Term
| Macronutrient diet percentages |
|
Definition
Fats: 20-35%
Carbohydrates: 45-65%
Protein: 10-35% |
|
|
Term
|
Definition
|
|
Term
| Hourly and daily BMR estimate |
|
Definition
1 kcal/hr/kg
25 kcal/kg/day |
|
|
Term
| Folate supplement recommendation |
|
Definition
| 400 mcg/day for all females who might get pregnant |
|
|
Term
|
Definition
100% fat = 0.7
100% carbs = 1.0
>1 = excess calories, fat synthesis
<0.7 = ketogenesis |
|
|
Term
| kcal/g for macronutrients and alcohol |
|
Definition
Fat - 9 kcal/g
Protein - 4 kcal/g
Carbohydrate - 4 kcal/g
Ethanol - 7 kcal/g |
|
|
Term
| Kcal deficit to lose 1 pound |
|
Definition
|
|
Term
| PAR for levels of exercise |
|
Definition
Light exercise: 1-2
Moderate exercise: 2-4
Heavy exercise: 4-15 |
|
|
Term
| Thermic effect as % of calories ingested |
|
Definition
|
|
Term
| Injury factors for trauma, sepsis, burn |
|
Definition
Trauma = 1.4
Sepsis = 1.6
Burn = 2.1 |
|
|
Term
|
Definition
|
|
Term
| Recommended daily cholesterol intake |
|
Definition
|
|
Term
| Recommended daily MUFA, saturated fats |
|
Definition
MUFA - 50% total fat
SAT - <7% total calories, no more than 8-10% calories |
|
|
Term
| Recommended dietary sodium intake |
|
Definition
|
|
Term
| Recommended protein intake for healthy/ill adults |
|
Definition
0.8 g/kg/day for healthy adult
up to 2.0 g/kg/day for burn patients |
|
|
Term
|
Definition
| 16% (6.25 conversion factor) |
|
|
Term
| Nitrogen balance equation |
|
Definition
| Intake (g/24h) - (UUN [g/24h] + 4 g) |
|
|
Term
| Normal albumin serum levels |
|
Definition
|
|
Term
|
Definition
Normal = 18.5-24.9
Overweight = 25-29.9
Obese = 30-39.9
Severely obese = 40+ |
|
|
Term
|
Definition
85-95% = overweight
>95% = obese |
|
|
Term
| Normal fasting blood glucose and conversions |
|
Definition
70-100 or 110 mg/dL
mg/dL = 18 * mM |
|
|
Term
| Criterion for malnutrition |
|
Definition
| Unintentional weight loss of >10% in 6 months |
|
|
Term
|
Definition
Women - waist > 35.5 inches
Men under 40 - >40 inches
Men over 40 - >36 inches |
|
|
Term
| Fat/carb intake in last 30 years |
|
Definition
| Carbohydrates increase, fat decrease, overall intake increase |
|
|
Term
|
Definition
| High sugar content (carbohydrates), used in foods for preservation |
|
|
Term
|
Definition
Amylose - linear polysaccharide
Amylopectin - branched polysaccharide
Starch = 20:80 ratio |
|
|
Term
| Common disaccharides consumed |
|
Definition
| Sucrose, lactose, maltose |
|
|
Term
|
Definition
| Natural (fruit) and industrial (common) - sorbitol most common, derived from glucose; poorly absorbed; 1-2.5 kcal/g - caloric restriction in gums/candies |
|
|
Term
|
Definition
| Sweetener/preservative - 55% (soft drink, sweetened beverage, frozen desserts) or 42% (baked goods, canned fruit, condiments) common (honey also 55% fructose) - not linked to obesity |
|
|
Term
|
Definition
| Nondigestible because unable to break beta-(1,4) linkages |
|
|
Term
| Type of carbohydrates we should intake |
|
Definition
| Ideally mostly complex but about 50% refined or processed |
|
|
Term
|
Definition
| 130 g/day, minimum for brain, median is 200-300 g |
|
|
Term
|
Definition
| Endoglycosidase, start absorption of carbohydrates, break random alpha(1,4) bonds in starch, glycogen; break down to dextrins and short oligosaccharides; inhibited by low pH in stomach |
|
|
Term
|
Definition
| Need HCO3 to raise pH for maximum activity, break down to di- and tri-saccharides like maltotriose, isomaltose, maltose |
|
|
Term
|
Definition
| Upper jejunum, breakdown to glucose, fructose, galactose; specific (lactase only works on lactose) - from there monosaccharides enter portal circulation and go to liver |
