Class Notes for Nutrition and You, 4th Edition

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INSTRUCTOR’S RESOURCEAND SUPPORT MANUALNUTRITION & YOUFOURTH EDITIONJOAN SALGE BLAKE

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iiTable of ContentsPART 1Chapter Overview and Lecture OutlineiiiCHAPTER 1What Is Nutrition?1CHAPTER 2Tools for Healthy Eating9CHAPTER 3The Basics of Digestion18CHAPTER 4Carbohydrates: Sugars, Starches, and Fiber25CHAPTER 5Fats, Oils, and Other Lipids35CHAPTER 6Proteins and Amino Acids44CHAPTER 7Vitamins53CHAPTER 8Minerals and Water70CHAPTER 9Alcohol84CHAPTER 10Weight Management and Energy Balance92CHAPTER 11Nutrition and Fitness102CHAPTER 12Consumerismand Sustainability:Food fromFarm to Table111CHAPTER 13Food Safety and Technology120CHAPTER 14Life Cycle Nutrition: Pregnancy through Infancy128CHAPTER 15Life Cycle Nutrition: Toddlers through theLater Years136CHAPTER 16Hunger at Home and Abroad144PART2Teaching Tips for First-Time Instructorsand Adjunct Professors149PART3SampleSyllabi156PART4MasteringNutritionOverview and Teaching Tips163PART5MyDietAnalysis Teaching Tips and Activities165PART6Great Ideas in Teaching NutritionNewsletters171

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iiiPrefaceThe Instructor Resource and Support Manual forthefourthedition ofNutrition&Youwas developed to make teaching a nutrition class a little easier. The nutrition classenvironment is a place where many students learn to dispel myths, gain new insight andenough understanding to apply the information to their daily lives, and even prepare to passon what they learn in a professional capacity. Making the material seem more personal tostudents through discussion questions and activities helps students retain importantinformation.Part 1The following is provided for each chapter:ChapterSummaryThe overview provides a general summary of the topics in the chapter.Chapter ObjectivesThe chapter objectives list the key concepts students should understand as they reach theconclusion of each chapter. These objectives can be helpful in organizing lesson plans orlectures.Chapter OutlineThe outlines for each chapter are helpful in formulating and structuring lectures. In additionto including an outline for each topic covered in the chapter, this section also includesreferences to Animations, NutriTools,and ABC News video clips provided, so you can moreeasily incorporate visual elements into your class lectures and discussions where appropriateto each topic.In-Class Discussion QuestionsThe discussion questions are presented to help students understand the material conceptually.Some concepts may be difficult to grasp, but these discussion questions can help leadstudents in the direction of understanding more complicated ideas.In-Class ActivitiesSpark student interest in your lessons by integrating classroom activities. Split students intogroups to have smaller discussions, bring visual aids to class, or have students create samplenutrition plans specifically targeted to help students understand chapter concepts.

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ivPREFACECriticalThinking QuestionsA list of critical thinking questions provided to accompany the chapter provide an opportunityfor class discussion on current nutrition topics or assignments as homework for furtherevaluation of an important topic.PracticalTips VideosAuthor Joan Salge Blake walks students through making better eating choices in familiarenvironments in the video clips available to instructorson the Teaching Toolkit DVD and tostudents for viewing by using the QR codes throughout the book.Lecture Launcher VideosThese videos are available free of charge linked from the PowerPoint lectures and inMasteringNutrition.Part 2Teaching Tips for First-Time Instructors and Adjunct ProfessorsExcerpts from professional reference books provide successful and helpful tips and strategiesfor managing large classrooms and stimulating student interactivity.Part 3Sample SyllabiThe 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 thiscourse, and the third has been made available as a general template to follow when writinga syllabus.Part 4MasteringNutritionOverview and Teaching TipsWondering how to incorporateMasteringNutritioninto your lesson plans? This sectionprovides information, tips, and suggestions for using the program to enhance your classroom,hybrid, or online course.Part5MyDietAnalysis Teaching Tips and ActivitiesWondering how to integrate MyDietAnalysis into your lesson plans? Or looking foradditional activities for MyDietAnalysis? This section provides information, tips, andsuggestions for using the program to enhance student learning.'NEWS

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PREFACEvPart 6Great Ideas in Teaching NutritionNewlettersFrom ourGreat Ideas in Teaching Nutritionnewsletter series, these teaching tips includesome of your colleagues' best teaching ideas from the classroom. These tips are useful forfirst-time instructors, those who have not taught the course in a while, or the experiencedprofessor seeking new ideas.

