NST 10, Fall 2013 Exam 1 Review Guide

Lectures
I.

Introduction Why do we care about nutrition o Plays a part in our health mentally and physically o Prevents/causes disease o Conflicting information in media Definition of nutrition versus nutrients o Nutrition: How foods impact our body o Nutrients: Essential things in our food that are required for sustaining life Added sugars and their negative effects Intake of sugar is greater than energy used o Glycemic Stress o Obesity o CVD o Diabetes Macronutrients (chemical composition, function, example, kcal/gram) o Lipids/Fats: 9 kcal/gram Energy Storage 20-35% AMDR Triglycerides is the most major form Major form of fat in blood Key Energy Source Made of fatty acid + glycerol (makes fat more soluble) Carbon, Hydrogen, Oxygen o Proteins: 4 kcal/gram - For our muscles and bones 10-35% AMDR Carbon, Oxygen, Hydrogen, Nitrogen Formed by bonding amino acids o Carbohydrates: 4 kcal/gram - Sugar, Starch, Fiber If not enough carbs, body will break down proteins (ketosis) 45-65% AMDR Carbon, Oxygen, Hydrogen Complex: Polysaccharides Starch (in grains), Glycogen, Oligosaccharides Simple: (mono/disaccharides) Micronutrients: Yields no energy o Minerals: Salt, Zinc, Iron, ect. o Vitamins: A, D, E, K fat soluble [increases risk of toxicity b/c stored in body] B, C Water Soluble [deficiencies because its excreted easily] Organic Nutrients: Contain Carbon o Carbohydrates, proteins, lipids, vitamins Inorganic Nutrients: No Carbon o Water, Minerals Water: Lubricant, body temperature regulation, transporter, solvent

II.

Tools of a healthy diet Dietary Reference Intakes o Identifies a healthy persons nutrient needs Nutrient recommendation terms (RDAs, AIs, ULs) o Estimated Average Requirement: 17 nutrients that have functional markers Meets need for 50% of population o Recommended daily allowance: average daily intake that meets needs for 97-98% of healthy people in a given population Gender/Age Specific Set for many micronutrients, protein, carbs o Adequate intake: Insufficient amount of information to create an EAR Value based on an observed/experimentally determined approx. of nutrient intake by a group -> Needs more research Set for some minerals, vitamins, water, fatty acids, fiber o Tolerable Upper Intake Level: Highest level of nutrient intake that doesnt cause a risk of adverse effects for a given population Going above the UL = risk for toxicity & detrimental health outcomes RDA & AI: tell the nutrient level to prevent chronic & deficiency diseases Energy recommendation terms (EER, AMDR) o Estimated Energy Requirement: Average daily caloric intake for each life-stage group o Acceptable Macronutrient Distribution Ranges Associated with reduced chronic disease Provides sufficient intake of essential nutrients Intake for energy yielding nutrients Expressed as a total percentage of total calories Dietary Guidelines for Americans: four key recommendations o Consume more fruits and vegetables o Limit nutrient intakes that increase risk of chronic disease (fats) o Build healthy eating patterns: eat more nutrient dense foods o Balance calories to manage weight MyPlate and its components o Proteins, Vegetables, Grains, Fruits, Some Dairy o Personalized plan for your age, weight, gender, height, activity level The food supply A place at the table (video) o children dont know where their next meal is coming from o 50 million Americans are food insecure Food insecurity- definition and statistics o Limitability/uncertain availability of adequate nutritional & safe food o Or ability to acquire acceptable food in a socially acceptable way o Food insecure households 14.9% o Households w/ low food security 9.2%

III.

