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Lecture Notes For Wardlaw's Contemporary Nutrition, 11th Edition

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    CHAPTER 1 NUTRITION, FOOD CHOICES, AND HEALTH OVERVIEW This introductory chapter provides an overv iew of the study of nutrition. Nutrients and their ro les in the body are discussed. Energy and how it is measured is described. Helpful math skills used in the st udy of nutrition are reviewed. The scientific m ethod is explained with particular focus given to its application in the study of nutrition. The typical North American eating pattern is presented along with methods the governmen t uses to monitor consumption. U.S. health objectives included in Healthy People 2020 are briefly described. Recommendations for promoting healthy behaviors and lifestyles are also discussed. The Nutrition and Your Health section, “ Eating Well in College, ” investigates common nutritional concerns faced by college students, including choosing foods, weight gain, alcohol and binge drinking , eating disorders, the vegetarian lifestyle, dietary concerns of student athletes, and tips for eating well on a budget. KEY TERMS Alcohol Amino acid Animal model Appetite Atom Bond Cancer Carbohydrate Cardiovascular disease Case - control study Cell Chemical reaction Chronic Complex carbohydrate Control group Diabetes Double - blind study Electrolyte Enzyme Epidemiology Essential nutrient Fat - soluble Fiber Gene Genomics Glucose Hunger Hypertension Hypothese s Inorganic Kilocalorie (kcal) Lipid Macronutrient Major mineral Metabolism Micronutrient Mineral Nutrient Obesity Osteoporosis Peer review Phytochemical Placebo Protein Registered dietitian (RD) Registered dietitian nutrit ionist (RDN) Risk factor s Satiety Scurvy Simple s ugar Solvent Starch Stroke Theory Trace mineral Vitamin Water W a t er - soluble STUDENT LEARNING OUTCOMES Chapter 1 is designed to allow you to: 1.1 Describe how our food choices are affected by the flavor, texture, and appearance of food; routines and habits; early experiences and customs; advertising; nutrition and health

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    concerns; restaurants; social changes; economic s; and physiological processes affected by meal size and composition. 1.2 Identify eating pattern and lifestyle factors that contribute to the 15 leading causes of death in North America. 1.3 Define the terms nutrition , carbohydrate , protein , lipid (fat) , alcohol , vitamin , mineral , water , phytochemical , kilocalorie (kc al) , and fiber . 1.4 Determine the total calories (kcal) of a food or eating pattern using the weight and calorie content of the energy - yielding nutrients, convert English to metric units, and calculate percentages, such as percent of calories from fat in an eating pattern . 1.5 Understand the scientific method as it is used in forming hypotheses and theories in the field of nutrition, including the determination of nutrient needs. 1.6 List the major characteristics of the North American eating patterns , the food habits that often need improvement, and the key “Nutrition and Weight Status” objectives of the Healthy People 2020 report. 1.7 Describe a basic plan for health p romotion and disease prevention and what to expect from good nutrition and a healthy lifestyle. 1.8 Identify food and nutrition issues relevant to college students. LECTURE OUTLINE 1.1 Why Do You Choose the Food You Eat? A. What influences your food choices? 1. Food is more than nourishment. 2. A mix of biological and social factors influence s your food choices (see Figure 1 - 1). a. Food f lavor, texture, and appearance are the most important factors . b. Early exposure to various people, places , and events c. Routines and habits d. Marketing and advertising by the food industry e. Restaurant dining i. Larger portions, nutrient poor, and more calorie dense than home cooked meals ii. Federal regulations require health information on menus of some restaurants. f. Time and convenience g. Cost and e conomics i. Food cost is second reason why people choose their foods. ii. Young adults and those with higher incomes spend the most on food. h. Nutrition i. Well - educated, middle class professionals make more health - related food choices. ii. A greater percentage of women read food labels than men. B. Why are y ou s o h ungry? 1. Hunger is the physiological (internal) drive to eat.

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    2. Appetite is the psychological (external) influences that encourage us to eat, often in absence of hunger. 3. Satiety is the state in which there is no longer a desire to eat , a feeling of satisfaction. 4. Th e f eeding center and satiety center of the brain work to promote adequate nutrient intake. C. Putting our food choices into perspective 1. Satiety regulation is not perfect. 2. Decrease portion sizes slowly to allow the body (appetite and satiety) time to adjust. 1.2 How Is Nutrition Connected to Good Health ? A. What is n utrition? 1. Science that links f ood t o health and disease 2. Ingestion, digestion, absorption, transport, and excretion of food substances B. Nutrients come from f ood 1. Nutrients are substances found in food that provide energy and are vital for growth and maintenance of body . 2. An essential nutrient is required by the body to meet its needs. The body cannot produce it, or produces it in too little quantity to meet its needs. 3. Essential nutrients must satisfy three criteria . a. One s pecific biological function of the nutrient must be identified in the body . b. Omission of the nutrient must lead to decline in biological functions . c. Replacing the omitted nutrient before permanent damage occurs restores normal biological functions . C. Why study n utrition? 1. Poor eating patterns and a sed entary lifestyle are risk factors for life - threatening chronic diseases (see Figure 1 - 4 ). 2. Cardiovascul ar disease, hypertension, diabetes, cancer, and related disorders account for two - thirds of all deaths in North America ( see Figure 1 - 4 ) . 3. Combination of poor eating patterns and a lack of physical activity may be the second leading cause of death in the United States . 4. Obesity is second leading cause of prevent able death in North America. 1.3 What Are the Classes and Sources of Nutrients? A. Overview 1. The s ix classes of nutrients can be c ategorized by function (see Table 1 - 1 ) . a. Provide calories to meet energy needs b. Promote growth, development, and maintenance c. Regulate body processes 2. The six classes of nutrients are also c ategorized by daily needs . a. Macronutrients are needed in gram or cup quantities each day . b. Micronutrients are needed in milligram or microgram quantities each day . B. Carbohydrates

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    1. Simple sugars (monosaccharides and disaccharides) 2. Complex carbohydrates ( polysaccharides) a. S tarch (digestible) b. F iber (indigestible) 3. Primary source of energy (4 kcal/g) C. Lipids (i.e., fats, oils) 1. Energy yield: 9 kcal/g 2. Primary form of energy storage 3. Animal fats (butter and lard) are solid at room temperature 4. Plant oils are liquid at room temperature 5. Essential fatty acids a. Not produced by the body and must be consumed (essential nutrient) b. Roles in blood pressure regulation and synthesis/repair of cells c. Small amo unt required i. Four tablespoons oil per day ii. Serving of fatty fish at least twice a week. D. Proteins 1. Functions a. Structural components of muscle and bone b. Blood components c. Body cell structure d. Enzymes e. Immune factors 2. Energy yield: 4 kcal/g (limited use for energy ) 3. Building blocks of proteins are amino acids 4. Dietary sources a. Animal b. Plant 5. Typical North American consumes up to two times daily requirement. E. Vitamins 1. Enable chemical reactions 2. Provide no energy (0 kcal/g) 3. 13 v itamins c ategorized by solubility a. Fat - soluble (vitamins A, D, E, and K) i. Main sources: dairy products, nuts, seeds, oils, breakfast cereals ii. Not readily excreted from the body iii. S ome may accumulate in the body toward toxic levels (i.e. , vitamin A) b. Water - s oluble (B vitamins and v itamin C ) i. Main sources: fruits and vege t a bles ii. Easily d estroyed by cooking iii. Most are r eadily excreted from the body F. Minerals 1. Inorganic — do not contain carbon 2. Not destroyed by cooking, but can be lost in cooking water 3. Provide no energy (0 kcal/g)

