NUTR100 Chapter Notes - Chapter 2: Overconsumption, Micronutrient, Dietary Reference Intake

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13 Dec 2017

School

University of Alberta

Department

Nutrition

Course

NUTR100

Professor

Sabina Valentine

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Document Summary

2,000 kclaories daily, a good estimate for most adults. They are based on 2 sets of standards. What are they: rdi are reference values established for ____ and ______, npn has ____ digits, what is a 24-hour recall, _____ measurements are the external measurements of the body. Chap 2 answers: age, gender and genetic makeup, nutrient-based approach and a food-based approach, dietary reference intake (dris, 1) estimated average requirement(ear) 2) recommended dietary allowance (rda) 3) adequate intake (ai) 4) Tolerable upper intake level (ul: criterion of adequacy, depletion-repletion, estimated average requirement, recommended dietary allowance, ear, upper limit, rdas are intakes that meet the nutrient requirements not of. Recommended daily intakes and reference standards: vitamins and minerals, 8, a method of accessing dietary intake in which a trained interviewer helps an individual remember what he or she ate during the previous day, anthropometric.

Related Questions

Using Standards for Data Comparison

(Week 3 Discussion)

Patient Information

Mr. Brown is a 65-year-old Caucasian male diagnosed 6 monthspreviously with a pre-malignant lesion of the tongue. The lesionwas surgically removed at that time and the patient was treatedwith radiation, 15 sessions over an 8-week period. Mr. Browncompleted radiation one month ago and now has no indication ofcancer.

During the radiation treatments, Mr. Brown developed sores inhis mouth, an extremely painful tongue, and a loss of taste. Hisdiet during that time consisted of very soft or liquid foods. Henow complains that he still only tolerates very soft or liquidfoods.

Overall, Mr. Brown appears pale and complains of tiring easily.He is 5â 10â tall and weighs 150 pounds. Prior to radiation, heweighed 180 pounds. At the end of his treatments he weighed 160pounds. Prior radiation, Mr. Brown was active and exercisedregularly. Mr. Brown is present in the outpatient clinic of thehospital to assess his weight loss and to evaluate him for thepresence of anemia.

Results from Mr. Brownâs lab tests are available and include aComprehensive Metabolic Panel and a Complete Blood Count.

Mr. Brown is married, and his wife is present with him duringhis clinic visit. He has a college degree and is employed in anoffice setting. Until his diagnosis, Mr. Brown was required totravel frequently for work.

You have been asked to see Mr. Brown and conduct a nutritionalassessment.

Question set #2. Recommended Nutrient Intakes. Recommendednutrient intakes for healthy people are recorded in the DietaryReference Intakes (DRI). Where can the DRIs be found? What are thefour different types of DRIs and what do they reference? How mightthe NHANES report âWhat We Eat in Americaâ be used as a comparatorin this case? Are you familiar with other nutrient intakestandards?

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Overall Caloric Distribution (10 points)

Average kcals consumed ________________

Percent of goal for kcal _________________________ (kcals consumed divided by recommended kcal * 100)

Since carbohydrate and fat are largely used to meet kcal needs, it makes sense to look at our intake in terms of percent of total kcal rather than in absolute gram amounts.

Record the percent of kcals coming from carbohydrate and fat in your diet in the chart below. Do not confuse the percent of kcals with the percent of a goal.

To calculate, use the following formulas:

Determine number of kcals from each macronutrient consumed on an average day

kcals from CHO = grams of CHO consumed per avg. day X 4 kcals per g CHO

kcals from FAT = grams of FAT consumed per avg. day X 9 kcals per g FAT

Divide number of kcals from each macronutrient by total day kcals consumed

% of total daily kcals from CHO = kcals from CHO / total daily kcals

% of total daily kcals from FAT = kcals from FAT/ total daily kcals

(Ex. 200 grams of CHO consumed * 4 kcals per g CHO = 800 kcals of carbohydrate. 800 kcals of carbs / 2400 kcals total consumed = .33 * 100 = 33% or 33% of kcals came from carbohydrate)

Macronutrient	Recommended percent of kcal (Acceptable Macronutrient Distribution Range - AMDR)	Percent of kcal from nutrient in your diet
Carbohydrate	45 - 65 % of kcals
Fat	20-35% of kcals

Did you consume the appropriate percent of kcal from carbohydrates, protein and fat? If not, how might you adjust your kcal to better meet the recommendations and what changes in your food intake could accomplish this?

Carbohydrate Intake - Further Analysis (6 points)

*note: if you are using myplate, ignore the recommendation of 130 grams for total carbohydrate on your printout.....that is a minimum not a recommended amount

3. Average grams of fiber consumed ______________________.

4. Percent of goal for fiber ________________________ (average fiber consumed divided by fiber recommended * 100)

5. Are you getting enough fiber (100% of goal for question 4)? If not, how might you fix this?

6. Take a look at your list of foods....are lots of your kcals coming from sugar? Only 10% or less of your total kcals should be coming from refined (added) sugar...how do you think you did? ______________________________________________

Fat Intake - Further Analysis (8 points)

7. Average grams of saturated fat consumer per day:_______________________

8. Percent of kcals from saturated fat per day: ______________________________ (Hint: average grams of sat. fat consumed times 9 kcals per gram divided by total kcals consumed)

9. Did you consume more that 10% of your kcals from saturated fat? If so, how might you reduce saturated fat?

(you do not need to be worried about consuming too little since there are no essential fatty acids that are saturated)

note: if you are using diet analysis plus to evaluate your diet, you can look at the spreadsheet report to see how much of a given nutrient is in each food that you ate.. For example, if your saturated fat were high, you could look at the spreadsheet report to see what foods contributed the most saturated fat to the diet. You can then think about reducing portion size or making substitutions

10. Average milligrams of cholesterol per day: ____________________________________. Are you consuming more than 300 milligrams of cholesterol? If so, how might you reduce this?