o Households with very low food security 5.7% Categories that are at risk for food insecurity o Single income families o Disabled individuals o Unemployed o Homeless o Seniors o Live in public housing Strategies to avoid hunger o Binge eating o Eating less at each meal o Buy in bulk/generic brands/coupons o Skipping meals o Hoarding o Putting off expenses/bills o Food pantries/soup kitchens o Eating highly filling foods o Small Variety o Low cost foods Health effects of food insecurity o Malnutrition o Decreased immune system o Asthma o Mental issues (anxiety, depression, childhood aggression) o Hunger Obesity Paradox Occurrence of obesity and food insecurity Lack of access to healthy foods High exposure to unhealthy foods Inconsistent access to food -> overeating o In food banks Focus on providing quality > quantity Nutrition policies: Decide what is purchased & accepted (no soda) Provide nutritional score to all distributed food (SF FB = 2.7/3) Teach cooking & nutrition classes at food pantries o Nutrition tips: Rinse canned beans & vegetables to lower sodium Use only packet of seasoning in bag Add water to juice -> lower sugar Add vegetables to food to make healthier meal o Higher weight of Obesity among lower incomes b/c [food deserts]: Food cost for healthy food = expensive. Fruits & veggies increased 40% between 1985-2000 while sodas decreased 25% Cheap food: low nutritional quality / high caloric density taste good Food landscape in low income neighborhoods: Lack of supermarkets, specialty shops, bakeries Low fruits/veggies availability Many corner/liquor stores & fast food restaurants

 IV.

o high cal, no nutrients Food access: transportation to grocery stores: low car ownership

Digestion 1 (Gluten Free Craze) Why Gluten free? o Craze that it will be healthier o Gluten intolerance o Celiac Disease (damages villi in small intestines) Definition of Gluten o Gluten is a wheat protein made up of amino acids and is a protein that gives dough its elasticity (traps carbon dioxide in so then the dough rises) o Not exactly beneficial, but its found in beneficial nutrients: wheat, barley, rye o Gluten = Gliadin (alcohol soluble) + glutenin (diluted acid soluble) Celiac disease: definition, signs and symptoms, association with obesity, treatment o Definition: Autoimmune disorder o Due to genetic disposition, immune deregulation, environmental factors o Signs: Bloating, abdominal pain, diarrhea Less noticeable: Anemia, joint, stomach pain, irritability, dental / bone disorders, weight loss, stunted growth in kids Irritable bowel Dermatitis herpetiformis o Disrupted intestinal nutrient uptake Damaged villi dont absorb the 6 nutrients + bile salts Untreated: nutritional deficiencies (iron/calcium/vitamins) o After ~4.5 years after gluten free diet, it doubled the % of overweight participants Nutritional imbalance of gluten-free foods Replaced gluten carbs w/ fat, protein, high cal bev. & decr. fiber o Treatment = no gluten! Anything that has wheat, barley, rye Includes malt (made from barley), food additive (soy sauce, caramel color, modified food starch) Processed foods (sausage, TV dinners) Non-Celiac gluten sensitivity: definition, symptoms, diagnosis, conflicting scientific evidence o Definition: unexplained gastrointestinal & other symptoms by patients attributed to gluten o Symptoms: Gastrointestinal (abdominal discomfort, bloating, pain, diarrhea) Extra-intestinal (headaches, foggy mind, depression, fatigue, musculoskeletal pains, skin rash) o Diagnosis: Non-celiac is negative for diagnostic tests for celiac disease No antibody test No evidence of intestinal atrophy o Self-reported (primarily) Concern about placebo and nocebo effect o Report 2011 -> gluten symptoms was higher and the placebo was lower (good) but then in the second study the high gluten intake was lower in symptoms and the placebo was higher. Peptide: Short chains of amino acids bonded by peptide bonds o Are the ones who choose which amino acids are involved in the chain Polymer/monomer: molecule bonded to other molecules to make a polymer

 V.

