NR228
NR228 Nutrition, Health, and Wellness Week 2 Study guide--Chapters 4, 7, 8
NR228 Nutrition, Health, and Wellness Week 2
NR228 Nutrition, Health,
... [Show More] and Wellness Week 2 Study guide.
NR228 Nutrition, Health, and Wellness
Week 2 Study guide--Chapters 4, 7, 8
Chapter 4: Carbohydrates
1. Carbohydrate:
a) They are a convenient and economical source of calories for people throughout the world.
b) Carbohydrates are composed of organic compounds composed of carbon, hydrogen, and oxygen.
i. The compounds consist of:
1. Simple carbohydrates like glucose and sucrose.
2. Complex carbohydrates like starch and dietary fiber.
2. What is the Dietary Reference Intake (DRI) and Acceptable Macronutrient Distribution Range (AMDR) for carbohydrates?
a) DRI: 130g/day for adults ages 19 to 30.
b) AMDR: 45% to 65% kcal intake per day, which come from primary complex carbohydrates.
3. According to your book Chapter 4 paragraph 3, what are the recommended average daily servings for carbohydrates
a) Three quarters of MyPlate consist of foods that are excellent sources of carbs, which are vegetables, fruits and grains.
i. 2 cups of fruits
ii. 2 ½ cups of vegetables
iii. 6 oz. of grains (at least ½ being whole grain, which provides an adequate amount of complex carbohydrates).
4. Review Box 4-1 and compare and contrast whole grains with refined grains.
a) Whole grains: Contains the entire grain kernel (bran, germ, and endosperm)
i. Example of whole grain products:
1. Amaranth, brown rice, buckwheat, bulgur (cracked wheat), millet, oatmeal, popcorn, rolled oats, quinoa, sorghum, triticale, whole grain barley, whole grain cornmeal, whole rye, whole wheat bread, whole wheat crackers, whole wheat pasta, whole wheat sandwich buns and rolls, whole wheat tortillas, wild rice, ready to eat breakfast cereals (whole wheat cereal flakes and muesli).
b) Refined grains: They have been milled were the process removes the bran and the germ. Dietary fiber, iron, and many vitamins have been removed as well.
i. Most refined grains have been enriched, meaning certain B vitamins (thiamin, riboflavin, niacin, and folic acid) and iron are added back in the process.
ii. Fiber is not added in the enriched grains.
iii. Example of refined grains products:
1. Cornbread, corn tortillas, couscous, crackers, flour tortillas, grits, noodles, pitas, pretzels, white bread, white sandwich buns and rolls, white rice, pastas (spaghetti and macaroni), and ready to eat breakfast cereals (corn flakes).
5. What does the term “enriched” mean?
a) Most refined grains have been enriched, meaning certain B vitamins (thiamin, riboflavin, niacin, and folic acid) and iron are added back in the process.
b) Fiber is not added in the enriched grains.
6. How much of grain consumption should be whole grains?
a) At least half of the grains need to be whole grains.
7. What enzymes are required to metabolize disaccharides? Lactase deficiency is common in what ethnic groups? What other factor contributes to lactase deficiency?
a) Enzymes needed to metabolize disaccharides:
Maltase
i. Maltose------------ glucose + glucose (Maltase for maltose)
Sucrase
ii. Sucrose----------- fructose + glucose (Sucrase for sucrose)
Lactase
iii. Lactose------------- galactose + glucose (Lactase for lactose)
iv. These specific enzymes for disaccharides are then secreted by the small intestine border cells, which then hydrolyzes the disaccharides into monosaccharides.
b) Lactase deficiency:
i. Asian/Pacific Islanders (Asian American)
ii. African (African American)
iii. Hispanic (Hispanic American)
iv. Latinos
v. Native American
c) Factors that contribute to lactase deficiency
i. Primary lactose intolerance is caused by a genetic factor that limits the ability to produce lactase.
ii. Secondary lactose intolerance happens when a chronic GI illness affects the intestinal tract, which decreases the amount of lactase produced.
8. (We will look at this is class, do not complete) Then review Box 4-1, or go through you cupboards at home and complete the table to describe a 1 ounce serving of the following foods. Then review The Diabetic Exchange List document and include the serving sizes for one 15 gram CARB exchange. Add the calories. Add the glycemic index from Table 4-2. Look up the information for the fruits and vegetables and add to your table.