|
|
Term
| Unavailable carbohydrates |
|
Definition
| Carbs not enzymatically digested in large intestine, are secreted; not include in calories for the day |
|
|
Term
| Primary lactose intolerance |
|
Definition
| 70% population, less common in N Europe or Scandinavian because first to domesticate cattle; lactase disappear after weaning (around age 2) |
|
|
Term
| Secondary and tertiary lactose intolerance |
|
Definition
Secondary - disease/disorder of digestive tract
Tertiary - congenital alactasia - no lactose gene to start |
|
|
Term
| Lactose intolerance symptoms |
|
Definition
| Bloating, cramping, flatulence, diarrhea due to intestinal bacteria digesting to 2C, 3C products, lactic acid, CO2, H2 |
|
|
Term
| Lactose intolerance treatment |
|
Definition
| Avoid dairy products with lactose, lactase supplement, Ca in diet, yogurts and cheeses with Lactobacilli that has fermented lactose (aged ~3 months or more) |
|
|
Term
| Glucose and galactose absorption |
|
Definition
| SGLT1 cotransporter with Na - secondary active transport |
|
|
Term
|
Definition
| GLUT5 facilitated transporter |
|
|
Term
Glc, Galac, Fructose enter bloodstream
Sugar alcohol enter blood stream |
|
Definition
GLUT2 facilitated transporter
Sugar alcohol by passive diffusion |
|
|
Term
|
Definition
| Saline and glucose, need Na to help get monosaccharides into cells via SGLT1 |
|
|
Term
| Soluble and insoluble fibers |
|
Definition
Soluble - cellulose, lignin
Insoluble - hemicellulose, gums, pectins |
|
|
Term
|
Definition
| Bran, root veggies, legumes, cabbage family, fruit skin |
|
|
Term
|
Definition
| Wheat, carrots, broccoli, fruit with edible seeds |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Apple, strawberry, citrus fruits |
|
|
Term
|
Definition
|
|
Term
| Dietary vs. functional fiber |
|
Definition
| Natural vs. extracted and added to processed foods |
|
|
Term
|
Definition
| Functional fiber, main ingredient in Metamusil, decreases serum cholesterol |
|
|
Term
|
Definition
| Bind water and swell, hypoglycemia effect, bind bile acids and increase excretion (hypocholesterolemic effect), fermented in colon by resident anaerobic bacteria (make gases, SCFA, promote normal laxation) |
|
|
Term
|
Definition
| Increase viscosity, decrease digestion speed and absorption, increase satiety (fruits, nuts, oatmeal) |
|
|
Term
| Insoluble fiber functions |
|
Definition
| Enlarge and soften stool, shorten fecal transit time (whole grains, veggies) |
|
|
Term
|
Definition
DRI: 25 g/day women, 28 g/day men, up to 50 g/day in DM, hyperlipidemia
Mean: 13.5 g/day |
|
|
Term
|
Definition
| Constipation, hemorrhoids, diverticula |
|
|
Term
|
Definition
| Constipation (low water), intestinal blockage, decreased absorption of mineral cations, excess satiety |
|
|
Term
| Fructose metabolism regulation |
|
Definition
| Reduced, because PFK1 is bypassed |
|
|
Term
|
Definition
| Little energy, non-nutritive, hundreds of times sweeter than sugar; aspartame contraindicated in PKU (contain Phe) |
|
|
Term
| Natural sugar substitutes |
|
Definition
| Sweet taste, no increased blood glucose (stevia, monk fruit extract) |
|
|
Term
|
Definition
| Low insulin, glucagon increases, degrade fat, form ketone bodies; promote catabolic state and loss of calories - produces weight loss if good adherence |
|
|
Term
|
Definition
| How quick blood glucose rises after eating food |
|
|
Term
|
Definition
| Rise in glucose compared to eating 50 g Glucose or white bread; rate of ingestion, food form, method of cooking matters |
|
|
Term
|
Definition
| GI-weighted measure of carb content - takes into account how much carbohydrate actually in a single serving; DM should have a diet with low GI, low GL is good too |