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1CHAPTER1What Is Nutrition?Chapter OverviewFood provides many nutrients and nonnutrients that work together to regulate and maintainbody 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 choices.Nutrition is the science of how nutrients in foods nourish you and affect your health. Goodnutrition plays a role in reducing the risk of four of the top ten leading causes of death in theUnited States, as well as many other diseases and conditions. In order for our bodies tofunction 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 yourdiet. They provide energy, which is measured in calories. Vitamins and minerals aremicronutrients because they are needed in smaller amounts. Vitamins and minerals areessential for metabolism because they play a role in many chemical reactions and bodyprocesses. Water is part of the medium inside and outside of cells that that carries nutrientsand waste products to and from your cells. The best way to meet your nutrient needs isthrough a well-balanced diet. In addition to nutrients, foods provide other dietary compoundssuch as phytochemicals and fiber. People who cannot meet all their nutrient needs from foodalone may benefit from taking a supplement.Many Americans do not meet all their nutrient needs but exceed their calorie requirements.Rates of overweight and obesity are of great concern.Healthy People 2020is a set of healthobjectives for Americans, which is part of a nationwide health improvement program with“Nutrition and Overweight” as one focus.Scientific knowledge about nutrition does not change as frequently as it may appear to inthe media. The scientific method is used to conduct credible research. Scientists submit theirresearch findings in peer-reviewed journals. It takes many affirming research studies before aconsensus is reached about nutrition advice. Scientists can use different types of experimentsto test their hypotheses.Registered dietitians are trained nutrition professionals that can provide credible nutritionadvice and guidance. When obtaining nutrition information online, carefully investigate(among other things) the site’s purpose, authors, funding sources, and the frequency of siteupdates.Chapter ObjectivesAfter reading this chapter, students should be able to:1.Discuss the factors that influence your food choices.2.Define the termnutrition.3.Differentiate between the six categories of essential nutrients found in food andin the body.

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2INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION&YOU,4E4.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 identifyreliable sources of nutrition information.Chapter OutlineI.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,andmaintenance, andtomaintain bodyprocesses.2.There are six classes of nutrients: carbohydrates, fats, protein, vitamins, minerals, andwater.a.Carbohydrates, fats, and proteins provide energy in the form of kilocalories.b.Vitamins and minerals help regulate body processes, including metabolism.c.Water is vital to life.3.Foodsalso provide nonnutrient compoundsthat help maintain and repair the body.B.We choose foods for manyotherreasons.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 environment.3.Social reasons and trends:a.People eat in certain social situations and based on what is readily available fromfood manufacturers.4.Cost, time, and convenience:a.People eat more healthfully if presented with lower-cost foods, time to cook them,and accessibility.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 Important?A.Nutrition is the science that studies how the nutrients and compounds in foods nourishyou, 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 identifieswhich of these are nutrition related.B.You are a product of what you eat, what youdon’teat, or what you may eattoo muchof.1.To meet your nutritional needs and be healthy, you need to understand the roles of theessential nutrients in your body and which foods to eat to get them.

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CHAPTER1What IsNutrition?3III.What Are the Essential Nutrients and Why Do You Need Them?1.Carbohydrates, fats, proteins, vitamins, minerals, and water are allessentialnutrients—you need them to function.a.Carbohydrates, fats, and proteins are macronutrients: higher amounts of them areneeded 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 thehuman body.4.Kilocalories (calories) 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 kilogramof 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 basedon your age, gender, and activity level.3.Carbohydrates supply glucose, which your cells use as the major energy source to fuelyour body.4.Carbohydrates, fats, and proteins are all organic because they contain the elementcarbon.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 theamount (weight in grams) of carbohydrates, protein, and fat in the food.2.To find this out, you need to multiply the total grams of each energy-yielding nutrientby the number of calories per gram of that nutrient.C.Vitamins and minerals are essential for metabolism.1.You need vitamins to use the carbohydrates, fats, and proteins you consume and tosustain numerous chemical reactions in your body.2.Many vitamins and minerals aid enzymes, which are substances that speed upreactions in your body.3.Vitamins are organic compounds, usually obtained from foods.a.The body is able to make some vitamins but sometimes cannot make enough tomaintain good health.4.Minerals are inorganic substances that play key roles in body processes and structure.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, andwaste products from, your cells.2.Water helps maintain body temperature, acts as a lubricant, and cushions organs frominjury.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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4INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION&YOU,4E1.A well-balanced diet provides other dietary compounds, such as phytochemicals andfiber, whichhave been shown to help fight many diseases.2.Other obvious benefits of food include taste, aroma, and texture, coupled with socialinteraction. 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 dietrestrictions 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 toolittle fiber and some vitamins and minerals.a.Men generally meet the recommended amounts of most vitamins and minerals, butwomen 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 outsidethehome; research shows that these foods tend to be less nutritious.3.Children and adolescents who skip breakfast are at a higher risk for overweight andobesity.B.Rates of overweight and obesity in Americans:1.The prevalence of those who are overweight and obese has become epidemic in theUnited States.2.Over 65 percent of American adults are overweight andabout 35percent areconsidered 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 17percent are considered obese.4.Overweight does not equate to well fed; many of the poorest Americans are obese andmalnourished.a.The featureNutrition in the Real World:“Poor, Obese, and Malnourished: ATroubling Paradox”on page 14 explains the links between poverty, obesity, andmalnutrition.C.Improving Americans’ diets is one goal ofHealthy People 2020.1.The U.S. Surgeon General has issued calls for a nationwide health improvementprogram since 1979.2.Healthy People 2020contains a set of health goals and objectives for the nation toachieve over the second decade of the twenty-first century.3.Healthy People 2020focuses on several overarching goals:a.Attain high-quality, longer lives free of preventable disease, disability, injury, andpremature 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 everystage of life.4.Table 1.2 lists the nutrition and weight status objectives proposed forHealthy People2020.