Grains 1 ounce serving 15 gram carb exchange serving Calories/15 g carb exchange Glycemic Index
Bagel 1 mini bagel 72
White bread 1 small slice 1 slice 72
English muffin ½ muffin ½ muffin
Oatmeal ½ cup cooked; 1 instant pckg; 1 oz. (1/3 cup) dry ½ cooked
Pancake 1 pancake (4 ½ inch diameter) 2 pancakes
Popcorn 3 cups—popped 3 cups
Raisin Bran 1 cup ½ cups 60
Cheerios ¾ cups 60
Macaroni ½ cup cooked ½ cup cooked 60
Tortilla – 6 inch 1 tortilla 1 tortilla
Rice ½ cup cooked 1/3 cup 60
Sugars 1 ounce serving 15 gram carb exchange serving Calories/15 g carb exchange Glycemic Index
Granulated Sugar
Maple Syrup 2 tbsp. 1 tbsp.
Honey
Coca Cola 63
Fruits and Vegetables 1 ounce serving
(approximate) 15 gram carb exchange serving Calories/15 g carb exchange Glycemic Index
Potato, mashed ½ cup 80 90
Corn ½ cup
Watermelon 1 ¼ cup (cubes) 60
Apple – small 1 small (2 ¼ diameter) 1 small 60 40
Banana ½ banana 60 50
Raisins 2 tbsp. 60
Orange juice ½ cup 60
9. Compare and contrast 1 ounce serving of grains with the 15 gram carb exchange. Compare and contrast 1 ounce serving of fruits with the 15 gram carb exchange. Why are fruits and vegetables different? Why do pancakes and tortilla show 2 exchanges instead of 1 in the Exchange table? (1 carb + 1 fat)? Draw some conclusions about how exchanges are different than carb counting for meal planning? Only counting the carb grams, not including the protein or fat grams found in an exchange.
10. Compare and contrast monosaccharides, disaccharides and polysaccharides.
a) Monosaccharides: are composed of a single carbohydrate units.
i. Glucose, fructose, and galactose are monosaccharides.
b) Disaccharides: They consist of two single carbohydrates bound together.
i. Sucrose, maltose, and lactose are disaccharides.
c) Polysaccharides: Consist of many units of monosaccharides joined together.
i. Starch and fiber are food sources of polysaccharides.
11. Explain the function of carbohydrates as a nutrient in the body.
a) Carbohydrates provide fiber, energy, and sweeteners (sucrose and fructose).
b) Energy is the only real nutrient function for carbohydrates.
c) When the body receives adequate levels of carbohydrates to meet the energy need, protein is spared or saved to be use as a function for protein.
i. This process is called the protein-sparing effect.
d) When the body doesn’t received enough carbohydrates fats are metabolized, resulting in the formation of ketones.
i. Insufficient levels of carbs to meet energy demands:
1. Increases levels of ketones
2. It overwhelms the physiologic system
3. Ketoacidosis develops
12. In what form does the liver and muscles store glucose?
a) Glycogen is carbohydrate energy that is stored in the liver and muscles.
b) The glycogen stored in the liver and muscle tissue is converted back into glucose by glycogenolysis.
13. What is a normal blood glucose range according to your text? (p. 67)
a) 70-100 mg/dL
14. What gland produces insulin and what is insulin’s role in the body?
a) The pancreas produces insulin by the beta cells of islet of Langerhans.
b) Insulin lowers blood glucose levels by enhancing the conversion of excess glucose to glycogen through glycogenesis or the fat is stored in adipose tissue.
c) It eases the absorption of glucose into the cells for glucose as energy is increase.
d) What other hormones does the pancreas secrete?
i. Glucagon stimulates the conversion of the liver glycogen to glucose, while assisting the regulation of glucose levels during the night.
ii. Somatostatin is secreted from the hypothalamus and pancreas, which inhibits the functions insulin and glucagon.
