Term
| Essential nutrient and examples |
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Definition
Substance that must be obtained from diet for species
Vitamin C (higher organisms), water, calories, 8-10 amino acids, essential fatty acids, 13 vitamins, 16-20 minerals |
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Term
| Micronutrient vs. macronutrient |
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Definition
| Smaller amount (mg/day) vs. Larger amount (g/day) |
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Term
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Definition
| Substance in food providing structural or functional components of energy to body; must participate in metabolic pathway to be a nutrient (antioxidants and dietary fiber are NOT nutrients) |
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Term
| Food regulation organizations |
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Definition
USDA - meat, poultry, eggs
FDA - everything else |
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Term
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Definition
| Structural claims (help relax), not disease claims |
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Term
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Definition
| Dietary Reference Intake values set by Food and Nutrition Board of Institute of Medicine, continuously re-evaluated |
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Term
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Definition
| Estimated Average Requirement - average daily intake to meet need of 1/2 healthy individuals in age/gender group, starting point for RDA |
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Term
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Definition
| Recommended Dietary Allowance - average daily intake to meet need of 97.5% healthy individuals in age/gender group |
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Term
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Definition
| Adequate Intake - average daily intake based on estimates of healthy people assumed to be adequate, used when RDA cannot be calculated (young infants) |
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Term
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Definition
| Tolerable Upper Intake Level - highest average daily intake that poses no threat to population; potential risk if more consumed |
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Term
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Definition
| Reference Daily Intake - highest RDA from all age and gender groups; basis for amount per serving on food labels |
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Term
| Macronutrients on food label |
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Definition
| Above line, provide calories and RDA (except fats) |
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Term
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Definition
| Acceptable Macronutrient Distribution Range - % of calories that should be provided by fat, carbs and protein |
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Term
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Definition
| 100% Daily Value - Upper limit, exceeding is bad |
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Term
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Definition
Macronutrients, sodium, cholesterol; no RDA, 25 g fiber/day
Sugar = mono- + di- saccharide; Carb = Poly- + oligo- saccharide |
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Term
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Definition
| %DV based on highest RDA among age groups, denominator is RDA; %DV is minimum value for individual |
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Term
| Changes for new food labels |
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Definition
| New requirements, Added Sugars, Vitamin D and potassium, revise serving size, calorie and serving size bigger |
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Term
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Definition
| Assess if US complying with recommendations, only for protein, everything else 20-82% |
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Term
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Definition
| Basal Metabolic Rate - used to carry out fundamental metabolic functions, fasted, reclined, comfortable temperature; vary between ages and sexes based on lean body mass |
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Term
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Definition
| Very high metabolic need for high growth rate, human milk intake |
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Term
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Definition
| Iron (1-3) and Calcium deficiency concern; risk of obesity, risks for vegan/food allergy kids; erratic eating more likely to cause parental anxiety |
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Term
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Definition
Intense anabolism, many potential deficiencies (A, B6, Ca, Fe, Zn, folate); risk of excess fat and sodium, eating disorders
Childhood obesity often leads to adulthood obesity |
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Term
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Definition
| High likelihood of malnutrition; less appetite, absorption problems (achlorhydria, e.g.); requirements stable or increase; risk for not enough protein, B12, Ca, D, C, Zn |
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Term
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Definition
| Reduced output of stomach acid |
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Term
| Causes of elderly malnutrition |
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Definition
| Loss of senses, physical limitations, social factors, money, isolation, depression |
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Term
| Food allergy vs. intolerance |
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Definition
| Allergy needs immune response; intolerance is non-immunte (e.g. 65% have trouble digesting lactose) |
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Term
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Definition
Low saturated fat, high fiber, high antioxidant, low weight, less heart disease; non-ideal balance of amino acids
Possible deficiencies: B12, Ca, D, Fe, Zn - recommend supplements |
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Term
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Definition
| Monoamine inducing NE release from sympathetic nerve terminal to increase BP and HR, found in fermented/decayed foods (wine, beer, cheese, yogurt), metabolized by MAOI |
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Term
| Drug-nutrient interaction example |
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Definition
| MAOI (antidepressant) inhibits MAO which metabolizes tyramine; increased tyramine leads to increased BP and possible hypertensive crisis |
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Term
| Reasons for increased nutrient requirements |
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Definition
| Fever, injury, surgery, increased exertion |
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Term
| Reasons for increased utilization |
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Definition
| Drug-nutrient interaction, disease, alcoholism |
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Term