Cilia: small hairs outside of single celled organisms for movement Villi: small hair like projections used for nutrient absorption in small intestines Digestion 2 (Microbiome) Different kinds and amount of microbes o 10x more microbial than human cells o ~1000 different species of microbes o 3 lbs of microbes in gut ~ 60% = stool Gut microbiome: definition, functions, composition (variety) o Microbiome: collectivity of all microbe in human body; environment o Microbe: Living organism (protozoa, fungus, bacterium, or virus) Majority are beneficial Some break down cellulose in the gut -> helps w/ digestion Synthesizes vitamins (folate, biotin) Develops immune system Pharmaceutical use of microbiome o Host gene expression changes o Drug -> byproduct toxin to host o Antibiotics -> kills bad bacteria How can the microbiome be changed o Nutrients affect the composition of intestinal microbial o Microbiota is distinct in lean/obese people Gut flora and obesity: transplant experiments o Obesity changes relative proportions of firmicutes vs bacteriods o Firmicutes > in obese people o Gut flora = responsible for energy production from food Test: Germ free mice had a higher increase in weight gain than the mice who were given normal gut flora o Mice given microbiota from obese/lean humans -> mice take on characteristics of the human donors Pre vs probiotics o Prebiotics: Food ingredient that promote the growth and expression of a beneficial biological property(s) of one or more resident gut microbes o Probiotics: live organisms when digested help in benefiting the host either directly through interactions with host cells or indirectly thru effects of members in microbiota Carbohydrates 1 a. Carbon, hydrogen, oxygen b. Produced by plants via photosynthesis Monosaccharides, disaccharides, oligosaccharides and polysaccharides o Monosaccharide: Glucose: Blood sugar Fructose: High Fructose corn syrup Galactose: part of lactose (galactose + glucose = lactose / milk sugar) Sugar Alcohols (monosaccharide derivatives) Xylitol, mannitol, sorbitol

VI.

Pentoses (5 carbon): Ribose & deoxyribose o Disaccharides: 2 monosaccharides linked by condensation reaction Condensation reaction: two molecules bond to form one larger molecule, but a small molecule is lost in the process Alpha or beta C-O-C bonds connect them Cant break down beta bonds b/c we dont have approp. Enzymes o (Cellulose) Lactose: Galactose + Glucose (beta bond) Maltose: Glucose + Glucose = Alpha bond Sucrose: Glucose + Fructose: Alpha bond o Oligosaccharides: 3-10 sugar units Raffinose and Stachyose Indigestible; bacterial fermentation gas o Polysaccharides: Contain many glucose molecules Alpha / beta bond determine digestibility Simple versus complex carbohydrates o Simple: Monosaccharides & Disaccharides o More complex: Polysaccharides (starch, glycogen, fiber) Digestible polysaccharides: plants versus animals, functions o Digestible: Starch (plants) o Amylose: Straight Chain o Amylopectin: Branched Glycogen (animals) o Storage form of glucose o Liver glycogen (90 g) converted to blood sugar o Muscle Glycogen (300 g) glucose for muscle use Indigestible polysaccharides: different kinds of fiber and its health benefits, functions o Indigestible: Total Fiber: Dietary fiber + functional fiver Soluble fibers: Pectin, gum, mucilages, some hemicelluloses o Found in veggies/fruits, oats, oatmeal, barley o When mixed with water, it swells up and aids in the regulation of glucose blood levels and lowering cholesterol Insoluble fibers: Cellulose, hemicelluloses, lignin o Found mainly in bran / cereal grains o Benefits intestinal health Helps in preventing hemorrhoids / constipation Functions: Promoting bowel health: constipation and hemorrhoids o Diverticula (on the large intestines) Reducing obesity risk (fullness and satiety) Enhancing blood glucose control (soluble fibers) Reducing cholesterol absorption (soluble fivers) Purpose of glycolysis and gluconeogenesis o Glycolysis: converts glucose to pyruvic acid (gives energy to cells) o Gluconeogenesis: Breaks down proteins back to carbs glucose

(when you dont eat enough carbs) Carbohydrates in food o Starch, fiber, nutritive sweeteners (mono & disaccharides, high fructose corn syrup, sugar alcohols) Alternative sweeteners o Yield no energy o Acceptable daily intake o Saccharin Oldest alternative sweetener Develops bitter taste with cooking o Aspartame Contains phenylalanine Tasteless when used to cook o Neotame: Similar to aspartame but not digested o Acesufamine K: Can be used in cooking o Sucralose: Made from sucrose: can be used in cooking o Tagatose: Isomer of fructose, pre-biotic o Stevia: Recently approved by FDA for use in beverages Sold as dietary supplement DRI for carbohydrates o RDA: 45-65 % total energy needs o Limit added sugars and caloric sweeteners o Fiber: 14g/1000kcal is adequate intake 25 g/d women under 50 (21 g/d after 51) 38 g/d men under 50 (30 g/d after 51) Our carbohydrate intake o 50% of total energy needs (meets) o Added sugars 16% kcal (exceeds) Recommendations: 6% kcal (dietary guidelines) 10% kcal (WHO) 25% kcal (DRI) o Dietary fiber: 25-50% less than recommended Average intake 1 fruit / 1 or fewer whole grain servings Carbohydrates digestion and absorption o Adequate carb intake spares proteins (body does not utilize gluconeogenesis converts pyruvic acid back to carbs (glucose)) o Prevents ketosis: Incomplete breakdown of fatty acids o Digestion: Mouth: Salivary amylase begins digestion Small intestine: Specific enzymes break down disaccharides Enzymes: maltase, sucrase, lactase Fiber not broken down o Absorption: Active absorption: glucose and galactose Facilitated absorption: fructose

