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171 Cards in this Set
- Front
- Back
What are the general demographics for eating disorders?
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Demographics- 95% female, 90% middle and upper class white, almost 100% wealthier, industrialized nations, 80% in highly educated households
Incidents- 1 in 100-150 women, 20% of college age women |
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What are some criteria for the diagnosis of aneroxia nervosa?
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Fear of obesity
Distorted body image Sever weight loss- over 25% of original body weight Refusal to maintain normal body weights |
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What is the age of onset of anorexia?
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early adolescence
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describe the course of anorexia
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usually unremitting unless there is intervention’
30% of those who go w/o treatment will continue until death Rare single episodes usually in response to extremely stressful event, full recovery but high risk of relapse Overall mortality is about 5-10% |
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Describe the features of anorexia
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peculiar behaviors around food,
obsessive or compulsive behavior, perfectionism, high functioning/ goal oriented people, |
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What are some complications of anorexia
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hypothermia,
edema (fluid accumulation) , amenorrhea- cessation of normal menstruation b/c not enough estrogen b/c of lack of body fat, lack of estrogen = bone loss, muscle wasting, lunago (downy hair covering body), brittle nails/ skin/ hair, weakness, poor wound healing, fatigue, electrolyte imbalance which can lead to a cardiac arrhythmia which can lead to death |
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How is anorexia treated?
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Hospitalization
Psychotherapy Nutrition education Drug treatment- antidepressants |
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How is bulimia diagnoses?
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recurrent binges, compensation/ purging activity (starving, vomiting, diuretics, laxative abuse, excessive exercise), awareness of the abnormality, fear of inability to stop, depressed mood, consumption of high calories and easily digested food, hidden eating during the binge, binge may continue until pain/ sleep/ interruption/ purging, weight fluctuations
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What is the age of onset of bulimia
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late adolescence to early adulthood (slightly later than anorexia)
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what is the course of bulimia
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chronic but intermittent over many years, episodes will alternate with periods of normal eating
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What are the patterns/ features of bulimia
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high achievement, planned binges, rapid eating, sense of loss of control and inability to stop, disassociation from process, depression, increased incidence of substance abuse
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What are some complications resulting from bulimia?
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enlarged parotid glands (under jaw line), ulcers or sores of the esophagus/ pharynx/ mouth because of stomach acid, pitting of the teeth, dehydration, reflexive vomiting, rebound constipation, electrolyte imbalances which can lead to arrhythmia which can lead to death
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How is bulimia treated
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Outpatient psychotherapy
Nutrition education Behavior modification Substance abuse treatment Drug Tx, usually antidepressant |
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Describe binge eating disorder
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Recurrent binging without the purging behavior
Increasing body weight to above normal Obsessive thoughts about food, weight, eating Awareness that the behavior is abnormal, fear of inability to stop, depressed mood |
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What populations may be significantly effected by binge eating disorder
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obese and depressed people
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What is the difference between activity and exercise?
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activity that is a part of the normal daily routine, exercise is non required excess activity
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What is aerobic exercise
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rhythmic use of large muscle groups
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What is strength exercise
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isolated used of specific muscle groups
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How often should a "normal" person exercise
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at least 3 times a week, if over worked there is not enough time to recover, if to little the benefits are not achieved
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What intensity should aerobic exercise be?
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60-80% of maximum heart rate
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What is a general rule of thumb for calculating max heart rate?
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220- age
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How long do you have to exercise to receive aerobic benefit
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at least 20 minutes
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What is the general rule of thumb for increasing exercise intensity
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increase at 10% each time
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What are some strategies for preventing injury during exercise
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proper warm up, good equipment (shoes, weight, etc), proper technique
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What should you do to recover from an injury
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reduce the stress on the injury but keep active
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what is pica
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eating of non food substances
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what is the age of onset for pica
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very young, ~1-2 years
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What is pica of pregnancy
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same thing as pica (eating non food substances) except during pregnancy
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What are some possible causes of pica
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mental retardation, neglect of children, poverty, mineral deficiencies?