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CHAPTER1What IsNutrition?5Practical Nutrition Video: Shop SmartLecture Launcher Video: Menu Calorie CountsVI.What’s the Real Deal When It Comes to Nutrition Research and Advice?A.Nutritional studies deemed to be interesting by the media give the impression thatnutrition knowledge and advice constantly changes, which is not the case.1.Diet advice seems to change all the time, butscientific knowledge about nutritiondoesn’t change that frequently.2.Multiple affirming research studies are needed before consensus is reached aboutnutrition advice.3.TheExamining the Evidencefeature“How Can I Evaluate Nutrition News?”on page16discusses how to scrutinize headlines and not get caught up in media hype.B.Sound nutrition research begins with the scientific method.1.Scientists come up with a hypothesis based on observations, test the hypothesis, andsee 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 hypothesis either is supported or not supported and must be modified or a newhypothesis 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 scientific consensus.C.Research studies and experiments confirm hypotheses.1.Studies are often done in a laboratory experiment with animals, or as observational orexperimental research with humans.2.Observational research:a.Observational research involves looking at factors in two or more groups ofsubjects to see if there is a relationship to a certain disease or another healthoutcome.b.Epidemiological research looks at populations of people in the search forcommonalities 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 isnot or is given a placebo.i.If neither the people receiving treatment nor the scientists conducting theresearch know which group has received the treatment, they are conducting adouble-blind, placebo-controlled study.c.Figure 1.7 uses a flow chart to illustrate the way scientists use experimentalresearch to test hypotheses.d.Contradictory studies and revisions of hypothesis can lead to intriguing researchquestions, such asinthe 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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6INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION&YOU,4Eii.This is made possible in part by the Human Genome Project, which revealed thecomplete sequencing of deoxyribonucleic acid (DNA) in human cells.iii.Nutritional genomics considers how dietary components cause different effectson 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, publichealth nutritionists, or licensed dieticiannutritionists.a.TheHealth Connection:Case Study feature “Fast-Food City” on page 21 illustrateshow 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 accreditedcourses 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.TheNutrition in the Real Worldfeature,“Don’t Be Scammed!”on page23covers key things consumers should look for when evaluating any media claimabout health and nutrition.E.You can obtain accurate nutrition information on the Internet.1.When obtaining nutrition information on the Internet, evaluate the website to be surethat it contains credible, up-to-date information, and its content is not biased by thosethat fund the website.2.The National Institutes of Health has developedkeyquestions to consider whenviewing such sites.a.Who runsand pays forthe 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 Discussion Questions1.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 ofclass and then discuss students’ questions after covering the first chapter. It is a goodtime 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 rolein 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 waythat you evaluate nutrition articles you see in the news?

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CHAPTER1What IsNutrition?7In-Class Activities1.Invite a registered dietitian from your university or the community to come talk to yourclass about the educational requirements and professional responsibilities of a dietitian.2.Investigate your state’s obesity rates and what programs are underway to address thisserious health issue. A good place to start your search is at the website for the Centers forDisease Control and Prevention.3.Provide groups of students with various research studies. After reading the articles, theymust identify what type of experiment was completed and determine the researchers’basic hypotheses. Each group should share their findings with the class.4.Allow students to plan various research studies (laboratory experiment, epidemiologicalresearch, experimental research) based on the following fictitious story and hypothesis:Scientists living in a small county in the Midwest noticed that rates of AttentionDeficit Disorder (ADD) in their county were high and attributed this to the fact thatlocals ate a lot of jelly beans. There is a jelly bean factory in the county which oftengives free samples to county residents. Their hypothesis is that the dye from the jellybeans is causing ADD.5.Show students an example of a website that contains credible nutrition information andone that does not. Challenge students to find examples of websites that provide reliableand unreliable sources of nutrition information.Critical Thinking Questions1.Consider which factors listed in the text most affect your food choices. Do the mostinfluential factors change based upon time of day, people who are with you, or other suchreasons? Does your budget determine your choices? After you have identified the factorswhich most affect your food choices, list ways in which you could change thosebehaviors to make positive changes in your life.2.In your opinion, how realistic are the objectives set forth inHealthy People 2020(seeTable 1.2)? If you were asked to provide the U.S. Surgeon General with ways in whichAmericans could achieve these objectives, what would they be? Be sure to consider thefactors discussed in the chapterthatpreclude many Americans from meeting theseobjectives.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” usideas about particular products or practices? Are some of these, in your opinion, moresuccessful than others? How would you put together your own list of items of whichpeople should be suspicious when they encounter them through various media? Considertelevision, radio, the Internet, print media, etc., separately, since tactics are different foreach type of media.PracticalNutritionVideosAuthor Joan Salge Blake offers lecture teaching tips for effectively communicating anutrition concept to students inPractical Tips forTeaching: Shop Smart,available on theTeaching Toolkit DVD and through course management.

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8INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION&YOU,4EShe also walks students through making better eating choices in familiar environments inthePractical Nutrition videoShopSmart,availableby scanning the QR code or throughtheTeaching Toolkit DVD andcourse management.

