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 Chapter 1: Living a Healthy Lifestyle Key concepts to review: 1. What are health and wellness? • Health: the absence of disease or illness, merges and balances 6 physical and psychological dimension of health, physical, intellectual, emotional, social, spiritual and environmental. ? Wellness: lifestyle (pattern of behaviors) that enhances level of health. ? Pasteurization and sanitation have reduced risk of foodborne and environmental hazards. ? Rene Dubos (1968) Definition of Health ? “Health is quality of life involving social, emotional, mental, spiritual, and biologic fitness on the part of the individual, which results from adaptations to the environment.” ? 6 Dimensions of Health ? Physical Health: efficient body functioning, maintaining immunity to disease and meet energy requirements ? Intellectual Health: use of intellectual abilities to learn and adapt to environment ? Emotional Health: ability to control emotions, express or suppress emotions appropriately. ? Social Health: interactions and relationships with other and sustaining relationship with people. ? Spiritual Health: cultural beliefs about the purpose of life, give purpose to human existence. ? Environmental Health: external factors that impact living and work setting, like ethnicity, education, income, and occupation. 2. Healthy People 2020: What is its vision and mission? ? Vision: a society in which all people live long, healthy lives. ? Mission/Overarching Goals: ? Attain high quality, longer lives free of preventable disease, disability, injury, and premature death. ? Achieve health equity, eliminate disparities and improve the health of all groups. ? Create social and physical environments that promote good health for all. ? Promote quality of life, healthy development and healthy behaviors across all life changes. 3. What is health literacy? ? Health Literacy: being able to receive and comprehend basic health concepts, such as nutrition and applying them to our own health decision. ? Health literacy develops through education on topics related to health promotion and illness. ? Education Process of Health Literacy ? Formal Education: purposely planned for implementation in a school setting. ? Non-formal Education: organized teaching and learning events in hospitals, clinics, and community centers. ? Informal Education: variety of educational experiences that occur through daily activities, like watching TV, reading newspapers and magazines, browsing the internet or conversing with other people. ? Health Context: takes into account the influence of culture, social, and individual factors with developing health literacy. ? Cultural factors: ethnicity, religion, race ? Social factors: setting that members receive support or lack of support for health promoting behaviors ? Individual factors: choices we make on willingness to acquire then apply health knowledge. ? Health Literacy Actualization: being able to use acquired health knowledge and skills. 4. Name and define the multidimensional aspects of health. ? 6 Dimensions of Health ? Physical Health: efficient body functioning, maintaining immunity to disease and meet energy requirements ? Intellectual Health: use of intellectual abilities to learn and adapt to environment ? Emotional Health: ability to control emotions, express or suppress emotions appropriately. ? Social Health: interactions and relationships with other and sustaining relationship with people. ? Spiritual Health: cultural beliefs about the purpose of life, give purpose to human existence. ? Environmental Health: external factors that impact living and work setting, like ethnicity, education, income, and occupation. 5. What are the 6 nutrient categories? ? Nutrition: how essential nutrients are processed and used by the body. ? Carbohydrates ? Proteins ? Lipids (fats) ? Vitamins ? Minerals ? water 6. What are essential nutrients and what are their functions? ? Essential Nutrients: essential because we can make some of it, but not enough so we get the rest through food. ? Carbohydrates: provide energy, help regulate body processes ¦ Source: glucose ? Proteins: provide energy, help regulate body processes, help aid growth and repair of body tissue. ¦ Source: amino acids ? Lipids (fats): provide energy, help regulate body processes, help aid growth and repair of body tissue ¦ Source: linoleic acid, linolenic acid ? Vitamins: provides energy, but as indirect role as catalyst for body’s use of energy nutrients, help regulate body processes. ¦ Source: Fat soluble vitamins (vitamin A, D, E, & K). Water soluble vitamins (vitamin all Bs & C) ? Minerals: provides