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What are some ways to incorporate exercise into your life
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make it fun/ recreational, transportation, necessary activity: mowing the lawn, snow shoveling
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What is the difference between aerobic and anaerobic exercise
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aerobic exercise- system can keep up with the oxygen demand, anaerobic- system can't keep up with the oxygen demand
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What is the basic unit of energy in the body
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ATP
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How is energy obtained from ATP
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loss of a phosphate group to ADP releases energy, the reaction is reversible (add a phosphate back) to store energy
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How is energy stored in the immediate energy system
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small amount of energy stored in cells as creation phosphate, it is rechargeable like a battery, emergency powerful physical response
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how long does energy from the immediate system last
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about 10 seconds
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What type of energy is used to maintain blood sugar
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liver glycogen
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What does muscle glycogen do
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used to power muscle, body tries to conserve it, does not help to maintain blood sugar
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Describe anaerobic glycolysis
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glucose is broken into 2, 3 carbon molecules called pyruvate, no oxygen is required, energy is released as ATP
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Describe aerobic metabolism
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pyruvate is broken into carbon dioxide and water, requires oxygen
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why does lactic acid build up
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after high intensity w/o enough oxygen a build up of pyruvate as lactate, muscles become acidic enzymes that complete glycolysis
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How is fat metabolized
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beta oxidation, carbon dioxide + water+ energy (ATP)
requires oxygen, lower intensity exercise, fat comes from intramuscular, visceral, and subcutaneous |
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How many calories are stored in the body as fat? as glycogen?
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fat- 40,000 kcals (lean person)
glycogen- 2,000 kcals |
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What is unique about the brain and its energy needs?
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The brain is an obligate glucose user, it is the only source is can use. The body undergoes gluconeogenesis and breaks down protein to make glucose
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What type of fuel is used when the body using at rest
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70-90% fat
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What type of fuel is used during high intensity, short duration exercise
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carbs primary fuel 80-90%, comes from muscle glycogen, build up of lactate
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What type of fuel is used when exercise is over an hour
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60-80% fat, the remainder is aerobic metabolism of CHO
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What is "hitting the wall"
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abrupt onset of fatigue, intensity goes down, reflects glycogen depletion (after about 2-3 hours of exercise)
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What are the benefits of a high carbohydrate diet to exercise?
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better glycogen stores, better performance, better training, more fitness
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Describe a good diet for an exerciser/ athlete
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carbohydrate at least 55%, fat 20-35%, protein 10-15%, food pyramid diet is consistent with this
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What is the RDA for protein for a normal person? an active person?
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normal- 0.8g/ kg body weight
active- 1-1.5 g/kg body weight |
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What should you eat before exercise
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low glycemic index carbohydrate, avoid fatty foods because they are slow emptying
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What should be consumed during exercise
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consume ~100-200 calories of high glycemic index cards every 20 -45 minutes after prolonged exercise (sports drink, energy bar, cookies, bannana etc)
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What should be consumed after exercise
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need to support lean tissue synthesis, maintain blood sugar, restore glycogen, eat high GI food within 20 minutes and a balanced meal within 2 hours when enzymes for glycogen synthesis peak
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What precent of the body is water and how is it distributed
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water is 50-60% of body mass, blood plasma 90%, muscle 72%, fat 20-35%
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What are the functions of water
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universal solvent, medium for chemical reactions, electrolytes, homeostasis, buffer, transportation, lubrication, temp. regulation
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WHat is water responsible for transporting
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cells, nutrients, gases, wastes
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How is water used for lubrication
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saliva, tears, synovial fluid
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Why is water important for temperature regulation
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high specific heat, constriction of capillaries, perspiration
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When does our sense of thirst kick in
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when we lose about 1% of our body weight in water
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How is water absorbed
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no digestion required, free water (not in food) is 80% absorbed in small ingestion, the rest in large intestine, water in food is absorbed in the large intestine
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Which direction does fluid shift
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water moves from areas of low concentration to high concentration, it follows salt
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How is water excreted
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kidneys, GI tract- feces, skin through sweat, skin and lungs (insensible losses),
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How much water is typically lost in a day
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2-3 liters depending on temperature, humidity, activity
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What part of the body regulates water and electrolytes
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kidneys
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How much water loss does sweat produce
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1-3 liter per hour
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how fast can water be absorbed
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about 1 liter an hour
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What amount of water loss can effect performance?
