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Class Notes for Nutrition and You, 4th Edition

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    INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL NUTRITION & YOU FOURTH EDITION JOAN SALGE BLAKE

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    ii Table of Contents PART 1 Chapter Overview and Lecture Outline iii CHAPTER 1 What Is Nutrition? 1 CHAPTER 2 Tools for Healthy Eating 9 CHAPTER 3 The Basics of Digestion 1 8 CHAPTER 4 Carbohydrates: Sugars, Starches, and Fiber 2 5 CHAPTER 5 Fats, Oils, and Other Lipids 3 5 CHAPTER 6 Proteins and Amino Acids 4 4 CHAPTER 7 Vitamins 5 3 CHAPTER 8 Minerals and Water 7 0 CHAPTER 9 Alcohol 84 CHAPTER 10 Weight Management and Energy Balance 9 2 CHAPTER 11 Nutrition and Fitness 10 2 CHAPTER 12 Consumerism and Sustainability : Food from Farm to Table 11 1 CHAPTER 13 Food Safety and Technology 12 0 CHAPTER 14 Life Cycle Nutrition: Pregnancy through Infancy 1 28 CHAPTER 15 Life Cycle Nutrition: Toddlers through the Later Years 136 CHAPTER 16 Hunger at Home and Abroad 144 PART 2 Teaching Tips for First - Time Instructors and Adjunct Professors 14 9 PART 3 Sample Syllabi 15 6 PART 4 Mastering Nutrition Overview and Teaching Tips 16 3 PART 5 MyDietAnalysis Teaching Tips and Activities 16 5 PART 6 Great Ideas in Teaching Nutrition New s letters 1 7 1

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    iii Preface The Instructor Resource and Support Manual for the fourth edition of Nutrition & You was developed to make teaching a nutrition class a little easier. The nutrition class environment is a place where many students learn to dispel myths, gain new insight and enough understanding to apply the information to their daily lives, and even prepare to pass on what they learn in a professional capacity. Making the material seem more personal to students through discussion questions and activities helps students retain important information. Part 1 The following is provided for each chapter: Chapter Summary The overview provides a general summary of the topics in the chapter. Chapter Objectives The chapter objectives list the key concepts students should understand as they reach the conclusion of each chapter. These objectives can be helpful in organizing lesson plans or lectures. Chapter Outline The outlines for each chapter are helpful in formulating and structuring lectures. In addition to including an outline for each topic covered in the chapter, this section also includes references to Animations , NutriTools, and ABC News video clips provided, so you can more easily incorporate visual elements into your class lectures and discussions where appropriate to each topic. In - Class Discussion Questions The discussion questions are presented to help students understand the material conceptually. Some concepts may be difficult to grasp, but these discussion questions can help lead students in the direction of understanding more complicated ideas. In - Class Activities Spark student interest in your lessons by integrating classroom activities. Split students into groups to have smaller discussions, bring visual aids to class, or have students create sample nutrition plans specifically targeted to help students understand chapter concepts.

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    iv PREFACE Critical T hinking Questions A list of critical thinking questions provided to accompany the chapter provide an opportunity for class discussion on current nutrition topics or assignments as homework for further evaluation of an important topic. Practical Tips Videos Author Joan Salge Blake walks students through making better eating choices in familiar environments in the video clips available to instructor s on the Teaching Toolkit DVD and to students for viewing by using the QR codes throughout the book. Lecture Launcher Videos These videos are available free of charge linked from the PowerPoint lectures and in MasteringNutritio n . Part 2 Teaching Tips for First - Time Instructors and Adjunct Professors Excerpts from professional reference books provide successful and helpful tips and strategies for managing large classrooms and stimulating student interactivity. Part 3 Sample Syllabi The sample syllabi provided can help you construct a rubric and outline for a nutrition course. The first two syllabi are modified from those in use by professors currently teaching this course, and the third has been made available as a general template to follow when writing a syllabus. Part 4 MasteringNutrition Overview and Teaching Tips Wondering how to incorporate MasteringNutrition into your lesson plans? This section provides information, tips, and suggestions for using the program to enhance your classroom, hybrid, or online course. Part 5 MyDietAnalysis Teaching Tips and Activities Wondering how to integrate MyDietAnalysis into your lesson plans? Or looking for additional activities for MyDietAnalysis? This section provides information, tips, and suggestions for using the program to enhance student learning. 'NEWS

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    PREFACE v Part 6 Great Ideas in Teaching Nutrition Newletters From our Great Ideas in Teaching Nutrition newsletter series, these teaching tips include some of your colleagues' best teaching ideas from the classroom. These tips are useful for first - time instructors, those who have not taught the course in a while, or the experienced professor seeking new ideas.

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    1 CHAPTER 1 What Is Nutrition? Chapter Overview Food provides many nutrients and nonnutrients that work together to regulate and maintain body processes. There are six classes of nutrients: carbohydrates, protein, fats, vitamins, minerals, and water. Many factors, such as taste, culture, social reasons, trends, cost, time, convenience, habits, and emotions, affect our food choi c es. Nutrition is the science of how nutrients in foods nourish you and affect your health. Good nutrition plays a role in reducing the risk of four of the top ten leading causes of death in the United States, as well as many other diseases and conditions. In order for our bodies to function properly, the six classes of nutrients are needed in various amounts. Carbohydrates, lipids, and proteins are macronutrients because you need higher amounts of them in your diet. They provide energy, which is measured in calories. Vitamins and minerals are micronutrients because they are needed in smaller amounts. Vitamins and minerals are essential for metabolism because they play a role in many chemical reactions and body processes. Water is part of the medium inside and outside of cells that that carries nutrients and waste products to and from your cells. The best way to meet your nutrient needs is through a well - balanced d i et. In addition to nutrients, foods provide other dietary compounds such as phytochemicals and fiber. People who cannot meet all their nutrient needs from food alone may benefit from taking a suppl e ment. Many Americans do not meet all their nutrient needs but exceed their cal o rie requirements. Rates of overweight and obesity are of great concern. Healthy People 2020 is a set of health objectives for Americans, which is part of a nationwide health improvement program with “Nutrition and Ove r weight” as one focus. Scientific knowledge about nutrition does not change as frequently as it may appear to in the media. The scientific method is used to conduct credible research. Scientists submit their research findings in peer - reviewed jou r nals. It takes many affirming research studies before a consensus is reached about nutrition advice. Scientists can use different types of experiments to test their h y potheses. Registered dietitians are trained nutrition professionals that can provide credible nutrition advice and guidance. When obtaining nutrition information online, carefully investigate (among other things) the site’s purpose, authors, funding sources, and the frequency of site updates. Chapter Objectives After reading this chapter, students should be able to: 1. Discuss the factors that influence your food choices. 2. Define the term nutrition . 3. Differentiate between the six categories of essential nutrients found in food and in the body.

