bones are living _________ that contain what three things?
organs
bone tissue
cartilage
connective tissue
__________ and __________ run within the channels in bone to support its activities
nerves, blood
bones provide __________ and ________________
strength and flexibility
contains about 65% inorganic minerals, providing the __________________ of bone
hardness
contains 35% organic structures for ?
strength, durability, and flexibility
what is most important for bone flexibility?
collagen
mineral crystals around collagen designed to bear weight
hydroxyapatite
compact bone that accounts for 80% of the skeleton and is the outer surface of bone
cortical bone
spongy bone that accounts for 20% of the skeleton and is found on the inside of bones
trabecular bone
increase in bone size
complete by age 18 in girls and 21 in boys
bone growth
shaping of bone
complete by early childhood
exercise and overweight increases thickness
bone modeling
recycling of bone tissue
bone remodeling
compactness of bones
bone density
when bones are strongest
peak bone density
surface of bones is broken down by osteoclasts
resorption
cells that erode the surface of bones
osteoclasts
new bone matrix formed by osteoblasts
formation
bone builder cells
osteoblasts
bone resorption and formation are ________ in young, healthy adults
equal
resorption ______________ new bone formation after age 40
exceeds
non-invasive measurement of bone density (T-score)
duel energy x-ray absorptiometry (DXA)
used to assess a person's risk for fracture and diagnose osteoporosis
t-score
t-score:
+1 and -1 =
-1 and -2.5 =
-2.5 =
normal
low bone mass
osteoporosis
the most recognized nutrient associated with bone health
calcium
functions of calcium:
provides ____________ for bone and teeth
assists with __________-_________ balance
assists in the transmission of _________ impulses
assists in _____________ contraction
maintains healthy ____________ _______________
initiates ______
structure
acid-base
nerve
muscle
blood pressure
blood clotting
regulates
the body's ability to absorb and utilize calcium
bioavailability
The body cannot absorb more than ___ mg of calcium at any one time.
500
as the amount of calcium in a meal goes up, the fraction absorbed goes __________
down
sources of calcium include:
dairy products
green, leafy veggies
fortified foods
fish with edible bones
excess dietary calcium is ?
excreted in the feces
high blood calcium
hypercalcemia
causes include: cancer or parathyroid hormone overproduction
symptoms include: fatigue, appetite loss, constipation, mental confusion, and calcium deposits in soft tissues
hypercalcemia
occurs from long-term calcium deficiency
osteoporosis
causes include: kidney disease, vitamin D deficiency, or diseases that inhibit the production of PTH
symptoms include: muscle spasms and convulsions
hypocalcemia
low blood calcium
Hypocalcemia
fat-soluble vitamin that can by synthesized by the body from exposure to UV rays from the sun
Vitamin D
considered a hormone because it's synthesized in one location and regulates activities in other parts of the body
Vitamin D
regulates blood calcium levels (regulates calcium and phosphorous absorption from the small intestine)
Vitamin D
Vitamin D stimulates ____________ when calcium is needed elsewhere in the body
osteoclasts
vitamin D source ergocalciferol is found in ?
plants and supplements
vitamin D source cholecalciferol is found in ?
animal foods and exposure to the sun
what occurs if you consume too much calcium?
hypercalcemia
what occurs if you don't consume enough calcium?
loss of bone mass from fat malabsorption
vitamin D deficiency in children
rickets (bowed legs)
vitamin D deficiency in adults
osteomalacia ("soft bones")
fat-soluble vitamin stored in the liver
vitamin K
plant (dietary) form of vitamin K
phylloquinone
The animal form of vitamin K produced by bacteria in the large intestine is
menaquinone
what are the two major jobs of vitamin K?
blood coagulation
bone metabolism
vitamin K also plays a role in __________ _____ production
gla" protein (bone protein)
secreted by osteoblasts (bone remodeling)
osteocalcin
in protein matrix of bone, cartilage, blood vessel walls, and soft tissues
may prevent calcification of arteries, reducing risk of CVD
matrix Gla protein
what are the major sources of Vitamin K?
synthesized by bacteria in the large intestine
green, leafy veggies
what if you consume too much vitamin K?