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2-3% of body weight
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What are some symptoms of heat stroke
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dehydration, over heating, electrolyte loss
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what are some permanent effects of heat stroke
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reduced heat tolerance, kidney failure, death
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What happens when a person is over hydrated
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over dilution of electrolytes, hyponatremia- too little sodium, hypokalenia- too little potassium, can lead to heart arrhythmia
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What is unique about electrolyte replacement drinks
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isotonic (same concentration as gut) solution that promotes rapid absorption
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What should you drink after exercise
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do not need sports drink, drink water and eat a bit of salty food, and fruits or veggies for potassium
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How much water should be consumed based on physical activity
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1-1.5 liters per 1,000 kcals burned
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WHat three states can micronutrient intake be in
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deficient, adequate, toxic
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WHat % of the population is included in the RDA
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98%
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Describe vitamins in general
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essential nutrients, no energy content (non caloric), organic, needed in microscopic quantities
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How are vitamins classified
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based on solubility, water soluble and fat soluble
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WHat are the fat soluble vitamins
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A, D, E, K
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Why is there a higher risk of toxicity with fat soluble vitamins
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the body can't excrete the fat so the body stores the surplus in the body, deficiencies develop over prolonged periods of time
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What happens to excess water soluble vitamins
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body excretes the excess, deficiencies are rapidly developed, low risk of toxicity
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What are some functions of vitamin A aka. retionol
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mucous and tear production, immune function, cellular differentiation
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WHat are the consequences of a vitamin A deficiency
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night blindness, complete blindness, illness and infection, cancer (failure of differentiation), keratinization (hard nail like deposits), xerophthalmia- dry eyes from lack of tears
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What are some sources of vitamin A
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retinal (preformed)- milk, liver, fish oil, eggs
pro vitamin (body finishes synthesis) beta carotene from orange and yellow fruits and veggies and dark green leafy veggies |
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What is the only form of vitamin A that can cause toxicity
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retinal, the body does not process excess beta carotene
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What constitutes an acute toxic does of vitamin A
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over 100 times the RDA
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what constitutes chronic toxicity of Vitamin A
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about 10 times the RDA
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What are some consequences of vitamin A toxicity
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liver enlargement, CNS problems, cognitive/ behavioral problems, teratogenicity- can cause birth defects with even two times the RDA
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What does Vitamin D do
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calcium absorption, bone metabolism
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What are the consequences of vitamin D deficiency
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children- rickets- bones don't form right, bow legged
adults- osteomalacia- weak bones that lack minerals |
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What are sources of vitamin D
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can make vitamin D from cholesterol using UV light from the sun, should get about 15 min/ day of sun exposure, fortified milk, other fortified foods
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What levels cause vitamin D toxicity. What are the consequences
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5 times the RDA in children, over absorption can lead to deposits in the kidneys and soft tissue
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What are the fat soluble vitamins?
