Comprehensive Guide to Nutrition, Carbohydrates, Energy, and Diabetes

Updated : 07/2022 NSC 310 Module 2 Exam Study Guide How to USE this guide: 1. Download this study guide at the start of the module. Review it before you begin reading to get an understanding of what you will be reading about. 2. Fill in answers to the questions/prompts and make notes as you learn about each topic through the readings, presentations, and other course content. You should do additional research on topics beyond the assigned readings if these topics are unclear and you need further clarification. 3. Use this guide as a place to compile all the module content so your exam time is not spent on looking up answers in the textbook/additional material. You will be allowed to utilize this study guide and any other notes you have collected while taking this exam. How NOT to use this guide: 1. This study guide will not provide you with explicit/overt exam questions/answers. This is a 300-level course and critical thinking is a necessary skill. Connections between seemingly unrelated concepts may need to be made. 2. If a specific sub-topic is (or is not) listed on this guide, it does not mean it will (or will not) be covered on the module exam. This is only a guide – always refer to e-text/articles/charts/informationals/videos. Module Reading/Review Module 2: TOPICS: Nutrition and Society, Carbohydrates, Energy from Nutrients, & Diabetes ● ● ● ● ● ● ● Comparing diets and dietary trends. Food costs, inflation, and food security. Nutrition and your health. Carbohydrate – digestion and absorption. Carbohydrate – functions within the human body. Carbohydrate – health consequences and benefits. Metabolism and the main processes of energy productions and utilization. ● Prediabetes. ● Type-1 and Type-2 Diabetes. ● Nutritional implications of prevention and treatment of diabetes. ❖ Social Identities – review documents found in the “Articles, Charts, & Informationals” Module. 1. NUTRITION AND SOCIETY: The intersection of food and society; from sustainable practices, through historical and cultural influences on food choice, to economic concerns and food security.yle. ● ● What is the difference between health and wellness? -Health: is regarded merely as the absence of illness -Wellness: is a state of optimal well-being that enables an individual to maximize their potential. This concept includes a host of dimensions such as physical, mental, emotional, social, environment, and spiritual. These dimensions are the things that can affect an individual’s quality of life. How have dietary food trends changed over time? Updated : 07/2022 -Hundreds of years ago, when food was less accessible and daily life required a vast amount of physical activity Special Dietary foods: These foods do not have to be administered under a doctor’s care, and can be found in a variety of stores. Similar to medical foods, they address special dietary needs and meet the nutritional requirements of certain health conditions. For example, a bottled oral supplement administered under medical supervision is a medical food, but it becomes a special dietary use food when it is sold to retail customers. Ex: Gluten-free foods, lactose-free dairy products, and formulas and shakes that promote weight loss. ● What are functional foods? Functional foods: -Functional foods are generally understood to be a food, or a food ingredient, that may provide a health benefit beyond the traditional nutrients (macro and micronutrients) it contains. Functional foods are often a rich source of phytochemicals or zoochemicals, or contain more of a certain nutrient than a normal food. There are four types of functional foods, which are conventional foods, modified foods, medical foods, and special dietary foods. .-Conventional foods: It represents the simplest form of functional foods. These are whole foods that haven’t been modified. Ex: Fruits & Vegetables (abundant in phytochemicals and antioxidants), and Yogurt & Kefir (which contains a natural probiotic bacteria that can help maintain digestive system health), and moderate amounts of dark chocolate that is made with 70% or more cacao (which contains antioxidants). -Modified foods: Foods that have been fortified, enriched, or enhanced with additional nutrients or bioactive compounds. The foods are modified by using biotechnology to improve their nutritional value, and health attributes. Ex: Calcium-fortified orange juice, breads enriched with B vitamins, iodized salt, cereals fortified with vitamins and minerals, margarine enhanced with plant sterols, and energy drinks that have been enriched with herbs (ginseng or guarana) or amino acids (taurine). Medical foods: They are foods that are designed for enteric administration under the guidance of a medical profession. (During enteric administration, food is treated so it could go through the stomach undigested. Instead , the food is breaking down into the intestines only). These foods are created to meet very specific nutritional requirements. Ex: Liquid formulas for people with kidney disease, liver disease, diabetes, or other health issues.