No known side effects from large quantities
What if you don't consume enough vitamin K?
reduced blood clotting
excessive bleeding
fat malabsorption
long term use of antibiotics can cause deficiency
infants are injected with this at birth
a major intracellular negatively charged electrolyte
critical in bone formation
required for proper fluid balance
component of DNA and ATP
phosphorus
sources of phosphorus?
milk
meats
eggs
legumes
processed foods for binding
soft drinks as phosphoric acid
excessive vitamin ____ supplements or phosphorus-containing antacids can cause high phosphorus levels (muscle spasms and convulsions)
D
_________ regulate blood magnesium levels
kidneys
functions of magnesium:
mineral found in bone _______________
cofactor for over 300 ______________ systems
required for ATP, DNA, and _____________
structure
enzyme
proteins
sources of magnesium?
green leafy veggies
whole grains
seeds
nuts....
what if you consume too much magnesium?
excess supplements cause diarrhea, nausea, cramps, dehydration, and acid-base imbalances
occurs in individuals with impaired kidney function
hypermagnesemia
results in hypocalcemia; associated with osteoporosis, heart disease, high blood pressure, and type 2 diabetes
hypomagnesemia
trace mineral stored in teeth and bones
fluoride
fluoride combines with calcium and phosphorus to form __________________ to form teeth
fluorohydroxyapatite
functions of fluoride:
develop and maintain __________ and _____________
combines with calcium and phosphorus to protect teeth from ________
stimulates bone ___________
teeth and bones
bacteria
growth
sources of fluoride?
Fluoridated dental products
Fluoridated water
(excess fluoride) increases the protein content of tooth enamel and makes teeth porous; teeth become stained and pitted
fluorosis
what happens if you don't consume enough fluoride?
Dental caries (cavities)
most prevalent disorder affecting bone health
osteoporosis
osteoporosis is characterized by:
low bone _________
deterioration of bone ____________
bone ___________________
mass
tissue
compaction
the shortening or hunching of the spine
kyphosis
______% of Americans with osteoporosis are women
80
women have a ___________ bone density than men
lower
low ____________ production increases bone loss
estrogen (postmenopausal women and teen girls that try extreme dieting)
______________ effects hormones that influence bone formation and resorption
smoking
associated with fractures
alcoholism
increases urinary calcium loss
caffiene
regular _______________ positively stresses bone tissues and stimulates bone density
exercise
what kind of activities can help increase bone mass?
weight-bearing (walking, jogging)
_______________ and _____________ consumption associated with improved bone health
fruit and veggie
is there a cure of osteoporosis?
no
factors that slow the progression of osteoporosis:
adequate __________ and vitamin ____ intake
regular _____________
________________ training
certain ___________________
calcium, D
exercise
resistance
medications
functions include:
transporting nutrients and oxygen to the cells
removing waste
blood
blood plays a role in _________ function through ?
immune, white blood cells
blood is a mechanism for _________ transfer
heat
red blood cells that transport oxygen throughout the body
erythrocytes
white blood cells that are key the to our immune system
leukocytes
cell fragments that assist in blood clotting
platelets
fluid portion of the blood that maintains adequate blood volume
plasma
iron is a component of oxygen-carrying _____________ in erythrocytes and _______________ in muscles
hemoglobin
myoglobin
___________ groups depend on iron to carry oxygen in hemoglobin
heme
component of cytochromes
iron
electron carriers within the metabolic pathways for energy production from macronutrients
cytochromes
what are the two types of iron in foods?
heme iron
non-heme iron
part of the hemoglobin and myoglobin, found only in animal-based foods and is more absorbable
heme iron
found in both plants and animals, not as easily absorbed
none-heme iron
the majority of iron in food is _________ iron
nonheme
most of the iron in animal-based foods is _______ iron
heme
factors that enhance iron absorption:
__________ factor
________________ acids
Vitamin _____
meat
stomach
C
transports iron and regulates intestinal absorption and release
ferroportin
iron-transport protein in blood
transferrin
where is iron stored?
liver, bone marrow, spleen
absorption of iron depends on:
amount ______________
amount ________________
___________ factors affecting absorption
consumed
needed
dietary
as cells break down, iron is ________________ and returned to the body's ________ _________
recycled
iron pool
RDA for iron?
8 mg for men
18 mg for women
most common cause of poisoned deaths in children
symptoms: nausea, vomiting, diarrhea
accidental iron overdose
excessive absorption of dietary iron and altered iron storage
hemochromatosis
most common nutrient deficiency in the world
iron deficiency
caused be a decrease in iron stores
iron depletion (stage I)
occurs with decreased iron transport
iron-deficiency erythropoiesis (stage II)
results in reduced normal, healthy read blood cell production, decreased size, and inadequate hemoglobin
iron-deficiency anemia (stage III)
functions of zinc:
component of _______________ (heme synthesis)
maintain _________________ integrity and shape of proteins (zinc fingers)
assist in ______________ gene expression
enzymes
structural
regulating
regulates absorption and release of zinc
metallothionein
RDA for zinc?