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A D E K
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What are the functions of vitamin E
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antioxidant
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What does an antioxidant do
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prevents oxidative damage to cells, free radicals are a result of metabolic processes, they can cause mutation to DNA which can lead to cancer
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Describe a vitamin E deficiency
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rare to see a deficiency with symptoms but marginal intakes are common because vitamin can be reduced or destroyed during food processing
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What are good sources of vitamin E
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whole grain, wheat germ, seed oils
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What does vitamin K do
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needed for the synthesis of blood clotting factors
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What happens in a vitamin K deficiency
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defective blood clotting, drugs sometimes given to block vitamin k and thin blood to prevent heart disease
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What foods are good sources of vitamin K
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dark green leafy veggies, cabbage family (Cabbage family: collars, kale, mustards, turnip greens, bok choy, broccoli, spinach, lettuces)
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What does vitamin C do
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Collagen synthesis
Antioxidant Enhanced iron absorption Synthesis of various compounds Enhances immune response |
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what is a deficiency of vitamin c called
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scurvy
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In what type of diet do we see vitamin c deficiency
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low in fruits and veggies
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What are some symptoms of vitamin C deficiency
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Lack of collagen: bleeding gums- teeth failing out, old scars open, poor would healing
Iron deficiency anemia (shortage of red blood cells- lower oxygen carrying capacity leading to weakness, exhaustion, lethargy, irritability, insomnia) |
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which class of vitamins poses lower risks of toxicity
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water soluble because the body readily excretes excess, fat soluble vitamins are stored in the body with the fat
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What are good sources of vitamin c
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fruits, especially citrus, kiwis, veggies especially peppers
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In general, what are the B vitamins involved in
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co enzymes, energy release
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in general, what do b vitamin deficiencies look like
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All cells effected
Symptoms are very generalized- weakness, exhaustion, irritability insomnia Tend to cluster- deficient in one B vitamins usually means deficiencies in others Very difficult to diagnose Best treated by whole foods |
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What foods are good sources of b vitamins
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Whole grains
Protein foods- meat, fish, poultry, beans, dairy products Veggies (not as much)- dark green leafy veggies |
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what are the common b vitamins
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Thiamin, riboflavin, niacin, folate (folic acid),Cobalamin (B 12),Pyridoxine (B-6),Pantothenic Acid, biotin
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what does thiamin do
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co enzyme involved in energy release
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what is a thiamin deficiency called and what happens
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called beriberi- I can’t I can’t, weakness, tired, loss of strength and coordination, often see in impoverished populations living on white rice with few animals products, usually compounded with other B vitamin deficiencies, in US often seen with alcoholics (poor absorption and intake), found in proteins, whole grains
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what does riboflavin do
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Co enzyme involved in energy release
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what does a deficiency of riboflavin look like
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In connection with other B deficiencies
Seen in food deprivation Diets that lack animal products or green leafy veggies |
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What foods are good sources of riboflavin
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Milk
Green leafies Animal products |
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What does niacin do
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Co enzyme
Energy release |
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What is a deficiency of niacin called and what are the symptoms
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Called Pellagra
Common in southwest until 1940s Associated with the 3M diet (meat -pork fat, meal- cornmeal, and molasses) Symptoms of Pellagra- the 4 D’s - dermatitis, diarrhea, dementia, death Often see in populations that subsist largely on corn, there is niacin in corn but it is not bioavalible unless the corn is treated with lime (calcium carbonate), this is seen in Latin American countries |
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What type of diet is associated with niacin deficiency?