energy, but as indirect role as catalyst for body’s use of energy nutrients, help regulate body processes, help aid growth and repair of body tissue ? Water: help regulate body processes, help aid growth and repair of body tissue. ? Non-essential nutrients: made natural in body but also be absorbed from certain foods. Nutrition Facts L (Links to an external site.)Links to an external site. Water a Vital N (Links to an external site.)Links to an external site. 7. Nurses promote and increase the level of health for individuals, families, groups, and communities through the use of knowledge, different techniques and through community support. How do they do this? ? Through health promotion. ? Health Promotion: what we do to increase the level of healthy individuals, families, groups and communities. ? As nurses we do this through the use of: ? Knowledge ? Different techniques ? Enlisting support of community. 8. What are primary, secondary, and tertiary disease prevention behaviors and examples of each? ? Primary Prevention: initial treatment for prevention of a disease. Focus on promotion. ? Ex: immunization, low fat diet, high fiber (plant based) eating style. ? Secondary Prevention: early detection to try and decrease or halt the progression of disease. So already has been diagnosed. ? Ex. reducing sodium intake for a patient who has hypertension. ? Tertiary Prevention: already have disorder, but you want to minimize the effects of potential complications or assist with restoration of health. ? Ex. receiving chemotherapy for cancer may have side effects of nausea and loss of appetite, so a diet plan should include a diet that should have the patient well- nourished as possible to aid the healing process. 9. What do the five health literacy factors refer to: Health literacy actualization, Individual factors, Social factors, Support factors, and Cultural considerations? ? Health Literacy Actualization: being able to use acquired health knowledge and skills. ? Cultural factors: ethnicity, religion, race ? Social factors: setting that members receive support or lack of support for health promoting behaviors ? Individual factors: choices we make on willingness to acquire then apply health knowledge. ? Support factors: health system, what help is out there? 10. What are the kilocalorie values of carbohydrates, proteins, lipids, and alcohol? If lipids burn more kilocalories, why aren’t they better for us to eat than proteins or carbs? NUTRIENT KCAL VALUE PER GRAM Carbohydrates 4 Protein 4 Lipids (fats) 9 Alcohol 7 ? Kilocalories (kcal): is the energy released from foods measured in kcal or calories. ? Alcohol provides energy but it’s not considered a nutrient because the body does not need it. When alcohol is consumed in excess the body treats it as a toxin. Moderate usage of alcohol can be beneficial for heart disease which is 2 servings or fewer per day for men and one serving for women. 1 serving of alcohol equals 12-ounce beer, 5-ounce wine, or 1.5 ounces of 80-proof spirits. ? Essential fatty acids are the fat-soluble vitamins A, D, E & K. 11. What are simple and complex carbs and what is the difference? ? Simple Carbs: sugars, found in fruits, milk and sweeteners ? Complex Carbs: starches and most fibers found in cereals, grains, fruits, and vegetables. ? Fiber does not break down to units of glucose but is important for digestion and absorption. ? Glucose: most efficient form of energy for body. 12. Name the most efficient form of energy for the brain. ? Glucose 13. Proteins are composed of 20 of these and 9 of them are essential. ? Proteins: provides energy and play a role in bone and muscle structure, enzymes, hormones, blood, the immune system, and cell membranes. ? Consumption of excess protein leads to protein breakdown into amino acids that become E or further breakdown to be stored as fat or excreted thru the kidneys in urine. ? 20 Amino Acids (9 Essential Amino Acids are bolded) ? alanine – ala – A ? arginine – arg – R ? asparagine – asn – N ? aspartic acid – asp – D ? cysteine – cys – C ? glutamine – gln – Q ? glutamic acid – glu – E ? glycine – gly – G ? histidine – his – H ? isoleucine – ile – I ? leucine – leu – L ? lysine – lys – K ? methionine – met – M ? phenylalanine – phe – F ? proline – pro – P ? serine – ser – S ? threonine – thr – T ? tryptophan – trp – W ? tyrosine – tyr – Y ? valine – val – V 14. What are phospholipids and while too much phospholipids in the diet can lead to coronary artery disease, these have several important functions which include: ? Phospholipids is a form of fat containing phosphate. ? Function: fats are the densest form of energy, plays role in functioning of components of all cell structures, production of hormones, and providing padding to protect body organs. 