Nutrition Muscle weakness Intro
Terms
undefined, object
copy deck
- known categories of essential nutrients for humans
-
water
calories
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)
-
RDA
aka? -
recommended dietary allowances
the recommended allowance average over a few days, not just one.
a DRI Daily reference intakes -
RDA
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 - AI
-
adequate intake
recommended intake level for use when RDA is not available (nor EAR) - EAR
-
estimated average requirement
average value which is used as a starting point for calculating RDA - UL
-
tolerable upper intake level(also TUL)
daily mac nutrient intake that is unlikely to pose adverse health effects - RDI
-
the highest RDA
below the black line(vitamins and some minerals) - DRV
-
applies to nutrients that dont have an RDA
(above the black line)(cholesterol fiber macronutrients) - %DV
-
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 -
HEI
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
B12
Ca
D
iron
zinc - BMR
-
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
achlorhydria -
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
- TEE
- total energy expenditure - total of all calories expended during the course of one 24 hr day
-
BEE
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 - RMR vs BMR
- 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 - RQ
-
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
-
.85
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
- PAR
-
Physical activity ratio
a multiple of BMR
light 1-1.8
moderate 2-4
heavy >4 - what do you need to calculate the TEE
-
BMR
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
analogous