Liver converts fructose and galactose to glucose Blood glucose used by cells Glucose storage: Muscle and liver glycogen Excess glucose: convert to fat by liver (stored in adipose tissue) Health concerns related to carbohydrates o Very high fiber diets (above 50-60 grams) High fiber + low fluid = constipation Decrease absorption of certain minerals o High sugar diets Increase risk of weight gain / obesity Increase risk of dental caries CVD o Lactose intolerance: Primary: decreased lactase production Secondary: Associated with disease that damage the lactase producing cells o Glucose intolerance: Hypoglycemia Hyperglycemia Regulation of blood glucose o Normal concentration: 70-100 ml/dL (regulated by liver) o Insulin (pancreas): hormone: facilitates transfer of glucose from blood into cells. Lowers blood glucose o Glucagon, Cortisol, Epinephrine, Norepinephrine & growth hormone Raise blood glucose Other blood sugar disorders o Metabolic syndrome: Group of factors that increase risk for type 3 diabetes & CVD o Hypoglycemia: Reactive hypoglycemia: exaggerated insulin response after eating Fasting Hypoglycemia: Low blood sugar after fasting Glycemic index and glycemic load o Glycemic index: ratio of the blood glucose response to a given food, compared w/ a standard Influenced by many factors Based on a 50g carbohydrate serving o Glycemic Load: Amnt. Of carbs in consumed food (x) GI and divided by 100 Better reflects a foods effect on blood glucose than GI alone Diabetic: After hours, blood glucose levels dont go down Type 1 Diabetes: o Autoimmune disease: insulin producing cells in pancreas = destroyed o Diet must be coordinated with insulin: carb counting, exchange system o Increased risk for CVD, blindness, kidney disease Type 2 Diabetes: o Progressive disease o Insulin resistance Production may be low, normal, or high

o Most common type of diabetes (90% of cases) o Treatment: Diet, physical activity, medications VII. Lipids Types of lipids: triglycerides, phospholipids, sterols (makeup, sources, function) o Triglycerides: Fatty acids (most common in food & body) Esterification: Joining 3 fatty acids to a glycerol unit De-esterification: Release of fatty acids-results in free fatty acid Diglyceride: Losing one fatty acid Monoglyceride: Losing 2 fatty acids Re-esterification: reattaching a fatty acid Source: Animal fats & vegetable oils (described by predominate fatty acid) Low in fats =>Dairy, grains, fruits, vegetables (low in fat except avocado & coconuts) Function: Provides energy, compact energy storage, insulate & protect the body, aid in fat-soluble Vitamin absorption & transport, Essential fatty acid functions (Eicosanoids messenger in CNS) o Phospholipids: Hydrophobic & hydrophilic ends Function: Components of cell membranes Emulsifiers (way in which phospholipid can become more water soluble) (bile) Sources: Synthesized by body Egg yolks, wheat germ, peanuts o Sterols: Carbon arranged in rings Most well-known: cholesterol Bile referred to as detergent (injected to intestines after big meal) Functions: steroid hormones, bile, cell membranes lipoprotein shell Sources: Synthesized by the body Foods of animal origin (cholesterol) and plants (plant sterols such as sitostanol) Cholesterol gets into cell membrane -> makes sterol Only one tissue in our body can break cholesterol down Converting cholesterol into bile is only way to get rid of it Our body is able to make cholesterol Sterols do not give energy Types of fatty acids, chain length and bond structure o Fatty acids: Carbon chains of varied length (always even) Long chain: 12 or more carbons Medium chain: 6-10 carbons Short chain: <6 carbons Saturated versus unsaturated fatty acids o Saturated: No Double bonds (no kinks -> stacks up / single chain) o Monounsaturated: One double bond (one kink -> better than saturated) o Polyunsaturated: Many double bonds (best fatty acid)