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Associated with the 3M diet (meat -pork fat, meal- cornmeal, and molasses)
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What are the 4 D's , the symptoms of niacin deficiency
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4 D’s - dermatitis, diarrhea, dementia, death
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What is the precursor to niacin
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tryptophan- an amino acid that can be made into niacin
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What types of food are good sources of niacin
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Preformed found in meat, fish, peanuts
Protein food are best but there are lesser amounts in whole grains |
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What symptoms are associated with niacin toxicity
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Flushing- high dose causes rush of blood flow to skin, burning sensation
Higher chronic intakes can lead to liver and kidney damage Raise HDL- can be used to treat heart disease but should be done under the supervision of a physician |
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WHat are the functions of folate (folic acid)
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DNA formation
Protection against heart disease and cancer |
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WHat is significant about the relationship between folate and vitamin B 12
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Folate can mask a B 12 deficiency
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What happens in a folate deficiency
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Can’t synthesize DNA- rapidly growing cells can’t divide- cells get very big which causes:
Megaloblastic anemia-red blood cells are big and few, can’t carry enough oxygen |
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What risks are associated with a low intake of folate during pregnancy
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Low intakes of folate are associated with a higher risk of neural tube defects such as Spina bifida
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What foods are good sources of folate
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dark green leafies, orange jucie, beans
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What does Cobalamin (B 12)do
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Regenerates folate
Maintenance and development of myelin sheaths of the nerve fibers |
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What happens in a What does Cobalamin (B 12) deficiency
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Nervous system damage (adults), this damage in children is irreversible
Can’t regenerate folate- causes folate deficiency anemia- pernicious anemia Absorption involves intrinsic factor which is secreted from the stomach lining, the two bond together are then are absorbed Most commonly seen in the elderly because production of intrinsic factor decrease Can be masked by Folate, B 12 deficiency causes a secondary folate deficiency, taking in a folate substitute will cure the anemia but not the neurological factors |
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What foods are good source of Cobalamin (B 12)
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All animal products- meat, fish, poultry, eggs, dairy (less)
Plant products have none- problem for vegans Well stored by the body (unique for water soluble vitamin), deficiencies develop slowly Vegans should use supplements or fortified foods (cereals, soymilk, multivitamin) |
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What does Pyridoxine (B-6) do
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Synthesis of amino acids (all would be essential without B6)
Synthesis of hemoglobin (protein inside RBCs that transports oxygen) Synthesis of neurotransmitters Energy release |
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what happens in a deficiency of Pyridoxine (B-6)
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Anemia
Neurological problems Quite rare |
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what foods are sources of Pyridoxine (B-6)
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wide variety of foods
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WHat are symptoms of vitamin of Pyridoxine (B-6)
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Was used to treat PMS
1000x the RDA daily for 2 years- irreversible neurological damage |
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What does Pantothenic Acid do/ deficiency/ sources?
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B vitamin
Involved in energy release Deficiencies are rare Tons of sources |
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What does Biotin do/ source/ deficiency?
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B vitamin
Coenzyme Energy release Widespread sources, rare deficiencies |
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Why is water important to proper mineral function
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The charge on the ions pull the water in = osmotic pressure, Dissociate in water to form ions, Osmotic pressure causes fluid shifts, ls act as buffers and stabilizer pH, they absorb an release H+ to control pH
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What are some properties common among all minerals?
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Involved in fluid balance, Acid base balance
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What is the most common mineral toxicity? Deficiency?
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iron is both, compare to vitamin A that also is commonly toxic and deficient
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What are the functions of calcium
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Bone
Transmission of nerve impulses Maintaining muscle tone (w/o calcium the muscles can’t relax after contraction) Various metabolic roles |
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How is the blood calcium level regulated
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•The concentration of calcium in blood is in flux with that in bone, they go back in forth,
The concentration of calcium in the blood is maintained in a narrow range Bone is the calcium reservoir, extra/ lack in the blood- add/ take away from bone |
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Describe the absorption of calcium
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it is vary variable,
high during childhood (75%) and pregnancy (50%), lower in adults (30%) low intakes can be compensated for by a higher absorption rate but this is not sufficient to fully account for the deficit |
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What are the general recommendations for calcium intake
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Peak bone mass is acquired by about age 30
High intake to about age 24 to maximize bone mass Moderate intake after to maintain bone mass |
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WHat are good sources of calcium and how do they vary in their absorb-ability
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•Dairy products- 30% absorbed (milk, yogurt, cheese), low fat versions have more calcium, high fat (ice cream) has less because fat displaces calcium, none in butter or cream
Veggies (50% absorbed) dark green leafies (kale, collards, mustards, turnip greens, bok choy) Veggies (5% absorbed) contain oxalic acid that binds with the calcium making it insoluble (spinach, chard) Other plant foods (20% absorption) almonds, sesame, beans Miscellaneous sources- fish bones, stock made from bones, calcium fortified foods (tofu, orange juice, soy milk) stone ground wheat flour, tortillas that are ground with lime (helps niacin intake as well) |
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What does phosphorus do? What are the sources?