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    4. Functions: role in nervous system, water balance, structural systems , and other cellular systems 5. Sixteen or more essential minerals 6. Categorized by dietary need a. Major minerals (needed in amounts greater than 100 mg ) b. Trace minerals (needed in amounts less than 100 m g ) 7. Electrolytes — minerals that function based on electrical charge when dissolved in water (sodium, potassium, and chloride) G. Water 1. Functions a. Solvent b. Lubricant c. Transport of nutrients and wastes d. Medium for temperature regulation and chemical processes 2. Human body is approximately 60% water 3. Human needs a. Men: 13 c ups /d ay b. Women: 9 c ups /d ay 4. Sources a. Beverages b. Foods c. By - product of metabolism H. Other important components in food 1. Phytochemicals a. Found in foods from plant sources, and especially in fruits and vegetables b. Not essential nutrients c. Provide a variety of health benefits and may reduce risks for certain diseases d. Foods with high phytochemical content are referred to as “superfoods.” e. Table 1 - 2 lists common food sources of some phytochemicals . 2. Sphingolipids and conjugated linoleic acid (CLA) a. F ound in meat and dairy products b. S how some health benefits I. Sources of nutrients 1. 500 g (1 poun d) protein, fat , and carbohydrates consumed daily 2. 20 g minerals (in total) consumed daily 3. 300m g vitamins (in total) consumed daily 4. Genetic material directs the use of nutrients in the body . 1.4 What Math Concepts Will Aid Your Study of Nutrition? A. Calories 1. Sources a. Carbohydrates (4 kcal /g) b. Lipids (9 kcal /g)

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    c. Proteins (4 kcal /g) d. Alcohol (7 kcal /g; not a n essential nutrient, therefore not required ) 2. Most foods provide more than one calorie source 3. Energy (kcal) is used to a. Build new compounds b. Perform muscular movements c. Promote nerve transmission d. Maintain electrolyte balance within cells 4. Energy derived from food is measured in kilocalories (kcal ) a. 1 calorie = heat energy needed to raise the temperature of 1 g ram of water 1°C b. 1 kilocalorie ( C alorie) = 1000 calories (1 kcal) = heat energy needed to raise the temperature of 1000 grams of water 1°C c. On food labels, “ calories ” without a capital “ C ” means kcal. d. Figure 1 - 5 is a food label example of whole wheat bread. B. Calculating calories 1. Use the 4 - 9 - 4 estimates to calculate calories from carbohydrate, fat, and protein. 2. Use the 4 - 9 - 4 estimates to determine what portion of total calorie intake is contributed by carbohydrate, fat, and protein . C. Percentages 1. Percent refers to a part of the total when the total represents 100 parts . 2. Nutrition relevance: Used often when referring to menus and nutrient composition D. The metric sy stem 1. 1 ounce = 28 grams 2. 1 kilogram = 2.2 pounds 3. 1 millimeter is approximately the thickness of a dime 4. 1 inch . = 2.54 centimeters 5. 1 quart = 0.946 liters 1.5 How Do We Know What We Know About Nutrition? A. The scientific method (see Figure 1 - 6 ) 1. Make observations and ask questions. 2. D evelop hypothesi s a. Generated by observing natural phenomeno n b. Generated by studying patterns among population groups 3. Epidemiology is the study of diet and disease patterns among various populations. 4. Controlled experiments are conducted to test hypotheses . a. Double - blind placebo controlled study design is the most rigorous type of experiment — neither researcher nor participant is aware of the group assignment. i. E xperimental group ii. C ontrol group

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    b. Case – control stud y design involve s comparisons made between individuals with and without certain conditions. B. Testing a hypothesis: can a high - fat diet cause weight loss? (see Figure 1 - 6) 1. Observations made and questions asked 2. Hypothesis generated 3. Research experiments conducted 4. Results evaluated by other scientists and published. 5. Follow - up experiments conducted to confirm or extend the findings 6. Accept or reject hypothesis? C. Types of e xperiments (see Figure 1 - 7 ) 1. Human studies provide strong evidence about relationship s between nutrients and health. 2. Animal model 3. Case – control studies 4. Epidemiological studies a. S tudy eating and disease patterns among populations . b. Suggest hypothesis that then need s to be tested by controlled experiments . 1.6 What Is the Current State of North American Eating Patterns and Health ? A. Does obesity threaten our future? 1. Obesity is defined as having an excessive amount of body fat relative to lean tissue. 2. It is estimated that more than 36.5% of adults are obese. 3. Two - thirds of adults an d 1/3 of children are overweight or obese. 4. Robert Wood Johnson Foundation report: F as in Fat: How Obesity Threatens America's Future 2013 (see Further Reading 1 2 ) . a. Self - reported, state - by - state obesity data from the CDC (see Figure 1 - 8 ) b. Calls for national commitment to the prevention of obesity by 2030. 5. Obesity plays a role in chronic illnesses . a. Heart disease b. Stroke c. High blood pressure d. High cholesterol e. Diabetes f. Arthritis g. Certain cancers 6. Problem: Consumption of too many energy dense, nutrient poor foods while living a sedentary lifestyle B. Assessing the current North American eating pattern 1. National Health and Examination Survey (NHANES) data from 2009 to 2012 indicates: a. 1 6 % of calories as proteins ( FNB recommends 10% to 35%) b. 5 0 % of calories as carbohydrates (FNB recommends 45% to 65%) c. 33% of calories as fats (FNB recommends 20% to 35%)

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    2. Majority (2/3) of protein intake for most North Americans is from animal sources 3. Approximately half of carbohydrates are from simple sugar sources , with the remaining coming from starches such as pastas, breads, and potatoes. 4. Approximately 60% of dietary fats are from animal sources . 5. NHANES 2011 – 2012 results show positive trends toward healthier lifestyles . a. Daily calorie consumption is declining b. Soda (full - calorie) intake has declined 25% since late 1990s. 6. Consume a variety of nutrient - dense foods within and across the f ood groups, especially whole grains, fruits, veg etables, low - fat or fat - free milk or milk products, and lean meats and other protein sources 7. Balance calorie intake with energy need s. a. Increase intake of nutrient - dense fruits and vegetables b. Decrease intake of energy - dense foods such as sugary beverages and f atty foods C. Health objectives for the United States for the year 2020 1. Healthy People 2020 is issued by the U.S. Department of Health and Human Services’ (DHHS) Public Health Service. a. Health objectives for our nation released every 10 years b. Contains more than 600 health objectives across 42 topic areas c. Outlines national standards to: i. Eliminate health disparities ii. Improve access to health education and care iii. Strengthens public health services and efforts 2. 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 health of all groups. c. C reate social and physical environments that promote good health for all. d. Promote quality of life, healthy development, and healthy behaviors across all life stages. 3. See www.HealthyPeople.go v for more information 4. Nutrition and Weight Status a. Topic area specific to nutrition b. Includes targeting individual behaviors c. Focuses on policies and environments that impact these behaviors in community settings d. Maintaining a healthy weight e. Supporting the benefits of a healthful eating pattern i. Consuming a variety of nutrient - dense foods within and across the food groups, especially whole grains, vegetables, fruits, low - fat or fat - free milk or milk products, and lean meats and other proteins.

