1. Define essential and non essential nutrients.

An essential nutrient omission leads to decline and normal function is regained when

restored to the diet. Has a specific biological function. Carbs, Lipids, Proteins, Vitamins, Minerals,

and Water. A nutrient is said to be "essential" if it must be obtained from an external source,

either because the organism cannot synthesize it or produces insufficient quantities. Non-

essential nutrients include antioxidants and phytochemicals. Nonessential nutrients are those

nutrients that can be made by the body, they may often also be absorbed from consumed food.

The categories of functional nutrients include: Provide Calories, For Growth, Development, and

Maintenance, and Regulate Body Processes

2. Define and describe fiber, how is fiber digested? What are the recommended dietary

guidelines for daily fiber consumption?

Fiber is undigested starch. The body cannot break the bonds and fiber is not digested. Insoluable

fiber includes cellulose, lignin, etc and is not fermented by the bacteria in the colon. Soluable fiber

includes gum, pectin, mucilage and is found in fruit, vegetables, rice bran, psyllium seed.

AI is 25 grams/day for women, 38 grams/day for men. Goal of 14 grams/1000 kcal. DV is 25

grams for 2000 kcal diet.

3.Define Kilocalorie

a measurement of energy. The amount of heat it takes to raise the temperature of 1 gram of

water 1 degrees celsius. 1000 calories= 1kcal= 1 (food) Calorie The amount of heat it takes to

raise 1000 grams (1 liter) of water 1 degree celsius.

4. Calculate the percentage of meal macronutrients to kcal

If days intake is 1980 calories

290 gm of carbs (*4 kcal/gm), 60 gm of fat (*9 kcal/gm), 70 gm of protein (*4 kcal/gm)

%of kcal as carbs (290*4)/1980= .59 or 59%

%of kcal as fat= (60*9)/1980= .27 or 27%

% of kcal as pro=(70*4)/1980= .14 or 14%

5. Know energy provisions per gram for each macronutrient:

Carbs and Protein both 4 kcal/gm, Fat=9 kcal/gm, and Alcohol= 7 kcal/gm

6. What are the My Pyramid serving recommendations based upon?

Gender, age, size, and activity levels determines how many calories you need per day.

The food guide pyramid translates science into practical terms while helping people meet

nutritional needs. Suggests a pattern of food choices and incoporates foundations of healthy diet:

variety, balance, moderation.

7. What is the FDA?

Food and Drug Administration. Ensures safety and wholesomeness of all foods in interstate

commerce (except meat, poultry, and processed egg products), regulates seafood, and controls

product labels. Their methods include inspection, food sample studies, sets standards for specific

foods.

8. Define and Describe monounsaturated, polyunsaturated, and saturated fat; how are they

digested, what are the effects of each on the body?

Saturated fat includes single carbon bonds while monunsaturated fatty acid structure includes

one double bond, and polyunsaturated fatty acids have 2 or more double bonds. All groups

include a methyl end and an acid group. Saturated fats are found in solid form while unsaturated

are in the liquid form. Fats are composed of both.

9. What are the different components of a clinical nutrition assessment?

ABCDE'S: Anthropometric, biochemical, clinical, and dietary information help determine a

person's nutritional state. Economic status adds further information.

Background: Medical history (current diseases, past surgeries, current weight, weight history and
current medications), social history (martial status, living conditions), family health history,

education attainment, economic status.

Nutritional: Antrhopometric assessments, biochemical assessments of blood and urine, clinical

assessments (general appearance of skin, eyes, and tongue etc), as well as dietary assessment

(i.e. 5 day food log)

10. Why were the dietary guidelines developed?

Published by USDA and DHHS and were created to promote optimal nutrient intakes and diet

composition as well as adequate vitamin and mineral intakes. Reduce the risk of chronic

diseases. Intended for healthy children 2 and over as well as adults.

11. What is the difference between nutrient dense and nutrient poor foods?

Nutrient dense is the comparison of vitamin and mineral content with number of kcals vs nutrient

poor= empty calories.