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9CHAPTER2Tools for Healthy EatingChapter OverviewIncorporating the principles of balance, variety, and moderation is fundamental to healthyeating. 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 appropriatelyto meet individual needs. Using the available tools designed to help you plan and consume ahealthy diet helps to make these goals a reality.The Dietary Reference Intakes (DRIs) help you to obtain the recommended amount ofeach nutrient. TheDietary Guidelines for Americanssummarize the current recommendationsfor healthy individuals over the age of two regarding nutrition and lifestyle (includingphysical activity) for good health. These guidelines are also geared toward helping peoplereduce 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 conceptsfrom theDietary Guidelines for Americans.MyPlate also includes guidance regarding thenumber of servings from each food group to help individuals to meet the DRIs for nutrientneeds based on appropriate calorie intake (based on age, gender, and activity level). MyPlatemay be accessed via the Internet.Food labels are another type of tool intended to assist you with selecting healthy foods. Inaddition 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 providefurther 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 foodsmay help prevent adverse health conditions; but problems can arise if too much of a particularcompound is consumed. This is a particular risk when consuming prepackaged functionalfoods.Chapter ObjectivesAfter 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 helpguide you.2.Explain what the DRIs are and the differences between the EAR, AI, RDA, UL, andAMDR.3.Describe the principles in theDietary Guidelines for Americans.4.Explain the concept of MyPlate and name the five food groups and the typical foodsrepresented 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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10INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4EChapter OutlineI.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 energy.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 calories.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, theDietary Guidelines for Americans,MyPlate, and the Nutrition Facts panelon food labelsmay be used to help you avoidstates of undernutrition 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 issuedby theInstitute of Medicine of the U.S.National Academy of Sciences.1.DRIs are specific amounts of each nutrient needed to maintain good health, preventchronic 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 nutrientsmight impact disease prevention; subsequent research has also looked at dietarysupplements 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 percentof the individuals in a similar age and gender.i.This is considered a good starting point for determining the daily amountneeded for good health.2.Recommended Dietary Allowance (RDA)a.The RDA is based on, butsethigher than, the EAR.b.The RDA represents the average amount of a nutrient that meets the needs of nearlyall (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 anEAR, so an RDA cannot be set.3.Adequate Intake (AI)a.An AI is the approximate amount of a nutrient estimated for individuals to consumein a similar age and gender group to maintain good health.

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CHAPTER2Tools for Healthy Eating11b.The AI is used when an RDA cannot be set due to a lack of scientific informationavailable to determine the EAR for a nutrient.4.Tolerable Upper Intake Level (UL)a.The UL is the highest amount of a nutrient that may be consumed daily withoutharm.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, andprotein.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 activity level, andindicates the amount of energyyouneed daily to maintain energy balance.ii.Table 2.1 gives the range of calories needed daily based on age, gender, andactivity level.7.Figure 2.2 illustrates the relationships between the reference values.D.How to use the DRIs:1.Youcan 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 nutrients needed daily.5.The Table Tips feature “Tip-Top Nutrition Tips” on page 37 provides ideas for usingthe DRIs in daily life.eLearn: Healthy Eating on a BudgetAnimation: DRI DeterminationIII.What Are theDietary Guidelines for Americans?A.Due tothe health consequences ofoverconsumption of fat, saturated fat, cholesterol, andsodium, the government designed goals to improve Americans’ diets.1.TheDietary Guidelines for Americansare intended for healthy individuals over theage of two and correspond with the latest recommendations for nutrition and physicalactivity.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, heartdisease,andcertain cancers.b.TheNutrition in the Real World feature“TheDietary Guidelines for Americans ataGlance”provides an overview of the 2010 guidelines.i.For the2015 updateto 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 bestfoods for your diet.1.A food guidance system is an illustrated diagram to help people select from a varietyof foods to design a healthy diet.

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12INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4E2.Many countries have developed their own food guidance systems, as illustrated inFigure 2.3.3.Some food guidance systems are specifically geared toward reducing risk of certaindiseases, as is the case with the DASH (Dietary Approaches to Stop Hypertension)diet and the Mediterranean-style eating pattern.4.The websitewww.ChooseMyPlate.govand the tool MyPlate were released by theUSDA in 2011..a.MyPlate, which depicts five food groups in a place setting (see Figure 2.4),servesas an icon to remind consumers to eat healthfully.a.ChooseMyPlate.gov provides information, tips, and tools to help you build ahealthier diet based on theDietary Guidelines for Americans.B.MyPlate and ChooseMyPlate.gov emphasize changes in diet, eating behaviors, andphysical activity.1.MyPlate and ChooseMyPlate.gov promote proportionality, moderation, variety, andpersonalization.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 nutrientscompared to the number of calories—from each food group.a.The foundation of your diet should be nutrient-dense foods with little solid fats andadded sugars.b.Figure 2.5 shows a comparison of the nutrient density of two versions of a potato: amedium baked potato and an ounce of potato chips.c.Figure 2.6 compares sample nutrient-dense food choices to less healthy foodchoices 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 MyPlatewill increase your chances of consuming all 40 of the nutrients 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 theDietary Guidelines for Americans.a.Advice regarding physical activity can also be found at ChooseMyPlate.gov.C.How to use MyPlate and ChooseMyPlate.gov1.MyPlate reminds you to eat a diverse group of foods, and ChooseMyPlate.gov willgive you the exact numbers of servings to eat from each food group, based on yourdaily calorie needs.2.If you cannot go to the website, you can obtain similar information by usingTables 2.1 and 2.3 in this chapter.a.First, figure out how many calories you should be eating daily by considering youractivity level.b.Refer back to Table 2.1 on page36for the number of calories you need based onyour activity level, age, and gender.c.Next, Table 2.3 tells you how many servings from each food group you shouldconsume to healthfully obtain the calories your body requires.3.Figure 2.8 provides an easy way to eyeball your serving sizes.a.TheNutrition in the Real World feature“When a PortionIsn’ta Portion”on pages46–47shows how portion sizes have changed over the years, and how portiondistortion can adversely affect your health.