15. What are fat soluble vitamins? ? Vitamins A, D, E & K 16. What are water soluble vitamins? ? Vitamins Bs & C 17. How many essential minerals are there? ? There are 16 essential minerals, divided into two categories, ? Major minerals (in bold) ? Trace minerals (italicized & underlined) ? 16 Essential Minerals ? calcium ? phosphorus ? potassium ? sodium ? chloride ? Magnesium ? sulfur ? iron, ? zinc, ? copper, ? manganese, ? iodine ? selenium, ? molybdenum, ? chromium ? Fluoride 18. Define DRI’s and the following terms r/t DRI’s: EAR, RDA, AI, and UL ? Dietary Reference Intakes (DRI’s): set of nutrient standards that you need per day to prevent nutritional deficiency disease. ? DRI’s combines concerns of deficiency disease with interest of reducing the risk of chronic diet-related disease such as CAD, cancer, and osteoporosis. ? Takes into account availability of nutrients, food components, and the use of dietary supplements. ? Estimated Average Requirement (EAR): amount of nutrients you need to meet the basic requirements of half the individuals in a specific group that represents the need of the population. ? Public health nutrition researchers and policymakers use EARs to determine basis for setting the RDA’s. ? Recommended Dietary Allowance (RDA): level of nutrient intake needed to meet the needs of almost all healthy individuals of a life-stage and gender group. ? GOAL: supply adequate nutrients to decrease risk of chronic disease. ? Adequate Intake (AI): estimated level of an average nutrient intake determined by observation/experimentation with a particular group/population that appears to maintain good health. ? Tolerable Upper Intake Level (UL): level of nutrients that should not be exceeded to prevent adverse health risks. KEY CONCEPTS CHAPTER 2 19. Name the factors that influence food selection ? Food Preferences: foods we choose to eat even though all foods are available at the same time and in the same quantity. ? Factors: ? Genetic determinants: inborn desires for sweets and salty flavors. ¦ “Super Tasters” people find food like broccoli and Brussel sprouts as bitter, so they avoid it. ¦ Eating cruciferous vegetables, like broccoli and Brussel sprouts can decrease risk for developing certain cancers. ? Environmental effects. Result of cultural and socioeconomic influences. Family is the most influential and affect us throughout our lives. ? Media ? Health promotion issues ? Cost ? Convenience ? Food Choice: foods that are convenient to choose from when we are ready to eat. ? Food Liking: foods we really like to eat. 20. What information is required on a Nutrition fact panel ? Amounts per servings ? Energy (kcal) ? Fat ? Total food energy ? Food energy from fat ? Total fat ? Saturated fat, including trans fat ? Sodium ? Total carbohydrates ? Dietary fiber ? Sugars ? Proteins ? Vitamins A and C ? Calcium ? Iron 21. What are exchange lists? ? Exchange List: carbohydrates are divided up and diabetes can use then to exchange for different food so they can adjust their metabolic nutrition based on their lifestyle. ? It lists carbohydrates, meats and meat substitutes, and fats. ? It encourages variety and help control kilocalories and grams of CHO, proteins and fats. 22. Food Labeling: What do the following food descriptors mean? Free, Low, Lean, Extra Lean, Reduced/Less/Fewer, Light/Lite, More, and Good source of Box 2-4 Food Descriptors Free Contains only a tiny or insignificant amount of fat, cholesterol, sodium, sugar, and/or calories. For example, a “fat-free” product contains less than 0.5 g of fat per serving. Low “Low” in fat, saturated fat, cholesterol, sodium, and/or calories; can be eaten fairly often without exceeding dietary guidelines. So, “low in fat” means no more than 3 g of fat per serving. Lean Contains less than 10 g of fat, 4 g of saturated fat, and 95 mg of cholesterol per serving. “Lean” is not as lean as “low.” “Lean” and “extra lean” are US Department of Agriculture terms for use on meat and poultry products. Extra Lean Contains less than 5 g of fat, 2 g of saturated fat, and 95 mg of cholesterol per serving. Although “extra lean” is leaner than “lean,” it is still not as lean as “low.” Reduced, Less, Fewer Contains 25% less of a nutrient or calories. For example, hot dogs might be labeled “25% less fat than our regular hot dogs.” Light/Lite Contains one third fewer calories or one half the fat of the original. “Light in sodium” means a product with one half the usual sodium. More Contains at least 10% more of the daily value of a vitamin, mineral, or fiber than the usual single serving. Good Source of … Contains 10% to 19% of the daily value for a particular vitamin, mineral, or fiber in a single serving. 