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Lecture

NUR 306 Lecture Notes - Sirloin Steak, Coronary Artery Disease, Dietary Fiber

5 pages36 viewsFall 2013

Department
Nursing
Course Code
NUR 306
Professor
Linda Parker

Page:
of 5
Calories and Energy Balance
Body needs energy in 3 categories
basal metabolism: maintain normal body functions while at rest (60-80%)
breathing, heartbeat, body temp, renewal of muscle/bone tissue,
growth, including pregnancy/lactation, to maintain life
men: body weight x 11, women: body weight x 10.1
factors that affect how efficiently body uses calories
physical activity level, muscle mass, height, health status, genetics
physical activity: needed for muscular work, vary on how active you are. if
you're active, 75% of basal metabolic calories, average is 50%, inactive is 30%. also
depends on your height and weight, smaller people will burn less
Issues
People overestimate time in physical activity
diet thermogenesis: needed to digest food (smallest component, 10%)
Energy in Foods **
carbs: 4 calories/gm
protein: 4 calories/gm
fat: 9 calories/gm, most energy dense
alcohol: 7 calories/gm, not considered a food item
Caloric Calculations
given how many gms of carbohydrates, protein, fat
multiply by the appropriate number and add up
will be on exam
*** foods are a combination of all sources of energy (will be asked)
Some foods are composed of just one energy nutrients, most contain various
Lean sirloin steak: 32% protein, 8% fat, 60% water
Caloric Intake Regulations
Body mechanisms encourage regular calorie intake, independent of weight
hungry signal when cells run low on energy
signals from brain, stomach, liver, fat cells indicate satiety
Appetite
urge for pleasure of eating
triggered by smell/sight of food
people resist eating in spite of hunger pains
different from hunger*
Energy Balance
adults maintaining weight are in energy balance
smoking, lean muscle mass, genetic makeup all rev up basal metabolism
Small changes are best
calories don't mean fattening or bad for you
calories are life/health sustaining
Carbohydrates
preferred energy source
used exclusively by brain as energy source
should not be avoided when trying to lose weight
body runs primarily on glucose, simple sugar
polysaccharides
glycogen stores energy in liver, muscles
most of our body's stored energy is in fat
A pound of fat is 3500 calories, more than the glycogen stored in limited
amounts, replenished on a daily basis, for instant energy
fat moves via bloodstream to any cells that need it
feasting state: blood sugar is building up because you've just eaten, insulin is
secreted, drives energy into cells for use. if extra blood glucose is created,
will be stored as fat
fasting state: break down glycogen, if all used up then fat breaks down
Fibers
carbohydrates that are complex, not broken down by digestive enzymes,
removed from the body, (celluose), retained in colon, attract water, prevent fat from
being absorbed, used to prevent constipation, give feeling of fullness
soluble fibers: attract water, beneficial, create softer stool (oatmeal, cilium)
insoluble fibers: bran, celery, apple peel, whole wheat,
know benefits of fiber** (prevents constipation, prevents some fats from being
absorbed, heart healthy, reduce blood cholesterol as much as 10% by eating oatmeal
etc. on a regular basis)
Regulation of Blood Glucose
Insulin: facilitates blood glucose uptake by muscles, stimulates glycogen
synthesis, brings blood sugar levels to normal
Glucagon: triggers the breakdown of liver glycogen to single glucose
molecules
opposing hormones, insulin lowers blood sugar after a meal, glucagon
elevates blood sugar during fasting
Health Effects of Sugars and Alternative Sweeteners
Added sugars: dramatic increase in recent years, leading source is soft drinks,
excessive amounts are linked to obesity, heart disease, nutrient deficiencies, and
dental caries
fix: eliminate soda, dilute fruit juice with water, carbs from unrefined
plant sources, simple sugar should be less than 10% of our calories. in
nyc they banned super size soft drinks, sparked debate b/c should
obesity be treated on the public health level (freedom of speech/
action), prepackaged food has a lot of simple sugar, look at %
Recommended guidelines: 5-10% of carbs
Sugar alcohols (nutritive sweetners): trigger a lower glycemic response, 2/3
kcalories/gm, reduce calories in food items, in gum
us approved nonnutritive sweetners: aspartame, saccharin (sweet n low),
stevia, sucarlose (splenda)
Recommended intakes
Carbs: 45-65% of energy requirement
Fiber: 25-35 grams per day
FDA health claims
fiber grain products, fruits, veggies: reduced risk of cancer
fruits/veggies, grain products w fiber: reduced risk of coronary heart disease
soluble fiber from whole oats: reduced risk of coronary heart disease (reduce
absorption of fat in the gut)
whole grains: reduced risk of heart disease
Gluten Sensitivity
celiak disease: gluten is toxic to the gut (severe form of gluten senstivity)
immune disorder causing malabsorption
diarrhea, cramping, headaches, bloating
The Diabetes Epidemic
related to the global increase in obesity
chronic disease, lasts for life
200 million worldwide, 17 in US
most costly disease in the US
1 in 5 healthcare dollars spent on diabetes, 12k per person
Types of Diabetes
type 1 (insulin dependent), type 2 (non insulin dependent), gestational
diabetes (occurs in pregnancy)
type 2 is most common
diagnosed when fasting levels of blood glucose are 126 mg/dl and higher,
usually take years to develop
in all cases, the central defect is elevated blood glucose level caused by an
inadequate supply or ineffective utilization of insulin
Type 1
10% of all cases
insulin deficient
risk factors: viral infection early in life that destroys part of pancreas, young
birth age, certain medications
treatment: insulin, diet, exercise
inject themselves with insulin, insulin pumps
Type 2
90%
no, but possible in advanced stages of the disease
risk factors: obesity (especially abdominal fatness), sedentary lifestyle, insulin
resistance, high weight at certain ethnicities, family history, older age
treatment: weight loss, increased physical activity, sometimes oral
medications, and/or insulin
occurs in overweight and obese, inactive
mostly people over 40, but increasingly seeing it in children
Gestational Diabetes
3%-6%, don't have diabetes until stress of pregnancy
hormones of pregancy are antagonistic to insulin
incidence varies by age (older), weight (obese), ethnicities
baby grows faster, in 1st trimester more susceptible to genetic anomalies
increases risk of fetal death
mothers carry a greater risk for diabetes later in life
tends to occur in successive pregnancies
Insulin
hormone produced by pancreas
reduces blood glucose level
facilitates passage of glucose into cells
low insulin means cells starve, long term: ketoacidosis
Effects of high glucose
elevated blood levels of triglycerides
increased blood pressure
hardening of the arteries
Poorly controlled diabetes (both types)

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