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    2 INSTRUCTOR ’ S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E 4. Understand the importance of a well - balanced diet in meeting your daily nutrient needs. 5. Discuss the current nutritional state of the American diet. 6. Understand the scientific method that is involved in nutrition research and identify rel i able sources of nutrition information. Chapter Outline I. What Drives Our Food Choices? A. We need to eat and drink to live. 1 . We get fuel from chemical compounds known as nutrients. a . Nutrients work to provide energy, growth, and maintenance, and to maintain body processes. 2. There are six classes of nutrients: carbohydrates, fats, protein, vi t amins, minerals, and water. a. Carbohydrates, fats, and proteins provide energy in the form of kil o calories. b. Vitamins and minerals help regulate body processes, including m e tabolism. c. Water is vital to life. 3. Foods also provide nonnutrient compounds that help maintain and repair the body. B. We choose foods for many other reasons. 1. Many factors affect our daily food choices. (Figure 1.1) 2. Taste and culture : a. These are affected by geographical location and the social enviro n ment. 3. Social reasons and trends: a. People eat in certain social situations and based on what is readily available from food man u facturers. 4. Cost, time, and convenience : a. People eat more healthfully if presented with lower - cost foods, time to cook them, and a c cessibility. 5. Habits and emotions : a. These influence what and when people eat. Self - Assessment: Do Outside Factors Influence Your Food Choices? Self - Assessment: What Does the Health of Your Family Tree Look Like? II. What Is Nutrition and Why Is Good Nutrition So I m portant? A. Nutrition is the science that studies how the nutrients and compounds in foods nourish you, help you function, and affect your health. 1. Your body needs all the nutrients to function properly. a. A chronic deficiency will affect your body’s ability to function in the short term. b. Chronic deficiencies, excesses, and imbalances can affect long - term health. 2. Table 1.1 lists the top ten leading causes of death in the United States and identifies which of these are nutrition related. B. You are a product of what you eat, what you don’t eat, or what you may eat too much of . 1. To meet your nutritional needs and be healthy, you need to unde r stand the roles of the essential nutrients in your body and which foods to eat to get them.

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    CHAPTER 1 What Is Nutrition? 3 III. What Are the Essential Nutrients and Why Do You Need Them? 1. Carbohydrates, fats, proteins, vitamins, minerals, and water are all essential nutr i ents — you need them to function. a . Carbohydrates, fats, and proteins are macronutrients: higher amounts of them are needed in the diet. b. Vitamins and minerals are micronutrients: they are needed in lesser amounts. 2. Alcohol provides calories but is not an essential nutrient. 3. The body is made up of the same nutrients that are found in food. a. Figure 1.2 compares the nutrients found in raw broccoli, a chicken breast, and the human body. 4. Kilocalories (cal o ries) are used for energy during metabolism. 5. Figure 1.3 shows the essential nutrients and their functions. A. Carbohydrates, fats, and proteins provide energy . 1 . One calorie equals the amount of energy needed to raise the temperature of 1 kil o gram of water 1 degree Celsius. a. Carbohydrates and protein provide four calories per gram. b. Fats provide nine calories per gram. 2 . The amount of calories that you need daily to maintain your weight is estimated based on your age, gender, and activity level. 3 . Carbohydrates supply glucose, which your cells use as the major energy source to fuel your body. 4 . Carbohydrates, fats, and proteins are all organic because they contain the element ca r bon. B. You can calculate the amount of energy a food provides. 1. The number of calories in one serving of a given food can be determined based on the amount (weight in grams) of carbohydrates, pr o tein, and fat in the food. 2. To find this out, you need to multiply the total grams of each energy - yielding nutrient by the number of calories per gram of that nutr i ent. C. Vitamins and minerals are essential for metabolism. 1. You need vitamins to use the carbohydrates, fats, and proteins you consume and to sustain numerous chemical reactions in your body. 2. Many vitamins and minerals aid enzymes, which are substances that speed up rea c tions in your body. 3. Vitamins are organic compounds, usually o b tained from foods. a. The body is able to make some vitamins but sometimes cannot make enough to maintain good health. 4. Minerals are inorganic substances that play key roles in body processes and stru c ture. a. A mineral deficiency can cause disease symptoms. D. Water is vital for many processes in your body. 1. Water is part of the medium inside and outside your cells that carries nutrients to, and waste products from, your cells. 2. Water helps maintain body temperature, acts as a lubricant, and cushions organs from injury. IV. How Should You Get These Important Nutrients? A. The best way to meet your nutrient needs is with a well - balanced diet.

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    4 INSTRUCTOR ’ S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E 1. A well - balanced diet provides other dietary compounds, such as phytochemicals and fiber, which have been shown to help fight many diseases. 2. Other obvious benefits of food include taste, aroma, and texture, coupled with social interaction. You can’t get those from a pill. B. You can meet some nutrient needs with a supplement. 1. People who cannot meet their nutrient needs through food alone, due to diet restri c tions or higher nutrient needs, may benefit from taking a supplement. V. How Does the Average American Diet Stack Up? A. The quality of the American diet : 1. In general, Americans eat too much protein, sugar, sodium, and saturated fat, and too little fiber and some vitamins and minerals. a. Men generally meet the recommended amounts of most vitamins and minerals, but women fall short of many. 2. The lack of a healthy diet may be due to where we eat. a. Americans spend over 40 percent of their food budget on foods consumed outside the home; research shows that these foods tend to be less nutritious. 3. Children and adolescents who skip breakfast are at a higher risk for overweight and obesity. B. Rates of overweight and obesity in Americans : 1. The prevalence of those who are overweight and obese has become epidemic in the United States. 2. Over 65 percent of American adults are overweight and about 35 percent are considered obese. a. Figure 1.4 illustrates obesity trends among U.S. adults, by state. 3. Of children and adolescents aged 2 to 19 years, 15 percent are overweight and 17 percent are considered obese. 4. Overweight does not equate to well fed; many of the poorest Americans are obese and malnourished. a. The feature Nutrition in the Real World: “ Poor, Obese, and Malnourished: A Tro u bling Paradox ” on page 14 explains the links between poverty, obesity, and maln u trition. C. Improving Americans’ diets is one goal of Healthy People 2020 . 1. The U.S. Surgeon General has issued calls for a nationwide health improvement pr o gram since 1979. 2. Healthy People 2020 contains a set of health goals and objectives for the nation to achieve over the second decade of the twenty - first century. 3. Healthy People 2020 focuses on several overarching goals: a. Attain high - quality, longer lives free of preventable disease, disability, injury, and premature death. b. Achieve health equity, eliminate disparities, and improve the health of all groups. c. Create social and physical environments that promote good health for all. d. Promote quality of life, healthy development, and healthy behaviors across every stage of life. 4 . Table 1.2 lists the nutrition and weight status objectives proposed for Healthy People 2020 .