Men: 11 mg
Women: 8 mg
sources include red meats, some seafood, whole grains, enriched grains and cereals
zinc
toxicity can occur from supplements
symptoms: intestinal pain, cramps, nausea, vomiting
depressed immune function
too much zinc
deficiencies are uncommon in the US
symptoms include growth retardation, diarrhea, delayed sexual maturation, hair loss, impaired appetite, and infections
zinc deficiency
functions of copper:
required for ________ transport
cofactor in __________ metabolism and for connective tissue _____________
part of _________________ ______________ antioxidant enzyme system
regulates ______________________________ (serotonin)
iron
energy, production
superoxide dismutase
neurotransmitters
more copper is absorbed with _______-_____________ diet
low-copper
RDA for copper?
900 mg/day
sources include organ meats, seafood, nuts, seeds, whole-grain foods
copper
toxicity is not studied well
symptoms: abdominal pain, nausea, diarrhea, vomiting, liver damage (Wilson disease)
copper toxicity
deficiency is rare
symptoms: anemia, reduced white blood cells, osteoporosis (children - bone demineralization)
copper deficiency
fat-soluble vitamin important for both bone health and blood health
vitamin K
function of vitamin K:
coenzyme assists in synthesizing _____________ _______________ proteins
blood coagulating
AI for vitamin K?
120 micrograms male
90 micrograms female
sources include leafy veggies, soybean and canola oils
vitamin K
no known side affects for too much of this
vitamin K
deficiency is rare
blood fails to clot, bleeding, hemorrhaging
newborns lack intestine bacteria to produce this (injection at birth)
vitamin K deficiency
essential for heme synthesis
vitamin B6
RDA for B6?
1.3 mg/day
sources include meats, poultry, fish, soy-based foods, cereals, and starchy veggies
B6
vitamin b6 deficiency can cause ________________ _________ anemia and impairs protein metabolism
microcytic hypochromic
one of the B vitamins and is used for all forms of food folate with biological function, folic cid in supplements, and enriched and fortified foods
folate
functions of folate:
DNA and amino acid ______________
______________ division and differentiation
functions with b12 and b6 _______________
synthesis
cellular
metabolism
RDA for folate?
400 micrograms/day
sources include breads, flours, pasta, and grain products
liver, spinach, lentils, oatmeal, and asparagus
folate
serum levels of folate begin to decline
negative folate balance (stage I)
low serum and red blood cell folate
folate depletion (stage II)
folate levels are so low that erythropoiesis is inhibited
folate deficiency erythropoiesis (stage III)
the number of red blood cells has declined because folate is not available for DNA synthesis, and microcytic anemia develops
folate deficiency anemia (stage IV)
larger than normal red blood cells that inhibit adequate oxygen transport
Symptoms: fatigue, irritability, difficulty concentrating, headaches, shortness of breath, reduced capacity to work
microcytic anemias
functions of vitamin b12:
coenzyme for ________ synthesis
regeneration of ___________ acid
DNA
folic
RDA for B12?
2.4 micrograms/day
as b12 absorption declines, the blood level of b12 attached to its transport protein also declines
negative vitamin b12 balance (stage I)
blood levels of b12 attached to its transport protein continue to decline
vitamin b12 depletion (stage II)
the body's level of b12 is so low that the ability to synthesize new red blood cells is inhibited
vitamin b12 - deficiency erythropoiesis (stage III)
the number of red blood cells has declined because b12 is not available for DNA synthesis, and macrocytic anemia develops
vitamin b12 - deficiency anemia (stage IV)
found primarily in dairy products, eggs, meat, poultry, fish, and shellfish
b12
b12 requires acidic environment and protein _____________ ____________ for absorption
stored in the __________
intrinsic factor
liver
deficiency is rare, but associated with dietary insufficiency or reduced absorption
b12
results in reduced intrinsic factor production (deficiency that is the end stage of autoimmune disorder that causes the loss of various cells in the stomach
pernicious anemia
protects the body from infectious diseases
helps heal wounds
guards against the development of cancers
a healthy immune system
what are the two parts of the immune system?
nonspecific and specific
the body's defense against microbes, airborne particles, venom, ingested toxins (also called innate immunity)
inflammatory response causes discomfort, loss of appetite, fatigue, and fever
nonspecific immune system
directed against recognized antigens
induces antibodies to destroy an invader
specific immune system
remain in circulation
two main types are B and T cells :)
memory cells
what are the four ways of acquiring specific immunity?
