part 2

• Water


  A vital component - Human body is composed of about 60% water; you can live only a few days without water
• Antioxidant


  A substance that neutralizes free radicals - boost overall health
• Antioxidants


  • Vitamin C
  • Vitamin E
  • Selenium
  • Carotenoids
• From scientific studies come nutritional recommendations
• Recommended Dietary Allowance (RDA)


  Developed in 1943 by the subcommittee of the Food and Nutrition Board of the National Academy of Sciences - Established to meet the needs of healthy people under usual environmental conditions
• RDA


  Set at two standard deviations above the mean requirement and thus exceeds actual individual requirements - Meeting 2/3 of the RDA is considered adequate, but vitamin requirements change throughout the lifecycle
• Dietary Reference Intakes (DRI)


  Established in 1997 by National Academy of Sciences to focus more on health promotion and disease prevention
• Dietary Reference Intakes (DRI)


  • EAR - Estimated Average Requirements
  • RDA - Recommended Dietary Allowances
  • AI - Adequate Intake
  • UL - Tolerable Upper Intake Levels
• Adequate Intake (AI)


  Average amount of the nutrient that a group of healthy people consume - Set when there isn't enough research to set an estimated average requirement (EAR) or RDA
• Tolerable Upper Intake Level (UL)


  Maximum daily amount of nutrient that appears safe for most healthy people - Intake above the UL is associated with toxicity symptoms
• Estimated Energy Requirements (EER)


  Caloric intake that will maintain energy balance in a healthy person - Values given are for "reference" male and female who is fairly active - Values are not very useful for individuals!
• Acceptable Macronutrient Distribution Range


  Recommended intake of energy yielding nutrients - 45-65% of caloric intake from carbohydrate, 20-35% of caloric intake from fat, 10-35% of caloric intake from protein
• Other countries and international organizations set their own nutritional recommendations, e.g. World Health Organization (WHO)
• Nutrition and health are closely related

  Chronic health issues associated with diet: Heart disease, Type II Diabetes, Obesity, High Blood Pressure
• Risk factor


  Something that statistically increases the incidence of a disease - May not be the cause of the disease
• Risk factors that can be controlled

  • Smoking
  • Alcohol intake
  • Over-consumption of calories
  • Physical inactivity
  • Poor quality diet
• Risk factors that cannot be controlled

  • Age
  • Gender
  • Genetics (family history)
  • Ethnicity
• Ideal nutrition


  Intake is sufficient to meet daily needs and to keep nutritional stores full while maintaining a healthy body weight
• Borderline nutrition


  Intake is sufficient to meet daily needs, but not enough to keep reserves full - Body is not prepared to handle times of stress (Illness, pregnancy...) - Slows growth and development of fetus and growing child

  
• Malnourished - under-nourished/over nourished (obesity)


  Intake insufficient to meet daily caloric and nutrient needs and nutrient reserves are empty - Life threatening, medical intervention required - Or intake more than daily caloric & nutrient needs too much nutrient reserves - Life threatening, medical intervention required

  
• Populations at increased risk of mal/under-nourishment


  • Anyone living in poverty, especially infants, children, pregnant women, elderly
  • Elderly in general, including those living in nursing homes
  • Pregnant teens
  • Drug and alcohol addicts
  • Individuals with eating disorders
  • Anyone with prolonged illness, including hospitalized patients
• Over-nutrition


  Excessive caloric intake that leads to obesity - Increase risk of obesity related diseases (heart disease, diabetes, kidney failure...) - Overuse of vitamin supplements that leads to toxicity
• Evaluating nutritional status

  • Personal History (SES, living situation, personal health, family health history, diet history, drug history)
  • Anthropometric data (Height, Weight)
  • Vitals (blood pressure, pulse rate)
  • Physical exam (Hair, skin, eyes, tongue...)
  • Laboratory tests (Cholesterol levels, iron levels...)
• Overt vs. covert deficiency

  Overt - outward signs of the deficiency - Covert or sub-clinical - deficiency may be detected by lab tests, but not outward signs of the deficiency
• Primary vs. secondary deficiency

  Primary - inadequate intake of the nutrient - Secondary - body doesn't absorb adequate amounts, excretes too much.... - Body "mishandles" the nutrient

  
• Components of a healthy diet


  • Proteins
  • Fats
  • Carbohydrates
  • Vitamins
  • Minerals
  • Water
• Healthy eating means eating a variety of foods that give the nutrients needed to maintain health
• Dietary guidelines

  • Eat a variety of foods from all the food group daily
  • Eat a variety of fruits daily
  • Eat a variety of vegetables daily
  • Include peas, beans and nuts in your daily meals
  • Reduce intake of salty and processed foods
  • Reduce intake of fats and oils
  • Reduce intake of sugary foods and drink
  • Make physical activity a part of your daily routine
• Importance of a variety of foods daily: Promotes good health, Improves wellbeing, Provides all the nutrients our body needs, Helps the body to fight illness, Provides energy for work and other daily activities
• Earlier and optimal nutrition (>80%) is better! If you feed them (better!) They will leave (sooner!) (For High Risk Patients)
• Explain the difference between the following: a. Complete and incomplete proteins, b. Saturated, unsaturated, and trans fat, c. Simple and complex carbohydrates, d. Soluble and insoluble fiber
• Explain the role of fiber and antioxidants in the body