23. What do the following organic labels mean? 100% organic, organic, made with organic ingredients, and less than 70% organic ingredients KEY CONCEPTS CHAPTER 3 24. What are the organs of the digestive tract and the functions necessary for digestion and absorption? ? Digestive Tract Role in Wellness ? Growth, maintenance, and energy needs depends on the nutrients available ? The digestive system, responsible for breaking food down to essential nutrients and making delivery to the cells. ? Processes of digestion, absorption, and metabolism work together to provide all body cells with energy and nutrients ? Organs of Digestive Tract ? GI Tract ¦ Mouth ? Chemical digestion: action of saliva, that not only moistens, but contains amylase, an enzyme that begins the digestive process of starches. ? Mechanical digestion: depends on the teeth, where it tears and pulverize the food. ? More than 2000 taste buds in our tongue. ¦ Esophagus: muscular tube through which the bolus travels from the mouth to the stomach. ? Process begins with Peristalsis, which is involuntary movements of circular and longitudinal muscles. ? You have the mucosa, then submucosa, and digestion depends blood vessels and nerves of the submucosa. ? Muscularis surrounds the submucosa. ? Serosa: outermost layer of the GI wall and is actually the peritoneum lining the abdominal pelvic cavity and covers organs. ? Churning action allows secretions to mix with food mass. Rhythmic contractions of the muscles cause the action of peristalsis. ? Segmentation: combined effect of the circular and longitudinal muscles. ¦ Stomach: consist of fundus, body, and pylorus. Formation of chyme. ? Function of stomach: ? hold food for partial digestion, ? produce gastric juice, ? provide muscular action that, ? combined with gastric juice, mixes and tears food into smaller pieces, ? secretes intrinsic factor for vitamin B12 absorption, r ? releases gastrin. ? Destruction of pathogenic bacteria. ? Gastric secretions occur in 3 phases: Cephalic, Gastric, and Intestinal. ? Cephalic Phase: also called the “psychic phase” because mental factors can stimulate gastrin, a hormone stimulated by stomach mucosa. ? Gastric Phase: gastrin increases release of gastric juices when the stomach is distended by food. ? Intestinal Phase: gastric secretion change as chyme, a semiliquid mixture of food mass, passes through the duodenum. ? Hormones regulate the release of gastric juices and enzyme. ¦ Small Intestine ? Chyme moves through the jejunum and ileum of the small intestine. ? In small intestine, nutrients in chyme are prepared for absorption. ? Small intestine is the major organ for digestion and final stages of the digestive process occurs here. ? Bile: secreted in the liver and stored in the gallbladder, is released to emulsify fats, aiding in digestion of lipids. ? Secretin: hormone released by the small intestine, causes the pancreas to send bicarbonate to the small intestine to reduce the acidic content of the chyme. ¦ Large Intestine ? Consist of the cecum, colon, and rectum. ? Cecum: is a blind pocket, therefore the mass bypasses it and enters the ascending colon, then leads to the transverse colon running across the abdomen over the small intestine to the descending colon, then the descending colon extends down the left of the abdomen into the sigmoid colon and leads into the descending colon, on to the rectum and into the anal canal. ? Digestive Tract TABLE 3-1 Digestive Processes MECHANISM DESCRIPTION Ingestion Process of taking food into the mouth, starting it on its journey through the digestive tract Digestion A group of processes that break complex nutrients into simpler ones, thus facilitating their absorption; mechanical digestion physically breaks large chunks into small bits; chemical digestion breaks molecules apart Motility Movement by the muscular components of the digestive tube, including processes of mechanical digestion; examples are peristalsis and segmentation Secretion Release of digestive juices (containing enzymes, acids, bases, mucus, bile, or other products that facilitate digestion); some digestive organs secrete endocrine hormones that regulate digestion or metabolism of nutrients Absorption Movement of digested nutrients through the gastrointestinal mucosa and into the internal environment Elimination Excretion of the residues of the digestive process (feces) from the rectum, through the anus; defecation ? Digestion Chewing and swallowing Depends on texture and quantity Esophagus 5-7 seconds Stomach 2-6 hours Small intestine Approximately 5 hours Large intestine 9-16 hours Total 16-27 hours ingestion to elimination 25. What are the 3 phases of the gastric secretion process and what happens in each? ? Gastric secretions occur in 3 phases: Cephalic, Gastric, and Intestinal. ? Cephalic Phase: also called the “psychic phase” because mental factors can stimulate gastrin, a hormone stimulated by stomach mucosa. ? Gastric Phase: gastrin increases release of gastric juices when the stomach is distended by food. ? Intestinal Phase: gastric secretion change as chyme, a semiliquid mixture of food mass, passes through the duodenum. 