Nutrition Hmw One Forum and One DIET ANALYSIS ASSIGNMENT

1.
Forum:
You have learned quite a bit about micronutrients the past 2 weeks of content- additionally you have read recommendations on supplement intake in your lectures, and textbook.. Using this material, please state your current thoughts on whether you – personally – should be taking a vitamin or mineral supplement. You must justify your answer using the criteria discussed in the course content. Your posting and one response to a classmate is required for full credit.

2. DIET ANALYSIS ASSIGNMENT:

Vitamins, Minerals, Water

Name:_____________________________________

Date: _____/_____/_____ Section: ____________

FN235 Diet Analysis Project

Vitamins, Minerals & Water

20 points

Using your Diet Analysis Reports, classroom notes, & textbook, answer the following questions:

1. What are vitamins A (beta-carotene), C, & E classified as? What do they protect our body’s from? Please list 3 specific health problems or conditions that these nutrients may protect us from. 3 points

2. How does your intake compare to your recommendation? (is it “high >100%” “ <100% low” or “~100% adequate”) 1 point

a. Vitamin E

b. Vitamin C

c. Vitamin A

3. What changes could you make to your diet to more closely meet your recommendations? Provide a 3 examples of foods which are good sources for each… 3 points

a. Vitamin E

b. Vitamin C

c. Vitamin A

4. How many milligrams of sodium do you consume daily? How does your sodium intake compare to your recommendation? 1 point

5. Is it acceptable to be below the sodium DRI? Should you increase or decrease your intake & why? 1 point

6. What are some “big culprits”/in general, what foods are high in sodium (list at least 3)? 1 point

7. Is there an imbalance between sodium and potassium in your diet? Why is it important not to create an imbalance between the two of these? What condition may it lead to? 1 point

8. How much calcium do you consume daily? Does this meet your recommendation? 1 point

9. Why is calcium so important? What happens if we do not get enough calcium (think long-term)? With your calcium intake, are you at risk of any long-term consequences—explain. 2 points

10. What is the link between Calcium & Vitamin D in bone health? 1 point

11. What foods could you add to your diet to more closely meet your recommendations? List good sources for each nutrient which you will add to your diet if you are low 1 points

a. Calcium

b. Vitamin D

12. How much folate do you consume daily? Does this meet your recommendation? 1 point

13. Why is folate so important? Who REALLY needs to take a folic acid supplement, how much & why? 2 points

14. How much water do you consume daily? Does this meet your recommendation? 1 point

MINERALS
classification
Major minerals
needed in the body in the largest amounts
requirements >100 mg/day
calcium, sodium, potassium, phosphorus

There are many more minerals and trace elements, however, we will be focusing on the ones that are the most problematic in human nutrition and those which are important for chronic disease prevention.

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Calcium
Main functions:
bone/tooth formation
regulation of nerve transmission, blood clotting, contraction of muscles
helps maintain normal blood pressure
Stored in:
99% of the total calcium in the body is stored in the bones
1% of the total calcium in the body is found in the blood

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Calcium stored in the bones serves as a reservoir of calcium. Its there to help maintain blood calcium levels when intake of calcium is low.
A chronically poor intake of calcium, over a number of years, causes a lot of calcium to removed from the bones to supply the blood (which is used for more immediate needs like muscle contraction, nerve transmission, etc).

Eventually, calcium loss from the bones results in reduced bone density and this condition is known as osteoporosis. We will discuss osteoporosis in a bit.

Calcium has a low bioavailability so anything that you can do to enhance, and therefore, improve calcium absorption is important.
These are factors which enhance calcium’s bioavailability:
Vitamin D:
fortunately one of the best sources of calcium (milk) also contains Vitamin D. Women taking calcium supplements should also consider taking a calcium supplement that has some Vitamin D to help with absorption.
Lactose:
again, milk, our best calcium source also contains lactose. (What is lactose?)
Gastric acid:
is the acid secreted in your stomach for digestion; calcium absorption is enhanced in an acidic environment—since acid is secreted whenever you eat food, its best to take a calcium supplement with food.
Need:
any time you body needs more calcium, during pregnancy and periods of active growth such as infancy and adolescence, for example, our bodies can absorb more calcium

Factors which decrease Calcium absorption
Too much fiber in the diet
>35 gms/day
for most Americans, this is not a problem, since the average fiber intake is ~10-15 gms/day
Age
As we age, we produce less gastric acid
Excess use of laxatives
Too much phosphorus in the diet
Our main source of phosphorus is soda—and we drink a lot of soda, especially children and teens—which could be putting thier bones at risk, especially when they substitute soda for milk
Vitamin D deficiency
Too much coffee, tea

