NUTR1023 Lecture Notes - Lecture 6: Exercise Physiology, Recall Bias, Yogurt

Many fad diets claim we should eliminate dietary carbohydrate in order to lose weight. The truth is that calories from all sources need to be managed for weight control For this discussion, read the following article: Rodriquez, D. (2013 Mar 27) Good vs.Bad Carbohydrates. Retrieved from http://www.everydayhealth.com/diet-nutrition/101/nutrition-basics/good-carbs-bad-carbs.aspx Next create a post that answers the following questions in your own words based on what you learned. 1) How does the information in the article compare to what you have heard about different types of carbohydrates? 2) Identify two specific choices (food or beverage) you might make in order to replace a ‘bad carb' with a ‘good carb' in your own diet. (Choose examples beyond those listed in the article and from two different food groups) 3) The average American tends to consume excessive simple and added sugars (‘bad’ carbs), while lacking in ‘good carbs’ from dairy, whole grains, fruit and starchy vegetables. Do you agree? Have you observed this? Think about a time when you have observed others eating at a restaurant, cafeteria, or even family members at home. Discuss your observation and thoughts about carbohydrate consumption of others.

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)

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.

Terry Page is a 42 year old male who presents to an outpatient GI clinic with stomach pain and intestinal complaints. Terry has had both diarrhea and constipation for many years. Ht: 5’8” Wt: 294lbs. Medical History: GERD, obesity, Colonoscopy was negative Diagnosis: IBS Medications: Omeprazole 5o mg BID (proton pump inhibitor) ; Vitamin D 600 IU; 800 mg calcium; Lomotil PRN (for diarrhea), Metamucil 1 Tbsp in 8 oz liquid BID Labs: Negative for stool cultures (bacteria). Significant labs from CBS, CMP: FBG = 115; Cholesterol = 201; LDL- C = 155; HDL-C = 32; Triglycerides = 181; HbA1c = 6.1; Diet History: Terry has a good appetite even with abdominal pain and diarrhea. He has gained 20 pounds in the past 5 years. He does not seem to find any foods that trigger diarrhea more than others but notices increased gas with broccoli or cauliflower. AM: Yogurt smoothie with 1 cup fresh fruit (peaches and cherries) with 8 oz low fat yogurt or dry cereal with dried fruit, nuts mixed with yogurt and 2-3 cups of coffee with half & half and artificial sweetener. Mid-morning: Diet Pepsi, ½ cup dried fruit and nuts Lunch: Salad with kidney beans or lentils, cheese, tomatoes, carrots, asparagus with Italian dressing (1/4 cup) and 12-15 wheat crackers and Diet Pepsi or Sandwich with lunchmeat, cheese and chips PM: Some type of meat with pasta or potatoes and a variety of vegetables and some type of bread or roll with butter. Snacks: Ice cream, cake or cookies, usually each night but lately has been trying sugar free cookies to help with weight loss. Drinks wine or beer 2-3 times per week.

1- What is inflammatory bowel disease? What does your textbook indicate regarding its etiology? (use page numbers from textbook as reference and as part of your answer) (4)

2. Before Terry’s IBS diagnosis, Terry searched his symptoms on Google and he thought he had ulcerative colitis or Crohn’s. How could this happen? What are the similarities and differences between IBS, Crohn’s disease and ulcerative colitis? Use textbook page references with your answer(4)

3. Which of Terry’s laboratory values indicate the presence of inflammation? (4)

4. What would be the primary nutrition concerns for Mr. Page? (3)

5. Prepare a food plan that may help with Terry’s IBS symptoms (6)

6. What is standard treatment for Terry’s diarrhea & abdominal pain with IBS? (4)