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Nutrition 2 Final Exam Review


Nutrition 2 final 2009 exam review notes:
text: Medical Nutrition by Marz who has type B blood, 2nd ed.
Approximately 75% since midterm and 25% comprehensive
-please review the midterm exam review notes
final will be 23.5% of grade

MACROBIOTIC DIET
What are main characteristics?
sickness is being out of balance, consumption of too much meat and sugar, not enough exercise
Where do majority of calories come from?
50% or more whole grains, 20-30% veggies (2/3 cooked)
10-15% beans and seaweed
5% soup
1-2x/week small volume of white fish or shellfish
2-3x/week cooked fruit dessert in season, local, avoid imports, no juice except in hot weather
roasted seeds/nuts, salt from sea, tamari or miso (miso provides B12, K from bacteria)
number of meals can be 1-3, thorough chewing, no food for 3 hours before sleeping
no iced drinks
7 stages of dz: 1) fatigue 2) aches and pains 3) acidosis and hypercoagulability
4) emotional disorder 5) organ disease 6) nerve disease 7) arrogance
bad diet-->acidosis
arrogance is cause of all dz as well as being the endpoint
purpose of macrobiotic healing is to "cure arrogance"
common nutrient def: B12
seven levels of eating 1) mechanical (in utero) 2) sensory eating 3) sentimental/emotional eating
4) intellectual eating 5) social eating 6) idealogic eating 7) free eating
free eating: in harmony with universe, seasonal, evolutionary, adaptive
99% of people on earth eat at mechanical, sensory or sentimental/emotional levels

VEGETARIAN DIET
A man fed on whiskey and dead bodies cannot do the finest work of which he is capable"
-George Bernard Shaw

FAMOUS VEGETARIANS: Socrates, Plato, Einstein, Leonardo da Vinci, Shakespeare, Darwin, Gandhi, Mark Twain, Ralph Waldo Emerson, Kellogg, Tesla, Edison, Newton, Thorough, John Collins, Bruce Lee, Carl Lewis (9 olympic golds), Dave Scott (6x ironman champ)
VEGETARIAN GROUPS: Buddhists, Hindus, 7th Day Adventists
IN THE US: vegetarian population has doubled in last decade from 6-->12 million
vegans number 1/2 to 1 million
WORLDWIDE 6-10% of human pop, depending on definition
LEVELS OF VEG: vegan, lacto, lacto-ovo, lacto-ovo-pesco
vegans avoid all animal products incl honey
ADVANTAGES: envir: smaller carbon footprint, energy usage to make meat 80x more, less water usage
health: avoid xenobiotic toxins in animal fat, lower risk of cv dz, ca, osteoporosis, inflam, obes
leaf veggies provide 25x more prot/acre as beef ???
less prostate ca, breast ca, read The China Study
DISADVANTAGES: hard to get enough B12???
MORALITY: could you kill it?
average 60 grams prot/day
20:1 veg proteins: animal
to get 1 pound animal protein need 20 pounds from veg sources

TOO MUCH PROTEIN
perils of too much protein
gout, CV dz, CA, kidney stones, renal dz, arthritis, inflammatory conditions
incr animal prot-->incr AA intake-->incr inflam

FAMOUS DOCTORS
Famous scientists for 20 pts!

BEN FEINGOLD, M.D., 1899-1982, born in Pittsburg, PA, pediatric allergist from CA, proposed in 1973 that food additives including salicylates, artificial colors, & artificial flavors cause hyperactivity/ADD/ADHD in children. Modern application of the diet includes avoidance of BHA & BHT.

ROBERT ATKINS 1930-2003, cardiologist who popularized very low carb diet, was fat in 1963 and lost lots of weight this way, also probably died of the effects of this diet.

LINUS PAULING 1901-1994, American chemist, peace activist, author, and educator. Influential in quantum chemistry, molecular biology, and orthomolecular medicine, won multiple Nobel Prizes, also one of two people to get that prize in two different fields (chem & peace), also got Marie Curie prizes in both chem and physics, and not shared. He's the one who figured out that most animals make their own vitamin C, but we and a few other species don't.

WESTON A PRICE: 1870-1948 dentist from Cleveland who traveled world and found health correlations with dental decay and physical degeneration and diet, traditional diets best for health, dental arch width of particular interest, narrower with malnutrit. Book: Nutrition and Physical Degeneration 1939. Studied Swiss, Eskimos, N Amer Indians, Gaelic.

ROGER WILLIAMS: 1955 Biochemical Individuality, discovered pantothenic acid, proponent of antiox supps vit C & E, Nutrition and Disease (book), Roger John Williams (August 14, 1893 – February 20, 1988), was an American biochemist who named folic acid and discovered pantothenic acid, a member of the National Academy of Sciences and President of the American Chemical Society.

FRANCES M POTTINGER Jr MD: cats, linked to Price, fed cats various diets, cooked milk and meat-->genetic tendency twd pathol, mange, sickness, ill temper, poor coat raw milk raw meat health improved in 2-3 generations, Pottinger's Cats.