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    CHAPTER 1 What Is Nutrition? 5 Practical Nutrition Video: Shop Smart Lecture La uncher Video: Menu Calorie Counts VI. What’s the Real Deal When It Comes to Nutrition Research and A d vice? A. Nutritional studies deemed to be interesting by the media give the impression that nutr i tion knowledge and advice constantly changes, which is not the case. 1. Diet advice seems to change all the time, but scientific knowledge about nutr i tion doesn’t change that frequently. 2. Multiple affirming research studies are needed before consensus is reached about n u trition advice. 3. The Examining the Evidence feature “ How Can I Evaluate Nutrition News ?” on page 16 discusses how to scrutinize headlines and not get caught up in m e dia hype. B. Sound nutrition research begins with the scientific method. 1. Scientists come up with a hypothesis based on observations, test the hypothesis, and see if their idea is correct. a. The entire process can take years to complete. 2. Figure 1.5 illustrates the steps of the scientific method. a. Make an observation and ask questions. b. Form a hypothesis. c. Conduct an experiment. d. The h ypothesis either is supported or not supported and must be modified or a new h y pothesis proposed. e. Findings are shared with the scientific community in a peer - reviewed journal. 3 . Figure 1.6 lists the steps by which a hypothesis can lead to a scie n tific consensus. C. Research studies and experiments confirm hypotheses. 1. Studies are often done in a laboratory experiment with animals, or as observational or experimental research with humans. 2. Observational research : a. Observational research involves looking at factors in two or more groups of su b jects to see if there is a relationship to a certain disease or another health outcome. b. Epidemiological research looks at populations of people in the search for commo n alities or differences to test a hypothesis. 3. Experimental research : a. Experimental research involves at least two groups of subjects. b. The experimental group is given a specific treatment, whereas the control group is not or is given a placebo. i. If neither the people receiving treatment nor the scientists conducting the r e search know which group has received the treatment, they are conducting a double - blind, placebo - controlled study. c. Figure 1.7 uses a flow chart to illustrate the way scientists use experimental r e search to test hypotheses. d. Contradictory studies and revisions of hypothesis can lead to intriguing research questions, such as in the study of nutritional genomics . (Figure 1.8) i. This field of study researches the relationship between nutrition and genomics — the study of genes and gene expression. NEWS

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    6 INSTRUCTOR ’ S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E ii. This is made possible in part by the Human Genome Project, which revealed the complete sequencing of deoxyribonucleic acid (DNA) in human cells. iii. Nutritional genomics considers how dietary components cause different effects on your genes, initiating different physical responses in different people. D. You can trust the advice of nutrition experts. 1. Look to trained nutrition professionals, such as registered dietitian nutritionists, public health n u tritionists, or licensed dietician nutritionists . a. The Health Connection: Case Study feature “Fast - Food City” on page 21 illustrates how a registered dietitian nutritionist (RDN) can help with weight issues. 2. A person calling himself or herself a nutritionist may have taken few or no accredited courses in nutrition. 3. Beware of individuals who specialize in health quackery or fraud. a. Americans spend billions of dollars annually on fraudulent health products. i. The Nutrition in the Real World feature , “ Don’t Be Scammed! ” on page 23 covers key things consumers should look for when evaluating any media claim about health and nutr i tion. E. You can obtain accurate nutrition information on the Internet. 1. When obtaining nutrition information on the Internet, evaluate the website to be sure that it contains credible, up - to - date information, and its content is not biased by those that fund the website. 2. The National Institutes of Health has developed key questions to consider when vie w ing such sites. a. Who runs and pays for the site? b . What is the purpose of the site? c . What is the source of information ? d . What is the basis of the information? e . Is the information reviewed ? f . How current is the information? g . What is the site’s policy about linking to other sites ? h . How does the site handle personal information ? i . How does the site manage interactions with visitors? In - Class Discu s sion Questions 1. What do you hope to get out of this course? What are your questions about nutrition? (You can have students fill out the answers to these two questions on the first day of class and then discuss students’ questions after covering the first chapter. It is a good time to point out which chapters will answer the various nutrition questions.) 2. Obviously taste plays a big factor in our food choices, but what other factors play a role in your daily food choices? Do these factors change when you are extremely hungry? 3. Before reading this chapter, where did you get your nutrition information (TV, websites, newspapers, magazines)? Will the information you learned in this chapter affect the way that you evaluate nutrition articles you see in the news?

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    CHAPTER 1 What Is Nutrition? 7 In - Class Activities 1. Invite a registered dietitian from your university or the community to come talk to your class about the educational requirements and professional responsibilities of a diet i tian. 2. Investigate your state’s obesity rates and what programs are underway to address this serious health issue. A good place to start your search is at the website for the Centers for Disease Control and Prevention. 3. Provide groups of students with various research studies. After reading the articles, they must identify what type of experiment was completed and determine the researchers’ basic h y potheses. Each group should share their findings with the class. 4. Allow students to plan various research studies (laboratory experiment, epidemiological research, experimental research) based on the following fictitious story and h y pothesis: Scientists living in a small county in the Midwest noticed that rates of Attention Deficit Disorder (ADD) in their county were high and attributed this to the fact that locals ate a lot of jelly beans. There is a jelly bean factory in the county which often gives free sa m ples to county residents. Their hypothesis is that the dye from the jelly beans is causing ADD. 5. Show students an example of a website that contains credible nutrition information and one that does not. Challenge students to find examples of websites that provide reliable and unreliable sources of nutr i tion information. Critical Thinking Questions 1. Consider which factors listed in the text most affect your food choices. Do the most influential factors change based upon time of day, people who are with you, or other such reasons? Does your budget d e termine your choices? After you have identified the factors which most affect your food choices, list ways in which you could change those behaviors to make positive changes in your life. 2. In your opinion, how realistic are the objectives set forth in Healthy People 2020 (see Table 1.2)? If you were asked to provide the U.S. Surgeon General with ways in which Americans could achieve these objectives, what would they be? Be sure to consider the factors discussed in the chapter that preclude many Americans from meeting these objectives. 3. We are bombarded with nutrition and health claims through all kinds of media every day. What are some of the buzz words that seem to be repeatedly used in trying to “sell” us ideas about particular products or practices? Are some of these, in your opinion, more successful than others? How would you put together your own list of items of which people should be suspicious when they encounter them through various media? Consider television, radio, the Internet, print media, etc., separately, since tactics are different for each type of media. Practical Nutrition Videos Author Joan Salge Blake offers lecture teaching tips for effectively communicating a nutr i tion concept to students in Practical Tips for Teaching : Shop Smart, available on the Teac h ing Toolkit DVD and through course management.

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    8 INSTRUCTOR ’ S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E She also walks students through making better eating choices in familiar e n vironments in the Practical Nutrition video Shop Smart , available by scanning the QR code or through the Teaching Toolkit DVD and course ma n agement.

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    9 CHAPTER 2 Tools for Healthy Eating Chapter Overview Incorporating the principles of balance, variety, and moderation is fundamental to healthy eating. It is wise to have goals centered on having a diet consisting of a variety of foods (some in more moderate quantities), and the foods consumed must be balanced appropriately to meet individual needs. Using the available tools designed to help you plan and consume a healthy d i et helps to make these goals a reality. The Dietary Reference Intakes (DRIs) help you to obtain the recommended amount of each nutrient. The Dietary Guidelines for Americans summarize the current recommendations for healthy individuals over the age of two regarding nutrition and lifestyle (including physical activity) for good health. These guidelines are also geared toward helping people reduce the risk of many diseases where there is a relationship with diet and lifestyle choices. The food guidance system known as MyPlate provides a visual illustration of the co n cepts from the Dietary Guidelines for Americans. MyPlate also includes guidance regarding the number of servings from each food group to help individuals to meet the DRIs for nutrient needs based on appropriate calorie intake (based on age, gender, and activity le v el). MyPlate may be accessed via the Internet. Food labels are another type of tool intended to assist you with selecting healthy foods. In addition to the informative Nutrition Facts panel on the side or back of each food package, the Food and Drug Administration (FDA) allows and regulates labeling claims that provide further insight (that is also accurate) on each item. Functional foods contain potentially beneficial compounds derived from plants (phytochemicals) or animals (zoochemicals). Consumed as part of a healthy diet, these foods may help prevent adverse health conditions; but problems can arise if too much of a particular compound is consumed. This is a particular risk when consuming prepackaged functional foods. Chapter Objectives After reading this chapter, students should be able to: 1. Describe the three key principles of a healthy diet and the tools you can use to help guide you. 2. Explain what the DRIs are and the differences between the EAR, AI, RDA, UL, and AMDR. 3. Describe the principles in the Dietary Guidelines for Americans . 4. Explain the concept of MyPlate and name the five food groups and the typical foods re p resented in each group. 5. Identify the required components of a food label and how to use it. 6. Explain the role of functional foods in the diet.