o Unsaturated (cis): Soluble at room temperature o Hydrogenation: Adding hydrogen to make an unsaturated fat more saturated -> trans fatty acids (straight carbon chain) Cis versus trans structure o Cis adds the kinks (cause carbon chain to bend) to fatty acids (unsaturated) trans is like saturated straight carbon chain Essential fatty acidsnames, dietary sources, functions o Omega system: first double bond closest to methyl end of carbon chain o Delta system: starts w/ carboxyl end to indicate location for all double bonds o Alpha-linolenic (omega 3) Controls blood clotting, building cell membranes in the brain Reduces chance of CVD and stroke Reduce inflammation Polyunsaturated fatty acid o Linoleic (omega 6) Polyunsaturated fatty acid? Promote inflammation From plant oils Too much can lead to depression / other medical conditions Helps in reducing diabetic neuropathy, Rheumatoid arthritis, allergies, high blood pressure Fat dietary needs and recommendations (i.e. AMDR, DGA, AHA) o No RDA o AMDR: 20-35% o Dietary Guidelines 2010: Limit saturated & trans o AHA for those at risk for heart disease: Limit saturated fats to 7% of total cal Limit Cholesterol intake to less than 200 mg o Essential fatty acid needs: Adequate intake: 2-4 tablespoons oils daily Mediterranean Diet o 40% kcal from fat is healthy if mostly MUFA o Olive oil as main o Small amounts of cheese & yogurt daily o Weekly fish intake (limit use of eggs & red meat) o Exercise & diet o Moderate wine intake o Abundant amount of fruits & veggies, whole grains, beans, nuts, seeds American Fat intake o N. America fat intake has doubled in last century o Omega 6 intake = plentiful o Omega 3 intake = low Food sources, supplements, cautions Lipid digestionlocation and key players o Mouth (Lingual lipase) o Stomach (gastric lipase) o Small intestine: CCK (cholecystokinin) -> triggers bile Bile emulsifies fat o Fat digestion in small intestines:

Triglycerides are broken down into monoglycerides & free fatty acids Phospholipids are broken down into free fatty acids, glycerol, phosphoric acid Cholesterol esters: broken down into cholesterol & free fatty acids Fat is transported as lipoproteins Lipid absorption o Short & medium chain fatty acids = absorbed via portal vein o Long chain fatty acids = re-esterified & enter the lymphatic system o Bile is recycled via enterohepatic circulation Lipoproteins: chylomicrons, VLDs, IDLs, LDLs, HDLs and their makeup o Chylomicrons (triglyceride): Transport of dietary triglycerides Carries dietary fat from small intestine to cells o VLDLs (very low) (triglyceride): Produced by liver release triglycerides Carries lipids both taken up & made by the liver to cells o IDLs (intermediate): Formed from VLDL o LDLs (cholesterol): Formed from IDL contain mostly cholesterol Carries cholesterol made by liver and from other sources to cells o HDLs (protein): pick up and recycle or dispose of cholesterol from cells & excretes cholesterol from body Picks up and sends it back to liver By getting it back to the liver, it has more of a chance for your body to get rid of the cholesterol by making it into bile o When our body has too much cholesterol, liver just ships out excess cholesterol as VLDL & its stored in artery walls, ect Transporting fat in blood o Transported as lipoproteins: lipid core & shell composed of proteins, phospholipids and cholesterol Three pathways for cholesterol uptake o Receptor Pathway: LDLs taken up by cells, broken down, and components utilized. Excess in blood become oxidized o Scavenger Pathway: White blood cells remove oxidized LDLs Cholesterol can build up in these cells & kill them results in atherosclerosis (plaque of the artery -> blood starts clotting) o HDL: Picks up cholesterol throughout body Health concerns related to lipids o High polyunsaturated fat intake o Excessive omega 3 fat intake o Imbalances in omega 3 and omega 6 fats o Intake of rancid fats o Diets high in trans fat o Diets high in total fat Cardiovascular disease (CVD) and risk factors for heart disease, prevention of CVD o Major killer of N. Americans o Development of CVD: Atherosclerotic plaque

