Date post: | 25-Dec-2015 |
Category: |
Documents |
Upload: | barrie-jefferson |
View: | 222 times |
Download: | 6 times |
2
Nutritional Health Status
• Desirable Nutritional Status• Undernutrition– Subclinical deficiency– Clinical deficiency
• Overnutrition– Toxicities– Excesses of energy nutrients-obesity
EARs and RDAs
• EARs– Only set for
nutrients that have functional markers
–Meets needs for 50% population group
• RDAs– Based on EARs–Meet 97-98%
population group
– Prevent deficiency and chronic disease
AIs and ULs • AIs– Insufficient data
for an EAR– Estimate of
average nutrient intake that appears to maintain a defined nutritional state (bone health)
– Ideally meets more than RDA
• Uls– Based on chronic
intake of nutrients that are not likely to cause adverse effects in almost all individuals
– Based on nutrient intake from all sources
– Exceptions: niacin, magnesium, zinc and nickel are only nonfood sources
EERs and AMDRs
• EERs– Average daily
caloric need for each life stage group
• AMDRs– Range of intake,
as a percentage of energy (for example fat is 20-35% of kcal)
– Values are for Carbohydrates, Fat, Protein and Essential fatty acids
Nutrient Density
• Divide the amount of the nutrient per serving by the recommended amount
• Divide the calories in a serving by daily caloric need
• Compare the two• “Empty calorie foods”
Energy Density
• Comparison of a food’s caloric content per gram weight of the food
• High energy density foods (>4 kcal/g)– Graham crackers, potato chips, peanuts,
bacon
• Low energy density foods (<0.6 kcal/g)– Lettuce, strawberries, grapefruit, carrots
8
Fat Metabolism• Carbohydrates aid fat metabolism by providing
enough of key substrates to keep the citric acid cycle going
• Ketogenesis– Ketone bodies formed by incomplete fatty acid
oxidation
• Ketosis in Diabetes Mellitus• Ketosis in Semistarvation or Fasting or No
carbohydrates in diet
10
Vitamin E Functions
• Antioxidant (also C and carotenoids)• Reduces oxidative stress from free
radical damage• Vitamin E is a “chain breaking
antioxidant”
11
Vitamin A• Retinoids• Active form:
preformed Vitamin A
• Retinal, retinol and retinoic acid
• Dietary sources: liver, fish oils, fortified dairy products and eggs
• Caroteinoids• Provitamins-can
be converted to Vitamin A
• Dietary sources: dark green and yellow orange vegetables and fruits
12
Potassium• Foods (beans, potato, dairy, fruits, vegetables)• Needs
– AI is 4700 mg– Average intake below this
• Function: intercellular cation so same functions as sodium except that it decreases calcium excretion
• Deficiency– Hypokalemia (low blood potassium) can lead to
irregular heartbeat– Usually from urinary losses
• UL– Hyperkalemia (high blood potassium) with poor
kidney function
Match the deficiency with the anemia
• Vitamin E• Folate• Vitamin B12• Iron• Copper
• Megaloblastic• Microcytic• Hemolytic
13
*** See book for summary
Successful Weight Management: Lessons from
The National Weight Control Registry
• Registry members have lost an average of 66 pounds and kept it off for 5.5 years
– 90% exercise, on average, about 1 hour per day. – 62% watch less than 10 hours of TV per week. – 78% eat breakfast every day. – 75% weigh them self at least once a week.
Preventing CVD (limit)
• Total fat 20-35% total calories• Saturated fat < 7 % total calories• Trans fat low• Polyunsaturated < 10% total
calories• Monounsaturated < 20% total
calories• Cholesterol < 200 mg daily
15
Preventing CVD (emphasize)
• Include 2 grams plant stanols/sterols• Soluble fiber 20-30 g• Eat fatty fish 2x/week• Keep body weight at a healthy level• Increase physical activity• Do things to increase your HDL
(exercise)• Eat foods that prevent oxidation
16
17
Two Essential Fatty Acids
• Alpha-linolenic (3)• Polyunsaturated• Major source of
Omega 3 fatty acids in foods
• Used to make EPA and DHA and Eichosanoids
• Linoleic (6)• Polyunsaturated• Major source of
Omega 6 fatty acids in foods
• Used to make Arachidonic acid, and Eicosanoids
Two Essential Fatty Acids
• Alpha-linolenic• Cold water fish
(salmon, tuna, sardines), walnuts, flax, canola oil
• Reduces inflammation, thins blood, and reduces plasma triglycerides
• Linoleic• Beef, poultry,
safflower oil, sunflower oil, corn oil, mayonaise
• Regulates blood pressure, can increase blood clotting and inflammation
18
20
Recommended Intakes of Protein
• Equilibrium– Protein intake equals protein losses
• Positive Nitrogen Balance– Protein intake exceeds protein losses
• Negative Nitrogen Balance– Protein losses exceed protein intake
Calcium supplements
• Calcium carbonate (HCl-food) and calcium citrate• Who should take which?• When should you take it?• How much should you take?
• Interactions– Zinc, iron, and magnesium
21