15. What do all forms of “sugar” including white sugar, brown sugar, dextrose, high fructose corn syrup, honey, maple syrup, and glucose have in common? (p. 69)
a) They are all chemically similar
b) Each provides kcal
c) Most do not contain any other nutrient
16. What are the health concerns related to sugar consumption?
a) Nutrient displacement:
i. Happens when whole foods are minimally processed and are not eaten, but are replaced by foods containing added sugars.
1. Ex: If you consume candy, soda, and other sweet snacks foods instead of a sandwich and juice for lunch, you’ll lose a number of important nutrients.
ii. Foods and drinks with added sugars often contain empty kcal that provide few nutrients.
b) Dental caries:
i. They are related in eating concentrated sweets and sticky carbohydrates.
ii. Sugar supports the growth of bacteria, which promotes the formation of plaque.
iii. Plaque leads to tooth decay.
iv. Ways to decrease the formation of dental caries is by eating sweets at the end of meals—rather than between meals—and monitor the quantity and frequency of sugar intake.
v. Optimal dental hygiene reduces plaque formation and promotes dental health.
c) Health related issues of obesity and diabetes:
i. Obesity can be caused by excess intake of kcal from any of energy nutrients, which is then stored as fat.
1. A lot of sugary foods are high in fat.
2. Due to fat is the most energy dense nutrient, fat intake may be more of a risk factor for obesity than sugar intake.
ii. There is no confirmed relationship between the level of sugar intake and increased risk of developing type 2 diabetes mellitus.
1. When a person has the disorder, they are counsel to restrict the intake of concentrated sweets to assist in the regulation of insulin needs.
2. Obesity is a risk factor for type 2 DM.
17. Explain the difference between nutritive and non-nutritive sweeteners. (Table 4-3)
a) Nutritive sweeteners include:
i. Sucrose 4 kcal/g
ii. Fructose 4 kcal/g
iii. Sugar alcohols (monosaccharide polyols) are nutritive sweeteners because they provide 2-3 kcal/g but fewer than 4 kcal/g of carbohydrates.
1. Sorbitol
2. Mannitol
3. Xylitol
4. Erythritol
5. Tagatose
iv. They occur naturally in fruits and berries.
b) Nonnutritive sweeteners:
i. Are alternative sweeteners that are manufactured to use as sweetened agents in food products.
ii. They provide no nutrient and few or if any kcal
iii. Function is to replace naturally sweet substance such as sugar, honey and other sucrose containing substance.
iv. Commonly used in the U.S. and are approved by the FDA are aspartame, saccharin, acesulfame K, sucralose, and stevia
c) What happens when large amounts of sugar alcohols such as sorbitol are consumed?
i. Sorbitol 2.6 kcal/g.
1. GRAS label needs to warn people about the laxative effect
2. 50-70% as sweet as sucrose
3. People can experience a laxative effect from a load of sorbitol ≥ 50g.
ii. They may ferment in the intestinal tract because of their slow absorption rate.
iii. It may cause gas and diarrhea.
iv. Incomplete absorption results in a lower caloric value per gram because less energy is available.
18. Which non-nutritive sweetener should people with PKU not consume and why?
a) Aspartame because bodies can’t break down phenylalanine.
b) Products that contain aspartame have a warning label to alert individuals with PKU.
c) Label sign applies to pregnant women, because the fetus can be exposed to excess phenylalanine before the presence of PKU could be determine.
d) The adult population is advised to keep daily aspartame consumption (for a 132-pound person) at or less than 50 mg/kg body weight (the equivalent of 83 packets of Equal, an aspartame product) or 14 12-ounce cans of aspartame-sweetened soda (Fitch and Keim, 2012).
e) Aspartame, when added to products, is often listed by its original brand names, NutraSweet and Equal.