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    ii. Limiting intake of solid fats, cholesterol, added sugar, sodium (salt) , and alcohol . iii. Limiting intake of calories to meet caloric needs. f. Table 1 - 3 presents a list of the six categories of objectives for Healthy People 2020 Nutrition and Weight Status with 22 specific objectives. g. Table 1 - 4 presents a detailed sample of Nutrition and Weight Status Objectives and details about the current status and target goals for 2020 . 5. New topic areas included in Healthy People 2020 a. Highlights and focuses on changes in health needs of certain life stages i. Early and middle childhood ii. Adolescence iii. Older adults b. Genomics i. Investigating the relationship of nutrition and genetics ii. Nine out of 10 leading causes of death have a genetic component . 1.7 What Can You Expect from Good Nutrition and a Healthy Lifestyle? A. Healthy weight 1. Seek a lifestyle to promote weight maintenance . 2. Recognize that weigh t gain can be associated with overweight/obesity and risks for chronic illnesses . 3. Increased options for food as result of continual innovation by food manufacturers 4. Incorporate physical activity into the daily routine as much as possible B. Longer, healthier lives 1. North Americans live longer and enjoy better health. 2. Improve health by decreasing intake of animal fats and cholesterol and increasing intake of fruits and vegetables. C. The total diet 1. There are no “good” or “bad” foods. 2. “ T he total diet or overall pattern of food eaten is the most im portant focus of healthy eating ” (American Academy of Nutrition and Dietetics). 3. Other ways to promote health and prevent chronic diseases a. Consume enough essential nutrients while moderating energy, solid fat, added sugar, and alcohol intake . b. Obtain regular physical activity (30 – 60 minutes most days) . c. Minimize alcohol intake . d. Obtain adequate sleep (7 – 9 hours per night) . e. Consume recommended amounts of water daily . f. Reduce stress . g. Use medications only when necessary . h. Abstain from illicit drug use . i. Maintain healthy relationships .

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    1.8 Nutrition and Your Health : Eating Well in College A. Overview 1. H abits of college students fall short of recommendations for whole grains, vegetables, fruits, milk, and meat; include too much fats, sweets, and alcohol . 2. Health behaviors formed during young adulthood are likely to persist throughout life . B. Food c hoices 1. Stress may negatively impact nutrition and activity habits . 2. Abundance of energy - dense, nutrient - poor food choices on college campuses 3. Meals are a time for socialization . C. Weight c ontrol and the “Freshman F ifteen” 1. A recent study (see Further R eading 17 ) of 7000 U.S. college students fou n d that students gain 2.4 – 3.5 pounds during their first year away from home. a. Heavy alcohol consumption b. Working during college 2. Maintaining healthy weight and losing excess weight will improve short - term and long - term health . 3. Losing excess weight a. Set several, small , achievable goals . b. Monitor foods and activities ( Use interactive tools on www.ChooseMyPlate.gov ). c. Gradual weight loss of 1 – 2 pounds per week (deficit of 500 kcal /d ay below needs) d. Eat a balanced breakfast . e. Moderate use of alcohol and sugary beverages (including gourmet coffee beverages) f. Exercise regularly i. Enjoyable activities ii. Work out with a friend D. Alcohol and binge d rinking 1. Binge drinking a. Five or more drinks in a row for men b. Four or more drinks in a row for women 2. Moderate alcohol intake a. T wo drinks a day or less for men b. One drink a day for women 3. 39% of students on colle ge campuses participate in binge drinking . 4. Alcohol - related health risks a. Accidents/injuries b. Unsafe sex and its consequences c. Long - term health problems d. Suicides e. Academic problems f. Legal troubles g. Alcohol abuse or dependence 5. 20% of college students meet criteria for alcohol use disorders.

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    E. Eating d isorders 1. 30% o f college students are at risk of developing an eating disorder . 2. Short - term disordered eating patterns may progress to an eating disorder . 3. Food becomes the focus of emotional issues . 4. Risks a. Limited academic performance b. Loss of menstrual periods c. Thinning bones d. Gastrointestinal problems e. Kidney problems f. Heart abnormalities g. Death F. Choosing a v egetarian l ifestyle 1. Plant - based eating patterns can be a healthful lifestyle, but require appropriate planning 2. F ort ified breakfast cereals provide many vitamins and minerals . 3. Many vegetarian options available 4. Tips to optimize nutritional benefit of plant - based eating patterns. a. Choose baked, steamed, or stir - fried rather than deep - fried . b. Choose whole grains rather than refined carbohydrates . c. Consume foods fortified with vitamins and minerals . G. Fuel for competition: student a thletes 1. Increased calorie and nutrient needs . 2. Av oid severe calorie restriction — carb ohydrate and fat supp ly energy to exercising muscles. 3. Emphasis on fluids — sports drinks are ideal for events lasting longer than 60 minutes 4. Losing flu i d intentionally is an unhealthy practice . 5. Expensive supplements are not necessary . H. Tips for eating well on a college student’s b udget 1. Participate in a prepaid campus meal plan . 2. Planning ahead will save money and improve nutrient intake . 3. Never shop on an empty stomach . 4. Buy store brands . 5. Make use of canned and frozen fruits and vegetables and dry foods . 6. Purchase concentrated fruit juices and mix at home . 7. Eggs and peanut butter are inexpensive sources of protein . RATE YOUR PLATE I. Examine Your Eating Habits More Closely Choose a day of the week that is t ypical of your eating pattern. Using the first table found in Appendix C, list all foods and drinks you consumed for 24 hours. In addition, write down the approximate amounts of food you at e in u nits, such as cups, ounces, tea spoons, and tablespoons. Place the corresponding abbreviation from the list below in the Reason

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    Choice column to indicate why you picked that food or drink. There can be more than one reason for choosing a particular food or drink. FLVR Flavor/texture ADV Advertisement PEER Peers CONV Convenience WTCL Weight c ontrol NUTR Nutritive va l ue EMO Emotions HUNG Hunger $ Cost AVA Availability FAM Family/cultural HLTH Health Application Ask yourself what your most frequent reason is for eating and drinking. To what degree is health or nutritive value reason for your food choices? Should you make these higher priorities? I choose many foods because they are considered healthy and will help with my health goals and weight maintenance. Other times I am choosing foods that I am used to eating or because I am craving something sweet (taste). I should start to think of the nutrients provided by different foods , and some new foods I have not tried, in order to add some variety to my eating pattern . This variety will help me meet more of my nutrient requirements. I could add variety at breakfast , for example, with fruit . I could add a healthy snack in the afternoon, such as low fat yogurt and granola, rather than drinking regular cola. I noticed that this a time I am often hungry. This will also help me meet more of my nutrient requirements , such as calcium, and fiber .