| Reason for inadequate absorption |
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Definition
| Achlorhydria, drug-nutrient interaction, GI disease, alcoholism |
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Term
| Reason for inadequate food intake |
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Definition
| Dental problem, social, financial, less mobile, sensory loss, nutritional ignorance, medications |
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Term
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Definition
Reactive Oxygen Species - toxic by-product of oxygen metabolism in mitochondria
ROS can be enzymatically inactivated |
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Term
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Definition
Hydrogen peroxide (H2O2) - 2-electron reduction of O2
Superoxide - 1-electron reduction of O2
Hydroxyl radical - 3-electron reduction of O2
NO is ROS too; 4-electron reduction of O2 is H2O |
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Term
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Definition
| Reactive hydroxyl act on unsaturated fatty acid --> form lipid carbon-centered radicals --> recognized as foreign, phagocytosed by macrophages |
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Term
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Definition
| Production of ROS more quickly than antioxidants can consume them |
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Term
| Ischemia-reperfusion injury |
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Definition
| Restore blood supply after ischemic event, too much oxygen without antioxidants restored --> necrosis or death |
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Term
| Oxidative (respiratory) burst |
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Definition
| Phagocytic leukocytes increase O2 consumption in target cell, overproduction of superoxide --> destroy invading microorganism |
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Term
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Definition
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Term
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Definition
| Oxidate LDL, uptake by macrophage to make foam cell |
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Term
| ROS in Alzheimer's disease |
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Definition
| Elevated NO, mitochondrial dysfunction |
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Term
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Definition
| Decline in effective mitochondria |
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Term
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Definition
| Lipophilic antioxidant; includes tocopherols (saturated) and tocotrienols (3 double bonds); alpha-tocopherol is "natural" with highest activity |
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Term
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Definition
| Grains, wheat germ, nuts, vegetable oils (corn, safflower oil); made in plants |
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Term
| Vitamin E digestion and action |
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Definition
| Absorbed by intestine, transfer to liver in chylomicrons; act as chain-breaking antioxidant, stops propagation of lipid carbon-centered fatty acid residues of membrane (inc. those with ROS) |
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Term
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Definition
| RDA 15 mg/day, UL 1000 mg/day, no evidence of protection against heart disease; high does supplement competes with Vitamin K (bad if on anticoagulants) |
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Term
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Definition
| Major hydrophilic antioxidant existing in oxidized and reduced form in body |
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Term
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Definition
| Reduced = Ascorbic acid; Oxidized = Dehydroascorbic acid |
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Term
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Definition
| Return Vitamin E to reduced state, indirect impact on oxidizing membrane components; lowers oxidation markers in DNA (8-oxoguanine) and membrane (malondialdehyde) |
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Term
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Definition
| Oxidation marker in DNA; lowered by Vitamin C |
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Term
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Definition
| Oxidation marker in membranes; lowered by Vitamin C |
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Term
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Definition
| Glutathione peroxidases, superoxide dismutases, catalases |
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Term
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Definition
| Catalyze reduction of H2O2 by glutathione into H2O and glutathione disulfied; Se at active site (basis of some nutritional requirement for selenium) |
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Term
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Definition
| Dismutation of Superoxide into H2O2 and O2; 2+ isozymes |
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Term
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Definition
| Dismutation of H2O2 to H2O and O2; heme protein found in peroxisomes |
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Term
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Definition
| Plant-derived polyphenol/polyphonic acid; found in green tea, red wine, cocoa - possibly reduces cardiovascular disease and cancer |
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Term
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Definition
| Possibly antioxidants but not sure (e.g. beta-carotene) |
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Term
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Definition
| Most antioxidants per pint of any fruit/vegetable |
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Term
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Definition
| 1 C = 1000 cal = 1 kcal = 4.184 (4.2) kJ |
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Term
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Definition
| Rate per hour to expend calories just subsisting (asleep) |
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Term
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Definition
| Total Energy Expenditure - total # of calories used in one day, can be calculated |
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Term
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Definition
| Basal Energy Expenditure - basal metabolism staying alive, 60% daily energy used, under specific conditions, PER DAY |
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Term
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Definition
| Resting Energy Expenditure - base metabolism staying alive under less stringent conditions than BEE, PER DAY |
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Term
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Definition
| Basal Metabolic Rate - basal metabolism staying alive, very specific, at rest, fasted, no stimuli, PER HOUR |
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Term
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Definition
| Resting Metabolic Rate - BMR Under more realistic conditions, "close enough", PER HOUR |