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    10 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E Chapter Outline I. What Is Healthy Eating and What Tools Can Help? A. Healthy eating involves the principles of balance, variety, and moderation. 1. A balanced diet includes healthy proportions of all nutrients. 2. A varied diet includes many different foods. 3. A moderate diet provides adequate amounts of nutrients and ene r gy. B. Undernutrition is a state of not meeting your nutrient needs. 1. Malnourishment may result from not meeting nutrient needs on a long - term basis. C. Overnutrition is a state of having too much of a nutrient or too many ca l ories. 1. Some nutrients can be toxic in high amounts. 2. Too many calories can lead to obesity. 3. A person who is overnourished can also be malnourished. D. Tools such as the Dietary Reference Intakes, the Dietary Guidelines for Americans, M y Plate, and the Nutrition Facts panel on food labels may be used to help you avoid states of u n dernutrition or overnutrition. 1. Figure 2.1 illustrates the relationship between the tools. II. What Are the Dietary Reference Intakes? A. Dietary Reference Intakes (DRIs) are specific reference values for each nutrient issued by the Institute of Medicine of the U.S. National Academy of Sciences. 1. DRIs are specific amounts of each nutrient needed to maintain good health, prevent chronic disease, and avoid unhealthy excesses. B. DRIs tell you how much of each nutrient you need. 1. Nutrient needs vary with an individual’s age and gender and stage of the lifecycle (such as pregnancy), resulting in different DRIs. 2. Nutrition research in the 1990s suggested that higher amounts of certain nutrients might impact disease prevention ; subsequent research has also looked at dietary supplements and the potential problems of excessive consumption. 3. As research evolves, changes are made in the DRIs. C. DRIs encompass several reference values. 1. Estimated Average Requirement (EAR) a. The EAR is the average amount of a nutrient known to meet the needs of 50 percent of the individuals in a similar age and gender. i. This is considered a good starting point for determining the daily amount needed for good health. 2. Recommended Dietary Allowance (RDA) a. The RDA is based on, but set higher than, the EAR. b. The RDA represents the average amount of a nutrient that meets the needs of nearly all (97 – 98 percent) of the individuals in a similar age and gender group. c. Sometimes there is not enough scientific evidence about a nutrient to determine an EAR, so an RDA cannot be set. 3. Adequate Intake (AI) a. An AI is the approximate amount of a nutrient estimated for individ u als to consume in a similar age and gender group to maintain good health.

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    CHAPTER 2 Tools for Healthy Eating 11 b. The AI is used when an RDA cannot be set due to a lack of scientific information available to determine the EAR for a nutr i ent. 4. Tolerable Upper Intake Level (UL) a. The UL is the highest amount of a nutrient that may be consumed daily without harm. i. The higher the consumption above the UL, the greater the risk of toxicity. 5. Acceptable Macronutrient Distribution Range (AMDR) a. The AMDR are set for the energy - containing nutrients carbohydrates, fat, and protein. i. The AMDR for carbohydrates is 45 to 65 percent of daily calories. ii. Fats should be 20 to 35 percent of daily calories. iii. Proteins should be consumed at 10 to 35 percent of daily calories. 6. Estimated Energy Requirement (EER) a. The EER is the amount of energy, or calories, you need daily. i. It is calculated based on your age, gender, height, weight, and a c tivity level, and indicates the amount of energy you need daily to maintain energy balance. ii. Table 2.1 gives the range of calories needed daily based on age, gender, and a c tivity level. 7. Figure 2.2 illustrates the relationships between the reference va l ues. D. How to use the DRIs : 1. You can use the DRIs to make healthy food choices and plan a quality diet. 2. The goal should be to meet the RDA or AI of all nutrients, without surpassing the UL. 3. Table 2.2 summarizes the DRIs. 4. The inside front cover of the textbook shows the DRIs for all nutr i ents needed daily. 5. The Table Tips feature “Tip - Top Nutrition Tips” on page 37 provides ideas for using the DRIs in daily life. eLearn: Healthy Eating on a Budget Animation: DRI Determination III. What Are the Dietary Guidelines for Americans ? A. Due to the health consequences of overconsumption of fat, saturated fat, cholesterol, and sodium, the government designed goals to improve Amer i cans’ diets. 1. The Dietary Guidelines for Americans are intended for healthy individuals over the age of two and correspond with the latest recommendations for nutrition and physical activity. a. The intention of the guidelines is to lower risk for chronic diseases and conditions, such as high blood pressure, high blood cholesterol levels, diabetes mellitus, heart disease, and certain cancers. b. The Nutrition in the Real World feature “The Dietary Guidelines for Americans at a Glance ” provides an overview of the 2010 guidelines. i. For the 2015 update to the guidelines, see http://health.gov/dietaryguidelines. IV. What Are MyPlate and ChooseMyPlate.gov? A. There are several carefully designed food guidance systems to help you select the best foods for your diet. 1 . A food guidance system is an illustrated diagram to help people select from a variety of foods to design a healthy diet.

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    12 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E 2 . Many countries have developed their own food guidance systems, as illustrated in Figure 2.3. 3 . Some food guidance systems are specifically geared toward reducing risk of certain di s eases , as is the case with the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean - style eating pattern. 4 . The website www.ChooseMyPlate.gov and the tool MyPlate were released by the USDA in 2011. . a . MyPlate , which depicts five food groups in a place setting (see Figure 2.4), serves as an icon to remind consumers to eat healthfully. a . ChooseMyPlate.gov provides information, tips, and tools to help you build a healthier diet based on the Dietary Guidelines for Americans . B . MyPlate and ChooseMyPlate.gov emphasize changes in diet, eating behaviors, and physical a c tivity. 1. MyPlate and ChooseMyPlate.gov promote proportionality, moderation, variety, and personalization. 2. Food proportionality on the plate can have a dramatic effect on calorie intake. 3. You should choose mostly nutrient - dense foods — food with a high amount of nutrients compared to the number of calories — from each food group. a. The foundation of your diet should be nutrient - dense foods with little solid fats and added sugars. b. Figure 2.5 shows a comparison of the nutrient density of two versions of a p o tato: a medium baked potato and an ounce of potato chips. c . Figure 2.6 compares sample nutrient - dense food choices to less healthy food choices in each food group. 4. Energy density refers to foods that are high in energy but low in weight or volume. 5. Eating a variety of foods among and within the food groups highlighted in MyPlate will increase your chances of consuming all 40 of the nutr i ents your body needs. a. Figure 2.7 provides tips on how to choose a variety of foods from each food group. 6. Physical activity is an important component in the Dietary Guidelines for Americans . a. Advice regarding physical activity can also be found at ChooseM y Plate.gov. C . How to use MyPlate and ChooseMyPlate.gov 1. MyPlate reminds you to eat a diverse group of foods, and ChooseMyPlate.gov will give you the exact numbers of servings to eat from each food group, based on your daily calorie needs. 2. If you cannot go to the website, you can obtain similar information by using Tables 2.1 and 2.3 in this chapter. a. First, figure out how many calories you should be eating daily by considering your activity level. b. Refer back to Table 2.1 on page 36 for the number of calories you need based on your activity level, age, and gender. c. Next, Table 2.3 tells you how many servings from each food group you should consume to healthfully obtain the calories your body r e quires. 3. Figure 2.8 provides an easy way to eyeball your serving sizes. a. The Nutrition in the Real World feature “ When a Portion Isn’t a Portion ” on pages 46 – 47 shows how portion sizes have changed over the years, and how portion distortion can adversely affect your health.