19. What are the health effects of fibers?
a) Obesity:
i. Consuming high fiber foods can make weight control easier.
ii. Volume of such foods makes the person feel fuller, so they’ll consume less food.
iii. Higher fiber foods replace those that are higher in fat and kcal.
iv. Consuming high fiber and lower fat foods regularly may reduce or prevent obesity.
b) Constipation:
i. Insoluble fibers like wheat bran and whole grain can prevent dry and hard stools of constipation.
ii. Increasing fiber and fluid intake ensures larger and softer stools, which makes it easier to eliminate.
iii. Less straining during elimination reduces the risk of hemorrhoids (enlarged veins in the anus) and diverticular disease
c) Diverticular disease:
i. It affects the large intestine.
ii. Pockets (diverticular) develop outside the walls of the intestine.
iii. Having a low fiber diet may create an increase of internal pressure from segmentation muscle attempting to move the food mass because of the bulk of fiber that is not available, which weakens the intestinal muscles.
iv. A weakened muscle are at higher risk of formation of diverticula.
v. If feces get caught in the pockets, bacteria may develop, multiply, and cause serious and painful inflammation (diverticulitis).
vi. Medical treatment and nutritional recommendations are necessary.
d) Cancer:
i. Consuming enough dietary fiber may reduce the risk of colon cancer.
ii. 2 potential risk factors for colon cancer related to fiber intake are:
1. High dietary fat intake
2. Exposure to carcinogenic substances in the GI tract
iii. Eating more fiber we tend to eat less fat, because high fiber foods replaces food that are higher in fat.
iv. Foods containing fiber are bulkier, they seem to fill the stomach quicker, providing satiety sooner and with fewer kcal than foods containing fat.
v. Fiber-containing foods such as fruits and vegetables may contain other substances that may be protective for the colon.
e) Heart disease:
i. 2 heart diseases risk factors are:
1. High blood cholesterol
2. Increased lipid levels
ii. If we increase our dietary fiber consumption we can lower our blood cholesterol and lipid levels by:
1. high-fiber foods replace higher-fat foods, particularly those containing dietary cholesterol and saturated fats
2. Soluble fiber such as pectin (citrus fruits and apples), guar gum (legumes), and oat gum (oat bran) binds lipids and cholesterol as they move through the intestinal tract and are then excreted with the fiber.
f) Diabetes control:
i. Consumption of dietary fiber can help people with DM to stabilize blood glucose levels.
ii. DM affects the body’s ability to regulate blood glucose levels, so consuming soluble fiber; glucose may be absorbed more slowly.
iii. A slower absorption rate of glucose can keep blood glucose within acceptable levels.
20. Identify several foods that have more than 3—4 grams of fiber in them
a) Approximately 3g per serving:
i. Apple with skin, corn, orange, pear, peas, potato with skin, raisins, shredded wheat cereal, strawberries.
b) Approximately 4g or more per serving:
i. Baked beans, bran cereals, kidney beans, lentils, navy beans, whole wheat spaghetti
Chapter 07: Vitamins
1. Describe the difference between primary and secondary vitamin deficiency.
a. Primary vitamin deficiency:
i. Occurs when the vitamin is not consumes in sufficient amounts to meet physiologic needs.
b. Secondary vitamin deficiency:
i. Develops when absorption is impaired or excess excretion occurs; it limits the bioavailability.
c. Deficiencies can be detected through clinical and biochemical assessment.
2. Discuss the subgroups of Americans who are at risk for vitamin deficiencies.
a. Pregnant women are at risk for marginal deficiencies of essential vitamins.
b. Older adults are at risk because of their absorption ability is decrease and limited economic and physical resources affects food availability.
c. Poverty has a negative effect on the nutritional status of children and adults.
d. Chronic alcohol and drug abuse limits the body ability to absorb and use essential vitamins.
i. It also alters psychological and mental capacities of a person.
e. Long-term chronic disorders have a special vitamin concern due to their metabolic process of the body can compromise these disorders and by the medication prescribed.
i. Immunodeficiency syndrome (AIDS)
ii. Liver and kidney disorders.
3. List two distinguishing characteristics of water-soluble and fat-soluble vitamins.
• Water-soluble vitamins:
i. Dissolve or disperse in water
ii. They consist of B complex vitamins (thiamin, riboflavin, niacin, pyridoxine, folate, vitamin B₁₂, biotin, and pantothenic acid), choline and vitamin C.
iii. Easily absorbed in the small intestine and then passes into the bloodstream for circulation throughout the body.
iv. Readily excreted in the urine and they act as coenzymes to catalyze activity in the body.
v. The water solubility of vitamin B and C allows a minimal storage of any excess vitamin to be consumed.
vi. Tissues can be saturated with these vitamins, but are not usually stored.
vii. We need to consume these vitamins in a daily basis, because deficiencies can develop quickly (within weeks).
viii. Excess consumption aren’t generally toxic and are simply excreted through urine.
ix. Damage may result if vitamin levels are high over the long term because of supplementation.