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    II. Observe the Supermarket Explosion Today’s supermarkets carry up to 60,000 items. Think about your last grocery shopping trip and the items you purchased to eat. Following is a list of 20 newer food products added to supermarket shelves. For those items you have tried, use the key from Part I to identify why you chose those products. Answer choices may vary. Below are examples of why one might choose the following food products. CONV Prepackaged salad greens (variety packs other than iceberg lettuce) HLTH Gourmet or sprayable salad oils (e.g. , walnut, almond, olive, or sesame oil) CONV Precooked frozen turkey patties, precooked bacon PEER/CONV Microwavable sandwiches (e.g. , Hot Pockets or frozen sandwiches) CONV Microwavable meals in a bowl (e.g. , mac and cheese, or soup) CONV Refrigerated precooked pasta (e.g. , tortellini or fettuccini ) and accompanying sauces (e.g. , pesto or tomato basil) HLTH Imported grain products (e.g. , risotto, farfalle , gnocchi, or fusilli) $ ___ _ Whole - grain pasta or rice

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    CONV Frozen dinners (list your favorite of any of the wide variety) WTCL Bottle water (flavored or unflavored) ADV Trendy juices (e.g. , draft apple cider, acai, or pomegranate) ADV/FLVR/CONV Roasted and/or flavored coffees (e.g., beans, ground, instant, or K - Cups) CONV Instant hot cereal in a bowl (add water and go!) CONV “Fast - shake” pancake mix (add water, shake, and ready to cook) FLVR/HUNG Breakfast bars or cookies (e.g., granola or fruit - flavored bars) HLTH Dried fruit and nut mixes HLTH Meal replacement/fitness products (e.g., “energy” bars, high - protein bars, or sports drinks) HLTH/ADV Low - calorie muffin tops or bagel thins CONV/HLTH Packaged yogurt smoothies HLTH/ADV Milk substitutes (e.g., rice milk or soy milk) Finally, identify three new food products not on this list that you have seen in the past year. Discuss the appeal of these products to the North American consumer. Some other new food product examples include , but are not limited to : • R eady to eat, microwavable side items (e.g., mashed potatoes, macaroni and cheese, green beans casserole) appeal to individuals and families that value convenience. • Vitamin enhanced water offer s a health advantage to plain water, for individuals who may not be meeting nutrient needs. • “Take and bake” breads appeal to individuals and families that desire hot baked bread with a meal but lack the time to prepare and bake it fresh. There are a variety of brands including organic, multigrain, sourdough, Italian, etc. • Prepackaged, washed , and cut fruit and/or vegetables allow individuals to eat fresh produc e without spending time to wash, and/or cut.

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    CHAPTER 2 DESIGNING A HEALTHY EATING PATTERN OVERVIEW This chapter explores the components of healthy eating patterns , namely those that will minimize the risks of developi ng nutrition - related diseases. Three principles of a healthful eating pattern ( variety, proportionality , moderation) as well as nutrient and energy density are discussed. The purpose and key recommendations of the Dietary Guidelines and Physical Activity Guidelines for Americans are explained. Tools for planning and evaluating dietary intake are discussed, including the Dietary Reference Intakes (DRI) , the Dietary Guidelines , Choose MyPlate.gov , the Mediterranean Diet, nutrient standards, and food labels. An o verview of nutritional status and its assessment is provided . Suggestions are outlined to highlight the best approach to evaluate nutrition information. KEY TERMS Adequate intake (AI) Anthropometric assessment Biochemical assessment Clinical assessment Dietary assessment Dietary Reference I ntake s (DRIs) Environmental assessment Energy density Estimated Energy R equirement (EER) Functional foods Heart attack Malnutrition Megadose Nutrient density Nutritional state Overnutrition Phytochemical Recommende d Dietary A llowance (RDA) Subclinical Symptom Undernutrition Tolerable Upper Intake L evel (UL) STUDENT LEARNING OUTCOMES Chapter 2 is designed to allow you to: 2.1 Use variety, proportionality, and moderation, as well as nutrient and energy density, to develop a health y eating plan. 2.2 List the purpose and key recommendations of the Dietary Guidelines and the Physical Activity Guidelines for Americans. 2.3 Design a meal that conforms to the MyPlate recommendations as wel l as to the Mediterranean diet and/ or other diet planning guides. 2.4 Describe the three states of nutritional health. 2.5 Outline the measurements used (ABCDEs) in nutritional assessment: A nthropometric, B iochemical, C linical, D ietary, and E nvironmental status. 2.6 Describe the s pecific nutrient recommendation categories within the Dietary Reference Intakes . 2.7 Identify reliable sources of nutrition information.

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    2.8 Describe the components of the Nutrition Facts panel and the various health claims and label descriptors that are allowed. LECTURE OUTLINE 2.1 A Food Philosophy T hat Works A. Overview 1. Consume a variety of foods balanced by a moderate intake of each food. 2. Principles of variety, moderation, and proportionality B. Variety means eating many different foods 1. Choose foods from all the food groups and subgroups . 2. Use M yPlate as a guide. a. Vegetables b. Fruit c. Grains d. Protein e. Dairy 3. No single food meets all nutrient needs . 4. Various phytochemicals are present in fruits and vegetables . a. Provide health benefits beyond nutrient needs . b. Some phytochemicals can reduce the risk of disease . c. Table 2 - 1 provides tips for boosting the phytochemical content of the eating pattern . 5. Functional foods provide health benefits beyond those supplied by the traditional nutrients that the food contains . C. Proportionality means eating more nutrient - dense foods 1. Proportionality is also referred to as balance. a. Inc r eased intake of nutrient - dense foods (fruits, vegetables, whole grains, low - fat dairy products) . b. Decreased intake of foods that are high in certain fats, sugars, cholesterol, salt, and alcohol . c. Match calorie intake with energy expenditure to achieve or maintain a healthy weight . 2. Nutrient density is the ratio of the amount of one or more nutrients (e.g., protein, vitamins, and minerals) in a food relative to the calorie content of the food . a. Figure 2 - 1 illustrates how to choose more nutrient dense foods . b. Menu planning should focus on the total diet: overall, choose more nutrient - dense foods and fewer empty - calorie foods . c. Nutrient density is particularly important for those who consume few calories (e.g., on a weight - loss diet, children, older adults) . D. Moderation refers mostly to portion size 1. Don’t overconsume a specific nutrient . 2. Moderate intake of fat, sugars, salt, alcohol, and calories . 3. Energy density: c ompare the calorie content with the weight of the food . a. Hi gh energy density foods include nuts, fried food, cookies .