Osteoporosis
a chronic, degenerative disease
characterized by:
bone loss
decrease in bone density
2001:
1.5 million fractures annually
costs $17 billion/yr ($47 million per day)
prevention is key

. Bone loss from
osteoporosis
Normal bone

Bone loss occurs primarily in the
hips, spine and wrist

A DEXA scan is used to measure
bone density

Osteoporosis is a major public health threat for an estimated 44 million Americans

In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. 
Of the 10 million Americans estimated to have osteoporosis, eight million are women and 2 million are men.
34 million Americans, or 55% of the people 50 years of age and older, have low bone mass, which puts them at increased risk of developing osteoporosis and related fractures. 
Significant risk has been reported in people of all ethnic backgrounds.
While osteoporosis is often thought of as an older person’s disease, it can strike at any age

80% of those affected by osteoporosis are women.
20% of those affected by osteoporosis are men.
One in two women and one in four men over age 50 will have an osteoporosis-related fracture in their lifetime.
Osteoporosis is responsible for more than 1.5 million fractures annually, including:
300,000 hip fractures; and approximately 
700,000 vertebral fractures,
250,000 wrist fractures; and
300,000 fractures at other sites.

Osteoporosis Risk Factors
Increased age
Being female
Small boned, thin women
People with a history of anorexia nervosa
Caucasian/Asian women
Family history
Sedentary lifestyle
Smoking, heavy drinking
Long term use of certain medications such as prednisone

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Personal history of fracture after age 50
Current low bone mass
History of fracture in a 1° relative
Being female
Being thin and/or having a small frame 
Advanced age 
A family history of osteoporosis
Estrogen deficiency as a result of menopause, especially early or surgically induced 
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa 
Low lifetime calcium intake
Use of certain medications, such as corticosteroids and anticonvulsants
Low testosterone levels in men
An inactive lifestyle
Current cigarette smoking
Excessive use of alcohol
Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

Remember what a risk factor is??
It is something that increases the chances of developing a medical condition
The more risk factors one has, the higher the chance of developing the medical condition. Having one or even 2 risk factors does not necessarily mean one will definitely develop a problem, just that the chances are higher.

Preventing Osteoporosis
Consume adequate calcium and vitamin D in your diet– throughout life
Get regular physical activity, especially weight bearing exercise
Be moderation in alcohol/caffeine consumption
Prevention is key because currently, there is no cure

Treatment
Hormone replacement therapy (estrogen)
Calcium, vitamin D supplements
Drugs
Bisphosphonates
Alendronate (brand name Fosamax®)
Risedronate (brand name Actonel®)
Calcitonin (brand name Miacalcin®)
Raloxifene

Bisphosphonates are a family of drugs used to prevent and treat osteoporosis.
alendronate (Fosamax ®)
etidronate (Didrocal ®)
risedronate (Actonel ®).
How do they work?
Bisphosphonates bind permanently to the surfaces of the bones and slow down the osteoclasts (bone-eroding cells). This allows the osteoblasts (bone-building cells) to work more effectively.
How effective are they?
Bisphosphonates increase bone density and prevent fractures of the spine (vertebral fractures).

Calcium Needs
Women
age 19-50 1000 mg
> age 51 1200 mg
pregnancy 1000 mg
Men
age 19-50 1000 mg
Current average intake: 500-600 mg per day—only about half of what needs are

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Compare what is recommended to what our current intake is in the US:
500-600 mg/day
We only get about half our needs!

Food sources
milk, cheese, yogurt
foods made with milk/cheese (pudding, pizza)
Calcium fortified orange juice
Calcium fortified soy milk

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Calcium fortified orange juice and calcium fortified soy milk both have as much calcium in once serving as a glass of milk!

Calcium supplements
Who should take them?
people with lactose intolerance,
people who dislike milk
any one with a milk allergy (not the same thing as being lactose intolerant)

Side effects of calcium supplements
constipation, gas
decreases iron absorption
if you take an iron supplement for iron deficiency anemia, or to prevent anemia, take your calcium supplement and iron supplement at different times of the day

Tips for improving bioavailability from calcium supplements
calcium citrate is highly bioavailable (eg: Citracal)
take chewables (Tums with Calcium, Viactiv)
split your doses (take only 500 mg at a time)

take with food
don’t take more than 1500 mg/day
avoid oyster shell calcium, dolomite, bone meal, coral calcium

Phosphorus
Main functions:
assists many enzymes/vitamins to extract energy from ATP—adenosine triphosphate
component of cell membranes

bone structure

Requirements
same as calcium
excess phosphorus, esp. combined with poor calcium intake, may contribute to bone loss
Teens, or anyone, who drink a lot of soda and little or no milk are increasing the risk of bone loss…a real problem in the US

Deficiency
None— we have problems with excessive intake in U.S.