• Fat-soluble vitamins:
x. Dissolve in fatty tissues or substances
xi. They are vitamins A, D, E, and K.
xii. Follow a more complicated route of other fat containing substances.
xiii. Bile is needed for their absorption from the small intestine.
xiv. Fat-soluble absorbed in lymphatic system, stored in tissues, and have a hormone like function.
xv. Fat malabsorption problems can lead to a potential deficiency of fat-soluble vitamins.
xvi. If we consume more than our daily requirements our body stores the excess rather than excreting it.
xvii. DRIs take into account this storage capacity.
xviii. Organs that store fat-soluble vitamins are the liver and spleen, other fatty tissues in the body. They can retain excess amounts of fat-soluble vitamins.
xix. Overloading the storage capabilities can be toxic and produce illness.
xx. Toxicity can be rare from excessive dietary intake but rather from improper use of vitamin supplements.
4. List the vitamins needed for blood health, bone health, energy metabolism, and fluid and electrolyte balance.
a. Blood health: Blood is the body fluid, supplying tissues with oxygen, nutrients, and energy through circulation within the cardiovascular system. It is composed of water, red and white blood cells, oxygen, nutrients, and other formed substances. Always moving, blood gathers and distributes nutrients and oxygen to all cells and disposes of waste products. Deficiency of any of these nutrients will affect overall blood health.
i. Vitamins:
1. Cobalamin (B₁₂)—>Functiontransport/storage of folate needed for heme and cell formation and other functions.
2. Folate (folic acid, folacin, and PGA) Function Coenzyme metabolism (synthesis of amino acids, heme, deoxyribonucleic acid [DNA], ribonucleic acid [RNA], and other functions.
3. Pyridoxine (B₆) Function Hemoglobin synthesis and other functions.
4. Vitamin K (Active form: menaquinones) Function Cofactor in synthesis of blood clotting factors; protein formation.
b. Bone health: As living tissue, bone requires nutrients to maintain cellular structure. Blood circulates through bone capillaries, delivering nutrients while removing waste materials no longer needed by cells. Hormones regulate the use of minerals either for storage and structural purposes in bone or for controlling body processes. Specific vitamins and minerals are indispensable for these functions to occur.
i. Vitamins:
1. Vitamin D (Precursor 7-dehydrocholester and Active form: cholecalciferol) Function Bone mineralization.
2. Vitamin K (Active form: menaquinones) Function Protein formation for bone mineralization; cofactor for blood clotting factors.
3. Vitamin A (Precursors: carotenoids and Performed vitamin: retinoids) Function Bone growth; maintains epithelial cells; regulation of gene expression.
c. Energy metabolism: In order to metabolize carbohydrates, lipids, and protein for energy and other needs, the body depends on many nutrients to support the process, create new cells, and implement various related functions.
i. Vitamins:
1. Thiamin (B₁) Function Coenzyme energy metabolism; muscle nerve action
2. Riboflavin (B₂) Function Coenzyme energy metabolism
3. Niacin (nicotinic acid and niacinamide) (Precursor: tryptophan) Function Cofactor to enzymes involved in energy metabolism; glycolysis and tricarboxylic acid (TCA) cycle synthesis.
4. Pyridoxine (B₆) Function Forms coenzyme pyridoxal phosphate (PLP) for energy metabolism.
5. Folate (folic acid, folacin, and PGA) Function Coenzyme metabolism (synthesis of amino acid, heme, DNA, RNA).
6. Cobalamin (B₁₂) Function Metabolism of fatty acids/amino acids.
7. Pantothenic acid Function Part of coenzyme A.
8. Biotin Function Metabolism of carbohydrate, fat, and protein.
d. Fluid and electrolyte balance: Life systems depend on fluid and electrolyte balance within the body. Electrolytes consist of mineral salts that maintain cellular fluid balance. The acid-base balance of body fluids is buffered by other minerals.
i. Minerals:
1. Sodium Function Major extracellular electrolyte for fluid regulation; body fluid levels; acid-base balance; nerve impulse and contraction; blood pressure/volume.