26. How do the following hormones/enzymes affect digestion/absorption/metabolism: amylase, gastrin, chyme, secretin, CCK, bile, hydrochloric acid, bicarbonate? ? Cholecystokinin (CCK): hormone secreted by intestinal mucosa. inhibits gastric secretions. It’s also called “Pancreozymin” ? Bile: secreted in the liver and stored in the gallbladder, is released to emulsify fats, aiding in digestion of lipids. ? Secretin: hormone released by the small intestine, causes the pancreas to send bicarbonate to the small intestine to reduce the acidic content of the chyme. ? Chyme: a semiliquid mixture of food mass that passes through the duodenum. ? Gastrin: hormone secreted by the stomach mucosa, it increases the release of gastric juices when the stomach is distended by food. ? Amylase: enzyme in the mouth that begins the digestive process of starches. ? Hydrochloric acid: the stomach wall contains gastric mucosa with gastric pits. At the base of the pits are the gastric glands whose chief cells create gastric juice, a mucous fluid containing digestive enzymes, and parietal cells, which secrete stomach acid called “hydrochloric acid” ? Bicarbonate: reduces the acidic content of the chyme. 27. What are the differences between digestion, absorption, and metabolism? ? Digestion: a group of processes that break complex nutrients into simpler ones, thus facilitating their absorption; mechanical digestion physically breaks large chunks into small bits; chemical digestion breaks molecules apart. ? Absorption: movement of digested nutrients through the gastrointestinal mucosa and into the internal environment. ? Metabolism: process which absorbed nutrients are used by the body for energy to form and maintain body structures and functions. KEY CONCEPTS CHAPTER 4 Carbohydrates – Key concepts to review: Carbohydrate classifications: 28. What are simple carbs and complex carbohydrates and what do they do that makes them different from each other? ? Simple Carbohydrates (or sugars): monosaccharides (glucose, fructose, galactose), disaccharides (sucrose, lactose, maltose) ? Monosaccharide: fruits, sweeteners, honey, high fructose corn syrups, vegetables, part of lactose, found in milk. ? Disaccharides: sugarcane, sugar beets, fruits vegetables, milk and milk products, germinating grains. ? Complex Carbohydrates: polysaccharides (starches; which are strings of glucose, and fiber; which are strings of monosaccharides, usually glucose). ? Polysaccharides: grains, legumes, potatoes, whole grains, fruits, vegetables. ? Complex carbs give us continuous energy, instead of simple that gives us spikes of energy. 29. Why do the Dietary Guidelines for Americans recommend increased consumption of complex carbohydrates and dietary fiber? ? Our brain needs 100 g of carbs per day. 45% needs to come from carbs. ? The book says 130 g/day for carbs. ? 45-65% of carb should be fiber which is about 25-38 g of fiber per day. ? Carbohydrates (CHO): organic compounds composed of carbon, hydrogen, and oxygen. 30. What are the best energy sources of carbohydrates? ? Sugars ? Starch ? Fibers ? From the book: ? Grains ? Legumes ? Starchy root vegetables. 31. How does inadequate intake and excess intake of certain categories of carbohydrates affect health status? ? When there aren’t enough carbohydrates available, fat is metabolized, resulting in the formation of ketones. 32. What do alterations in carbohydrate metabolism disrupt and what does that result in? ? Alterations in carbohydrate metabolism disrupts blood glucose homeostasis between 70 to 100 mg/dL. 33. What is the minimum acceptable amount of carbs required per day? ? 130 g/day 34. What % of the daily diet should be carbs? ? 45% 35. How much of the daily % of carbs should be whole grain? ? 130 g/day is recommended with half being whole grains about 35-45%. 36. How much of the current American diet is typically whole grain? ? You should make half or your grains, whole grains. 37. What is the recommended % of calories consumed for added sugar in the diet? ? 