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    b. Low energy density foods contain high amounts of water and fiber (e.g., fruits and vegetables) and promote satiety without high calorie content . c. People tend to consume fewer calorie s when eating low energy dense foods . d. Table 2 - 2 presents the energy density of common foods . e. Foods can be nutrient dense and energy dense at the same time . 2.2 Dietary and Physical Activity Guidelines A. Dietary Guidelines — the basis fo r meal planning 1. Designed to inform the development of food, nutrition, and health policies and programs . 2. Five foundational guidelines of the 2015 – 2020 Dietary Guidelines a. Follow a healthy eating pattern across the lifespan. b. Focus on variety, nutrient density, and amount. c. Limit calories from added sugars and saturated fats and reduce sodium intake. d. Shift to healthier food and beverage choices. e. Support healthy eating patterns for all. 3. Figure 2 - 2 shows Key Recommendations that accompany the Dietary Guidelines and further detail s healthy eating patterns . 4. Healthy eating patterns are the hallmark of the 2015 – 2020 Dietary Guidelines . a. Goal: support healthy weight and reduce the risk of chronic disease . b. Follow Healthy U.S. - Styl e Eating Pattern (see Table 2 - 5 ) . c. American eating patterns are low in vegetables, fruits, total grains, dairy, protein foods , and oil ; intake is added sugars, saturated fats, and sodium (see Figure 2 - 3) . 5. Meeting nutrient needs within calorie limits could alleviate many chronic diseases. 6. Figure 2 - 4 shows estimated daily calorie (kcal) needs based on age and activity level . 7. Nutritional needs should be met primarily from foods . 8. Increase intake of vegetables, fruits, whole grains, fat - free or low - fat dairy, seafood, lean meats and poultry, eggs, beans and peas, nuts and seeds, and oils. a. Contribute to nutrient adequacy b. Lower intake of problem nutrients c. Improve gastrointestinal function d. Aid in weight management e. Decrease the risk of chronic diseases 9. Limit intake of added sugars (less than 10% total kcal/day) , saturated fat (less than 10% kcal/day) , trans fats, and sodium (less than 2300mg/day) . 10. Table 2 - 3 provides the examples of recommended changes to the eating pattern based on Dietary Guidelines. B. Physical Activity Guidelines for Americans (see Table 2 - 4) 1. Regular physical activity produces long - term health benefits 2. Guidelines f or c hildren (6+) and adolescents a. ≥ 60 minutes of physical activity per day

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    b. Include aerobic and muscle - strengthening and bone - strengthening exercises . c. Activities that are appropriate for age, enjoyable, and offer variety . 3. Guidelines f or adults a. Avoid inactivity. b. ≥ 150 minutes per week of moderate - intensity or ≥ 75 minutes per week of vigorous - intensity physical activity . c. Include muscle - strengthening activities 2 or more days per week . 4. Guidelines f or safe physical activity a. Understand the risks and choose appropriate activities for fitness level and health goals . b. Use appropriate gear and exercise in safe environments c. Consult with health care provider if there are chronic conditions and symptoms 2.3 MyPlate — A M enu - P lanning T ool A. Overview 1. MyPlate was released in 2011 and is a visual depiction of health y eating for Americans. 2. MyPlate shapes Dietary Guideline recommendations into a visual place setting (see Figure 2 - 5). B. Dishing up MyPlate 1. MyPlate provides a visual representation of a healthy plate at mealtimes. 2. The MyPlate icon emphasizes five food groups . a. Fruits and vegetables cover half of the plate . b. Grains cover slightly more than one - fourth of the plate; h alf of your grain intake should be from whole grain products . c. Protein covers the remaining portion of the plate; emphasize variety of protein foods including seafood, lean meats and poultry, eggs, legumes , ( beans and peas), nuts, seeds, and soy products. d. Dairy appears as a cup next to the plate; consume 2 to 3 cups of fat - free or low - fat dairy products or other rich sources of calcium . e. There is no separate group for fats or oils; limit solid fats and emphasize oils. C. Build a healthy eating style 1. All food and beverage choices matter — focus on variety, amount, and nutrition 2. Choose an eating style low in saturated fat, sodium, and added sugars 3. Make small changes to create a healthier eating style a. Each change is a personal “win ,” and each MyWin is a change to build a healthy eating style. b. Start with a few small changes 4. Support healthy eating for everyone D. MyPlate daily checklist 1. ChooseMyPlate.gov features an interactive tool , MyPlate Daily Checklist, for indiv iduals to estimate their calorie need s and suggests a food pattern based on age, gender, height, and weight .

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    2. Table 2 - 5 presents the Healthy U.S. - Style Eating Pattern: recommended amoun t s of food from each MyPlate food group at 12 kcal levels. 3. Helpful visual aids for estimating servings sizes are illustrated in Figure 2 - 6. 4. MyPlate sets the limits for empty calories; MyPlate Daily checklists allow for some empty calories throughout the day (usually 120 - 160 kcal per day). E. Additional MyPlate resources 1. USDA’s Ten Tips Nutrition Education series 2. What’s Cooking? USDA Mixing bowl – help with meal planning, cooking, and grocery shopping 3. Food - A - Pedia 4. SuperTracker F. Menu planning with MyPlate (see Table 2 - 7) 1. My P late guidelines are not i ntended for infants or children under 2 years of age . 2. Variety is key, as each food will provide different nutrients and each food group is important (see Table 2 - 6). 3. There can be variation i n the amount of nutrients and calorie content of foods within each food group . 4. Choosing fat - free or low - fat dairy options allows for greater amounts of foods from other groups in your daily plan. 5. Plant foods can be good sources of protein . 6. Focus on colorful fruits and vegetables to increase the nutritional quality of these choices . 7. Choose whole grain products instead of refined grains . 8. Include healthy oils from plants and fish as part of your weekly dietary pattern. G. Limitations of MyPlate 1. The MyPlate icon d oes not provide information about overall calories, serving sizes, or number of servings . 2. The MyPlate icon d oes not address types of food choices to make within each food group . 3. The MyPlate icon does not address total diet , which includes foods eaten between meals . 4. Public health campaign may not reach all of its intended audience . H. How does your plate rate? 1. Use SuperTracker tool to compare your overa ll intake to your personalized daily food p lan . 2. Use NutritionCalc software to compare your intakes to the DRIs . I. The Mediterranean Diet Pyramid (see Figure 2 - 8 ) 1. Useful alternative to MyPlate 2. The 2015 – 2020 Dietary Guidelines includes the Healthy Mediterranean - Style Eating Pattern. 3. Dietary pattern is linked to low rates of chronic disease and increased life expectancy . 4. Emphasizes minimally processed, plant - based foods at each meal 5. Emphasizes healthy fats ( e.g., o live oil , avocado, nuts) and limits saturated fats 6. Fish and seafood consumed 2x/week 7. En c ourages 5 – 10 servings of fruits and vegetables each day