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CHAPTER2Tools for Healthy Eating134.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 addedsugars, you may have leftover calories to “spend” on extra helpings or a smallsweet dessert.b.Table 2.4 shows how you can select foods to reduce your solid fats and addedsugars.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 eatinga.Read more about the time of day you should eat in the Examining the Evidencefeature“Does the Time of Day You Eat Impact Your Health?”on pages48–49.7.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 caloriecontents of foods.Practical Nutrition Video: Portion SizesSelf-Assessment: Does Your Diet Have Proportionality?NutriTools: Build-A-MealNutriTools: Build-A-SaladLecture Launcher Video: Fast-Paced Movies, Television Shows May Lead toMore SnackingLecture Launcher Video: Experiment Shows Portion Control is the Key toHealthy EatingV.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 foodii.The net weight of the foodiii.The name and address of the manufacturer or distributoriv.A list of ingredients in descending order by weightv.A Nutrition Facts panel, which lists total calories, calories from fat, total fat,saturated fat,transfats,cholesterol, sodium, total carbohydrate, dietary fiber,sugars, vitamin A, vitaminC, calcium, and ironvi.Serving sizes that are uniform amongsimilarproductsvii.An indication of how a serving of the food fits into an overall daily dietviii.Uniform definitions for descriptive label terms (such as “light” and “fat-free”)ix.Health claims that are accurate and science-basedx.The presence of any of eight common allergens that might be present in thefood, including milk, eggs, shellfish, tree nuts, peanuts, wheat, and soybeansb.Some foods, such as plain coffee and spices, are exempt from having a NutritionFacts panel.NEWSNEWS

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14INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4Ec.Nutrition labeling is mandatory for meat and poultry, unless they are sold asprepared 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 NutritionFacts 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,andtransfat; cholesterol; sodium; total carbohydrate, dietary fiber, and sugars;protein; vitamin A, vitamin C, calcium, and iron.i.Ifan additional nutrient such as vitamin E or vitamin B12has been added, or ifthe product makes a claim aboutanutrient, it must be listed; otherwise, themanufacturer lists additional vitamins and minerals voluntarily.c.The FDA is considering changes to the Nutrition Facts panel; the current content ofthe 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 householdmeasures (with which you are more familiar, such as cups or ounces).i.Serving sizes are standardized among similar products so you may easilycompare one brand of a product to another.ii.The remaining information on the Nutrition Facts panel is based on the servingsize listed.3.On the label: the Daily Values:a.The Daily Values (DVs) are general reference levels for the nutrients listed on thefood label.b.DVs are not as current as DRIs.c.There are only DVs for nutrients for which there exists sufficient scientific evidenceto set reference values.d.Depending upon the size of the food package, there may be a footnote at the bottomthat 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 nutrient if a servingprovides 20 percent or more of the DV.f.If a serving provides 5 percent or less of the DV, it is considered “low” in thatnutrient.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 structure/function claims.b.Nutrient content claims:i.Nutrient content claims are claims that express the level or amount of a nutrientin a product using descriptive terms (such as free, high, low, reduced, or extralean) and are permitted within the FDA criteria.ii.Each descriptor means something specific.iii.Figure 2.13illustrates 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) anda corresponding disease or health-related condition associated with the claim.

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CHAPTER2Tools for Healthy Eating15ii.Three types of health claims exist: authorized health claims, health claims basedon authoritative statements, and qualified health claims.iii.See Table 2.7 for definitions and examples of health claims.e.Structure/functionclaims:i.These claimsdescribe how a nutrient affects the structure or function of thehuman body.ii.Though they must be based in truth, structure/function claims do not need to bepreapproved by the FDA.iii.These claims cannot state that the nutrient or dietary compound can be used totreat a disease or condition.iv.Dietary supplement manufacturers using structure/function claims must followmore strict usage guidelines, including a label disclaimer.v.See a sample structure/function claim in Figure 2.14.5.All foods showing a health claim or a structure/function claim can be marketed asfunctional foods.6.Keep the types of claims straight by remembering these points:a.Authorized health claims and health claims based on authoritative statements arethe strongest.b.Qualified health claims are less convincing; these claims are “qualified” as based onevidence 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 LabelPractical Nutrition Video: Understanding Food ClaimseLearn: Virtual Food Label FunLecture Launcher Video: Changes Coming to Nutrition LabelsAnimation: Reading LabelsVI.Functional Foods: What Role Do They Play in Your Diet?A.The Academy of Nutrition and Dietetics defines functional foods as whole foods thathave a potentially beneficial effect on health when regularly consumed in enoughquantity 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 infoods.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 preventadverse health conditions.2.Problems may arise if too muchof a particular dietary substanceis consumed.a.Note that some functional beverages can have more calories and added sugar thansoft drinks.NEWS