MEDITERRANEAN DIET
Mediterranean diet studied by Ancil Keys (sp) compared chol btw Crete, MN, Spain, FR
char of diet: more fiber, omega 3's, whole grains, veg/fruit, plant prots instead of animal
7 countries study by ancil keys
leong dietary study terminated, nonmed diet pts were dying
“7 countries study” in 1958 and the “Lyon Diet Study”
Mediterranean Diet- Calories based on?
Know Meditarranean diet, who, what and when?
7 countries study and Lyon Diet Study

HEMOCHROMATOSIS
10% of world pop heterozygous for hemochromatosis
poor gluc control, inflam, lots of related dz
ferritin level normal 30-350 in adults
he likes it under 100
ferritin mb elevated dt other reasons so do %sat
if you have 2+% saturations over 40 get genetically tested
% sat ideal: 28-35% sat
ferritin ideal: males below 70, females

CHINESE FOOD CURES
diet as tx for dz
considers flavor, energy, movement, common and organic actions of food
flavors and colors for optimal health
5 FLAVORS:
1) pungent (onion, grapefruit, peppers, mint, coriander, ginger, clove)
2) sweet (frt, cbbg/carrot/cel, beef/chick/egg/milk, coffee/wine, coconut, barley/wheat, chestnut)
3) sour (lemon, plum, pear, apple, grape, hawthorne, kumquat, litchi, raspberry, tomato, vinegar)
4) bitter (asparagus, wild cuke, celery, coffee, grapefruit, hops, radish leaf, vinegar, wine, gall)
5) salty (kelp, seaweed)
cold/neutral/warm foods
upward (spring new growth)/downward (fall), outward (summer), inward (winter, bland)

BLOOD TYPE DIET
How are foods evaluated?
how determine sensitivity to food: measure agglutination in vitro
not tested in vivo, he says it doesn't happen in vivo
I take all this with a grain of potassium

High Protein versus High CHO diet- Know advantages and disadvantages of each

Rotary Diversified Diet- basic setup

Biological Classification of Foods

Genetically Modified Foods- Know which foods are GM and problems associated with?

PALEOLITHIC DIET
Paleolithic Diet- basic p
fiber macro element, 100-150 grams, never mind peeling anything
no grains
basis of CAVE PERSON DIET
"pre-Jesus"
Paleolithic people, what did they consume?
Fiber?
Potassium
Magnesium
% CHO, Fat, Pro?
Your Family Tree Connection by Reading

cashews?

FAMILY TREE CONNECTION
genetic condit assoc with consumption of grains
AI dz

DASH Diet- What main features? Sodium levels?
DIETARY APPROACHES TO STOP HTN
how much salt is optimal: 1.5 grams or less per day
1/3 from shaker, 1/3 in food, 1/3 in processing

ELEMENTAL DIET
substitute this for fasting esp for children
key characteristic: no allergens
free AAs instead of protein fragments
very little digestion involved
no fiber present, not for longterm
for allergies, colitis
ultraclear sustain, other products contain di & tri-peptides


Digestion and absorption, bowel toxicity p. 9 &10 & 16, pgs.18-21

Know ways to evaluate digestion:
1)Heidelberg or HCL testing
2)Bowel toxicity- urine indican (Obermeyer test)
3)Measuring butyrate levels in bowel- preferred substrate for SI, for LI?
4)Charcoal evaluation for BT

Carbohydrate metabolism, consumption, refining of CHO’s, milling, enrichment what nutrients put in? what nutrients taken out? Germ? Bran?
Maillard reaction (other names?) significance? What is involved?
fiber consumption & function?

Maillard reaction
a chemical reaction between an amino acid and a reducing sugar
usu requires heat
makes sausages turn golden brown when grilled
caramelization = non-enzymatic browning
named for chemist Louis-Camille Maillard
first described in 1910s
the reactive carbonyl group of the sugar reacts with the nucleophilic amino group of the amino acid
-->complex mixture of poorly characterized molecules
range of odors and flavors
process accelerated in alkaline environment (amino groups are deprotonated-->incr nucleophilicity)
type of the amino acid determines flavor: basis of flavoring industry
lysine is most reactive
interesting on science of meat

SUGAR SUBS
sucralose/splenda is topper in use
what is sucralose: chlorinated sucrose, nerve gas used for chlorination process
splenda is to sucralose as nutrasweet is to aspartame
nutrasweet is #2, breaks down to methanol, wood alcohol, toxic
also issue for borderline PKU pts, phenylalanine sensitivity
natural & artificial sweeteners, alcohol. pgs. 22-32
Aspartame- associated with ?
Sucralose
Stevia
Xylitol