4% kcal/g 38. What is the process of glycogenesis and how does it work? ? Glycogenesis: dietary starches and simple carbohydrates provide blood glucose after digestion and absorption; glycogen stored in the liver and muscle tissue is converted back to glucose. ? Process of converting glycogen from the liver/muscles back to glucose. ? Gluconeogenesis: process of producing glucose from fat. ? Glucagon: pancreatic hormone that releases glycogen from liver. ? Somatostatin: pancreatic and hypothalamus hormone that inhibits insulin and glucagon. 39. In terms of digestion and absorption what do the following do: Pancreatic amylase, sucrose, lactose, and maltose? ? Pancreatic Amylase: works on starch intermediary products to continue the breakdown to monosaccharides, simple sugars ? Sucrose: after absorption from the small intestine, fructose circulates in the bloodstream. When it passes through the liver, liver cells rearrange fructose into glucose. ? Sucrose is a table sugar. Sugarcane and sugar beets are two sources of sucrose. ? Lactose: composed of glucose and galactose, sometimes called “milk sugar” because it is the primary carbohydrate in milk. ? Maltose: created when two units of glucose are linked. It is available when cereal grains are about to germinate, and the plant start is broken down into maltose. ? The majority of maltose in human nutrition is created from the breakdown of starch in the small intestine. ? When maltose ferments, alcohol is formed. 40. What are the glycemic index and the glycemic load? ? Glycemic Index: how high blood sugar goes depends on; how quickly glucose enters blood stream and how much glucose it will deliver. ? A ranking of 100 is the highest glycemic index level. ? Glycemic Load: based on how slowly or quickly a food increases blood glucose level. Lower is slower, higher is faster. The highest rating is 100 ? Glycemic load considers the total glycemic index effect of a mixed meal or dietary plan. ? Less than or equal to 10 is LOW ? Greater than or equal to 20 is HIGH 41. Describe dietary fiber and what are the best sources of dietary fiber? ? Fiber: consist of strings of simple sugars, unlike starch, fiber cannot be broken down by human digestive enzymes. ? Dietary Fiber: consists of substances in plant foods, including carbohydrates and lignin, that for the most part the human body can’t digest. ? Fiber goes through our body without providing any kcal or nutrients. ? Soluble Dietary Fibers: dissolves in fluid (pectin, mucilage, guar, and other gums) ? Ex: kidney beans, split peas, lentils, chickpeas… lotta damn beans and peas. ? Insoluble Dietary Fibers: doesn’t dissolve in fluids so it provides structure and protection for plants. (cellulose, hemicellulose, lignin) ? Ex: whole grains, brown rice, buckwheat groats, whole wheat flour, whole wheat pasta ? Best sources of dietary fiber are: ? Fruits ? Vegetables ? Whole grain products 42. Are fruits and vegetables considered dietary fiber? Why or why not? ? Yes, they are. 43. What are the negative health effects of not enough dietary fiber? ? Obesity ? Constipation ? Hemorrhoids ? Diverticular disease ? Colon cancer 44. What are the positive health effects of dietary fiber? ? Improves the physical functioning of the body. The benefits aren’t directly nutritional but instead allow the body to function at a more efficient level. ? Adequate consumption of dietary fiber can be a primary disease prevention, because it can prevent a lot of diseases. BE SURE YOU REVIEW THE VITAMIN AND MINERAL REVIEW ppt. KEY CONCEPTS CHAPTER 8 Water and Minerals, p 129 – 146 Key concepts: 99. Water serves a number of functions in the body. What are those seven functions? ? Adequate Intake (AI) recommends that men drink 13 cups of water a day and women drink 9 cups a day. ? Box 8-2 ? Functions of Water ? Provides shape and rigidity to cells ? Helps regulate body temperature ? Acts as a lubricant ? Cushions body tissues ? Transports nutrients and waste products ? Acts as a solvent ? Provides a source of trace minerals ? Participates in chemical reactions 100. What is the relationship between water and each of the six dimensions of health: physical, intellectual, emotional, social, spiritual, and environmental? ? Physical Health: depends on adequate levels of these nutrients in water. ? Intellectual Health: when iron levels are low, iron deficiency affects cognitive abilities and thus diminishes the ability to learn. ? Emotional Health: rely on our being sufficiently hydrated with fluids. ? Cases of fluid volume deficit or dehydration have been mistaken for senility (old age) when the thirst acuity of older adults diminishes. ? Social Health: may be affected if older adults become debilitated by bone fractures or osteoporosis caused by chronic calcium deficiency; social mobility may be limited as their physical movement is inhibited. ? Spiritual Health: vegans who consume no animal-derived foods because of spiritual health beliefs need carefully designed eating plans that provide adequate levels of zinc, iron, and calcium to avoid deficiencies. ? Environmental Health: impacts access to safe and plentiful sources of water, a nutrient essential to health. 