2. Potassium Function With sodium and chloride, major intracellular electrolyte for fluid regulation; muscle function.
3. Chloride Function Acid-base balance.
4. Phosphorus Function Acid-base balance.
5. Merge Tables 7-3 and 7-6 to include both water and fat-soluble vitamins. List the alternative names, primary functions, and food sources for each vitamin. *Study these tables only; do not recreate
Water-Soluble Vitamins (Table 7-3):
Vitamin Primary function Food source
Thiamin (B₁) Coenzyme energy metabolism; muscle nerve action Lean pork, whole or enriched grains and flours, legumes, seeds, and nuts.
Riboflavin (B₂) Coenzyme energy metabolism. Milk/dairy products; meat, fish, poultry, and eggs; dark leafy greens (broccoli); whole and enriched breads and cereals
Niacin (B₃) (nicotinic acid and niacinamide)
Precursor: tryptophan Cofactor to enzymes involved in energy metabolism; glycolysis and TCA cycle. Meats, poultry, and fish; legumes; whole and enriched cereals; milk.
Pyridoxine (B₆) Forms coenzyme pyridoxal phosphate (PLP) for energy metabolism; CNS; hemoglobin synthesis Whole grains/cereals legumes, poultry, fish, pork, eggs
Folate (folic acid, folacin, and PGA) Coenzyme metabolism (synthesis of amino acid, heme, DNA RNA); fetal neural tube formation Widely available leafy green vegetables, legumes, ascorbic acid-containing foods
Cobalamin (B₁₂) Transport/storage of folate; metabolism of fatty acids/amino acids Animal sources
Biotin Metabolism of carbohydrate, fat, and protein Liver, kidney, peanut butter, egg yolks, intestinal synthesis
Pantothenic acid Part of coenzyme A Widespread in foods
Choline Synthesis of acetylcholine and lecithin Widespread—milk, eggs, peanuts
Vitamin C Antioxidant, coenzyme, collagen formation, wound healing, iron absorption, hormone synthesis Fruits/vegetables (citrus fruits, tomatoes, peppers, strawberries, broccoli)
Fat-soluble vitamins (Table 7-6):
Vitamin Primary Function Food Source
Vitamin A
(Precursors: carotenoids)
(Preform vitamin: retinoids) Maintains epithelial tissues (skin and mucous membranes); rhodopsin formation for vision; bone growth; reproduction Deep green, yellow, and orange fruits and vegetables; animal fat sources: whole milk, fortified skim, and low-fat milk; butter; liver; egg yolks, fatty fish
Vitamin D
(Precursor: 7-dehydrocholesterol)
(Active form: cholecalciferol) Calcium and phosphorus absorption; bone mineralization Animal (fat) sources: butter, egg yolks, fatty fish, liver, fortified milk; body synthesis
Vitamin E (α-Tocopherol) Antioxidant for polyunsaturated fatty acid and vitamin A; antioxidant with selenium and ascorbic acid Vegetable oil, whole grains, seeds, nuts, green leafy vegetables
Vitamin K (Active form: menaquinones) Cofactor in synthesis of blood clotting factors; protein formation Green leafy vegetables, intestinal synthesis
6. Name the main deficiency diseases associated with inadequate intake of the following water-soluble vitamins:
a. Thiamine:
i. Recommended daily intake:
1. Men: 1.2 mg
2. Women: 1.1 mg
ii. Clinical issues (Deficiency/toxicity):
1. Beriberi (ataxia, disorientation, tachycardia)
2. Wet beriberi (edema)
3. Dry beriberi (nervous system)
4. Wernicke-Korsakoff syndrome
5. Marginal deficiency: headaches, tiredness
b. Riboflavin:
i. Recommended daily intake:
1. Men: 1.3 mg
2. Women: 1.1 mg
ii. Clinical issues (Deficiency/toxicity):
1. Ariboflavinosis with cheilosis
2. Glossitis
3. Seborrheic dermatitis
c. Niacin:
i. Recommended daily intake:
1. Men: 16 mg NE
2. Women: 14 mg NE
3. (UL 35 mg NE)
ii. Clinical issues (Deficiency/toxicity):