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    CHAPTER 2 Tools for Healthy Eating 13 4. Figure 2.9 shows how solid fats and added sugars fit into a healthy diet. a. If you select mostly nutrient - dense, lean foods that contain few solid fats and added sugars, you may have leftover calories to “spend” on extra helpings or a small sweet dessert. b. Table 2.4 shows how you can select foods to reduce your solid fats and added su g ars. 5. Figure 2.10 shows how servings from the various food groups can create well - balanced meals and snacks throughout the day. 6. Nutrient needs are averaged over several days, or a week, of eating a. Read more about the time of day you should eat in the Examining the Evidence fe a ture “ Does the Time of Day You Eat Impact Your Health? ” on pages 48 – 49 . 7. Foods that you eat, such as pizza, may contribute to more than one food group. a. Table 2.5 provides examples of such foods. 8. As you shop, the food label can help you make sure you know the nutrient and calorie contents of foods. Practical Nutrition Video: Portion Sizes Self - Assessment: Does Your Diet Have Proportionality? NutriTools: Build - A - Meal NutriTools: Build - A - Salad Lecture La uncher Video: Fast - Paced Movies, Television Shows May Lead to More Snacking Lecture La uncher Video: Experiment Shows Portion Control is the Key to Healthy Eating V. What Is a Food Label and Why Is It Important? A. The food label (Figure 2.11) tells you what’s in the package . 1. The FDA regulates the food labels in the United States. a. The FDA mandates that every packaged food be labeled with: i. The name of the food ii. The net weight of the food iii. The name and address of the manufacturer or distributor iv. A list of ingredients in descending order by weight v. A Nutrition Facts panel, which lists total calories, calories from fat, total fat, saturated fat, trans fats, cholesterol , sodium, total carbohydrate, dietary fiber, sugars, v i tamin A , vitamin C, calcium, and iron vi. Serving sizes that are uniform among similar products vii. An indication of how a serving of the food fits into an overall daily diet viii. Uniform definitions for descriptive label terms (such as “light” and “fat - free”) ix. Health claims that are accurate and science - based x. The presence of any of eight common allergens that might be present in the food, including milk, eggs, shellfish, tree nuts, pe a nuts, wheat, and soybeans b. Some foods, such as plain coffee and spices, are exempt from having a Nutrition Facts panel. NEWS NEWS

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    14 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E c. Nutrition labeling is mandatory for meat and poultry, unless they are sold as prepared foods. B. The food label can help you make healthy food choices. 1. The information needed to make smart product choices is provided on the Nutrition Facts panel. 2. On the label: the Nutrition Facts panel : a. The Nutrition Facts panel provides a snapshot of what is inside the food package. b. The panel must, by law, list calories and calories from fat; total fat, saturated fat, and trans fat; cholesterol; sodium; total carbohydrate, dietary fiber, and sugars; pr o tein; vitamin A, vitamin C, calcium, and iron. i. If an additional nutrient such as vitamin E or vitamin B 12 has been added, or if the product makes a claim about a nutrient, it must be listed; otherwise, the manufacturer lists additional vitamins and minerals voluntarily. c. The FDA is considering changes to the Nutrition Facts panel; the current content of the panel and the proposed new label are both shown in Figure 2.12. d . The serving size must be listed as both weight in grams and common household measures (with which you are more familiar, such as cups or ounces). i. Serving sizes are standardized among similar products so you may easily co m pare one brand of a product to another. ii. The remaining information on the Nutrition Facts panel is based on the serving size listed. 3. On the label: the Daily Values : a. The Daily Values (DVs) are general reference levels for the nutrients listed on the food label. b. DVs are not as current as DRIs. c. There are only DVs for nutrients for which there exists sufficient sc i entific evidence to set reference values. d. Depending upon the size of the food package, there may be a foo t note at the bottom that provides a summary of the DVs for a 2,000 - calorie and a 2,500 - calorie diet. e. A manufacturer may claim that a food is “high” in a particular nutr i ent if a serving provides 20 percent or more of the DV. f. If a serving provides 5 percent or less of the DV, it is considered “low” in that n u trient. 4. On the label: label claims : a. The FDA allows food manufacturers to use three types of claims on food products: nutrient content claims, health claims, and stru c ture/function claims. b. Nutrient content claims : i. Nutrient content claims are claims that express the level or amount of a nutrient in a product using descriptive terms (such as free, high, low, reduced, or extra lean) and are permitted within the FDA criteria. ii. Each descriptor means something specific. iii. Figure 2.1 3 illustrates different nutrient content claims. iv . Table 2.6 shows the most common nutrient claims on food labels. d. Health claims : i. Health claims must contain both a food or dietary compound (such as fiber) and a corresponding disease or health - related co n dition associated with the claim.

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    CHAPTER 2 Tools for Healthy Eating 15 ii. Three types of health claims exist: authorized health claims, health claims based on authoritative statements, and qualified health claims. iii. See Table 2.7 for definitions and examples of health claims. e. Structure/function claims: i. These claims describe how a nutrient affects the structure or function of the human body. ii. Though they must be based in truth, structure/function claims do not need to be preapproved by the FDA. iii. These claims cannot state that the nutrient or dietary compound can be used to treat a disease or condition. iv. Dietary supplement manufacturers using structure/function claims must follow more strict usage guidelines, including a label disclaimer. v. See a sample structure/function claim in Figure 2.1 4 . 5 . All foods showing a health claim or a structure/function claim can be marketed as functional foods . 6. Keep the types of claims straight by remembering these points: a. Authorized health claims and health claims based on authoritative statements are the strongest. b. Qualified health claims are less convincing; these claims are “qualified” as based on evidence that is still emerging. c. Structure/function claims are the weakest and will have the weakest wording. 7 . Table 2.8 summarizes the various tools for healthy eating. Practical Nutrition Video: Reading a Food Label Practical Nutrition Video: Understanding Food Claims eLearn: Virtual Food Label Fun Lecture La uncher Video: Changes Coming to Nutrition Labels Animation: Reading Labels V I . Functional Foods: What Role Do They Play in Your Diet ? A. The Academy of Nutrition and Dietetics defines functional foods as whole foods that have a potentially beneficial effect on health when regularly consumed in enough quantity as part of a varied diet. 1. If the beneficial compound is derived from plants, it is called a phytochemical. 2. If the beneficial compound is derived from animals, it is called a zoochemical. 3. Table 2.9 provides a list of currently known health benefits of certain compounds in foods. B . Are there concerns associated with consuming functional foods? 1. The best way to use functional foods is as part of a healthy diet that can help prevent adverse health conditions. 2. Problems may arise if too much of a particular dietary substance is consumed. a. Note that some functional beverages can have more calories and added sugar than soft drinks. NEWS