1. have the disease
2. vaccinations
3. maternal antibodies
4. antiserum injection (snakebite)
these types of malfunctions cause chronic inflammation and infection:
______________ reactions
_____________________ response
common in __________________ individuals
______________ deficiency diseases
allergic
autoimmune
malnourished
immune
increases the risk for infection
protein-energy malnutrition
decreased ___________________________ is a sensitive indicator of reduced nutritional status
immunocompetence
increases incidence of infections
delays wound healing
poor antibody response to vaccination
obesity
precursors for signaling molecules called eicosanoids
essential fatty acids
maintains mucosal surface
Vitamin A
protect cell membrane from reaction oxygen species
Vitamins C and E
important for immune functions, gene expression, and enzyme activation
zinc
coenzyme for glutathione peroxidase
promotes B and T cell proliferation
antibody production
selenium
part of the superoxide catalase and dismutase
Deficiencies reduce immune response
iron and copper
excessive ________ can impair immunity
iron
can cause illness/infection reduces appetite and overall energy intake
reduced food intake
infections alter _______________ status
increased ______________ loss
increased resting metabolic rate with ___________
redistribution of energy and nutrients to enhance the ____________ response
nutrient
nutrient
fever
immune
What is a healthful body weight?
appropriate for _________
achievable and sustainable without constant ______________
compatible with ___________ BP, lipid levels, and glucose tolerance
based on ______________ background and family history
supported by go
age
dieting
normal
genetic
eating, activity
you
what are the three ways of determining if a person's body weight is healthful?
BMI
body composition
fat distribution
represents the ratio of a person's weight to he square of his or her height
body mass index
equation for BMI
(weight/height^2) x 703
BMI values below ___ or above ___ have increased health risks
18.5, 30
BMI less than 18.5
having too little body fat to maintain health
underweight
BMI between 18.5 and 24.9
normal weight
BMI between 18.5 and 24.9
having a moderate amount of excess body fat
overweight
BMI between 30 and 39.9
having excess body fat that adversely affects health, increasing disease risk significantly
obese
BMI greater or equal to 40
body weight exceeding 100% of normal, a very high risk for serious health conditions
morbid obesity
limitations of BMI:
not an indication of body _________________
not appropriate for use in ________ adults and ____________
doesn't account for physical and metabolic ___________________ in ethnic backgrounds
composition
older, children
differences
estimate body composition by assessing __________ ________ and ________ _________ _______
body fat
lean body mass
what are the ways of measuring body composition?
_________________ weighing
_______________ measurements
bioelectric impedance ____________
near-infrared _______________
duel-energy ______ absorptiometry
underwater
skinfold
analysis
reactance
x-ray
upper body fat patterning associated with increased risk of chronic diseases (more common in men)
apple-shaped fat patterning
lower body fat patterning associated with no significant increased chronic disease risk (more common in women)
pear-shaped fat patterning
what should the waist-to-hip ratio be?
men: higher than .90
women: higher than .80
what should waist circumference be?
men: above 40 in
women: above 35 in
what do fluctuations in weight depend on?
energy intake and energy expenditure
Energy Balance Equation
energy intake = energy expenditure
kcal from food and drink
energy intake
energy expended at rest and during physical activity
energy expenditure
Carbs = ___ kcal/g
4
Protein = ___ kcal/g
4
Fat = _____ kcal/g
9
alcohol = ____ kcal/g
7
what three components make up 24-hour energy expenditure?
basal metabolic rate (BMR)
thermic effect of food (TEF)
energy cost of physical activity
a method that measures the amount of heat the body releases
direct calorimetry
estimates energy expenditure by measuring oxygen consumption and carbon dioxide production
indirect calorimetry
energy expended to maintain basal (resting) functions of the body
basal metabolic rate
primary determinant of BMR is the amount of ________ _______ _______ in the body.