The ratio derived by dividing a food's nutrient content by its calorie content. When its contribution

to our need for that nutrient exceeds its contribution to our calorie need, the food is considered to

have a favorable nutrient density.

12. Describe the route of blood flow in and out of the heart.

1. Right side of heart accepts oxygen-depleted venous blood that has already circulated to body

cells.

2. Blood is pumped out of right side of the heart to lungs

3. Gas exchange takes place in the lungs. Blood picks up oxygen and relases carbon dioxide.

4. Left side of the heart receives oxygen-rich blood from the lungs.

5. Oxygenated eblood from the left side of the heart is destine for body cells.

6. Blood reaching the small intestine supplies oxygen and nutrients to intestinal cells; also picks

up nutrients from digestion of food.

7. Nutrient-rich venous blood leaves the small intestine and travels via a portal vein to liver.
8. Near the small intestine, lymph vessels pick up fats. Lymph is eventually returned to the blood.

9. When blood reaches the kidney, waste products, excess nutrients, and water are removed.

The removed substances are excreted via urine. Filtered blood returns back into circulation.

13. Describe the route of metabolism in detail, be able to trace each type of macronutrients thru

the body from entrance to exit, including enzymes and accessory organs. Be specific.

1. Mouth & salivary glands: chewing begins, moistens food with saliva, lubricates with mucus.

Release of starch-digesting (amylase) enzyme, initiation of swallowing reflex.

2. Esophagus: Lubricates with saliva, moves food to stomach by peristaltic waves

3. Stomach: Stores, mixes, dissolves, and continues digestion of food, dissovles food particles

with secretions, kills microorganisms with acid, releases protein-digesting (pepsin) enzyme,

lubricates and protects stomach surface with mucus, and regulates emptying of dissolved food

into small intestine.

4. Liver: production of bile to aid in fat digestion and absorption

5. Gallbladder: Storage, concentration, and later release of bile into the small intestine

6. Pancreas: secretion of sodium bicarbonate and carb, fat, and protein digesting enzymes

7. Small intestine: mixing and propulsion of contents, lubrication with mucus, digestion and

absorption of most substances using enzyme made by the pancreas and small intestine.

8. Large intestine: mixing and propulsion of contents, absorption of sodium, potassium, and

water, storage and concentration of undigested food, lubrication with mucus, formation of feces

9. Rectum: store feces and expel via the anus, which is the opening to the outside of the body.

Major sites of absorption:

Stomach: Alcohol (20% total) and minor amount of water

Small Intestine: Calcium, magnesium, iron and other minerals. Clucose, amino acids, fats,

vitamins, water (70-90%), alcohol (80% of total), bile acids

Large Intestine: sodium, potassium, some fatty acids, gases, water (10% to 30% of total)

Digestion of Carbohydrate:
Salivary amylase in the mouth breaks starch to shorter saccharides (maltose). Salivary amylase

is inactivated by strong acid in the stomach. Enzymes (amylase) from pancreas break down

starch into maltose in the small intestine. Enzymes in the wall of the small intestine break down

the disaccharides sucrose, lactose, and maltose into monosaccharides glucose, fructose, and

galactose. Monosaccharides are absorbed. Absorption of glucose, fructose, and galactose into

blood to be taken to the liver via a portal vein. Viscous fiber is fermented into various acids and

gases by bacteria in the large intestine. Nonfermentalbe fiber escapes digestion and is excreted

in feces, but little other dietary carbohydrate remains.

Digestion of Fats:

Only minor digestion of fat takes place in the stomach through the action of lipase enzymes.

Gastic lipase is activated by an acidic environment and acts on triglycerides containing short and

medium chain fatty acids. The liver produces bile, stored in the gallbladder and released through

the bile duct into the small intestine. Bile aids in fat digestion and absorption by emulsifying lipids

in the digestive juices. The pancreas secretes a mixture of enzymes, including lipase, into the

small intestine. The small intestine is the primary site for digestion and absorption of lipids. Fat is

broken down to monoglycerides and fatty acids in the small intestine. Once absorbed, long chain

fatty acids are packaged for transport through the lymph and bloodstream (shorter chain fatty

acids are absorbed directly into portal circulation). Less than 5% of ingested fat is normally

excreted in the feces.