1. Pellagra
2. Toxicity: vasodilation, liver damage, gout, and arthritic reactions.
d. B6:
i. Recommended daily intake:
1. Men: 1.3 mg
2. Women: 1.3 mg
3. (UL 100 mg)
ii. Clinical issues (Deficiency/toxicity):
1. Dermatitis
2. Altered nerve function
3. Weakness
4. Anemia
5. OCAs decrease B6 levels
6. Toxicity: ataxia, sensory neuropathy
e. Folate:
i. Recommended daily intake:
1. Men: 400 µg
2. Women: 400 µg
3. Pregnancy: 600 µg
4. Lactation: 500 µg
5. (UL 1000 µg)
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency: megaloblastic anemia; many drugs affect folate use
2. Toxicity: megadoses may mask pernicious anemia
f. B12:
i. Recommended daily intake:
1. Adults: 2.4 µg
ii. Clinical issues (Deficiency/toxicity):
1. Pernicious anemia
2. CNS damage
g. Vitamin C
i. Recommended daily intake:
1. Men: 90 mg
2. Women: 75 mg
3. (UL 2000)
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency: scurvy
2. Toxicity: cramps, nausea, kidney stone formation, gout (1-15 g), rebound scurvy
7. Name the deficiency diseases or symptoms associated with inadequate intake of the fat-soluble vitamins:
a. A:
i. Recommended daily intake:
1. Men: 900-µg RAE
Women: 700-µg RAE
UL 3000-µg RAE
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency:
a. Xerophthalmia
b. Night blindness
c. Keratomalacia
d. Degeneration of epithelial tissue
e. Inhibited growth (respiratory and gastrointestinal disturbances)
2. Toxicity:
a. Hypervitaminosis A (from supplements) with blistered skin, weakness, anorexia, vomiting, enlarged spleen and liver
b. D:
i. Recommended daily intake:
1. Adults: 5-µg AI
2. (<51 yr 10 µg)
3. (<70 yr 15 µg)
4. UL 50 µg
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency:
a. Bone malformation
b. Rickets (children)
c. Osteomalacia (adults)
2. Toxicity:
a. Hypercalcemia
b. Hypercalciuria
c. E:
i. Recommended daily intake:
1. Adults: 15-mg α-TE
2. UL 1000-mg α-TE
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency:
a. Primary deficiency rare
b. Secondary deficiency (caused by fat absorption) neurologic disorders
2. Toxicity: none, but supplements contraindicated with anticoagulation drugs
d. K:
i. Recommended daily intake:
1. Men: 120-µg AI
2. Women: 90-µg AI
ii. Clinical issues (Deficiency/toxicity):
1. Deficiency: blood coagulation inhibited; hemorrhagic disease (infants)
2. Toxicity: therapeutic vitamin K (menadione form) reactions in neonates, causing hemolytic anemia and hyperbilirubinemia
Chapter 08: Water and Minerals
1. Identify at least three functions of water.
• No growth or cell renewal occurs without water
• Gives shape and rigidity to cells
• Helps regulate body temperature.
• Helps cool body via insensible perspiration
• Lubricant joint fluid and mucous secretions
• Shock-absorbing fluid cushion for body tissues (e.g. amniotic sac, spinal cord, eyes)
• Acts as solvent enables glucose, minerals and vitamins to be moved throughout body
• Major component of blood, lymph, salvia, and urine
• Acts in chemical reactions
o EX: large molecules like fats, polysaccharides, and protein are split into smaller molecules in which water is involved and is changed in the process.
2. Describe fluid volume deficit (FVD) and fluid volume excess (FVE).
• Fluid volume deficit (FVD):
o A person experiences vascular, cellular, or intracellular dehydration
o Severe FVD happens when body fluid levels fall by 10% of weight
o Can occur from diarrhea, high fever, vomiting, excessive sweating, diuretics, polyuria (excess urination).
o Characteristics of FVD:
Infrequent urination, decreased skin elasticity, dry mucous membranes, dry mouth, drowsiness, lightheadedness, disorientation, thirst, nausea, slow/rapid breathing, sudden weight loss
o Orthostatic hypotension (rising from a sitting or lying position)
o Doesn't have to be illness; can be excessive physical activity, hot/dry weather
o Treatment for moderate or severe FVD:
Intravenous therapy (IV) to replaced fluids.
o Risk: older adults and infants
• Fluid volume excess (FVE):
o Increased fluid retention and edema.