lean body mass
energy expended to process food (about 5-10% of the energy content of a meal)
thermic effect of food (TEF)
about 15-35% of total daily energy output
energy cost of physical activity
BMI is based on genetic factors (______ to _____%) and nongenetic, environmental factors and lifestyle choices (____ to _____%)
50 to 90
10 to 90
common gene that may stimulate excessive food intake and reduce the feeling of satiety
fat mass and obesity- associate gene (FTO)
proposes that a gene causes people to be energetically thrifty
protects from starvation during times of extreme food shortages
gene has not been identified
thrifty gene theory
suggests that body weight stays within a narrow range
compensates for changes in energy balance and keeps a person's weight at his or her set point
set-point theory
metabolic factors that influence weight:
Relatively low _____________ rate
low level of spontaneous ___________ activity
low sympathetic ___________ system activity
low fat _________________
abnormally low level _____________ hormone
certain _____________
metabolic
physical
nervous
oxidation
thyroid
medications
hormone produced by adipose tissue, acts to reduce food intake
leptin
hormone produced in the stomach, stimulates appetite
ghrelin
protein produced in GI tract, decreases appetite
peptide YY (PYY)
uncoupling proteins in __________ ________ tissue increase energy expenditure
brown adipose
psychological drive to eat
appetite
disease linked to obesity
hypertension
dysipidemia
diabetes
heart disease
stroke
a cluster of factors that increases risk for heart disease, type 2 diabetes, and stroke
metabolic syndrome
what are the factors of metabolic syndrome?
abdominal obesity
triglyceride levels
HDL cholesterol levels
blood pressure
fasting blood glucose
what is the treatment for obesity?
diet and exercise
act as appetite suppressants and may increase satiety
obesity medications
speed up metabolic processes, are controversial, and may be dangerous
stimulants (caffeine, etc.)
considered a last resort for morbidly obese treatment
bariatric surgery
what are the types of bariatric surgery?
vertical band gastroplasty
gastric bypass surgery
gastric banding
liposuction
what type of diets are characterized by balanced nutrients, gradual weight loss, and energy deficits of 500-1,00 kcal/day?
high-carb, moderate fat and protein diets (Jenny Craig, DASH, USDA food guide)
what type of diets are characterized by 55-65% of total energy intake as fat and remaining energy from protein and causes ketosis
low-carb, high fat and protein diets (Dr. Atkins' diet revolution, sugar busters, paleo diet)
very low fat diets that emphasize complex carbs and fiber, regular physical activity, etc.
low-fat and very low-fat diets
set realistic goals that are ?
specific
reasonable
measurable
condition that is just as harmful as obesity
being underweight
ways to gain weight:
limit _______
eat _____ to _______ extra kcal a day
eat _______________ throughout the day
avoid _____________
exercise regularly with ___________ training
fat
500 to 1,000
frequently
tobacco
resistance
do NOT enhance muscle gain or result in improvements in strength
protein supplements
general term used to describe a variety of atypical eating behaviors that people use to achieve or maintain a lower body weight
occur on a continuum
disordered eating
psychiatric conditions involving extreme body dissatisfaction and long-term eating patterns that negatively affect body functioning
eating disorders
self-starvation leading to a severe nutrient deficiency
anorexia nervosa
recurrent episodes of extreme overeating and compensatory behaviors to prevent weight gain
bulimia nervosa
potentially deadly eating disorder that affects more women than men
extremely restrictive eating practices
intense fear of gaining weight
anorexia nervosa
no menstrual periods for at least 3 months; occurs with insufficient energy to maintain normal body functions
amenorrhea
health risks of anorexia nervosa include:
energy and nutrient _____________
_______________ imbalance
_____________________ problems
__________________________ problems
___________ problems
deficiency
cardiovascular
gastrointestinal
bone
what is the best chance for recovery from anorexia nervosa?
early intensive treatment
eating disorder characterized by repeated binge eating followed by purging
bulimia nervosa
feels a loss of self-control, a sense of euphoria, "a drug-induced high
binge eating
large quantity of food eaten in a short period of time
binge
occurs after most binge eating episodes
purging
symptoms include:
recurrent episodes of binge eating
recurrent inappropriate compensatory behavior to prevent weight gain
binge eating occurs on average at least twice a week for 3 months
body shape and weight unduly influence self-starvation
bulimia nervosa
signs of bulimia nervosa include:
chronically inflamed and sore _________
swollen _________ in the neck and below the jaw
throat
glands
health risks of bulimia nervosa:
_________________ imbalance
_______________________ problems
______________ problems
electrolyte
gastrointestinal
dental
occurs after stressful events
occurs about two weekly, not following by purging
certain foods act as triggers
binge eating
people who are not hungry during the day, but eat in the evening and night have what?
combination of eating disorder, sleep disorder, and mood disorder
night-eating syndrome
serious syndrome in some active females
low energy availability
amenorrhea
Osteoporosis
female athlete triad