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    8. Choose plant proteins more often and moderate intake of l ean prot eins and low - fat dairy products. 9. Red meats and sweet desserts are consumed less often 10. Includes regular physical activity 11. Incorporates moderate wine consumption 12. Water is the beverage of choice . 2.4 States of Nutriti onal Health (se e Figure 2 - 9 ) A. Desirable nutrition 1. Body tissues have enough of a nutrient to support normal metabolic function . 2. Surplus of nutrient s can be used in times of need . B. Undernutrition 1. Form of malnutrition in which nutrient intake does not meet nutrient needs . 2. When nutrient levels fall sufficiently low, health declines and biochemical evidence appears . 3. Subclinical deficiency shows no outward signs to reflect low nutrient levels and slow metabolic processes. 4. C linical deficiency develops within months or years of the undernutrition; clinical symptoms often evident in skin, hair, tongue, or eyes . C. Overnutrition 1. Form of malnutrition characterized by prolonged consumption of more nutrients than the body needs 2. Example: too much vitamin A can have negative effects during pregnancy 3. Excess calorie intake is most common in developed nations . 4. The difference between desirable and overnutrition is usually large , but is the smallest for vitamin A, calcium, iron, and copper . 2.5 Measuring Your Nutritional State A. Analyzing background factors 1. Family health history 2. Medical history 3. Medication list 4. Social history 5. Education level 6. Economic status B. Assessing nutritional status using the ABCDEs (see Table 2 - 8 and Figure 2 - 10 ) 1. Anthropometric assessment: height, weight, body composition, circumferences . 2. Biochemical assessment: measuring nutrients or by - products in the blood and other body fluids . 3. Clinical assessment: looking for physical evidence (e.g., high blood pressure) . 4. Dietary assessment: examining dietary intake . 5. Environmental assessment (from background analysis) . C. Recognizing the limitations of nutritional assessment 1. Clinical symptoms of nutrient status may take years to develop . 2. Many clinical symptoms are not specific to only a nutrient deficienc y . D. Concern about the state of your nutritional health is important

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    1. Maintaining nutritional health can lead to a long and vigorous life. 2. Maintaining nutritional health can reduce disease risk. 2.6 Specific Nutrient Standards and Recommendations A. Overview 1. Dietary Reference Intakes (DRI) is the umbrella term that describes four standards for nutrient needs . 2. Table 2 - 9 explains the usage of the DRI’s and Daily Value. B. Recommended Dietary Allowance s (RDA) 1. Amount of a nutrient that m eets the needs of ~ 97% of all healthy individuals in a particular age and gender group 2. I ntakes slightly above or below the RDA are of no concern 3. Intakes below 70% RDA or 3x or more above the RDA for an extended period can lead to deficiency or toxicity , respectively. C. Adequate I ntake (AI) 1. Set if there is not sufficient information on human needs to set an RDA 2. Further research is required before scientists can establish a more definitive number 3. Derived from dietary intakes of people who appear to be maintaining nutritional health (no deficiency apparent) D. Estimated Energy Requirement (EER) 1. Not set higher than average need (as for vitamins and minerals) because this would lead to excess calories and weight gain ; starting point for estimating calorie needs . 2. Takes into account age, gender, height, weight, and physical activity . 3. Also accounts for additional needs during growth and lactation . E. Tolerable Upper Intake Level (UL) 1. The highest amount of a nutrient that is unlikely to cause adverse health effects in the long run for most people . 2. Usually seen with eating patterns promoting excess intake of a limited variety of foods, many fortified foods, or megadoses of specific vitamins or minerals . F. Daily Value (not part of DRIs) 1. Generic standard used on food labels — usually reflects the highest RDA (or related nutrient standard) seen in various age and gender categories for the nutrient . 2. Based on a 2000 - kcal diet . 3. Allows consumers to compare intake from a specific food to desirable (or maximum) intake levels . G. How should these nutrient standards be used? 1. The type of standard that is set depends on the quality of available evidence . 2. Eating patterns should strive to meet the RDA or AI without exceeding the UL . 3. AI should not be used alone to evaluate individual needs . 4. EER is an estimate and may need to be adjusted.

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    5. Standards for each nutrient are found in appendix G of the text or at the link for Dietary Guidance at the Food and Nutrition Information Center’s website (https://fnic.nal.usda.gov/dietary - guidance/dietary - reference - intakes) 6. Daily Values, which appear on food labels, serve as rough guidelines for comparison of nutrient content of foods to approximate human needs; set at or close to highest RDA value . 7. Figure 2 - 11 illustrates how the various nutrient standards relate to each other and the risk for deficiency or toxicity . 2.7 Evaluating Nutrition Information A. Ensure that the nutrition claim adheres to basic principles of nutrition (e.g., Dietary Guidelines for Americans) B. Examine background and scientific credentials of the individual, organization, or publication making the nutritional claim. C. Beware of bad science 1. Possible disadvantages are ignored 2. Claims sound too good to be true ; claim a “cure” 3. Evidence of bias against medical community 4. Touted as a “breakthrough” D. Consider the study 1. Note the size and duration of the study; larger study and longer duration are better . 2. Note the type of study (i.e., epidemiology, case – control, double - blind) . E. Beware of hype F. Expect a nutrition professional to 1. Inquire about medical history, lifestyle, and current eating habits 2. Formulate an individualized eating pattern 3. Schedule follow - up visits to monitor progress 4. Involve social support 5. Consult with other health professionals G. Avoid megadose s of nutrient supplements . H. Examine product labels carefully . I. Seek advice from reputable professional, including a primary care physician or registered dietitian nutritionist (RDN) . 2.8 Nutrition and Your Health: Food Labels and Diet Planning A. Overview 1. Labels must include product name, manufacturer name and address, amount of product in package, ingredients in descending order by weight . 2. Monitored by FDA 3. Nutrition Facts panel ( Figure 2 - 12 ) must include a. Total calories (kcal) b. To tal fat c. S at urated fat d. T rans fat e. C holesterol

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    f. Sodium g. Total carbohydrate h. Fiber i. Total s ugar s j. Added sugars k. Protein l. Vitamin A, vitamin D, calcium, iron , and potassium m. Monounsaturated or polyunsaturated fats, potassium , and others listed if health claims are made about them or if food is fortified with them. 4. Percent age of the Daily Value usually listed for each nutrient per serving 5. Serving sizes must be consistent among similar foods but are not necessarily the same as what is recomm ended by MyPlate’s Daily Food Plans . 6. Nutrient claims must follow legal definitions (see Table 2 - 10) . B. Changes to nutrition labels approved 1. Figure 2 - 13 illustrates the new Nutrition Facts Labels with changes noted that were approved May 2016. 2. Increased type size for “Calories,” “S er vings per container,” and the “S erving size” declaration . 3. The number of calories and “Serving size” declaration will be in bold. 4. Daily value information for nutrients will be updated and will include the actual amount for vitamin D, calcium, iron, and potassium. 5. “Added Sugars” is an addition to the label. 6. “Calories from fat” will be removed. 7. Serving size information will more accurately reflect how much is consumed in one sitting. 8. Larger packages will have two columns on label to note “per serving” and “per package.” 9. July 2018 is the deadline for implementation for manufacturers with $10 million in food sales per year. C. Menu planning with labels 1. Daily Values generally align with RDAs and AIs for nutrients . 2. Food labels are useful for identifying nutrient - dense foods . D. Exceptions to food l abeling 1. Fresh foods (e.g., fruit, vegetables, and fish) are not required to have Nutrition Facts labels . 2. As protein deficiency is so rare in the US, %DV for protein is not required for the products designed for people aged 4 years or older 3. If % DV is included, the product must be analyzed for protein quality 4. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) requires manufacturers to label food products that contain an ingredient that is or contains protein from a major food allergen. E. Health claims on food l abels 1. Four categories of claims are used on food labels a. Health claims – closely regulated by FDA b. Preliminary health claims – regulated by FDA but evidence may be scant for the claim

