
naar minder mogelijk van boven naar onder)
o Anemie
o Vitamine deficiëntie
o Mineralen deficiëntie
o Toxiciteit
o Laag gewicht bij geboorte
o Verminderde weerstand tegen ziekte
o Arthritis
o Diabetes
o Hypertensie
o Hartaandoeningen
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