|
|
Term
| Dental caries with carbohydrates |
|
Definition
| Simple carbohydrates metabolize to acid by plaque bacteria leading to faster demineralization |
|
|
Term
| Cariogenic/cariostatic/anticariogenic entities |
|
Definition
Cariogenic - sucrose is most
Cariostatic - non-sugar sweeteners
Anticariogenic - xylitol and some cheeses
Fluoride also important in replacing ions in dental enamel |
|
|
Term
| Thiamin Deficiency Symptoms |
|
Definition
Beri-beri - muscle weakness, ataxia, paresthesia of toes, foot/wrist drop
Wet beri-beri - edema, cardiac failure
Wernicke-Korsakoff - amnesia, confusion, confabulation, nystagmus, ophthalmoplegia, coma |
|
|
Term
|
Definition
| Lean pork, whole grain cereals |
|
|
Term
| Riboflavin Deficiency Symptoms |
|
Definition
| Cheilosis (dry scaling and fissuring of lips), glossitis (inflammation of tongue), angular stomatitis, corneal vascularization, anemia |
|
|
Term
|
Definition
| Dairy products, yogurt, cheese, meat, eggs, broccoli, whole grain foods |
|
|
Term
| Niacin Deficiency Symptoms |
|
Definition
Pellagra, diarrhea, dermatitis, dementia
Early signs: Weakness, irritability, insomnia, numbness, vertigo |
|
|
Term
| Niacin toxicity and sources |
|
Definition
Flushing (toxicity)
Sources: lean meats, poultry, fish, cereals |
|
|
Term
| Pyridoxine (B6) deficiency Symptoms |
|
Definition
Pellagra-like symptoms with dermatitis, glossitis, cheilosis
Adults: depression, confusion, EEG abnormalities, seizures |
|
|
Term
|
Definition
| Toxic sensory neuropathy over 500 mg/day |
|
|
Term
|
Definition
| Poultry, pork, peas, potatoes, tomatoes, carrots, cabbage, fish, whole grains |
|
|
Term
| Vitamin B12 deficiency Symptoms |
|
Definition
| Sore tongue, paresthesias, neurological changes, megaloblastic anemia |
|
|
Term
|
Definition
| Red meat, poultry, shellfish, eggs, dairy products |
|
|
Term
| Vitamin C deficiency symptoms |
|
Definition
| Scurvy, poor wound healing, defective tooth formation, perifollicular petechiae and ecchymoses, loosening of teeth, gingivitis, anemia |
|
|
Term
|
Definition
| Most fruits and various green vegetables |
|
|
Term
| Vitamin E deficiency symptoms |
|
Definition
| RARE - hemolytic anemia, myopathy, weakness, ataxia, impaired reflex, ophthalmoplegia, retinopathy, damage to nervous tissue |
|
|
Term
|
Definition
| Pure vegetable oils; also wheat germ, whole grain bread, cereals, egg yoke, nuts and sunflower seeds |
|
|
Term
| Biotin deficiency symptoms |
|
Definition
| Dermatitis, hair loss, muscle pain, paresthesias, EKG abnormalities |
|
|
Term
| Folate deficiency symptoms |
|
Definition
| Depapillation of tongue, megaloblastic anemia, increased plasma HCys, weakness, fatigue, palpitations, SOB |
|
|
Term
| Folate deficiency warning and sources |
|
Definition
Warning: Folate masks a B12 deficiency
Sources: dark green leafy vegetables, some fruits |
|
|
Term
| Pantothenic acid deficiency symptoms (B5) |
|
Definition
| Vomiting, malaise, burning sensation, cramps, fatigue, insomnia, paresthesias |
|
|
Term
|
Definition
| Linoleic acid (18:2 w-6) and alpha-linolenic acid (18:3 w-3); humans cannot introduce double bonds at omega-6 and omega-3 positions |
|
|
Term
| Plants/animals rich in PUFAs vs. saturated fats |
|
Definition
PUFA - plants in cooler climates, cold water fish (omega-3 FA)
SAT - tropical plants, warm-blooded animals
Less saturated = lower melting temp, want to be in liquid
Olive oil is unsaturated, beef fat is more saturated |
|
|
Term
|
Definition
| Bacterial fermentation or catalytic hydrogenation or polyunsaturated vegetable oils in factory (partially hydrogenated oils) in baked and fried foot |