ASPARTAME
aspartame-->aspartic acid, phenylalanine, methanol-->formaldehyde, formic acid, diketopiperazine
HIGH levels of phenylalanine are health hazard to phenylketonurics
PKU = inherited dz, can't metab phenylalanine
in UK, foods that contain aspartame are legally required to list the chem and to say "with sweetener(s)" on the label close to the main product name
influences production of Leptin
-->alters food intake/energy expenditure via receptors on mediobasal hypothalamus
leptin was "significantly reduced by 34%" after "chronic ingestion of aspartame (ASP)"
a metabolite of aspartame inhibits angiotensin converting enzyme

ALCOHOL
Alcohol consumption? How much to be legally intoxicated in state of OR?
4 drinks for male in OR to be legally drunk
Theory of alcoholism based on Dr. Charles Bates—delta 6 desaturase def in some pops
book: EFAs immunity and mental health, if 25%+ scandinavian, irish, native am then prob low delta 6 desat and predisposed to alcoholism and depression, get GLA from EPO or borage decreases recidivism in alcoholics, decreases alcohol cravings
Fat consumption, processing, hydrogenated fats, oxidation
Pgs. 35-43, Eicosanoid pathways p. 47-54
Major enzymes? Lipoxygenase, phopholipase A2, delta 6 desaturase, delta 5 desaturase, cofactors, inhibitors & unregulators for each p. 53
Protein consumption, requirements p. 55, 59

#1 Vitamin def in US: folate
#1 mineral def: iron

Alternative diets: Ayurvedic, macrobiotics- philosophy believes that 99% of all eating occurs thru mechanical, sensory and emotional levels. 50% or more of the volume of each meal should be whole grains.

Chinese system,
detoxification pgs. 479-488- why? Liver function during?
Biological Classification of Foods. Know “Rotary diversified diet”, hypoallergenic diets,
fasting and physiology of- liver function? Susceptibility to drugs? Environmental toxins? withdrawal symptoms ? timing of, elemental diets MNFM P.288-311

Ideal diet information p.489-493 Ideal breakdown in % of calories

NUTRITIONAL PHYSICAL EXAM
p. 500-503
clinical assessment of signs of nutritional status
writeup elsewhere

Hypoallergenic Diet p. 512-515.
first do elimination diet
reintroduce foods on 5 day rotation or more

Coming off Coffee p. 518- caffeine content of various drinks, ETOH

Ideal Blood Test results p. 522-523

AGES = ADVANCED GLYCOSYLATION END PRODUCTS
cause cancer, cv dz
caramelized sugar, maod rxn
sugar sticks to aas esp lysine, combines with reducing sugars ie fructose

ENRICHMENT
B1 thiamine, B3 niacin, folate as of 97, iron

COOKING
steaming or even better pressure cooking preserves most nutrients
shorter cook time

UNIQUE RADIOLYTIC BYPRODUCTS
from microwaving and irradiation
1970's irradiating spices began, byproduct of nuclear industry
some byproducts "are definitely carcinogenic"
microwaving produces less of these
other probs with microwaving: damage to nutritional components, ie flavonoids
80% less flavonoids in broccoli after microwaving

TRANS FATTY ACIDS
from labs (nickel catalyst and bubbling CO2) and cow stomachs
cows have some in tissues, they appear naturally in dairy and meat
cook foods with iron and copper (oxidizing acids) makes free radicals not trans fatty acides
trans fas cause probs

BEST PRESERVATION OF FOOD
freezing
food travels average of 1500 miles

GENETICALLY MODIFIED GROWTH HORMONE
increases insulin-like growth factor
causes cancer
in "The Corporation" a seque, news crew fired

FASTING
avoid while fasting: all environmental toxins, xenobiotics
liver can't metabolize antibiotics while fasting
may need to decrease drug dosages during fast

MEMORIZE
p53 in text
biochem diagram
KNOW
delta 60 saturase cofactors
immune modulators for phospholipase A2: cortisone, quercetin, flavonoids
lipoxygenase converts AA to leukotrienes
what blocks it: omega 3, carotenoids, flavonoids
delta 6 desat generates PGE 1&3
PGE1-->neg modulate PLPA2
things we create in GI, putricine and cadaverine are polyamine toxins, upreg cGMP
cGMP inflam mediator-->incr psoriasis, asthma

GMO FOODS
four main oils: corn, soy, cotton, canola
cargill

IDEAL DIET
60% carb

HIGH FAT HIGH PROT DIET
advantages:
no grains--less allergies
low glycemic

NUTRIT PHYSICAL
skin: vit A, zinc, EFAs, vit C
chronic skin prob: blood sugar
bumps on back of arms: vit A, follicular hyperkeratosis

FOODS WITH HIGH OMEGA 3s
fish, flax, walnuts, hemp, pumpkin, algae, seaweed (also contains DHA)

ROTARY DIVERSIFIED DIET
Dr Marshall Mandell: 5 day allergy relief system
minimum number of days to rotate a food: 5 days per him
select foods from different food families
if sensitivity to a family then eliminate for up to 6 weeks before adding back to rotation

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