Digestion of Proteins:

Protein digestion begins with cooking, as proteins are denatured by heat. Once protein reaches

the stomach, enzymes cleave proteins into smaller segments of amino acids. As food travels

through the small intestine, protein breakdown products formed in the stomach are broken down

further to individual amino acids or short segments of amino acids and taken up into the

absorptive cells of the small intestine where final breakdown into amino acids occurs. The amino

acids then travel to the liver via the portal vein. From Figure: Partial protein digestion by the
enzyme pepsin and stomach acid. Further digestion of polypeptides by enzymes released by the

pancreas. Final digestion of amino acid chains to single amino acids takes place mostly inside

cells of the small intestine. Amino acids absorbed into the portal vein and transported to the liver.

From there they enter the general bloodstream. Little dietary protein is present in feces.

14. Define nutrigenomics

Nutritional genomics is the study of how food impacts health through its interaction with our genes

and its subsequent effect on gene expression. Nutrigenomics includes the study of how genes

determine our nutritional requirements.

15. What are the general dietary recommendations for heartburn?

1. Observe the recommendations for ulcer prevention:

1. Stop smoking

2. Avoid large does of aspirin, ibuprofen, and other NSAID compounds.

3. Limit consumption of coffee, tea, and alcohol

4. Limit consumption of pepper, chili powder, and other strong spices

5. Eat nutritious meals on a regular schedule; include enough fiber

6. Chew foods well

7. Lose weight if overweight

2. Wait about 2 hours after a meal before lying down.

3. Don't overeat at mealtime. Smaller meals that are low in fat are advised.

4. Try elevating the head of the bed (6 inch blocks).

16. Define and describe active, passive, and facilitated absorption.

Active absorption: in addition to the need for a carrier protein, some nutrients also require energy

input to move fromthe lumen of the small intestine into the absoptive cells. This mechanism

makes it possible for cells to take up nutrients even when they are consumed in low

concentrations. Some sugars, such as glucose are actively absorbed as are amino acids.
Passive diffusion: When the nutrient concentration is higher in the cavity (lumen) of the small

intestine than in the absoptive cells, the difference in nutrient concentration drives the nutrient into

the absoptive cells by diffusion. Fasts, water and some minerals are absorbed by passive

diffusion.

Facilitated diffusion: Some compounds require a carrier protein to drive them into absorptive

cells. Fructose is one example of a compound that makes use of such a carrier to allow for

facilitated diffusion.

17. What is PKU and what are the general dietary recommendations for this disease?

Phenylketonuria illustrates the importance of phenylalanine to make tyrosine. A person with PKU

has a limited ability to metabolize the essential amino acid phenylalanine. THe activity of the

enzyme used in this process is insufficient. Both phenylalanine and tyrosine become essential in

a person with PKU. Phenylalanine levels in the blood increase because it is not converted to

tyrosine. PKU is treated by limiting the consumption of phenylalanine with a special diet so that

phenylalanine and its by-products do not rise to toxic concentratsion in the body and cause the

severe mental retardation seen in untreated cases.

18. Compare and contrast starch and glycogen. Where is glycogen found in the body?

Where are starches found in nature?

Glycogen is the storage form of carbohydrate (glucose) for animals and human. Highly branched

structure. Structure similar to amylopectin. More sites for enzyme action and is synthesized and

stored in the liver and muscles.

Starch is a polysaccharide of 1,000 or more monosaccharides. Starch contains amylose (a

straight chain polymer= 20% of starches; vegetables, beans, breads, pasta, and rice) and

amylopectin (highly branched polymer= 80% of starches). It is a carb made of multiple units of

glucose attached together in a form the body can digest; also known as complex carbohydrate.