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    16 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E C . How to use functional foods: 1. Whole grains, fruits, vegetables, healthy vegetable oils, lean meat and dairy products, fish, and poultry are functional foods that contain varying amounts of phytochemicals and zoochemicals. 2. When consuming packaged functional foods, take care to not overconsume any one compound. 3. The Health Connection: A Case Study titled “Functional Foods and Cholesterol” on page 62 discusses the potential of use of functional foods to lower blood cholesterol. Lecture La uncher Video: Coconut: How Healthy Is the Superfood? In - Class Discussion Questions 1. Do you have a healthy diet? What exactly makes a diet “healthy”? How do you know if your diet fits that description? 2. Pick and discuss one of the Dietary Guidelines for Americans categories you feel is the most critical for children under the age of 18 or older adults. 3. The last time you bought a new food product at the store, what was it that convinced you to do so? The colors and pictures on the label? The nutrient content claims? The health claims? The structure/function claims? The information on the Nutrition Facts panel? Discuss what infl u ences you personally to purchase a new food item, and what you think sways the public. 4. Food guidance systems have changed over the years. What do you think is especially effective for the public about MyPlate? What else (if anything) would you do to enhance MyPlate to help Americans improve their eating habits? In - Class Activities 1. Ask students to write down four nutrients they know are important to their personal health. Then ask them how much they think they need each day and write that down as well. Have them compare their guesses to the actual amounts using the table on the inside cover of the text, and to note whether the amount for each is an EAR, RDA, AI, or UL. 2. (If you have computer and Internet access in your classroom.) Create a fictional profile to use with the ChooseMyPlate.gov SuperTracker ( https://www.supertracker.usda.gov/ ) . Find the “ Food Tracker ” section. Have students suggest a fast - food meal and note the nutrient content. Follow the instructions to analyze and see how this sample intake compares to the “acceptable or recommended range.” Go back and analyze a meal with healthier substitutions suggested by the class. You may also wish to use different types of profiles (for example: 20 - year - old male with a higher activity level, 45 - year - old female with lower activity level, etc.) so that students are able to see differences in how the intake compares to the re c ommendations for a variety of individuals. 3. Have students write down the foods they consumed in the meal prior to class (morning, afternoon, or evening prior). Instruct them to determine if their choices were nutrient - dense and to list more nutrient - dense options where possible. Have students share examples of how they might be able to improve their food intake in this manner. 4. Ask students to bring in a Nutrition Facts panel from home (it does not have to be “healthy”). In class, students should exchange labels with a fellow classmate. Have students take turns identifying one noteworthy value that makes his or her item “healthy” NEWS

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    CHAPTER 2 Tools for Healthy Eating 17 or “less healthy” by discussing a particular aspect of what is shown on the Nutrition Facts panel. Ask each student to explain why he or she would or would not purchase this food based solely on the Nutrition Facts panel. 5. Using the same labels as in Activity #4, have students locate the claim (if any) and identify it as either a nutrient content claim, a health claim, or a structure/function claim. Critical Thinking Questions 1. Consider how the information available on food labels and your knowledge of MyPlate actually affects the choices you make about the food you eat. Do you ever read food labeling information to make decisions when you shop for food? After reading this chapter, will you change your pu r chasing habits to include reading more food labels? 2. Were you familiar with the DRIs prior to reading this chapter? Do you think most Americans are familiar with them? Are the DRIs valuable to the average consumer? Why or why not? 3. What do you do when confronted with a restaurant menu that doesn’t i n clude the types of information that, by law, must be included on food labels? How can an understanding of the DRIs, MyPlate, and other guidelines help you make healthy choices even without a nutrition label? Practical Nutrition Videos Author Joan Salge Blake offers lecture teaching tips for effectively communicating a nutr i tion concept to students in Practical Tips for Teaching: Reading a Food Label , available on the Teaching Toolkit DVD and through course ma n agement. She also walks students through making better eating choices in familiar environments in the Practical Nutrition videos Portion Sizes ; Reading a Food Label ; and Understanding Food Claims , available by scanning the QR code s or through the Teaching Toolkit DVD and course management.

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    18 CHAPTER 3 The Basics of D i gestion Chapter Overview Digestion is the chemical or mechanical breaking down of food into smaller units so that it can be absorbed for use by the body. Digestion and absorption take place in the gastrointest i nal tract, which includes the mouth, esophagus, stomach, small intestine, and large intestine. You begin breaking down food in the mouth by chewing. Once swallowed, a bolus of food is pushed down the esophagus by peristalsis. The stomach churns and contracts, mixing food with digestive juices to form chyme. Chyme is gradually released into the small intestine during digestion. The small intestine is the primary organ for digestion and absorption. It is co v ered with thousands of small projections called villi , which increase the absorptive surface area of the small intestine. By the time food reaches the large intestine, the majority of the nutrients have been absorbed. The cells of the large intestine absorb water and electrolytes. As fluids are absorbed, stool is gradually formed and e x its the body through the anus. The liver, gallbladder, and pancreas are accessory organs for the gastrointestinal tract and are essential for digestion. Enzymes, hormones, and bile help break down foods and regulate digestion. Other body systems such as the nervous, circulatory, lymphatic, and excretory systems also play a role by reminding us to eat, distributing nutrients throughout our bodies, and e x creting waste products. Digestive disorders can range from mild to severe problems. Disorders of the mouth, gallbladder, stomach, and intestines can include periodontal disease, dysphagia, gastroesophageal reflux, peptic ulcers, gallbladder disease, constipation, diarrhea, and hemorrhoids. More serious intestinal disorders include irritable bowel syndrome (IBS), celiac disease, Crohn’s disease, and c o lon cancer. Chapter Objectives After reading this chapter, students should be able to: 1. Define digestion and the processes involved in preparing food for absorption. 2. Describe the organs involved in digestion and their primary functions. 3. Explain the function of enzymes, hormones, and bile in digestion, including their primary a c tion and their source of origin. 4. Describe the process of absorption. 5. Explain how the circulatory and lymphatic systems transport absorbed nutrients throug h out the body. 6. Describe the role of the nervous system and the endocrine system in keeping your body nourished. 7. Describe the symptoms and causes of the most common digestive disorders.