Heart attack and stroke o Risk Factors: Age, gender, race, genetics Blood cholesterol & triglyceride levels, hypertension, smoking, physical inactivity, obesity, diabetes, other diseases o Prevention: Include 2 grams plant stanols/sterols daily Soluble fiber intake 20-30 grams Moderate sugar intake Body weight at healthy level Increase physical activity Polyunsaturated <10% Monounsaturated <20% Kcals per gram of fat o 9 kcals / 1 gram of fat

Discussion Sections I. Nutrition Guidelines Dietary Reference Intakes o DRIs: Set of nutritional values that estimates the nutrient intake one must use when planning / assessing diets for healthy well-being Nutrient recommendation terms (RDAs, AIs, ULs) o Recommended Daily Allowance: Used to evaluate current intake for a specific nutrient. If intake strays above or below this value, the greater the likelihood a person will develop nutrition-related problems o Adequate Intake: Evaluates current intake for a specific nutrient, but its an estimate. Further research needs to be done to set RDA. o Upper Level: Evaluates highest amount of daily nutrient intake thats unlikely to cause health effects in long run. Intake higher than UL, potential adverse effects inc Energy recommendation terms (EER, AMDR) o Estimated Energy Requirement: Used to estimate energy needs according to height, weight, age, activity level, gender o Acceptable micronutrient distribution range: Determines whether percent of calories from each macronutrient falls within suggested range. Greater the discrepancy with AMDR, greater risk for nutrition-related chronic disease Carbohydrates: 45-65 Proteins: 10-35 Fats: 20-35 Dietary Guidelines for Americans: four key recommendations o Balance calories to manage weight (physical activity) o Food & food components to reduce: sodium, fat, solid fat, refined grains, added sugar, alcoholic beverages o Food & food components to increase: vegetables, potassium, fruit, whole grains, dietary fiber, vitamin D, calcium o Building healthy eating patterns MyPlate and its components o Latest food guide from USDA (US Department of agriculture)

o Illustrates appropriate proportions of food from each food group that make up a healthy diet o Fruits, vegetables, proteins, grains, dairy II. Digestion Digestion: definition o Gastrointestinal Tract: Takes in food and absorbs the nutrients and energy from the food and gets rid of the waste Gateway for converting food to nutrients (energy) Main digestive organs: name and order o Stomach: Acidic env. stops salivary amylase. Very little digestion of carbs takes place here o Small intestines: o Large intestines: fiber is partially broken down by bacterial enzymes o Anus: Allows waste to leave the body o Stomach: Secretes hydrochloric acid (HCL) to denature proteins and convert pepsinogen to pepsin -> digests protein. Accessory organs o Salivary glands: Amylase begins to break down starches into shorter glucose chains o Pancreas: Produces and releases pancreatic amylase o Secretin tells pancreas to secrete bicarbonate (naturalizes chyme/acid) & CCK tells pancreas to secrete pancreatic enzymes into the small intestine o Secretin stimulates liver to secrete bile into gallbladder o Liver: Produces bile o Gallbladder: Stores bile. CCK triggers gallbladder to secrete bile to small intestines Appetite vs Hunger o Appetite: More discriminating. Psychological desire/craving for specific food o Hunger: Physiological process that is less discriminating (eat anything edible) Gastrointestinal motility and peristalsis Digestion of Carbohydrates, Protein and Fat: events in each organ, which enzymes and hormones are involved o Carbs: Mouth/Salivary glands Stomach pancreas small intestine large intestines anus Hormones: o Secretin: tells pancreas to secrete bicarbonate Stimulates CCK -> tells pancreas to secrete pancreatic enzymes in small intestines Enzymes: o Salivary amylase: Breaks down starches