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    c. Nutrient claims – closely regulated by FDA (see Table 2 - 10) d. Structure/function claims (not FDA approved, or necessarily valid ) 2. FDA permits some health claims with restrictions a. T here m ust be a significant scientific agreement that a relationship exists between the nutrient and the disease . b. Food must be a “good source” of fiber, protein, vitamin A, vitamin C, calcium, or iron. c. Single serving of the food product cannot contain more than 13 grams of fat, 4 grams of saturated fat, 60 milligrams of cholesterol, or 480 milligrams of sodium 3. Current allowed health claims a. Calcium and vitamin D for reduced risk of osteoporosis b. Low total fat intake and reduced risk of some cancers c. Low s aturated fat and cholesterol intake for reduced risk of cardio - vascular disease ( CVD ) d. Fiber from fruits, vegetables, and grains for reduced risk of cancers e. Low sodium and high potassium for reduced risk of hypertension and stroke f. Fruits and vegetables and reduced risk of some cancers g. Folate for reduced risk of neural tube defects h. Sugarless gum for reduced risk of tooth decay i. Fruits, vegetables, and grain products that contain fiber for reduced risk of CVD ; oats and psyllium can be single d out in reduction of CVD risk j. Eating pattern rich in whole grains and other plant foods, low in total fat, saturated fat and cholesterol for reduced risk of CVD k. Soy protein and reduced risk of CVD l. Fatty acids from fish for reduced risk of CVD m. Plant stanols and sterols for reduced risk of CVD 4. Table 2 - 10 describes allowable nutrient claims in detail, such as a. Sugar free: < 0.5 grams per serving b. Reduced fat: 25% less fat than the reference product c. Fortified or enriched: vitamins or minerals have been added back to at least 10% of what is normally present d. Good source: serving of food contains 10 – 19% of the DV for a particular nutrient RATE YOUR PLATE Does Your Diet Compare to MyPlate? Using your food - intake record from Chapter 1, place each food item in the appropriate group of the accompanying MyPlate chart. That is, for each food item, indicate how many servings it contributes to each group based on the amount you ate (see Food Composition Table Supplement for serving sizes). Many of your food choices may contribute to more than one group. For example, spaghetti with meat sauce contributes to three categories: grains, vegetables, and proteins. After entering all the values, add the number of servings consumed in each group.

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    Finally, compare your total in each food group with the recommended number of servings shown in Table 2 - 5 or obtained from the ChooseMyPlate.gov website. Enter a minus sign ( – ) if your total falls below the recommendation or a plus sign (+) if it equals or exceeds the recommendation. Indicate the number of servings from MyPlate that each food yields: Food or beverage Amount E aten Grains Vegetables Fruits Dairy Protein Orange juice 1 cup 0 0 1 0 0 Crispix 1 cup 1 0 0 0 0 Nonfat milk ½ cup 0 0 0 0.5 0 Sugar 2 tsp 0 0 0 0 0 Black coffee 1 cup 0 0 0 0 0 Diet cola 12 oz 0 0 0 0 0 Chicken sandwich with lettuce and mayonnaise 3 oz chicken, 2 slices white bread, 2 tsp mayonnaise 0 2 0 0 0 0 0 0 0 0 0 0 3 0 0 Pear 1 medium 0 0 1 0 0 Nonfat milk 1 cup 0 0 0 1 0 Regular cola 12 oz 0 0 0 0 0 Pork chop 3 oz 0 0 0 0 3 Baked potato 1 medium 0 1 0 0 0 Margarine 2 tbsp 0 0 0 0 0 Lettuce and tomato salad 1 cup 0 0.75 0 0 0 Ranch dressing 2 tbsp 0 0 0 0 0 Peas (green) ½ cup 0 0.5 0 0 0 Whole milk 1 cup 0 0 0 1 0 Cherry pie 1 piece 1.5 0 0 0 0 Iced tea 12 oz 0 0 0 0 0 Apple 1 medium 0 0 1.5 0 0 Water 1 cup 0 0 0 0 0 Group totals 4.5 2 .25 3.5 2.5 6 Recommended servings (2000 - kcal plan) 6 2.5 2 3 5.5 Shortages/overages in numbers of servings - - + - +

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    CHAPTER 3 THE HUMAN BODY: A NUTRITION PERSPECTIVE OVERVIEW This chapter examines the anatomy and physiology of the human body as it pertains to nutrition. Comprehensive descriptions of the structure and functions of cells and organ systems are described, including the circulatory system, urinary system, nervous system, endocrine system, immune system, and digestive system . A brief section describes the sto rage capabilities of the body. An introduction to digestion and absorption is presented as part of the discu ssion of the digestive system. The science of nutri tional genomics and its emerging application in personalized nutrition is introduced . The Nutrition and Your Health section reviews common problems with digestion, including heartburn, ulcers, constipation, hemorrhoids, irritable bowel syndrome, diarrhea, gallstones , celiac disease, and nonceliac gluten sensitivity . KEY TERMS Absorptive cells Absorption Active absorption Adenosine triphosphate (ATP) Adipose tissue Anal sphincters Antibody Antigen Anus Amylase Artery Ascending colon Bile Bile acid Bolus Capillary Cardiovascular system Catalase Cecum Celiac disease Cell nucleus Cholesterol Chromosome Chyme Connective tissue Constipation Cytoplasm Descending colon Deoxyribonucleic acid (DNA) Diarrhea Digestion Digestive system Duodenum Endocrine gland Endocrine system Endoplasmic reticulum (ER) Enterohepatic circulation Enzyme Electrolyte Epiglottis Epinephrine Epigenetics Epigenome Epithelial tissue Erythropoietin Esophagus Facilitated diffusion Feces FODMAPs Gallbladder Gastroesophageal reflux disease (GERD) Gastrointestinal (GI) t ract Gene Gene expression Gluten Golgi complex Hemorrhoid Hepatic portal circulation Hepatic portal vein Ileocecal sphincter Ileum Insoluble fiber Insulin Intrinsic factor Jejunum Lacteal Laxative Lipase Lower esophageal sphincter Lumen Lymph Lymphatic system Lysosome Microvilli Mitochondria Motility Muscle tissue Myelin Nervous system Nervous tissue Neuron