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    CHAPTER 3 The Basics of Digestion 19 Chapter Outline I. What Is Digestion and Why Is It Important? 1. Through a multistep digestive process, food is softened with moisture and heat, and then broken down into smaller particles by chewing and exp o sure to enzymes. A. Digestion occurs in the GI tract. 1. The gastrointestinal (GI) tract consists of the mouth, esophagus, stomach, small inte s tine, large intestine, and other organs. 2. The main roles of the GI tract are to break down food, absorb nutrients, and prevent microorganisms or other harmful compounds consumed with food from entering ti s sues of the body. 3. The GI tract is long (stretched vertically, about as high as a two - story building) and lined with cells that have a life span of only three to five days, after which they are shed into the lumen — the interior of the intest i nal tract — and replaced with new, healthy cells. B. Digestion is mechanical and chemical. 1. Mechanical digestion involves breaking food down through chewing and grinding, or moving it through the GI tract with peristalsis. a. Figure 3.1 illustrates peristalsis. 2. Chemical digestion involves breaking food down with digestive juices and enzymes. a. Segmentation is a “sloshing” motion that thoroughly mixes food with chemical secretions in the small intestine. b. Pendular movement is a constrictive wave that involves both forward and reverse movements. It enhances nutr i ent absorption. i. Chemical breakdown in the small intestine can be interrupted, as shown in the Nutrition in the Real World feature “ Tinkering with Your Body’s Digestive Process ” on page 72 . 3. Figure 3.2 reminds us of how organs are built from cells and tissues and how they work together in various body systems. Animation: Overview of Digestion and Absorption Animation: Basic Absorption Mechanisms Animation: Role of Enzymes II. What Are the Organs of the GI Tract and Why Are They Important? 1. See Figure 3.3 for an overview of the organs of the GI tract and the role each plays in digestion. A. Digestion begins in the mouth. 1. Saliva moistens food and helps dissolve small food particles, making them easier to swallow. 2. Chewing cuts and grinds food into smaller pie c es. a. Saliva contains electrolytes, enzymes, and mucus. 3. The tongue pushes the chewed food to the back of the mouth and through the pharynx. 4. Once swallowed, a bolus of food is pushed down your esophagus by peristalsis. a. The epiglottis closes off the trachea during swallowing, as shown in Figure 3.4. b. The esophagus propels food into the stomach.

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    20 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E 5. The gastroesophageal sphincter is at the bottom of the esophagus and opens to allow food into the stomach and then closes to prevent acid from the stomach from flowing back into the esophagus. a. Heartburn occurs when hydrochloric acid from the stomach flows back into the esophagus and irritates the lining. b. Chronic heartburn and stomach acid reflux are symptoms of gastroesophageal reflux disease (GERD). B. The stomach stores, mixes, and prepares food for digestion. 1. The stomach continues mechanical digestion by churning and contracting to mix food with digestive juices (see Figure 3.5). a. The stomach secretes gastrin, hydrochloric acid (HCl) , enzymes, mucus, and intrinsic factor. i. Gastrin stimulates the secretion of HCl, which activates pepsin, a pr o tein - digesting enzyme. b. The stomach churns and contracts to mix food with digestive juices, forming chyme. i. The HCl secretions in the stomach activate the enzyme pepsin, enhance absorption of minerals, break down the connective tissue in meat, and destroy some microorganisms. c. Foods high in carbohydrate exit the stomach faster. d . The pyloric sphincter releases chyme into the small intestine at a rate of about 1 tsp every 30 seconds. C. Most digestion and absorption occurs in the small intestine. 1. The small intestine is the primary organ for digestion and absorption in the human body. a. The small intestine consists of the duodenum, jejunum, and ileum. b. Both chemical and mechanical digestion occur in the small intestine. c. All macronutrients are broken down; vitamins and minerals are a b sorbed intact. d. Thousands of villi and microvilli in the small intestine increase surface area and mix chyme with intestinal secretions to maximize absorption (see Figure 3.6). D. The large intestine eliminates waste and absorbs water and some nutrients. 1. Chyme is released through the ileocecal sphincter into the large i n testine. 2. As shown in Figure 3.7, the large intestine is formed of three segments: the cecum, c o lon, and rectum. 3. The cells of the large intestine absorb water and electrolytes gradua l ly, forming stool. 4. Bacteria in the small intestine play a role in producing some vitamins, including the B vitamins, biotin, and vitamin K. 5. Stool is propelled forward until it reaches the rectum where it is stored until it enters the anal canal and then exits the body via the anus. E. The liver, gallbladder, and pancreas are access o ry organs. 1. The accessory organs — the liver, gallbladder, and pancreas — are essential to the dige s tive process (see Figure 3.8). 2. The liver is the largest gland in the body, and survival without it is not possible. a. The liver produces bile.

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    CHAPTER 3 The Basics of Digestion 21 b. It helps regulate the metabolism of carbohydrates, fats, and protein. c. It stores several nutrients, and is essential for processing and detox i fying alcohol. 3. The gallbladder stores bile and secretes the bile through the bile duct into the small intestine. 4. The pancreas produces digestive enzymes and the blood - regulating hormones insulin and glucagon. III. How Do Hormones, Enzymes, and Bile Aid Digestion? 1. The complete digestion of chyme requires chemical secretions including enzymes, hormones, and bile. 2. Table 3.1 summarizes the functions of digestive secretions. A. Hormones regulate d i gestion. 1. When food reaches your stomach, gastrin is released to signal the rest of the GI tract to prepare for digestion. 2. When you haven’t eaten, the hormone ghrelin stimulates hunger. 3. The small intestine secretes secretin, which stimulates the release of bicarbonate ions to neutralize HCl; and secretes cholecystokinin, which stimulates the release of digestive enzymes, controls the pace of digestion, and contributes to meal satisfaction. B. Enzymes drive the process of digestion. 1. Enzymes break apart food particles into small, unbound nutrients for efficient absor p tion. 2. The pancreas produces amylase, lipase, trypsin, chymotrypsin, and carbox y pept i dase. C. Bile helps digest fat. 1. Bile consists of water, bile acids (and/or salts), various fats including cholesterol, and pigments. 2. Bile breaks down large fat globules into smaller fat droplets. Bile can be reused. D. Table 3.2 summarizes the organs of digestion and their functions. eLearn: Take a Ride through the GI Tract IV. How Are Digested Nutrients Absorbed? A. Digestion is the forerunner to absorption . 1. Once the nutrients have been completely broken down, they are ready to be used by the cells of the body. 2. To reach the cells they have to leave the GI tract and move to the other parts of the body ; this is accomplished by absorption through the walls of the intestines. B . Digested nutrients are absorbed by three methods. 1. Passive diffusion is a process in which nutrients are absorbed due to a concentration gradient. 2. In facilitated diffusion, nutrients are absorbed from a high to a low concentration, but facil i tated diffusion requires a specialized protein to carry the nutrients. 3. Active transport requires both a carrier and energy to shuttle nutrients across the cell me m brane. 4. Figure 3.9 shows absorption methods in the small intestine .

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    22 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E V. What Happens to Nutrients after They Are Absorbed? A. The circulatory system distributes nutrients through your blood. 1. The blood is the body’s primary transport system, shuttling oxygen, nutrients, ho r mones, and waste products throughout the body (see Figure 3.10). 2. During digestion, the blood picks up nutrients through the capillary walls in the GI tract and transports them to your liver and eventually to the cells of your body. 3. Blood also removes excess water and waste products from cells and brings them to the ki d neys for excretion. B. The lymphatic system distributes some nutrients through your lymph vessels. 1. Some absorbed nutrients are too large to enter the bloodstream directly and many pass through the lymphatic system first. 2. Lymph transports digested fat - soluble vitamins from the intestinal tract to the blood and also contains white blood cells that aid the immune sy s tem. C. Your body can store some surplus nutrients. 1. For example, some excess carbohydrate is stored in your liver and muscles in a form called glycogen. D. The excretory system passes waste out of the body . 1. The kidneys allow waste products to be excreted via urine , along with excess water - soluble vitamins . a. Kidneys play an important role in helping to maintain water balance in the body. 2. The system is illustrated in Figure 3.11. VI. What Other Body Systems Affect Your Use of Nutrients? A. The nervous system stimulates your appetite. 1. The nervous system helps each of us make daily decisions regarding what to eat, when to eat, where to eat, and, perhaps most important, when to stop ea t ing. B. The endocrine system releases hormones that help regulate the use of absorbed n u trients. 1. The hormones regulate growth, reproduction, metabolism, and cells’ use of n u trients. VII. What Are Some Common Digestive Disorders? 1 . The Table Tips feature “Digest it Right!” gives tips on healthy eating habits. A. Disorders of the mouth and throat : 1. Gingivitis and periodontal disease may lead to tooth loss, making chewing and swa l lowing more difficult. 2. Difficulty swallowing, or dysphagia, can lead to malnutrition and compr o mised health. B. Esophageal problems : 1. These can include heartburn, gastroesophageal reflux disease (GERD , i n flammation, o b struction, and cancer. C. Disorders of the stomach : 1. Stomach problems can include a minor sto m achache, gastroenteritis, peptic ulcers, and stomach cancer. D. Gallbladder disease : 1. Gallstones can form in the gallbladder or bile duct when bile is abnormally thick. a. Various medical treatments include medicine to dissolve or shock - wave therapy to break up the stone, or surgery to remove the gallbladder.

