HLTH 220 Lecture Notes - Lecture 5: Dietary Supplement, Digestion, Submucosa

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26 Oct 2016

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Nutrient content claims are statements about the level or amount of a nutrient the product does or does not contain. : describe a relation between a good, food component, or dietary supplement ingredient and reducing risk of a disease or health-related condition. Health claims require a high standard of evidence: totality of the publicly available evidence must support diet-disease relationship of claim. Based on emerging evidence; require specific wording. Can t state the nutrient or compound can be used to treat a disease or condition. Do not require preapproval by the fba before being used on labels. Lecture 5 - digestion and absorption part 1. Foods must be digested to release their nutrients for absorption into the body. Digestion is the mechanical and chemical breakdown of food. Mechanical: chewing, grinding of food into smaller parts. Chemical: enzymes and digestive juices break chemical bonds to form absorbable nutrients. Mouth - esophagus - stomach - small intestine (duodenum) - large intestine (colon)

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Oat Bran Muffin
Nutrition Facts
Serving Size ¹/₂ muffin (2 oz/57g)
Servings Per Container 2
Amount Per Serving
Calories 245			Calories from Fat 120
					% Daily Value*
Total Fat 13g					20%
Saturated Fat 2g					10%
Trans Fat 0g
Cholesterol 30mg					11%
Sodium 250mg					10%
Total Carbohydrate 27g					9%
Dietary Fiber 5g					20%
Sugars 16g
Protein 5g
Vitamin A 2%		â¢		Vitamin C 2%
Calcium 2%		â¢		Iron 6%
* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.
	Calories					2,000	2,500
Total Fat	Less than					65g	80g
Sat Fat	Less than					20g	25g
Cholesterol	Less than					300mg	300mg
Sodium	Less than					2400mg	2400mg
Total Carbohydrate						300g	375g
Dietary Fiber						25g	30g

Ingredients

Whole Wheat Flour, Enriched Flour (Flour, Malted Barley Flour, Niacin, Reduced Iron, Thiamin Mononitrate, Riboflavin, Folic Acid), Sugar, Rolled Oats, Eggs, Soybean Oil, Oat Bran, Walnuts, Raisins, Water, Apples, High Fructose Corn Syrup, Wheat Bran. Contains 2% or less of the following: Food Starch - Modified, Soy Flour, Whey, Leavening (Baking Soda, Sodium Aluminum Phosphate, Monocalcium Phosphate), Salt, Potassium Sorbate, Propylene Glycol Monostearate, Mono- and Diglycerides, Sodium Stearoyl Lactylate, Cinnamon, Natural and Artificial Flavors, Caramel Color, Xanthan Gum, Calcium Sulfate, Lecithin.

Review the food label. Discuss if this is a good/healthy product to eat for breakfast every day. Focus on fiber, carbohydrate, fat,

if there would be a health or nutrient-content claim, the percent DV and ingredient list. I am looking for a comprehensive review

of this label.

1. Biological specimens such as urine, stool and saliva samples can be useful for identifying all of the following, except

A risk factors for disease

B characteristics associated with having the disease

C blood pressure

D presence of disease

2. Abstracts provide a glimpse into the content of an article?

A true

B false

3. Acquisition of evidence for improving clinical and public health practices and policies is an example of a societal benefit of health research?

A true

B false

4. Population health research objectives may include:

A identifying and classifying new health problems

B determining risk factors

C evaluating the impact of health policies on health outcomes

D al of the above

5. All of the following are examples of tests of physiological function, except:

A spirometry

B electrocardiography

C audiometry

D all of the above

6. Which is not an example of population based research?

A compare rates of acure lung disease in several metropolitan areas and see whether the rates of disease are correlated with local air quality

B determine whether survival following breast cancer diagnosis is linked to the presencw of certain genes

C conduct a vaccine trial

D analyze biochemical composition of selected foods

7. Health researchers examine all of the following factors that contribute to health and to disease illness disability and death except:

8. ____ is physiological measurements that can be accurately taken after minimal instruction.

A anthropometry

B basic vital signs

C clinical examinations

D biological specimens

9. Population based studies are typically conducted using:

A human subjects

B animals

C research facilities

D none of the above

10. The process of systematically and carefully investigating a subject in order to learn or discover new information about the world is known as?

11. When identifying specific exposures diseases and populations of interest identifying relevant statistics is not helpful.

A true

B false

12. Which of the following is not an example of an adittional assessment that can be conducted as a way to supplement self reported information during the data collection process?

A vital signs

B test of physiological function

C physical fitness tests

D surveys

13. To look for a health science abstract in PubMed one an use all of the following search methods except:

14. When conducting anthropometric measurements, there is no need for the researcher to ensure that the methods used to take these measurements are standardized

A true

B false

15. There is no need to read the full article if the abstract is available.

A true

B false

16. Which of the following is not an example of an examination a clinician can conduct to examine many health states that machines are unable to assess well?

A breath sounds and other respiratory functions

B heart sounds

C heart rate

D the condition of the skin hair and nails

17. Which is not a step in the research process?

A identify a study question

B select a study approach

C report study findings

D all of the above

18. A paragraph length summary of an article chapter or book is known as a

19. Health science abstracts usually provide a brief description of

A study design

B the study populatio

C key findings of the study

D all of the above

20. The goal of every research project is to find and address gaps in the literature and to build on precious work.

A true

B false

21. Which is not an example of laboratory research?

A compare tests of air quality in several metropolitan areas

B identify biological mechanisms for the emergence of drug resistant bacteria

C use a food frequency questionnaire to examine dietary behaviors in a selected population

D develop a new vaccine

22. If clinical examinations are conducted as part of the data collection process an assessment form should carefully describe each component of the examination procedure to be used and diagnostic procedure for each item on the assessment form

A true

B false

23. ____ is the measurement of the size/composition of the human body

A anthropology

B vital signs

C clinical examinations

D biological specimens

24. Health research is considered to be a scientific process only.

A true

B false

25. The goal of any one research project is to contribute vast amount of information that when pooled with other researchers information will provide evidentiary foundation for change

A true

B false

26. Which is an example of health abstract databases available from libraries via subscription

27. All of the following are examples of anthropometric measurements except:

A height

B waist circumference

C skinfold measurements

D blood pressure

28. All of the following are good sources of information that a researcher can use to explore what his primary area of research interest is except:

29. Which of the following is the most important publicly available health science database?

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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HLTH 220 Lecture Notes - Lecture 5: Dietary Supplement, Digestion, Submucosa

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