o Protein: Stomach Pancreas Small Intestine Hormones: o Protease: Enzyme that starts the cannibalism of the protein by hydrolysis of the peptide bonds that bind amino acids o CCK: Digestion of fat & proteins Causes release of digestive enzymes & bile from pancreas and gall bladder o Secretin Enzymes: o Intestinal brush border digestive enzymes: digest small polypeptides to amino acids o Pepsin: digests proteins o Pancreatic peptidases: hydrolyze peptide bondso Fats: Pancreas Liver Gallbladder Small intestines Hormones: o Secretin: regulates water homeostasis. Control environment in duodenum by regulating secretions of the stomach/pancreas o CCK: Is released w/ secretin when food reaches duodenum Stimulates the digestion of fat and proteins Causes release of digestive enzymes & bile from pancreas and gallbladder Digestive Enzymes Lipase: Enzyme thats a catalyst of hydrolysis of fats Bile: where its made and stored; its function. How is its secreted/ storage is regulated o Bile emulsifies fat o Helps form tiny droplets of fats which move up against the mucosal lining (lining of stomach), facilitating fat absorption Carbohydrates Sources of carbohydrates o Grain produces, veggies, fruits (Sugar, starch, fiber) Kcals per gram of carbohydrate o 4 kcals/g AMDR for carbohydrates o 45-65% Calculating % of carbohydrates as a percent of total kcals consumed o g intake x 4kcals = x -- (x / total calories) 100

o Intestinal brush border digestive enzymes: digest sugars into monosaccharides

III.

Parts of a whole grain o Bran: outer most layer: has fiber & vitamins (but lost during processing) o Germ: mid layer: mostly starch o Endosperm: unsaturated fatty acid. Contains Vit B & E (lost thru processing) Enrichment (what is it) versus Fortification o Enrichment: Replaces nutrients that were originally in the food o Fortification: Introducing new nutrients into the food Benefits of Fiber o Fills you up o Promotes a healthy gut microflora o Slows nutrient absorption (stabilizing glucose levels) o Stimulates gastrointestinal tract mobility o Can reduce CVD and cholesterol Added sugar and why is it bad o Can increase CVD o Increase obesity o Diabetes, increased blood levels of triglycerides o Increase LDL lower HDL o Increase dental caries (tooth decay) o Hyperactivity in children Whole wheat/grain: contains all 3 parts of the grain. o On boxes, whole wheat means that its only needs to contain 51% of whole grains Multigrain: Doesnt necessarily mean that its healthier just that multiple grains are used o Oats, barley, wheat Refined grains: to taste better and increase shelf life o Remove bran & germ layers o Refined grains are enriched with certain B vitamins after processing o Riboflavin, niacin, thiamin, iron, folate [fitrn] Still lacks fiber Dietary Fat Fat in the media Bad Fats o Saturated Fats: Stacks up and solid at room temperature Increases LDL cholesterol o Trans Fats: Hydrogenation of unsaturated fats. More stable easier to cook with. Prolong shelf life o Cholesterol: increased cholesterol => risk of CVD Good o Monounsaturated fats: One kink/double bond. Harder to stack up. Liquid at room temperature Avocado oil, olive oil o Polyunsaturated fats: Omega 3: Alpha Linolenic Fatty fish (salmon) Omega 6: Linoleic: Plant oils (safflower, nuts, seeds sunflower oil) Recommendations for fat intake o 20-35 % AMDR

IV.

o < 7% Saturated fat o < 200 mg cholesterol o < 160 LDL cholesterol o Triglyceride levels < 150 mg Modifiable and non-modifiable risk factors for cardiovascular disease o Non-modifiable: Gender: guys are at a higher risk than girls for CVD Age: those at a higher age are more likely to get CVD Genetics: having a family member dying at a young act to CVD Race: African Americans -> more severe hypertension -> possible CVD o Modifiable: High cholesterol intake Smoking (risk 2-4x) Lack of physical activity Obesity (excess fat on sides = increases in LDL) Blood pressure: hypertension leads to toughening and thicker heart muscle Diabetes: practically a precursor to having CVD 75% die of some sort of CVD Tips to reduce fat intake when eating out o Skim milk instead of whole milk o Cook with less oil o Dressing on side o Portion sizes o Skin off fat - MSG: monosodium glutamate: leads to hypertension -> atherosclerosis Excitoxin: over excites your cells and damages them (damages parts of brain hypothalamus) Can lead to Parkinsons disease (brain dysfunctions impaired speech / movements), Alzheimers, ect