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16INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4EC.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 phytochemicalsand zoochemicals.2.When consuming packaged functional foods, take care to not overconsume any onecompound.3.The Health Connection: A Case Study titled “Functional Foods and Cholesterol” onpage 62 discusses the potential of use of functional foods to lower blood cholesterol.Lecture Launcher Video: Coconut: How Healthy Is the Superfood?In-Class Discussion Questions1.Do you have a healthy diet? What exactly makes a diet “healthy”? How do you know ifyour diet fits that description?2.Pick and discuss one of theDietary Guidelines for Americanscategories you feel is themost 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 youto do so? The colors and pictures on the label? The nutrient content claims? The healthclaims? The structure/function claims? The information on the Nutrition Facts panel?Discuss what influences you personally to purchase a new food item, and what you thinksways the public.4.Foodguidancesystems have changed over the years. What do you think is especiallyeffective for the public about MyPlate? What else (if anything) would you do to enhanceMyPlate to help Americans improve their eating habits?In-Class Activities1.Ask students to write down four nutrients they know are important to their personalhealth. Then ask them how much they think they need each day and write that down aswell. Have them compare their guesses to the actual amounts using the table on the insidecover 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 profiletouse with the ChooseMyPlate.gov SuperTracker (https://www.supertracker.usda.gov/).Findthe “Food Tracker” section. Have students suggest a fast-food meal and note thenutrient content. Follow the instructions to analyze and see how this sample intakecompares to the “acceptable or recommended range.” Go back and analyze a meal withhealthier substitutions suggested by the class. You may also wish to use different types ofprofiles (for example: 20-year-old male with a higher activity level, 45-year-old femalewith lower activity level, etc.) so that students are able to see differences in how theintake compares to the recommendations 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 shareexamples 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. Havestudents take turns identifying one noteworthy value that makes his or her item “healthy”NEWS

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CHAPTER2Tools for Healthy Eating17or “less healthy” by discussing a particular aspect of what is shown on the Nutrition Factspanel. Ask each student to explain why he or she would or would not purchase this foodbased solely on the Nutrition Facts panel.5.Using the same labels as in Activity #4, have students locate the claim (if any) andidentify it as either a nutrient content claim, a health claim, or a structure/function claim.Critical Thinking Questions1.Consider how the information available on food labels and your knowledge of MyPlateactually affects the choices you make about the food you eat. Do you ever read foodlabeling information to make decisions when you shop for food? After reading thischapter, will you change your purchasing habits to include reading more food labels?2.Were you familiar with the DRIs prior to reading this chapter? Do you think mostAmericans are familiar with them? Are the DRIs valuable to the average consumer? Whyor why not?3.What do you do when confronted with a restaurant menu that doesn’t include the types ofinformation that, by law, must be included on food labels? How can an understanding ofthe DRIs, MyPlate, and other guidelines help you make healthy choices even without anutrition label?PracticalNutritionVideosAuthor Joan Salge Blake offers lecture teaching tips for effectively communicating anutrition concept to students inPractical Tips for Teaching:Reading a Food Label,available on the Teaching Toolkit DVD and through course management.She also walks students through making better eating choices in familiar environments inthePractical NutritionvideosPortion Sizes;Reading a Food Label; andUnderstanding FoodClaims,availableby scanning the QR codesor through the Teaching Toolkit DVD andcourse management.

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18CHAPTER3The Basics of DigestionChapter OverviewDigestion is the chemical or mechanical breaking down of food into smaller units so that itcan be absorbed for use by the body. Digestion and absorption take place in thegastrointestinal tract, which includes the mouth, esophagus, stomach, small intestine, andlarge intestine. You begin breaking down food in the mouth by chewing. Once swallowed, abolus 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 smallintestine during digestion. The small intestine is the primary organ for digestion andabsorption. It is covered with thousands of small projections called villi,which increase theabsorptive surface area of the small intestine. By the time food reaches the large intestine, themajority of thenutrients have been absorbed. The cells of the large intestine absorb water and electrolytes.As fluids are absorbed, stool is gradually formed and exits the body through the anus. Theliver, gallbladder, and pancreas are accessory organs for the gastrointestinal tract and areessential for digestion. Enzymes, hormones, and bile help break down foods and regulatedigestion. Other body systems such as the nervous, circulatory, lymphatic, and excretorysystems also play a role by reminding us to eat, distributing nutrients throughout our bodies,and excreting 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, andhemorrhoids. More serious intestinal disorders include irritable bowel syndrome (IBS), celiacdisease, Crohn’s disease, and colon cancer.Chapter ObjectivesAfter 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 primaryaction and their source of origin.4.Describe the process of absorption.5.Explain how the circulatory and lymphatic systems transport absorbed nutrientsthroughout the body.6.Describe the role of the nervous system and the endocrine system in keeping your bodynourished.7.Describe the symptoms and causes of the most common digestive disorders.