Edema is an excess accumulation of fluid in the interstitial spaces, which is caused by the circulatory system.
o Compromises the regulatory mechanism, excess fluid, or excess sodium intake.
o Sodium sensitive people retain fluids when consuming lots of sodium, but also increases blood pressure, which can lead to hypertension.
o Water intoxication- consuming large volumes of water within short time, so dilutes electrolytes in body fluids
Causes: muscle cramps, decreased blood pressure, and weakness
3. List three factors that may affect the bioavailability of minerals.
• Minerals in soils where plants are grown
• Food processing
• Fat content
• Binders
o EX: oxalic acid and phytic acid bind with calcium so human body cannot separate it for Ca absorption.
4. Do minerals provide energy? Why or why not?
• No, they are inorganic and are not metabolized by the human body.
5. How are blood calcium levels regulated?
• They are regulated via calcium homeostasis.
• Parathyroid hormone: responds to low calcium levels
• Calcitriol: increases calcium levels
• Calcitonin: lowers both calcium and phosphate in blood; responds to high calcium levels
6. List several nondairy sources of calcium.
• Leafy greens
• Small fish with small bones
• Orange juice (fortified)
• Legumes
• Tofu
7. Name several factors that hinder calcium absorption.
• Aging
• Binders (e.g. phytic and oxalic acids)
• Dietary fat (can form insoluble soap with calcium it’s so hard to digest.
• Dietary fiber high fiber moves food through the GI tract too fast for mineral to be absorbed.
• Drug use
• Sedentary lifestyle causes less bone density
• Excessive intake of phosphorus or magnesium
8. List three risk factors for osteoporosis.
• Unmodifiable factors: race, gender, and family history.
• Modifiable factors: nutrition (Calcium intake), alcohol, smoking, caffeine, and sedentary lifestyle.
9. Name the seven major minerals, and list one good food source of each.
• Calcium
o Source milk or leafy green vegetables
• Phosphorus
o Source dairy foods, egg, and poultry
• Magnesium
o Source whole grains and legumes.
• Sulfur
o Source all protein containing foods.
• Sodium
o Source salt (3/4 tsp)
• Potassium
o Source naturally found in fruits/veggies (tomatoes, white potatoes with skin, bananas, and oranges).
• Chloride
o Source foods containing sodium (salt)
10. Name the nine trace minerals, and describe one function of each.
• Iron
o Function responsible for distributing oxygen throughout the body. Iron also assists enzymes with oxygen use by cells.
• Zinc
o Function assists insulin function and affects growth process, taste and smell ability, headlining process, immune system, and CHO metabolism.
• Iodine
o Function part thyroxin hormone which is involved in regulating growth and development, basal metabolic rate, and body temperature.
• Fluoride
o Function increases resistance to tooth decay; part of tooth formation and skeletal health.
• Selenium
o Function part of enzyme that acts as antioxidant. They work with vitamin E to prevent cells and lipid membrane damage from oxidizing substances.
• Copper
o Function:
Coenzyme involving antioxidant reactions and energy metabolism.
A component of wound healing
Constituent of nerve fiber protection
Required element for iron use
• Chromium
o Function role in CHO metabolism as a constituent of glucose tolerance factor that facilitates the reaction of insulin.
• Manganese
o Function a component of enzyme involved in metabolic reactions.
• Molybdenum
o Function coenzyme
11. Which vitamin enhances the absorption of iron?
• Vitamin C
12. Name three life cycle stages that have an increased risk for anemia.
• Young children
• Teenage girls
• Women of childbearing
13. Explain two possible reasons for hemosiderosis.
• It’s a health concern that involves storing too much iron in the body.
• Hemochromatosis: is a genetic disorder that allows more dietary iron to be absorbed than normal.
• Consumption of very high levels of iron containing foods. [Show Less]