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Term
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Definition
1 kcal/1kg-hr, slightly less for woman
25 kcal/kg/24 hrs |
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Term
| Harris-Benedict equations |
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Definition
| Empirical equations for specific population based on height, weight, age, sex, constants to more accurately assess BMR |
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Term
| How to measure BMR/RMR experimentally |
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Definition
| Indirect calorimetry - measure O2 consumed and/or CO2 produced - estimate # of kcal expended during period of measurement |
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Term
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Definition
| Respiratory Quotient - ratio of CO2/O2 - informs proportion from fat/carb (ignoring protein) |
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Term
| RQ for oxidation of carbohydrate |
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Definition
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Term
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Definition
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Term
| RQ for oxidation of protein |
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Definition
| RQ = 0.82 (63/77) but this is not how we measure protein |
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Term
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Definition
| Urinary Urea Nitrogen - amount of urea secreted, represents our intake of protein |
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Term
| RQ of typical American diet |
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Definition
| RQ = 0.85, 50% of fat/carb (ignoring protein) |
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Term
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Definition
| Patient with severe dyspnea (e.g. COPD) benefit from high fat diet (less CO2 per O2) |
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Term
| Caloric content of carb/fat/protein/EtOH |
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Definition
Carbohydrates = 4 Cal/g
Fat = 9 Cal/g
Protein = 4 Cal/g
Ethanol = 7 Cal/g |
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Term
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Definition
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Term
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Definition
| Physical Activity Ratio/Level - multiple of BMR for exercise, same as MET |
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Term
| PAR for levels of exercise |
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Definition
Light = 1.0-1.8
Moderate = 2-4
Heavy = 4-15 |
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Term
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Definition
| Metabolic Equivalent of Task - increase in energy expenditure relative to basal |
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Term
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Definition
| Energy used above BMR to process food for use/storage - add extra 10% (ONLY IF EATING) |
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Term
| TEE calculation for healthy person |
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Definition
| ((BMR*(24-exercise time) + BMR*PAR*Exercise time)) * 1.10 |
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Term
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Definition
| Hypercatabolic state - counterregulatory hormones rise, increased protein breakdown, gluconeogenesis, glycogenolysis |
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Term
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Definition
| 1.20 if confined to bed, 1.30 if allowed out of bed |
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Term
| Approximate Injury Factors |
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Definition
Trauma = 1.4
Sepsis = 1.6
Burns = 2.1 |
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Term
| AMDR for fat/carb/protein |
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Definition
Fat: 20-35%
Carbohydrate: 45-65%
Protein: 10-35% |
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Term
| Folate supplement for females who might get pregnant |
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Definition
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Term
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Definition
| Excess calories, fat synthesis |
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Term
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Definition
| Ketogenesis; breakdown of fatty acids |
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Term
| TEE Calculation for sick person eating |
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Definition
| BMR*Injury Factor*Activity Factor*1.10*24 hours |
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Term
| TEE Calculation for sick person not eating |
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Definition
| BMR*Injury Factor*Activity Factor*24 hours |
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Term
| Nutritional deficiency causes (5) |
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Definition
| Inadequate intake, inadequate absorption, decreased absorption, increased losses, increased requirements |
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Term
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Definition
Physical measures of weight/dimiensions of body
Mid-arm circumference - used in developing countries for kids
Adults - waist measurement, skin-fold thickness for subcutaneous fat |
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Term
| Adult female desirable weight |
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Definition
| 100 lb/5 ft + 5 lb/inch; 10% up/down for large/small frame |
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Term
| Adult male desirable weight |
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Definition
| 106 lb/5 ft + 6 lb/inch; 10% up/down for large/small frame |
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Term
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Definition
Body Mass Index = Weight (kg) / (Height (m)^2) = 703*lbs/(in^2)
18.5-24.9 = normal, 25.0-29.9 = overweight, 30+ = obese
<18 or <19 is underweight; up to 27.0 normal in some categories |
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Term
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Definition
| Muscle vs. fat proportion not indicated so Lebron Jame would be overweight with 27.5 BMI |
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Term
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Definition
| Involuntary weight loss of >10% in six-month period |
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Term
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Definition
| Protein not in skeletal muscle, in visceral organs |
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Term
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Definition
| Most common visceral protein evaluated in nutritional assessment; used to see nutrition over long period; fre-living population or upon hospital admission |
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Term
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Definition
| Transthyretin - 2-3 day half-life; monitor nutritional progress in hospital |
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Term