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CHAPTER3The Basics of Digestion19Chapter OutlineI.What Is Digestion and Why Is It Important?1.Through a multistep digestive process, food is softened with moisture and heat, andthen broken down into smaller particles by chewing and exposure to enzymes.A.Digestion occurs in the GI tract.1.The gastrointestinal (GI) tract consists of the mouth, esophagus, stomach, smallintestine, large intestine, and other organs.2.The main roles of the GI tract are to break down food, absorb nutrients, and preventmicroorganisms or other harmful compounds consumed with food from enteringtissues of the body.3.The GI tract is long(stretched vertically, about as high as a two-story building)andlined with cells that have a life span of only three to five days, after which they areshed into the lumen—the interior of the intestinal tract—and replaced with new,healthy cells.B.Digestion is mechanical and chemical.1.Mechanical digestion involves breaking food down through chewing and grinding, ormoving 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 chemicalsecretions in the small intestine.b.Pendular movement is a constrictive wave that involves both forward and reversemovements. It enhances nutrient absorption.i.Chemical breakdown in the small intestine can be interrupted, as shown in theNutrition in the Real World feature“Tinkering with Your Body’s DigestiveProcess”on page72.3.Figure 3.2 reminds usof how organs are built from cells and tissues and how theywork together in various body systems.Animation: Overview of Digestion and AbsorptionAnimation: Basic Absorption MechanismsAnimation: Role of EnzymesII.What Are the Organs of the GI Tract and Why Are They Important?1.See Figure 3.3 for an overview ofthe organs of the GI tract and the role each plays indigestion.A.Digestion begins in the mouth.1.Saliva moistens food and helps dissolve small food particles, making them easier toswallow.2.Chewing cuts and grinds food into smaller pieces.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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20INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4E5.Thegastroesophagealsphincter is at the bottom of the esophagus and opens to allowfood into the stomach and then closes to prevent acid from the stomach from flowingback into the esophagus.a.Heartburn occurs when hydrochloric acid from the stomach flows back into theesophagus and irritates the lining.b.Chronic heartburn and stomach acid reflux are symptoms of gastroesophagealreflux disease (GERD).B.The stomach stores, mixes, and prepares food for digestion.1.The stomach continues mechanical digestion by churning and contracting to mix foodwith digestive juices (see Figure 3.5).a.The stomach secretes gastrin, hydrochloric acid(HCl), enzymes, mucus, andintrinsic factor.i.Gastrin stimulates the secretion of HCl, which activates pepsin, a protein-digesting enzyme.b.The stomach churns and contracts to mix food with digestive juices, formingchyme.i.The HCl secretions in the stomach activate the enzyme pepsin, enhanceabsorption of minerals, break down the connective tissue in meat, and destroysome microorganisms.c.Foods high in carbohydrate exit the stomach faster.d.The pyloric sphincter releases chyme into the small intestine at a rate of about1 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 humanbody.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 absorbed intact.d.Thousands of villi and microvilli in the small intestine increase surface area andmix 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 intestine.2.As shown in Figure 3.7, the large intestine is formed of three segments: the cecum,colon, and rectum.3.The cells of the large intestine absorb water and electrolytes gradually, forming stool.4.Bacteria in the small intestine play a role in producing some vitamins, including the Bvitamins, biotin, and vitamin K.5.Stool is propelled forward until it reaches the rectum where it is stored until it entersthe anal canal and then exits the body via the anus.E.The liver, gallbladder, and pancreas are accessory organs.1.The accessory organs—the liver, gallbladder, and pancreas—are essential to thedigestive 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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CHAPTER3The Basics of Digestion21b.It helps regulate the metabolism of carbohydrates, fats, and protein.c.It stores several nutrients, and is essential for processing and detoxifying alcohol.3.The gallbladder stores bileand secretes the bile through the bile duct into the smallintestine.4.The pancreas produces digestive enzymes and the blood-regulating hormones insulinand 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.Hormonesregulate digestion.1.When food reaches your stomach, gastrin is released to signal the rest of the GI tractto 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 ionsto neutralize HCl; andsecretes cholecystokinin, which stimulates the release ofdigestive 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 efficientabsorption.2.The pancreas produces amylase, lipase, trypsin, chymotrypsin, and carboxypeptidase.C.Bile helps digest fat.1.Bile consists of water, bile acids (and/or salts), various fats including cholesterol, andpigments.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 TractIV.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 bythe cells of the body.2.To reach the cells they have to leave the GI tract and move to the other parts of thebody; 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 concentrationgradient.2.In facilitated diffusion, nutrients are absorbed from a high to a low concentration, butfacilitated diffusion requires a specialized protein to carry the nutrients.3.Active transport requires both a carrier and energy to shuttle nutrients across the cellmembrane.4.Figure 3.9 shows absorption methods in the small intestine.

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22INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4EV.What Happens to NutrientsafterThey Are Absorbed?A.The circulatory system distributes nutrients through your blood.1.The blood is the body’s primary transport system, shuttling oxygen, nutrients,hormones, and waste products throughout the body (see Figure 3.10).2.During digestion, the blood picks up nutrients through the capillary walls in the GItractandtransports them to your liver and eventually to the cells of your body.3.Bloodalsoremovesexcess water andwaste products from cells and brings them to thekidneys 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 passthrough the lymphatic system first.2.Lymph transports digested fat-soluble vitamins from the intestinal tract to the bloodand also contains white blood cells that aid the immune system.C.Your body can store some surplus nutrients.1.For example, some excess carbohydrate is stored in your liver and muscles in a formcalled glycogen.D.The excretory systempasses waste out of the body.1.The kidneysallowwaste 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, whento eat, where to eat, and, perhaps most important, when to stop eating.B.The endocrine system releases hormones that help regulate the use of absorbed nutrients.1.The hormones regulate growth, reproduction, metabolism, and cells’ use of nutrients.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 andswallowing more difficult.2.Difficulty swallowing, or dysphagia, can lead to malnutrition and compromised health.B.Esophageal problems:1.These canincludeheartburn, gastroesophageal refluxdisease (GERD, inflammation,obstruction, and cancer.C.Disorders of the stomach:1.Stomach problems can include a minor stomachache, gastroenteritis, peptic ulcers, andstomach 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 tobreak up the stone, or surgery to remove the gallbladder.