Food sources
Soft drinks, milk, cheese, baked goods, meat, food additives

Sodium (Na+)
Sodium chloride (NaCl) known as “table salt”
Main functions:
fluid/water balance
conduction of nerve impulses
glucose transport/absorption
acid-base balance

Physiological requirements: 500 mg/day
This is the amount we need every day to prevent a deficiency

Average U.S intake: 5000-8000 mg/day

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The minimum amount of sodium you need each day is 500 mg. Compare this to the average amount Americans consume each day!

Recommended intake for good health <2400 mg/day How does this compare with the average intake in the US? A grain of salt * A magnified view of a grain of salt. Food sources Table salt: 1 tsp = 2250 mg Naturally occurring Na Food serving size Na+ (mg) milk 1 cup 120 meat (raw) 3 oz 50 fruits ---- <10 vegetables ½ cup 5-50 Sodium is naturally present in almost all foods—so it is impossible to have a sodium free diet * Sodium is naturally present in almost all foods naturally. A cup of milk right from the cow contains 120 mg! Sodium Added During Processing Food serving size Na (mg) ham 3 oz 1200 bologna 2 slices 580 canned soup 1 can 800-1000 cottage cheese 1 cup 920 McDonalds shake medium 300 dill pickle 1 whole 850 soy sauce 1 tbsp 1029 * We get most of our sodium from salt added during processing…not from the salt we add at the table to foods. Remember what your physiological requirements are….if you eat one can of soup (not the low sodium kind) you are already consuming twice your needs and 1/3 of what is recommended for an entire day. Sodium content of select foods Taco bell bean burrito (1) 1100 mg McD. Quarter Pounder w/cheese 1300mg Pizza Hut Stuffed Crust Pizza (2 slices) 2850 mg Chicken wings (12) 1750 mg Kraft Mac and cheese (1 cup, prepared) 750 mg Taco Bell Taco (1) 330 mg American cheese (1 slice) 300 mg BK Whopper 900 mg * Processed foods and fast foods are generally high in sodium. Sodium: major food sources canned, cured, smoked meats bologna, salami, pepperoni, sausage, ham canned soups canned vegetables Bouillon, Ramen noodles olives, sauerkraut, anchovies chips, crackers seasonings (garlic salt, celery salt), MSG (monosodium glutamate) some frozen dinners Hypertension (high blood pressure) Blood pressure the measurement of how hard your heart has to work to pump blood from your heart to the rest of your body Optimal blood pressure: systolic <120 diastolic <80 Hypertension Causes of hypertension: 1. No known cause this type of hypertension occurs in 90-95% of people diagnosed with hypertension 2. Kidney disease kidney disease is the cause of hypertension in only 5-10% of people with hypertension The cause of high blood pressure is unknown in the majority of cases….there are many risk factors, but the exact cause is not known. For a small percentage of the US population, kidney disease causes their high blood pressure. * Symptoms None until significant organ damage has occurred Headaches, visual problems Hypertension is called the “silent killer” because there are no symptoms and therefore, most people do not know they have hypertension Long term complications of uncontrolled hypertension stroke kidney disease blindness/impaired vision heart failure * Hypertension is known as “the silent killer” because you can have high blood pressure for years and years and yet never know it because there are no outward signs or symptoms. That is why regular monitoring is important, especially if you are at high risk. You can have your blood pressure checked free of charge at most supermarkets and pharmacies. Hypertension Risk Factors older age as we age, our blood pressure increases family history obesity diabetes/insulin resistance Type 1 or 2 smoking, heavy alcohol intake African-American descent usually develop high BP at an earlier age and it can be more severe heart disease Hypertension: Prevention low to moderate sodium consumption lose weight if overweight eat a diet high in fruits, vegetables consume low fat dairy products, whole grains emphasize poultry, fish, nuts; eat less red meat get some exercise * These are the recommendations to reduce your risk of developing high blood pressure. If you already have high blood pressure, these recommendations can also help. The DASH diet The DASH diet is a plan that has been clinically proven to help reduce blood pressure Information regarding the DASH diet is available at the following website. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/ (Or download the pdf file about the dash diet linked on the syllabus) Read the article available at the CSPI website: http://www.cspinet.org/nah/dash.htm Potassium Main functions: conduction of nerve impulses critical in maintaining the heartbeat fluid and electrolyte balance Deficiency: 90% we eat is absorbed potassium has a high bioavailability Low blood levels may be caused by: excessive vomiting, prolonged diarrhea, certain diuretics, laxative abuse * bioavailability: refers to how much of the nutrient our bodies can actually absorb from foods. Potassium Toxicity can occur with potassium supplements (KCl) Food sources leafy greens (spinach) oranges, orange juice, broccoli, bananas, tomatoes * All fruits and vegetables contain potassium…those listed are especially high in potassium.

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