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    KEY TERMS (continued) Neurotransmitter Nonceliac gluten sensitivity (NCGS) Nonspecific immunity Norepinephrine NSAIDs Nutrigenetics Nutrigenomics Nutritional genomics Oleogustus Organ Organ system Organelles Passive diffusion Perforation Peristalsis Peroxisome pH Phagocytosis Pharynx Phospholipid Pinocytosis Plasma Prebiotic Probiotic Proton pump inhibitor Pyloric sphincter Receptor Rectum Ribonucleic acid (RNA) Ribosomes Secretory vesicles Sigmoid colon Soluble fiber Specific immunity Synapse Thyroid hormones Tissues Trachea Transcription Translation Transverse colon Ulcer Umami Urea Ureter Urethra Urinary system Vein Villi (singular, villus) White blood cells STUDENT LEARNING OUTCOMES Chapter 3 is designed to allow you to: 3.1 Understand some basic roles of nutrients in human physiology . 3.2 Identify the functions of the common cellular components . 3.3 Define tissue, organ , and organ system . 3.4 Identify the role of the cardiovascular and l ymphatic systems in nutrition . 3.5 List basic characteristics of the nervous system and its role in nutrition . 3.6 List basic characteristics of the endocrine system, especially the pancreas, and its role in nutrition . 3.7 List basic characteristics of the immune system and its role in nutrition . 3.8 Outline the overall processes of digestion and absorption in the mouth, stomach, small intestine, and large intestine, as well as the roles played by the liver, gallbladder, and pancreas . 3.9 List basic characteristics of the urinary system and its role in nutrition . 3.10 Understand the importance of the body storage areas for nutrients . 3.11 Understand the emerging field of nutritional genomics. 3.12 Identify the major nutrient - related gastrointestinal health problems and approaches to treatment . LECTURE OUTLINE 3.1 Nutrition’s Role in Human Physiology A. The human body is composed of trillions of cells . B. Levels of organization: cells → tissues → organs → organ systems

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    1. Each cell is a self - contained, living entity 2. Cells of the same type join to form tissues 3. One or more tissues combine to form organs a. Organs are important in nutritional health b. Nutritional state determines how the organ functions 4. Several organs cooperate and form an organ system C. Constant chemical reactions within living cells require: 1. Energy 2. Water 3. Building supplies ( i.e., protein, minerals) 4. Regulation ( i.e. , vitamins) 3.2 The Cell: Structure, Function, and Metabolism (see Figure 3 - 1) A. Cell (plasma) membrane 1. Holds cellular contents together 2. Regulates direction and flow of substance into and out of the cell 3. Cell - to - cell communication 4. Composed of lipid bilayer (double membrane) , which contains: a. Phospholipids — water - soluble heads and water - insoluble tails b. Cholesterol — fat soluble; provides stability c. Proteins — function as structural support, enzymes, channels, receptors, and gates d. Carbohydrates — identify cells, cell - to - cell communication, and immune defense B. Cytoplasm 1. Fluid material and organelles within the cell 2. Site of anaerobic metabolism C. Mitochondria 1. “Power plants” — convert the chemical energy stored within carbohydrates, proteins, and fats into energy that cells can use 2. Site of aerobic metabolism 3. All cells except red blood cells contain mitochondria D. Cell n ucleus 1. All cells except red blood cells contain at least one nucleus . 2. Bound by its own double membrane 3. Contains genetic material a. DNA → genes → chromosomes b. Gene expression — DNA directs synthesis of proteins i. RNA carries DNA’s message to the outside of the nucleus (transcription) ii. On ribosomes, RNA’s message is used to synthesize a protein (translation) E. Endoplasmic reticulum (ER) 1. Continuous network of tubes on the outer membrane of the cell nucleus 2. Rough ER contains ribosomes — sites of protein synthesis 3. Functions of ER

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    a. Protein synthesis b. Some lipid synthesis c. Detoxification of toxic substances d. Calcium storage F. Golgi complex 1. Sacs within the cytoplasm 2. Package proteins in secretory vesicles for secretion by the cell G. Lysosomes 1. Sacs contain enzymes fo r digestion of foreign material 2. Active in immune function H. Peroxisomes 1. Contain enzymes that detoxify harmful chemicals, including alcohol 2. Detoxification results in formation of hydrogen peroxide 3. Catalase prevents accumulation of hydrogen peroxide in cells I. Cell metabolism 1. C hemical processes involved in maintaining life a. Release and use of energy (adenosine triphosphate) from foods b. Synthesis of compounds c. Preparation of waste products for excretion 2. Anabolic reactions put molecules together and require energy . 3. Catabolic reactions take molecules apart and release energy (e.g., metabolism of energy - yielding nutrients) 3.3 Body Systems (see Figure 3 - 2) A. Types of tissue 1. Epithelial tissue a. C overs surfaces inside and outside the body b. Secretes substances c. Absorbs nutrients d. Excretes wastes 2. Connective tissue a. Found in tendons, cartilage, bone, skin, blood vessels, and elsewhere b. Supports and protects the body c. Stores fat d. Produces red blood cells 3. Muscle tissue a. Found in skeletal muscles and organs b. D esigned for movement 4. Nervous tissue a. Found in brain and spinal cord b. Designed for communication B. Systems may work together (e.g., digestive system aids immune system by preventing pathogens from entering the body) . 3.4 Cardiovascular System and Lymphatic System A. Cardiovascular system

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    1. Blood flows through the heart and blood vessels from pumping of the heart . 2. Blood is made of plasma, red blood cells, white blood cells, platelets, and other substances . 3. Blood circulation through the body (see Figure 3 - 3) a. Blood travels from the right side of the heart to the lungs to pick up oxygen and release carbon dioxide, and then travels back to the heart . b. Blood travels from the left side of the heart through the arteries and capillaries to deliver oxygen and nutrients and pick up wastes from the body’s cells, and then returns to the heart through veins . i. Capillaries have web - like pores . ii. Capillaries are only one cell - width thick . 4. Portal circulation in the gastrointestinal tract a. Water and nutrients may be used to nourish cells of the gastrointestinal tract, but most are taken up by capillaries in the small intestine and st omach. b. Capillaries merge into veins that empty into the portal vein . c. Portal vein leads to the liver . d. Liver processes absorbed nutrients before they enter general circulation . B. Lymphatic system 1. Lymph flows through the lymphatic vessels and lymph tissues . 2. Lymph consists of plasma and white blood cells . 3. Lymph flows throughout body and eventually empties into major veins near the heart . 4. Flow is driven by muscle contractions from normal body movement . 5. Lymphatic circulation in the gastrointestinal tract (see Figure 3 - 4) a. Lymph vessels that serve the small intestine are called lacteals. b. Lymph vessels pick up most products of fat digestion and fat absorption . c. These products are too large to enter the bloodstream directly 3.5 Urinary S ystem (see Figure 3 - 5) A. Two kidneys 1. Remove wastes from the blood 2. Help to maintain acid/base balance of the blood 3. Convert vitamin D to its active hormone form 4. Produce erythropoietin (hormone that stimulates red blood cell synthesis) 5. Produce glucose from amino acids during fasting 6. Filter e xcess water - soluble nut rients and minerals B. Urine travels from kidneys to bladder by ureter s . C. Bladder empties through urethra 3.6 Nervous System A. Functions 1. Exercises central control over most body functions

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