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Nutrition Muscle weakness Intro


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known categories of essential nutrients for humans
essential aa's 10
essential fatty acids
13 vitamins
16-20 minerals
a nutrient needed in large amounts

a nutrient needed in small amounts
macronutrient (g)

micronutrient (mg)
substances that are not necessarily essential to man but might become so
2 ex

name the one that is a necessary energy source for intestinal mucosa
carnitine: synthetic capacity could be compromised

glutamine - gln can become limiting under acute stress in some people, gln is essential for energy production in intestinal mucosa
beri beri
due to?
eijkman 1897 ameliorated beri beri with rice polishings (thiamine)
recommended dietary allowances

the recommended allowance average over a few days, not just one.

a DRI Daily reference intakes
what is it?

what are the two things it is affected by?
mean requirement (EAR) plus two standard deviations (97%)

RDA for calories is the mean for the population that covers 97% of people

affected by age and gender only
adequate intake
recommended intake level for use when RDA is not available (nor EAR)
estimated average requirement

average value which is used as a starting point for calculating RDA
tolerable upper intake level(also TUL)

daily mac nutrient intake that is unlikely to pose adverse health effects
the highest RDA

below the black line(vitamins and some minerals)
applies to nutrients that dont have an RDA
(above the black line)(cholesterol fiber macronutrients)
percent daily value

in a package label:
g of fat or carbohydrates or fiber or whatever
divided by
DRV(fat/carbs/fiber) orr the RDI for vitamins
Notoriously toxic in excess
fat solubule ADek

B6 pyridoxine over 500mg daily causes toxic sensory neuropathy
how much of each major food group should we eat?
20-35% fat
45-65% carbs
10-35% protein

major changes over prior recommendations = more milk, less grains and meat
what is it
correlation rates of nutrients
healthy eating index: score between 0 and 100 on whether you are eating in concordance with the food pyramid, score of 80 or better

not even poor diets have adequate amounts of certain nutrients(low correlation)
while others are a good indicator of a good diet(high correlation
what are vegetarian diets deficient in?
some aa's
lean body mass is a major determinant and men have less body fat

calories per hour
BMR timeline
peak at infancy (~60), declines rapidly through childhood, declines slowly with age
Years 1-10
eating patterns
given a diet with foods from all food groups children will choose adequate nutrients, erratic eating patterns even out over time, major concerns for iron deficiency and calcium
dieting for children
obesity at under 3 doesnt predict later obesity, older and it becomes an indicator, dont know enough about 3-10 range to recommend diet
older adult
energy needs
67% due to decreased activity
33% due to decreased BMR
can lead to insufficient essential nutrient
older adults
greatest risl for inadequacy in?
proteins, B12, Ca, and D
older vs younger fat
older: intra-abdominal and intramuscular

younger: subcutaneous
periodontal disease
perio: gum disease, chewing may become difficult

achlorhydria - decreaed HCL in stomcah affects protein digestion, Ca and B12 absorption
MAO inhibitors
nutritional restriction if you're taking it
monoamine oxidase:antidepressant
can suffer hypertensive crisis from eating tyramine containing foods

tyramine increases Bld P and is usually degraded by MAO
is a calorie the same as a Calorie?
1 Calorie = 1000 calorie or 1 kcal
how many kj in one Calorie
4.184 kj
total energy expenditure - total of all calories expended during the course of one 24 hr day
makes up what percent of TEE

how do you get BEE
basal energy expenditure, makes up about 60% of TEE

BEE is simply the BMR multiplied by 24 (hours in a day), since the BMR is the Calories required per hour
Resting Metabolic Rate (RMR); the RMR can be measured under more realistic conditions which would not meet the precise definition of "basal", but might be regarded as "close enough". If you multiply the RMR (which is also expressed as Cal/hr) by 24 hours in the day, you get the REE (Resting Energy Expenditure), which is analogous to the BEE.
what are the units of BMR
Cal/m^2 hr
BMR calc vs estimation
bmr is estimated
for a man roughyl 1Cal/kg hr
woman is slightly less
what equation relys upon parameters such as height, weight, age, and gender (multiplied by arbitrary constants) to CALCULATE a BMR for that particular individual.
Harris-Benedict equation
how do you MEASURE rmr?
measuring O2 consumed or CO2 produced via indirect calorimetry
ACTUAL energy expenditure
ratio of CO2/O2
respiratory quotient
tells you what proportion of calories comes from fat and what from carbs
should patients with chronic obstructive pulmonary disease COPD burn more fat or carbs?
they should burn more fat for calories than carbs because metabolically fat has a lower RQ than carbohydrates,

this means that there is less CO2 production which reduces the work of breathing
relate RQ to fat/carb burn using rxn equations
know what the actual numerical value for fat and carbs are in terms of RQ
in carbs
gluc +6O2 --> 6CO2 + 6H2O
RQ = 1
in fat
fat + 78.5 O2 --> 55 CO2 + 53 H2O
RQ = 55/78.5 = .71
how do you determine RQ for protein?
protein is only 10-15% of cal's burned usually
RQ for protein is usually .82

measure protein by measuring amount of urea in urine

urinary urea nitrogen(UUN)
What is the normal rQ
50% fat
50% carbs
what is the average value Cal/g for fat? for carbs?
fat = 9
carbs = 4
what is the Cal/g of protein?
or ethanol?
protein = 4
ethanol = 7
how many calories in a pound
3300 cal
Physical activity ratio
a multiple of BMR
light 1-1.8
moderate 2-4
heavy >4
what do you need to calculate the TEE
E expenditure due to physical activity
thermic affect (heat prod by body during digestion, adds an additional 6-10%)
describe TEE for sick people using vocab like hypercatabolic, counterregulatory hormones, and injury factor
sick ppl are hypercatabolic where counterregulatory hormones rise causing increase prot/gluc/glyc consumption.
H include glucocorticoids and adrenergic Hormones

injury factor
minor operation 1.2
severe burn 2.1
TEE for sick people equation
BMR, injury facto, activity factor, thermic effect(1.1)
injury factor and calorimetry
intravenous nutrition
if indirect calorimetry is used to obtain the RMR, this will already include the injury factor (this is part of the measured metabolic rate), if a patient is receiving intravenous nutrition, then the thermic effect doesn't apply and would not be included in the calculation.
diff b/w BMR and BEE

RMR and REE?
BMR cal/hr
BEE cal/day


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