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•Bone
•DNA •Energy release (ATP-ADP) abundant sources |
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What does magnesium do
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•Most in bone
•Bone maintains blood levels •Muscle contraction •Hundreds of enzymes |
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What happens in a magnesium deficiency
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•Not often seen, need extenuating circumstances
•Poor intake (dietary deficiency) •High losses (vomiting, diarrhea |
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What are the sources of magnesium
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•Abundant
•Greens, grains |
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What does sodium do
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•Major positive extracellular fluid
•Nerve impulses •Muscle contraction •Deficiencies are rare |
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What happens in acute sodium excess?
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•Excess concentration in blood stimulates thirst
•Dilute with water and increase blood volume, stimulates urination •Lose excess water and salt •Kidneys regulate water and electrolytes |
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What is the difference between systolic and diastolic blood pressure
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systolic =pressure of the heart contraction
diastolic = pressure between heart beat |
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Why is systolic pressure higher than diastolic
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• Systolic will be higher than diastolic because to move the blood you have to overcome the residual pressure before the blood can move again
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What values are defined as high blood pressure
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greater than 140/90
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Why might a single reading of blood pressure give misleading results?
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blood pressure can be temporarily increased by stress, exercise etc
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What are some long term consequences of high blood pressure
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High blood pressure contributes to the development of atherosclerosis, heart attack, stroke, congestive heart failure (pumping against a high pressure wears out the heart
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Describe the setup of the DASH study
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3 different groups
control- low intake of fruits, veggies, dairy fruit/veggie group: high intakes of fruit and veggie but no extra dairy fruit veggie dairy group: high intakes of all, fruit, veggie, dairy |
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What were the results of the dash study
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those who had high intakes of fruits and veggies decreased bp by 7/3, those with high fruits, veggies, and dairy decreased bp by 11/6
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what is the effect of food processing on the sodium potassium ration
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food processing increases the sodium potassium ratio: more sodium, less potassium, fresh foods are usually the opposite
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what are the functions of potassium?
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•Major positive ion of intracellular fluid
•Transmission of nerve impulses •Maintain heartbeat |
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Which positive ion is extracellular, which is intracellular
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sodium is extracellular, potassium is intracellular
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what factors can cause a short term potassium deficiency?
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•Short term losses can be cause by diuretics, diarrhea, excessive or prolonged sweating, purging (eating disorders)
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What is a possible consequence of chronically low potassium levels
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•Low levels of potassium can lead to a cardiac arrhythmia , which can result in death, seen in eating disorders or prolonged hot weather exercise
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What foods are sources of potassium
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fruits and veggies
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What are the functions of chloride
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•Major negative ion
•Acid base balance •Fluid balance •Stomach acid •Major source is salt |
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WHat is the function of sulfur
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component of several amino acids
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What are the functions of iodine
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•Component of thyroxine (thyroid hormone)
•Thyroid hormone regulates BMR (thought iodine deficiency is not usually the cause of overweight) |
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What happens in an iodine deficiency?
|
"Goiter"- thyroid enlargement
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WHat causes iodine levels to be low in food sources
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poor soil concentration of iodine
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Why don't we see as many iodine deficiencies as we used to?
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•Iodine added to salt to compensate for low soil levels
•Dairy products are now an iodine source because iodine is used as a disinfectant •Bakery products added iodine products as dough conditioners |
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what are the functions of iron
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•Component of hemoglobin the part of the RBCs that transports oxygen
•Component of myoglobin- carrier of oxygen in muscle cells •Enzyme systems |
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WHat happens in an iron deficiency
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•Most common mineral deficiency
•Iron is pretty well stored so stores must be depleted first •Unable to synthesize hemoglobin, unable to produce RBCs, leads to undersized and too few RBCs- anemia |
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What can cause an iron deficiency/ when are demands higher
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•Can be caused by a dietary deficiency- low intake from food deprivation, eating foods with low nutrient density
•Increased needs for iron- pregnancy, growth in childhood, blood loss: injury, parasites, menstruation (pre –menopausal women have higher iron need) |