REVIEW FOR FINAL

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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

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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

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Vitamin E Functions

• Antioxidant (also C and carotenoids)• Reduces oxidative stress from free

radical damage• Vitamin E is a “chain breaking

antioxidant”

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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

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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

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*** 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

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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

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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

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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

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Calcium

• Absorption• Slightly more efficient in upper SI (more

acidic)• Things that influence absorption:– Food source– Vitamin D needed– Efficiency increases during times of need– Full stomach– Age– Fiber, oxalate, phosphorus, polyphenols

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