101. Explain why water is called a fundamental nutrient? Because we can live several weeks without food, but only a few days without water. 102. What is the AI per day of water for men and women? ? 13 cups a day for men. ? 9 cups a day for women. ? Minimum recommended is 4 cups. 103. What is hard water and what is soft water? ? Hard water: water that contains high amounts of minerals such as calcium and magnesium. ? Non-nutrition related problems from hard water can develop, mineral deposits may damage appliances and other machinery that interacts with water, and soap suds are reduced. ? To lessen these problems, a filtration process can be installed to soften water by replacing some minerals with sodium chloride (salt). ? Soft water: contains sodium but can be a problem for sodium-sensitive individuals, such as those at risk for hypertension. ? To prevent problems, water softeners may be used on only the hot tap in kitchens, leaving the cold tap unsoftened for consumption. 104. Imbalances of fluid distribution lead to fluid volume deficit or fluid volume excess. What are the related health effects of FVD? ? FVD: person experiences vascular, cellular or intracellular dehydration. ? Causes: FVD can occur from diarrhea, vomiting, high fever, sweating, diuretics, and polyuria. ? Health Related Effects: infrequent urination, decreased skin elasticity, dry mucous membranes, dry mouth, unusual drowsiness, lightheadedness or disorientation, extreme thirst, nausea, slow or rapid breathing and sudden weight loss, orthostatic hypotension. ? FVE: person experiences increased fluid retention and edema. ? Causes: compromised regulatory mechanism, excess fluid intake or excess sodium intake. Or kwashiorkor. ? Water intoxication: consumption of large volumes of water in short period of time. 105. How does ADH play into fluid imbalances? ? When fluid in the body becomes low, the hypothalamus stimulates the pituitary gland to release ADH. ? ADH is secreted due to high sodium levels or too low BP or blood volume. ? The kidney then conserves water by decreasing excretion of water. 106. What are cations and anions and what does the balance between them do? ? Cations: positively charged ions ? Ex: sodium and potassium are cations ? Anions: negatively charged ions. ? Ex: chloride is an anion. ? The balance between them maintain fluid balance. Water will follow sodium concentration. 107. Identify which of the following are positively charged cations and which are negatively charged anions: Cl, K, Na, HC03, Ca, PO, Mg, and SO? ? Chloride (Cl): anion ? Bicarbonate (HCO3): anion ? Calcium (Ca): cation ? Magnesium (Mg): cation ? Phosphate (PO): anion ? Sulfate (SO): anion 108. Minerals are divided into two categories, what are they and how do you differentiate them? ? Major and Trace Minerals ? Major minerals: must consume 100 mg or higher a day to maintain body levels. ? Calcium ? Chloride ? Magnesium ? Phosphorus ? Potassium ? Sodium ? Sulfur ? Trace Minerals: less than or equal to 20 mg. ? Chromium ? Copper ? Fluoride ? Iodine ? Iron ? Manganese ? Molybdenum ? Selenium ? Zinc 109. What are the main sources of minerals? ? Plant and animal foods. ? Plant foods: most fruits, vegetables, legume, and whole grains. ? Animal foods: beef, chicken, eggs, fish, and milk products. 110. What is bioavailability? ? Bioavailability: level of absorption of a consumed nutrient. ? Minerals from animal foods can be absorbed more easily than those from plants. 111. How do Na and K work together? ? The sodium/potassium pump works to exchange sodium from within the cells for potassium. 112. How do Ca and PO work together? 113. Iron is a trace mineral but has a very important role. What is Fe’s role? ? Distribution of oxygen throughout our bodies. 114. What is heme iron v nonheme iron? Why is it important to talk about B12 when considering heme and non heme iron? ? Heme Iron: is found in animal sources, meat, fish, and poultry and heme iron is easily absorbed than non-heme iron found in plant foods. ? Non-heme iron: found in plant sources, vegetables, legumes, dried fruits, whole grain cereals, and enric

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