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CHAPTER3The Basics of Digestion23E.Disorders of the intestines:1.Flatulencea.Flatulence can be uncomfortable, butitis normal and is affected by diet and fluidintake.2.Constipation and diarrheaa.Constipation is caused by excessively slow movements of the undigested residuethrough the colon, and is often due to insufficient fiber or water intake.b.Diarrhea is the passage of frequent, watery, loose stools.3.Hemorrhoidsa.Hemorrhoids are a condition in which pressure in the veins in the rectum and anuscauses swelling and inflammation.F.More serious intestinal disorders:1.More serious small intestine and large intestine problems tend to involve nutrientmalabsorption, which can cause severe health consequences.a.Irritablebowel syndrome(IBS)i.IBS is a functional disorder that involves changes in colon rhythm; it is not anactual disease.b.Celiac diseasei.Celiac disease is an autoimmune genetic disorder that causes a person’s ownimmune system to damage the small intestine when gluten, a protein in wheatand 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 page89for more information on celiac disease.iv.The Table Tips feature “Eat Gluten Free”on page 90gives tips on limitinggluten intake.c.Crohn’s diseasei.Crohn’s disease is the general name for diseases that cause swelling in theintestines.d.Colon canceri.Colon cancer is one of the leading forms of cancer and is one of the mostcurable 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 Questions1.Food does not just slide through the digestive tract. What are some ways that the musclesaround 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 surgeonmakes a small pouch at the top of the stomach and bypasses portions of the smallintestine. Initially the stomach is only able to hold one ounce of food at a time. Usingwhat you learned in this chapter, discuss how gastric bypass surgery affects the digestiveprocess.3.Have you or anyone in your family ever experienced any of the digestive disordersdiscussed in this chapter? Can you share your experiences with the class?

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24INSTRUCTOR’S RESOURCE AND SUPPORT MANUAL FORNUTRITION & YOU,4EIn-Class Activities1.This chapter provides a lot of information regarding the size of the gastrointestinal tractand the volume of digestive contents it can contain. In order to put it in perspective forstudents, bring a measuring tape, rulers, measuring cups, two-liter bottles, etc., that canbe used to demonstrate various concepts during the discussion of the digestion andabsorption.2.Sam is a 25-year-old college student. He works full time in addition to taking a fullcourse load. He usually eats fast-food cheeseburgers and fries in his car for lunch and atake-out pepperoni pizza right before bed. Sam has noticed that he has put on some extraweight in the past few months, and his clothes are fitting very tight. He also has beenexperiencing severe heartburn several nights a week. Working in groups, come up withsome 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 majorsugar found in milk. Investigate the causes, symptoms, and treatments as well asnutritional recommendations for this condition. The NationalInstitute of Diabetes andDigestive and Kidney Diseasesmaintainsaccurate, comprehensive coverage on thistopic.Seewww.niddk.nih.gov/health-information/health-topics/digestive-diseases.Critical Thinking Questions1.In what ways do the mechanical and chemical aspects of digestion differ? How do theywork 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, ofcourse) to decrease their symptoms? Be very specific.3.Explain how the nervous system, circulatory and lymphatic system, and endocrinesystem work together to use nutrients. Address each separately and then discuss how thesystems work in harmony.PracticalNutritionVideosAuthor Joan Salge Blake walks students through making better eating choices in familiarenvironments in thePracticalNutritionvideoProbiotics:Do You Need Them?,availablebyscanning the QR code or through theTeaching Toolkit DVDand course management.

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25CHAPTER4Carbohydrates: Sugars,Starches, and FiberChapter OverviewCarbohydrates 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 isglucose. The two carbohydrate categories are known as simple carbohydrates (mono-anddisaccharides) and complex carbohydrates (polysaccharides). Dietary fiber, found in wholegrains, fruits, and vegetables, has some important health benefits, but your body does notdigest it.When carbohydrates are digested, the process starts in the mouth, with the majority of theactivity occurring in the small intestine. Enzymatic action is required to break down thecarbohydrates into their simplest forms.Some people do not produce enough of the enzyme lactase and have difficulty digestingthe carbohydrate known as lactose (found in dairy products). This lactose maldigestion mayresult in lactose intolerance.Insulin, a hormone produced and released by the pancreas, directs the process of gettingthe glucose from your bloodstream to your body’s cells for energy. If your body does nothave an immediate need for glucose, the excess from your blood will be stored in the musclesand the liver in the form of glycogen. When the blood glucose level decreases, the hormoneglucagon will signal the release of glucose from stored glycogen. This is important, as yourbody needs a constant supply of fuel to support the functions of red blood cells, the brain, andthe 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 ormore days. This process involves using fat for fuel and protein to create glucose instead of thepreferred carbohydrates. Fasting will ultimately 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 muchadded sugar in your diet, as it can have undesirable effects on the body. Sugar substitutes areoften used by those who want the sweetness of sugar without the calories or by people withdiabetes who are managing their blood glucose levels.Diabetes is a growing epidemic in the United States. In type 1 diabetes, the body isn’tproducing enough insulin. In type 2 diabetes, the body develops insulin resistance. Poorlymanaged diabetes can have serious effects; diabetes is the seventh leading cause of death inthe nation.Both type 1 and type 2 diabetes arebestmanaged with diet, along with otherlifestyle modifications.

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