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Definition
| Intermediate half-life of 8-9 days; assess cumulative nutrition status over a longer hospital stay |
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Term
| Hemoglobin and Hematocrit |
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Definition
| First detected sign of severe protein nutrition deficiency |
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Term
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Definition
| Creatine-Height Index - estimate skeletal muscle mass |
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Term
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Definition
| 24-hour recall, food frequency questionnaire, typical day history, food diary (only prospective one) |
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Term
| Mini Nutritional Assessment of Elderly |
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Definition
| Anthropomorphic measures, dietary mesaures, assess lifestyle and social factors, self-perception of health + nutrition status |
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Term
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Definition
| Liquid diet directly into stomach; preferred over parenteral feeding due to preservation of gut integrity; less expensive |
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Term
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Definition
| Intravenous nutrition, hyperalimentation, "hyperal" - requires amino acids, sterile, appropriate vitamins and minerals all entering in purified form normally encountered in blood |
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Term
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Definition
| Lead to hypercatabolic state with increased need for calories, protein, vitamins |
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Term
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Definition
| Integrally related to nutritional state of patient |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Thiamine (B1), Riboflavin (B2), Niacin (B3) Pantothenic Acid (B5), Pyridoxine (B6), Biotin (B7), Folic acid (B9), Cobalamin (B12) |
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Term
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Definition
| TPP-thiaine; FADH-riboflavin; NAD-niacin; CoA-SH-pantothenic acid |
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Term
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Definition
| Phosphorylated form (TPP) cofactor for forming/degrading alpha-ketols by transketolase; oxidative decarboxylation of alpha-keto acids (pyruvate to acetyl~CoA) |
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Term
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Definition
| Beriberi - muscle weakness, ataxia, paresthesia of toes, foot/wrist drop, ocular muscle weakness |
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Term
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Definition
| Normal beriberi symptoms + edema, cardiac failure, DOE, peripheral edema |
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Term
| Wernicke-Korsakoff (encephalopathy) |
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Definition
Enzyme mutation where TPP binding is weak, occurs with alcoholism, poor diet, malabsorption, overcome by increased thiamine intake
Symptoms: Amnesia, confusion, confabulation, nystagmus, ophthalmoplegia, coma |
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Term
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Definition
| Wet (edematous, more CV) and dry (non-edematous, muscular, mental) |
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Term
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Definition
| Rare except among alcoholics, since alcohol interferes with thiamine absorption |
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Term
Wernicke's encephalopathy
Korsakoff's psychosis |
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Definition
WE - confusion, short-term memory loss, nystagmus, ataxia
KP (late Wernicke) - amnesia, confusion, apathy, coma |
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Term
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Definition
| Lean pork**, whole grain cereals**, yeast, legume; heat and alkali-labile |
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Term
| Alcoholic enter ED confused |
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Definition
| Immediately given thiamine |
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Term
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Definition
| Substituted pyridine derivative, most intake and use as NAD+ or NADP+, used in dehydrogenase reactions as co-enzyme/co-substrate; can be synthesized from Trp by B6; substrate for ADP-ribosylation, precursor of cyclic ADP-ribose (important for intracellular calcium) |
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Term
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Definition
Pellagra (pellagra-like symptoms if Trp low too); Diarrhea, Dementia, Dermatitis, Death
Early symptoms: weak, irritable, insomnia, numbness, vertigo |
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Term
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Definition
| Darkening of skin around neck, exposed areas sensitive to UV radiation; rednessa nd thickening of skin with hyperkeratinosis and scaling |
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Term
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Definition
| Lean meats**, poultry**, fish**, cereals**, legumes (low in corn), impaired by alcohol |
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Term
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Definition
| High dose (1-3 g), RDA = 20 mg; reduce LDL, increase HDL, decrease fat, >1 g can cause ACUTE FLUSHING and itching; chronic intake is bad |
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Term
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Definition
| 1C donor in many biochemical reactions (purine synthesis), THF seen as cofactor; mostly in diet has chain of Glu in peptide linkage |
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Term
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Definition
| Diet --> Folic Acid --> DHF --> THF --> N10 formyl (purine synthesis), N5N10-methylene (dTMP), N5 methyl (HCys --> Met) - folate pool which is recycled |
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Term
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Definition
| Dark green leafy vegetables**, some fruits**, legumes**, grain and masa fortified |
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Term
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Definition
Common among poor (less fresh produce), macrocytic anemia, associated with neural tube defects
Needed for purine/pyrimidine synthesis, deficiency inhibits synthesis of new cells --> macrocytic anemia, vilous atrophy, depapillation of tongue |
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Term
| Consequences of inadequate folic acid intake |
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Definition
| Serum folate drop --> RBC folate drop --> hypersegmented neutrophils appear --> MCV increase --> Hb drops |
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Term
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Definition
| Lack of dTMP, unable to synthesize new cells so RBC just increase in size; can becaused by low folate or low B12 (cobalamin) |
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Term
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Definition