11. Are you consuming foods rich in omega-3 fatty acids? If so, what are they? If not, how might you increase your intake of omega-3 fatty acids?

Protein Intake - Further Analysis (6 points)

12. What is your protein RDA? (Multiply your body weight in kilograms by 0.8 g PRO/kg)

13. Are you consuming an appropriate amount of protein? (Recommendation is to consume a minimum of the RDA amount and a maximum of twice the RDA)

14. If you are not within the range indicated in question 13, indicate how you might adjust your diet.

The people of Malaysia belong to three communities: the local people called Malays, immigrants from South India called Tamils, and immigrants from China. During the early 20th century, the Malays lived mainly in coastal villages, the Tamils worked on rubber estates, and the Chinese worked in tin mines. In general, the people were very poor and they consumed a limited variety of foods.[1] Rice was the staple diet of all three communities and therefore the key source of caloric and nutrient content. Malays typically grew their own rice and dehulled it before consuming it; dehulling partially removes the aleurone layer of the rice seed. Following their South Indian food habits, the Tamils ate parboiled rice, and the Chinese ate polished white rice imported from Thailand. It was found that among the three Malaysian communities, the Chinese community was much more prone to suffer from some degree of sub-optimal thiamin intake. Out of every 1,000 Chinese inhabitants, about 120 had mild thiamin deficiency, about 80 had severe thiamin deficiency, and about 16 people had died of it. Suboptimal intake of thiamin was rare in Malays and was not reported at all in Tamils.[1] Thiamin, also called Vitamin B1, is required for all tissues, and its deficiency causes the disease Beriberi. Less severe deficiency results in non-specific symptoms such as weight loss, malaise, irritability, and confusion. Although the origin of the word Beri-beri is disputed, it is believed to be a Philippine word meaning âI canât, I canâtâ and was probably coined to refer to the lack of neuromotor coordination in people afflicted with this disease.[2] Thiamin is water-soluble and is stable in the acidic medium. It is unstable to heat, oxygen, and UV light in neutral and alkaline medium. The active form of thiamin is thiamin pyrophosphate (TPP). This active form is a cofactor for pyruvate dehydrogenase and transketolase enzymes that are involved in the metabolism of carbohydrates. These enzymes play an important role in the biosynthesis of a number of cell constituents such as neurotransmitters, pentoses, and reduced equivalents, used in oxidant stress. The human body cannot store thiamin and therefore requires a continuous supply of the vitamin. The thiamin in an individual on a thiamin-free diet typically depletes in fewer than two weeks. Thiamin absorption is affected by compounds, called thiamin antagonists or anti-thiamin factors, that alter the structure of thiamin. These compounds include alcohols, polyphenols, flavonoids, and thiaminase, a heat labile enzyme found in certain foods.[2] In affluent countries, where the diet is rich in thiamin, the most common cause of thiamin deficiency is excessive alcohol consumption. Alcohol intake affects thiamin status in two ways. First, alcoholics get a significant percentage of their daily energy intake from alcoholic beverages, which are nutrient deficient. In other words, alcoholics replace their consumption of nutrient dense foods that are part of their normal diet with the consumption of nutrient deficient alcohol. Second, alcohol inhibits the intestinal ATPase involved in the absorption of thiamin.[4] Sub-clinical thiamin insufficiency associated with excessive alcohol consumption produces an encephalopathy called Wernicke-Korsafoff syndrome. Patients with this syndrome have a higher than normal incidence of abnormal transketolase, which has a very low binding affinity to TPP. This problem can be overcome by putting patients on high-dose thiamin therapy. Some patients, however, might have a form of abnormal transketolase that does not bind at all with TPP. Such people do not respond to high-dose thiamin therapy.[4] Thiamin deficiency is observed in individuals who have low thiamin intake and a diet rich in polished rice, especially if their diet also consists of anti-thiamin factors such as tea, coffee, raw fermented fish, and betel nuts. The minimum amount of thiamin needed by the body can increase because of increased physiological or metabolic demands arising from pregnancy and lactation, heavy physical exertion, illnesses like cancer, liver diseases, hyperthyroidism, and surgery. Since TPP is required for carbohydrate metabolism, the recommended dietary allowances for thiamin are based on the assumption that its intake is related to total energy intake. The recommended dietary allowance in the United States is 0.5 mg/1000 Kcal.

Questions
1. Thiamin deficiency was observed only in the Chinese community even though all three
communities had the same staple (rice) diet. Explain.
2. On packages of enriched rice sold in supermarkets, the rice preparation directions state that the
rice should not be washed before cooking. Explain.
3. Severe metabolic acidosis caused by high levels of lactate is often associated with thiamin
deficiency. Explain.
4. Provide two plausible explanations for what might cause above normal levels of pyruvate in blood
and urine. How can one determine which of the two explanations is correct?
5. Why does thiamin utilization increase among cancer patients?
6. A negative correlation exists between the need for thiamin and the amount of fat in the diet.
Explain.

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NUTR100 Chapter Notes - Chapter 2: Overconsumption, Micronutrient, Dietary Reference Intake

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