|
|
Term
| Diet rich in trans fatty acids |
|
Definition
| Increase plasma cholesterol, linked to heart disease |
|
|
Term
| Effect of fats on LDL and HDL and impact |
|
Definition
Saturated and trans fats raise LDL, trans fats lower HDL
LDL increases risk of CHD, HDL protects against CHD |
|
|
Term
|
Definition
| Precursor to arachadonic acid, which leads to eicosanoids including thromboxanes, leukotrienes, prostaglandins |
|
|
Term
|
Definition
|
|
Term
|
Definition
Scaly, dry skin, add EFA to diet (linoleic more effective); deficiency leads to "closest form" which is triene (Mead's acid made)
Triene/tetraene > 0.2 = EFA deficit |
|
|
Term
| Populations at risk of EFA deficiency |
|
Definition
| Geriatric population with PVD, fat malabsorption syndrome patients (e.g. after surgical bowel resection), prolonged parenteral alimentation with a formula low in EFA |
|
|
Term
|
Definition
| >1%, >3% in pregnancy to combat maternal depletion, increase linolenic acid |
|
|
Term
|
Definition
| Break down TG to FA and monoglycerides in digestion, 90% dietary lipid is TG |
|
|
Term
|
Definition
| Break down phospholipids in diet to FA and other products |
|
|
Term
|
Definition
| Break down cholesteryl esters to cholesterol and other products by cleaving the fatty acyl tail |
|
|
Term
| Absorption of TG breakdown products |
|
Definition
| Bile salts and phospholipids help them enter mixed micelles which are taken up by enterocytes; almost complete absorption of TG but poor absorption of sterols |
|
|
Term
|
Definition
| Prefers shorter FA, better at digesting SCFA, MCFA |
|
|
Term
|
Definition
| Active at stomach acid pH, little effect on LCFA, low in newborns |
|
|
Term
| Pancreatic lipase and colipase |
|
Definition
Do most of work in lipid digestion, maximal activity above pH 7
Colipase bind lipase to TG, displace bile salt, PL, let lipase work - product enter mixed micelle; colipase reverses bile acid's inhibition of pancreatic lipase |
|
|
Term
| Cholesterol ester hydrolase |
|
Definition
| Made by pancreas, activated by bile salts - hydrolyzes cholesterol esters, phospholipase hydrolyzes the remaining phospholipids |
|
|
Term
|
Definition
| Diet and endogenous cholesterol secretion into bile; free cholesterol only absorbed after soubilized in bile salt micelles, cholesterol esters hydrolyzes much slower and less completely than TGs |
|
|
Term
|
Definition
| Absorbed about 5%, interfere with cholesterol absorption, so supplements can decrease LDL 5-15% |
|
|
Term
|
Definition
| Increased amount of beta-sitosterol absorbed leading to deposits and normal cholesterol |
|
|
Term
| Fat malabsorption reasons |
|
Definition
| Cancreatic disease, insufficient bile production, lose segment of small intestine, Celiac sprue, abetalipoproteinemia |
|
|
Term
|
Definition
Autoimmune response - peptide fragment of gluten intact through digestion leading to autoimmune destruction of enterocytes
Symptoms: lipid-soluble vitamin deficiency, steatorrhea, lactose intolerance, hypocalcemia (less absorbed), weight loss - test by 74 hr fecal fat test |
|
|
Term
| Fat malabsorption symptoms |
|
Definition
| Steatorrhea, inability to absorb fat-soluble vitamins, interference with divalent cations (form metal soaps), more efficient absorption of plant oxalates leading to kidney stones |
|
|
Term
| Therapeutic measure for fat malabsorption |
|
Definition
| Medium chain triglycerides - no need for pancreatic lipase, easily digested |
|
|
Term
| Lipids and atherosclerosis |
|
Definition
| Incidence increased by dietary fat and cholesterol, changes lipoprotein profile and more susceptible to thrombosis - cruid buildup in lining of blood vessels |