| Overcome folate shortage or B12 deficiency, restores folate pool; will help determine whether masking of B12 deficiency is occurring |
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Term
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Definition
| Regenerate THF from N5-methyl THF; defect decreases DNA synthesis; involved in conversion of methylmalonic acid to succinyl~CoA as well |
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Term
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Definition
Macrocytic anemia (low dTMP); neuropathy (methylmalonic acid effect)
Anemia precedes neuropathy |
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Term
| Methylmalonic acid effect |
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Definition
| Failure to metabolize odd-number fatty acids, can be due to B12 deficiency |
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Term
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Definition
| Meat, fish, dairy, eggs (vegetarians at risk for deficiency) |
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Term
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Definition
| Gastric acid release B12 from food, bind to R-protein and release in duodenum, bind Intrinsic Factor which is necessary for proper absorption |
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Term
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Definition
| Last 10-20 years; disrupted absorption can lead to anemia in 3-6 months |
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Term
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Definition
| Inability to synthesize IF, treat by B12 injections; other types of deficiencies treated with B12 supplementation (e.g. achlorhydria) |
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Term
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Definition
| Check B12 absoption when adding intrinsic factor; if corrected, then pernicious anemia |
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Term
| B12 deficiency at-risk population |
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Definition
| Elderly (achlorhydria), reflux disease patients who take Protein Pump Inhibitors; strict vegans |
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Term
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Definition
| Increase risk of CHD; due to lack of B12 or folate, in reaction where 5-methyl THF --> THF |
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Term
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Definition
| Precursor to PLP; involved in amino acid metabolism, glycogen breakdown; coenzyme for HCys --> Cys; increased HCys increases CVD risk |
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Term
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Definition
| Increase CVD risk; reduced by Pyridoxine |
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Term
| Pyridoxine toxicity and deficiency |
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Definition
| Large dose causes irreversible peripheral neuropathy (>500 mg/day) - only water-soluble vitamin with overdose toxicity; deficiency is rare, found in many foods |
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Term
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Definition
| Enzyme prosthetic groups (FMN, FAD) of redox reactions; found in wide variety of foods |
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Term
| Riboflavin deficiency symptoms |
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Definition
| Dermatitis, cheliosis (fissure at corner of mouth), glossitis (smooth and dark tongue), angular stomatitis, corneal vascularization, anemia |
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Term
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Definition
| Coenzyme in carboxylation, carrier of activated CO2, covalently bound to Lys in enzyme; widely distributed in food |
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Term
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Definition
| Raw egg whites in shakes have avidin (strong binding partner) - cause of biotin deficiency |
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Term
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Definition
| CoA component for transfer of acyl groups; also part of acyl carrier domain of fatty acid synthase |
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Term
| Pantothenic acid source and toxicity |
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Definition
| Eggs, liver, yeast, many foods, cooking can destroy; no RDA, toxicity rare, no TUL |
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Term
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Definition
| <300 mg/day non-toxic; parenteral 400 mg/day can cause anorexia, mild ataxia, lethargy |
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Term
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Definition
| Dairy products**, yogurt**, cheese**, meat**, eggs**, broccoli**, asparagus, whole grain foods** |
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Term
| Pyridoxine deficiency symptoms |
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Definition
| Pellagra-like symptoms - dermatitis, glossitis, cheilosis; depression, confusion, EEG abnormalities, seizures in adults |
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Term
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Definition
| Poultry**, fish**, pork**, liver, kidney, whole grains**, carrots**, peas**, potatoes**, tomatoes** |
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Term
| Cobalamin deficiency symptoms |
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Definition
| Sore tongue, paresthesias, neurological changes, megablastic anemia |
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Term
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Definition
| Red meat**, poultry**, shellfish**, eggs**, dairy products** |
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Term
| Vitamin C deficiency symptoms |
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Definition
| Scurvy, poor wound healing, defective tooth formation, petechiae and ecchymosis, loose teeth, gingivitis, anemia |
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Term
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Definition
| Excessive intake tolerated; toxic effects if hemochromatosis or iron-storage disease |
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Term
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Definition
| Most fruits**, various green vegetables** including green peppers, broccoli, cabbage |
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Term
| Vitamin E deficiency symptoms |
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Definition
| RARE hemolytic anemia, myopathy, weakness, ataxia, impaired reflexes, ophthalmoplegia, retinopathy, damage to nervous tissue |
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Term
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Definition
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Term
| Biotin deficiency symptoms |
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Definition
| VERY RARE dermatitis, hair loss, muscle pain, paresthesias, EKG abnormalities |
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Term
| Pantothenic acid deficiency symptoms |
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Definition
| EXTREMELY RARE Vomiting, malaise, burning sensation, cramps, fatigue, insomnia, paresthesias |
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