Starches are digestible. Found mainly in grains, vegetables, and fruits.

19. What is the glycemic index and how is it used?

Glycemic index is the ratio of blood glucose response to a given food compared to a standard

(typically, glucose or white bread). Glycemic index is influenced by starch structre; fiber content;

good processing; physical structure, and macronutrients in the meal, such as fat. It is used when

figuring out the glycemic load of a food= grams of carbs in a food multiplied by the glycemix index

of that food. Divide result by 100. Useful in planning a diet to avoid hyperglycemia (high blood

glucose).

20. Compare and contrast the actions of insulin and glucagon. How and why are they

secreted? What is their effect on the body?

Insulin is a hormone produced by the pancreas. When the concentrations of glucose in the blood

is high, such as during and immediately after a meal, the pancreas releases insulin into the

bloodstream. Among other processes, insulin increases the synthesis of glycogen in the liver and

the movement of glucose from the bloodstream into body cells. When a person has not eaten in

a few hours and blood glucose begins to fall, the pancreas releases glucagon. This hormone has

the opposite effect of insulin. Glucagon is a hormone made by the pancreas that stimulates the

breakdown of glycogen in the liver into glucose; this ends up increasing blood glucose. Glucagon

also performs other functions. Insulin: promotes glycogen synthesis; increases glucose uptake by

the cells. Reduces gluconeogenesis. Net effect: lowers blood glucose. Glucagon: breakdown

glycogen. Enhances gluconeogenesis. Net effect: raises blood glucose.

21. What is lactose intolerance and what are the general dietary guidelines for this

condition?

Lactose intolerance is a severe case of lactose maldigestion. There is a reduction of lactase

made by the body resulting in lactose being undigested and not absorbed. Lactose is metabolized

by large intestinal bacteria which causes gas, bloating, cramping, and discomfort. Dietary

guidelines: determine amount you can tolerate, eat dairy with fat, cheese and yogurt are usually

well tolerated, use lact-aid.

22. What are the diagnositc markers for cardiovascular disease?

Total blood cholesterol greater than 200 mg/dl. Smoking: increases clotting, increases expression

of genetic link, hypertension (greater than 139/89), diabetes: insulin increases cholesterol

synthesis, guarantees development of cardiovascular disease.

23. What is cholesterol and what type of foods can cholesterol be found?

Cholesterol is a sterol: multi-ringed structure, does not have a glycerol backbone, waxy

substance, doesn't readily dissolve in water, found in animal foods. Functions: essential

component of cell membrane, produced by the liver, found only in animal products, forms

important hormones: estrogen, testosterone, vitamin D, precursor to bile acids.

24. What are plant sterols and what is their effect on the body when consumed?

Plant sterols are naturally occurring substances found in plants. They are present in small

quantities in many fruits, vegetables, vegetable oils, nuts, seeds, cereals and legumes. Research

has shown that plant sterols/stanols included with a heart healthy eating plan may reduce your

risk for heart disease. The sterols/stanols work by blocking the absorption of cholesterol in the

small intestine. This lowers the low density cholesterol known as the 'bad' cholesterol (LDL ) by 6-

15%, without lowering the good cholesterol known as the high density cholesterol ( HDL).

Effectiveness has been shown with dosages of 2 to 3 grams plant stanols per day.

25. What are omega 3 fatty acids and what type of foods can omega 3 fatty acids be

found?

Omega 3 fatty acids ( alpha-linolenic acid) are primarily from fish oil. Also found in canola,

walnuts, flax seeds, mussels, crab, shrimp, and soybean oil. Recommended intake of 2 servings

of fish per week. The 1st double bond is located on the 3rd carbon from the omega end.

Decreases blood clotting, reduces heart attack, decreases inflammation, excess may cause

hemorrhagic stroke, other possible uses: lower triglycerides, rheumatoid arthritis, behavior
disorders. Is considered an essential fatty acid.. Performs important roles in immune system

function and vision, forms parts of vital body structures, helps form cell membranes, and

produces hormone-like compounds.