|
|
Term
| Fatty acids and atherogenicity |
|
Definition
SAT and Trans FA - atherogenic, PUFA & PUFA less atherogenic
omega-3 fish oil fatty acids more antiatherogenic |
|
|
Term
|
Definition
Fruits, veggies, fish, whole grains, limit unhealthy fats
Much more MUFA than SFA than Western Diet, same % fats
Lower LDL cholesterol, reduce CV and overall mortality
Reduced incidence of cancer, Parkinson, Alzheimers
Plant-based foods, olive and canola oil, herbs/spices, 2x weekly ifsh and poultry, red wine, eat with family, exercise, antioxidants |
|
|
Term
| 7 Countries Study results |
|
Definition
| Serum cholesterol, blood pressure, diabetes, smoking are universal risk factors for CHD - Mediterranean diet leads to lower CHD and all-cause mortality, postpone cognitive decline, reduce risk of depression |
|
|
Term
|
Definition
MLK HIV WTF
Arg - NO precursor essential in extreme circumstances
His - doesn't fulfill all criteria to be indespensible
Conditionally essential - Arg, Gln - increased amounts in parenteral alimentation leads to decreased hospital stay |
|
|
Term
| High and low protein need times |
|
Definition
High - fast growth, after trauma or burn, after period of wasting
Low - acute liver/kidney failure, need to decrease nitrogenous products |
|
|
Term
| Protein requirement through life |
|
Definition
| 2 g/kg in infancy, 1g/kg by age 1, 0.8 g/kg as adult, extra 10-15g/day in pregnancy, highest in critically ill patients (2 g/kg/day) |
|
|
Term
|
Definition
| Provide all AA at right amount, many animal proteins |
|
|
Term
| Vegetarian protein consumption |
|
Definition
| Need mix of plant proteins that complement each other |
|
|
Term
|
Definition
| Score for AA abundance correcting for digestibility (egg is gold standard, milk protein and soybean high); excess of AA metabolized for energy |
|
|
Term
|
Definition
| Blood Urea Nitrogen, measure of protein metabolism, poor quality protein leads to higher BUN |
|
|
Term
|
Definition
| Proteases in stomach and pancreas make free AA and oligopeptide, peptidases on brush border, AA, di- and tr-peptides enter enterocytes - dipeptidases and tripeptidases in cell so AA exit enterocytes |
|
|
Term
|
Definition
| 60% metabolized, 20% to protein, 20% released in blood; 70% released by liver are BCAA to muscle mostly |
|
|
Term
| Enterocyte energy source and release |
|
Definition
| Mostly use Gln and generate alanine and citrulline |
|
|
Term
|
Definition
| Growth, weight gain, after surgery, pregnancy |
|
|
Term
|
Definition
| Weight loss, starvation, muscle breakdown, sickness |
|
|
Term
| Kwashiorkor vs. Marasmus (basic) |
|
Definition
Kwashiorkor - protein deficiency with adequate caloric nutrition (nonadapted starvation)
Marasmus - all macronutrients inadequate and calories inadequate (adapted starvation) |
|
|
Term
| Protein Energy Undernutrition |
|
Definition
| Deficiencies of macronutrients; spectrum of states of varying acuity and need for intervention |
|
|
Term
|
Definition
Weaned child or adult with chronic disease
Edema, EC water increase, hair depigmentation, skin disorder, hepatomegaly (LP buildup), hypoalbuminemia, fatty liver, compromised immune system, muscle protein breakdown, decreased tissue lipolysis |
|
|
Term
|
Definition
| No edema, general muscle wasting, no subcutaneous fat, hypoglycemia and hypothermia, abdominal distension |
|
|
Term
| Relative treatments for kwashiorkor and marasmus |
|
Definition
Kwashiorkor - aggressive refeeding immediately
Marasmus - more gradual slow re-feeding |
|
|
Term
|
Definition
| Malnutrition leading to low weight and body decline, associated with chronic disease |