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    CHAPTER 3 The Basics of Digestion 23 E. Disorders of the intestines : 1. Flatulence a. Flatulence can be uncomfortable, but it is normal and is affected by diet and fluid i n take. 2. Constipation and d i arrhea a. Constipation is caused by excessively slow movements of the undigested residue through the colon, and is often due to insufficient fiber or water intake. b. Diarrhea is the passage of frequent, watery, loose stools. 3. Hemorrhoids a. Hemorrhoids are a condition in which pressure in the veins in the rectum and anus causes swelling and inflammation. F. More serious intestinal disorders : 1. More serious small intestine and large intestine problems tend to involve nutrient malabsorption, which can cause severe health cons e quences. a. Irritable bowel syndrome (IBS) i. IBS is a functional disorder that involves changes in colon rhythm; it is not an actual disease. b. Celiac disease i. Celiac disease is an autoimmune genetic disorder that causes a person’s own immune system to damage the small intestine when gluten, a protein in wheat and other grains, is consumed. ii. Treatment is the consumption of a gluten - free diet. iii . See the Health Connection: A Case Study feature “ Tired of Gluten ” on page 89 for more i n formation on celiac disease. iv. The Table Tips feature “Eat Gluten Free” on page 90 gives tips on limiting gluten intake. c. Crohn’s disease i. Crohn’s disease is the general name for diseases that cause swelling in the inte s tines. d. Colon cancer i. Colon cancer is one of the leading forms of cancer and is one of the most cu r able forms of cancer, if it is detected in the early stages. f. Common digestive disorders are summarized in Table 3.3. Practical Nutrition Video: Probiotics: Do You Need Them? In - Class Discussion Questions 1. Food does not just slide through the digestive tract. What are some ways that the muscles around the organs of the GI tract aid in the digestion and absorption of food? 2. When a person undergoes a gastric bypass surgery such as Roux - en - Y, the surgeon makes a small pouch at the top of the stomach and bypasses portions of the small intestine. Initially the stomach is only able to hold one ounce of food at a time. Using what you learned in this chapter, discuss how gastric bypass surgery affects the digestive process. 3. Have you or anyone in your family ever experienced any of the digestive disorders discussed in this chapter? Can you share your experiences with the class?

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    24 INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FOR NUTRITION & YOU , 4 E In - Class Activities 1. This chapter provides a lot of information regarding the size of the gastrointestinal tract and the volume of digestive contents it can contain. In order to put it in perspective for students, bring a measuring tape, rulers, measuring cups, two - liter bottles, etc., that can be used to demonstrate various concepts during the discussion of the d i gestion and a b sorption. 2. Sam is a 25 - year - old college student. He works full time in addition to taking a full course load. He usually eats fast - food cheeseburgers and fries in his car for lunch and a take - out pepperoni pizza right before bed. Sam has noticed that he has put on some extra weight in the past few months, and his clothes are fitting very tight. He also has been experiencing severe heartburn several nights a week. Working in groups, come up with some changes that Sam can make to his daily habits to help alleviate his heartburn. 3. Lactose intolerance is the inability to digest significant amounts of lactose, the major sugar found in milk. Investigate the causes, symptoms, and treatments as well as nutritional recommendations for this condition. The National Institute of Diabetes and Digestive and Kidney Diseases maintains accurate, comprehensive coverage on this topic. See www.niddk.nih.gov/health - information/health - topics/dige stive - diseases. Critical Thinking Questions 1. In what ways do the mechanical and chemical aspects of digestion differ? How do they work together? 2. If a friend or relative came to you and said they’d been diagnosed with celiac disease, what would you advise them to do (other than continuing to see their physician, of course) to decrease their symptoms? Be very specific. 3. Explain how the nervous system, circulatory and lymphatic system, and endocrine system work together to use nutrients. Address each sep a rately and then discuss how the systems work in harmony. Practical Nutrition Videos Author Joan Salge Blake walks students through making better eating choices in familiar environments in the Practical Nutrition video Probiotics : Do You Need Them? , available by scanning the QR code or through the Teaching Toolkit DVD and course management.

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    25 CHAPTER 4 Carbohydrates: Sugars, Starches, and Fiber Chapter Overview Carbohydrates are your body’s preferred source of energy. Your body digests carbohydrates, and your body’s cells, including brain and red blood cells, use the resulting glucose for fuel. Plants create carbohydrates during the process of photosynthesis. The main carbohydrate is glucose. The two carbohydrate categories are known as simple carbohydrates (mono - and disaccharides) and complex carbohydrates (polysaccharides). Dietary fiber, found in whole grains, fruits, and vegetables, has some important health benefits, but your body does not digest it. When carbohydrates are digested, the process starts in the mouth, with the majority of the activity occurring in the small intestine. Enzymatic action is required to break down the carbohydrates into their simplest forms. Some people do not produce enough of the enzyme lactase and have difficulty d i gesting the carbohydrate known as lactose (found in dairy products). This lactose maldige s tion may result in lactose intolerance. Insulin, a hormone produced and released by the pancreas, directs the process of getting the glucose from your bloodstream to your body’s cells for energy. If your body does not have an immediate need for glucose, the e x cess from your blood will be stored in the muscles and the liver in the form of glycogen. When the blood glucose level decreases, the hormone glucagon will signal the release of glucose from stored glycogen. This is important, as your body needs a constant supply of fuel to support the functions of red blood cells, the brain, and the central nervous system. Without enough glucose, the body will produce ketone bodies, making the blood slightly acidic, leading to an eventual state of ketosis if you fast for two or more days. This process involves using fat for fuel and protein to create glucose instead of the preferred carbohydrates. Fasting will ult i mately lead to death. The DRI for carbohydrates is a minimum of 130 grams/day for adults and children. Getting carbohydrates from healthy sources, such as whole grains, fruits, vegetables, legumes, nuts, and seeds is preferred. You are wise to be cautious about including too much added sugar in your diet, as it can have undesirable effects on the body. Sugar substitutes are often used by those who want the sweetness of sugar without the calories or by people with diabetes who are managing their blood glucose levels. Diabetes is a growing epidemic in the United States. In type 1 diabetes, the body isn’t producing enough insulin. In type 2 diabetes, the body develops insulin resistance. Poorly managed diabetes can have serious effects; diabetes is the seventh leading cause of death in the nation. Both type 1 and type 2 diabetes are best managed with diet, along with other lifestyle modifications.

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