26. What are trans fats? Why are they used in food manufacturing? What is their effect in

the body?

Trans fats are similar to the shape of a saturated fatty acid and are formed during the

hydrogenation of fatty acids. This is the process used to solidify an oil and increase its shelf life.

Addition of H to C=C double bonds. Excessive trans fatty acid intake: raises LDL, Lowers HDL,

increases risk for cardiovascular disease, current intake is 3%-4% of toal kcal, and was added to

food labels in Jan. '06.

27. What is adipose tissue? What is its function? How and why do adipose cells store fat?

Adipose cells tend to re-form the fatty acids into triglycerides for storage.

28. Define proteins, what is their chemical and structural make-up? What are essential vs.

non essential amino acids? What is a limiting protein?

Protein contains nitrogen, carbon, hydrogen, and oxygen and functions to regulate and maintain

body functions as well as provide an essential form of nitrogen (in the form of amino acids).

Structurally they contain an R group, a nitrogen group, as well as an acid group.

The human body uses 20 different amino acids from protein-containing foods. A heathy body can

synthesize 20 of the amino acids, so it is not necessary to obtain all amino acids from foods- only

nine of these must come from the diet and are therefore termed essential amino acids. The

essential amino acid in smallest supply in a food in relation to body needs is called the limiting

amino acids because it limits the amount of protein the body can synthesize.

29. What is denaturation? Be able to provide some examples of how a protein can be

denatured.
Denaturation is the alteration of a protein's three dimensional structure, usually beacuse of

treatment by heat, enzymes, acid or alkaline solutions, or agitation. Heat/acid (i.e stomach

acid)/alkaline/enzymes can result in alteration of the protein's three-dimensional structure.

30. What is the RDA for protein? Be familiar with the guidelines for how to calculate

indvidual protein needs.

.8 gm of protein/kg of healthy body weight (divide pounds by 2.2 for kg). The RDA is increased by

10-15 gm/day for pregnancy. Endurance athletes: may need 1.2-1.7 gm/kg healthy weight,

provide about 8-10% of total kcal, most of us eat more than the RDA for protein and excess

protein cannot be stored as protein.

31. Compare and contrast marasmus vs. kwashiorkor

Marasmus is seen in hospital patients and is a wasting away. It is a skin and bones appearance

with little or no subcutaneous fat tissue. Kwashiorkor can result from a baby being cut off from

breast milk to early. Edema occurs with maintenance of some subcutaneous fat tissue.

Symptoms include apathy, diarrhea, listlesness, failure to grow and gain weight, and withdrawal

from the environment. Death from infections of marasmus is common. Both are protein-energy

malnutrition.

32. What is BMI? Be familiar with how to calculate BMI.

Weight (in kilograms) divided by height (in meters: divide inches by .0254) squared. Body Mass

index

Underweight: less than 18.5

Healthy weight: 18.5-24.9

Overweight: 25-29.9

Obese: 30-39.9

Severely Obese: Greater than 40

33. What is the thermic effect of food?

Energy used to digest, absorb, and metabolize food nutrients. "Sales tax" of total energy

consumed. 5-10% above the total calories consumed. TEF is highest for protein (20-30%) then

carbohydrate (5-10%) and fat (0-3%).

34. What is the body's set point and how does it play a role in energy balance?

Set-Point theory says weight is regulated by the body. Proposes that humans have a genetically

predetermine body weight or body fat content, which the body closely regulates. Genetically

predetermined body weight. Body resists weight change. Leptin assists in weight regulation (the

protein that supresses hunger), reduction in calorie intake results in lower metablic rate.

35. How many calories are needed to promote ONE pound of weight loss?

Body fat contains 3500 kcal per pound. Fat storage (body fat plus supporting lean tissues)

contains 3300 kcal per pound. Must have an energy deficit of about 3300 kcal to lose a pound per

week.