|
|
Term
| Comparing marasmus and kwashiorkor |
|
Definition
| Marasmus weighs less, kwashiorkor has edema, both irritable baby but kwashiorkor apathetic when alone, kwashiorkor has poor appetite |
|
|
Term
| Rapid re-introduction of carbs in marasmus |
|
Definition
| G6P formation and poor utilization, deplete phosphate pool leading to cardiac failure and death |
|
|
Term
| Best anthropomorphic measurement for malnutrition |
|
Definition
|
|
Term
| Health risks associated with obesity |
|
Definition
| CVD, CVA, HTN, colon or breast cancer, DM type II, sleep apnea, osteoarthritis, infertility, NAFLD, gout, incontinence |
|
|
Term
| Health risks associated with BMI >30 |
|
Definition
| Atherosclerosis, diabetes, kidney disease, certain cancers |
|
|
Term
| All-cause mortality increase |
|
Definition
| Most if BMI <18.5, also >30, especially if >60 |
|
|
Term
|
Definition
| 18.5-24.9, not based on mortality risk |
|
|
Term
|
Definition
3+ of the following:
Excessive waist size, high fasting glucose, high serum TGs, low HDL, HTN - increased risk of CVD, DMII, obesity, NAFLD, CKD< POS |
|
|
Term
| Health risks associated with overweight |
|
Definition
Diabetes, kidney disease
Decreased Alzheimers, Parkinson, injury death, COPD |
|
|
Term
| BMI in different ethnic groups |
|
Definition
| Variable, different risks for different racial/ethnic groups at different BMIs |
|
|
Term
|
Definition
| Genetics, increased consumption, labor-saving devices, formula feeding |
|
|
Term
| Formula feeding and obesity |
|
Definition
| Recommend breastfeed for first 5 months to be less obese at age 2 but could be due to publication bias |
|
|
Term
|
Definition
| Made by adipose tissue, reduces appetite, increases with increased body weight |
|
|
Term
|
Definition
| Made by adipose tissue - reduce free FA in blood, improve lipid profile, increases insulin sensitivity, reduces inflammation, decreases with increased body weight |
|
|
Term
|
Definition
| Released by GI, produced in absence of food to increase appetite, highest before meals |
|
|
Term
|
Definition
| Apple-shaped body is at higher risk for DM type II than pear-shaped body |
|
|
Term
|
Definition
| Stabilized body weight, resist changes from this level, resistant to reductions in weight, often return once diet is stopped |
|
|
Term
| Weight loss recommendations |
|
Definition
| <10% in 6 months, low calorie balanced diet, stress management, eating stimulus control, social support, cognitive restructuring, adherence to diet |
|
|
Term
|
Definition
BMI >30
Qsyma - appetite suppression and feel fuller (phentermine and topiramate)
Orlistat - decrease fat absorption by inhibiting lipase
Sibutramine - enhance satiety - serotonin/Norepi reuptake |
|
|
Term
| Contraindications for weight loss therapy |
|
Definition
| Pregnant, lactating, psych disorder, severe illness amplified by caloric restriction |
|
|
Term
|
Definition
| BMI >40 or <35 with comorbidities - Gastric banding, Gastroplasty and Roux-en-Y are all options - lead to long-term reduction in weight, reduced cumulative mortality |
|
|
Term
|
Definition
| Send impulse to abdominal vagus nerve to trick brain that stomach is full and not hungry, BMI 35+ with obesity-related complication |
|
|
Term
| Pediatric metabolic syndrome |
|
Definition
| High fasting glucose, high TG, low HDL |
|
|
Term
| When to test kid for obesity |
|
Definition
| Overweight, family history of DM Type II, native American, African American, Hispanic, Asian/Pacific Islander, signs of insulin resistance (acanthosis nigricans) |
|
|
Term
|
Definition
| Darkening in neck, underarms, groin - found in 90$ of kids with Diabetes Mellitus Type II |
|
|