--- Medical food is also given to comatose patients through a gastronomy tube because they cannot eat by mouth. Use the table below to describe each diet and whether it falls under the category of a fad diet or backed by scientific evidence. Diet The DASH Diet Description/Key Features of Diet -Dietary Approaches to Stop Hypertension: focuses on reducing sodium intake to either 2,300 milligrams per day (as recommended Pros Cons Is this a fad diet or scientifically sound? -Recommended by the -There are very few -Scientifically Sound National Heart, Lung, negative factors and Blood Institute, associated with the the American Heart DASH diet. Association, and many -Risk for hyponatremia physicians Updated : 07/2022 by the Dietary Guidelines for Americans) or 1,500 -Helps to lower blood milligrams per day for pressure and certain populations. This diet is an evidence-based cholesterol. eating plan that can help reduce high blood pressure. -Reduces risk of heart -DASH dieters are recommended to consume disease and stroke a variety of whole grains and high-fiber fruits and -Reduces risk of vegetables, and moderate amounts of low-fat dairy certain cancers products, lean meats, and heart-healthy fish. -Reduces diabetes risk The Gluten-Free Diet Low-Carb Diets -The gluten-free diet helps -Reduces the -Risk of folate, iron, people whose bodies symptoms of gluten thiamin, riboflavin, cannot tolerate gluten, a intolerance, such as niacin, and vitamin B6 protein found in wheat, chronic diarrhea, deficiencies. barley, and rye. It is cramping, -Special gluten-free prescribed for patients constipation, and products can be hard with gluten intolerance bloating. to find and expensive. and celiac disease, an autoimmune disorder with -Promotes healing of the small intestines for -Requires constant a genetic link. vigilance and careful -A gluten-free diet should people with celiac food label reading, disease, preventing be followed only with a since gluten is found in malnutrition. physician’s many products. recommendation. -People who have celiac -May be beneficial for disease cannot consume other autoimmune diseases, such as gluten products without damaging their intestinal Parkinson’s disease, rheumatoid arthritis, lining. -It emphasizes fresh fruits, and multiple sclerosis. vegetables, and other foods without gluten. -Low-Carb diets include the -Restricts refined -Not entirely evidenceAtkins and the South carbohydrates, such as based. Beach Diet, focusing on white flour and white -Results in higher fat limiting carbohydrates sugar. and protein such as grains, fruit, and -May temporarily consumption. starchy vegetables to improve blood sugar -Does not meet the promote weight loss. The or blood cholesterol RDA for carbohydrates theory behind this type of levels. to provide glucose to diet is that insulin prevents the brain. -Fad Diet -Fad Diet Updated : 07/2022 the breakdown of fat by allowing sugar in the form of blood glucose to be used for energy. -Proponents of this approach believe that because limiting carbs generally lowers insulin levels it would then cause the body to burn stored fat instead. The Macrobiotic Diet -Diet that focuses on foods -Low in saturated fats -Not entirely -Fad Diet that are low in saturated and high in fiber. evidence-based. fats and high in fiber, -Emphasizes whole -Lacks certain vitamins which can help to lower foods and and minerals; the risk of cardiovascular de-emphasizes supplements are often disease. processed foods. required. Part of a health and -Rich in -Can result in a very wellness regimen based in phytoestrogens which low caloric intake. Eastern philosophy. It may reduce the risk of -Lack of energy may combines certain tenets of estrogen-related result from inadequate Zen Buddhism with a cancers. protein. vegetarian diet and supports a balance of the oppositional forces of yin and yang. -Foods are based on their so-called yin and yang characteristics. -Yin foods are thought to be sweet, cold, and passive. -Yang are considered to be salty, hot, and aggressive. -A diet that focuses on -A reduced risk of -Does not specify daily -Scientifically Sound The Mediterranean Diet small portions of cardiovascular disease serving amounts. nutritionally-sound food. and mortality. -Potential for high fat -The diet features food -A lower risk of cancer. and high calorie intake from plant sources, -De-emphasizes as nuts and oils are including vegetables, fruits, processed foods and calorie-dense foods. whole grains, beans, nuts, emphasizes whole -Drinking one to two seeds, breads, potatoes, foods and healthy fats. glasses of wine per and olive oil. -Lower sodium intake, day may not be -Limits the consumption of due to fewer healthy for those with processed foods and processed foods. certain conditions. recommends eating locally -Emphasis on grown foods rich in monosaturated fat micronutrients and leads to lower antioxidants. cholesterol. Updated : 07/2022 The Raw Food Diet -This eating plan includes -Highlighting fruits and consuming fish and poultry vegetables raises at least twice per week, consumption of eating red meat only a few antioxidants. times per month, having up to seven eggs per week, and drinking red wine in moderation. -It incorporates low-fat cheese and dairy products, and it substitutes olive oil, canola oil, and other healthy oils for butter and margarine. -More than fifty years of nutritional and epidemiological research has shown that people who follow the Mediterranean diet have some of the lowest rates of chronic disease and the highest rates of longevity among the populations of the world. -Followed by those who -Emphasizes whole avoid cooking as much as foods. possible in order to take -Focuses on advantage of the full nutritionally-rich nutrient content of foods. foods. -The principle behind raw foodism is that plant foods in their natural state are the most wholesome for the body. -This diet is not a weight-loss diet plan, it is a lifestyle choice. -People who practice raw foodism eat only uncooked and unprocessed foods, emphasizing whole fruits and vegetables. -Staples of the raw food diet include whole grains, beans, dried fruits, seeds and nuts, seaweed, sprouts, and unprocessed produce. -Food preparation mostly involves peeling, chopping, -Not entirely evidence-based. -Very restrictive and limits protein and healthy fat intake. -Could encourage the development of foodborne illness. -Extremely difficult to follow. -High in fiber which can cause essential nutrient deficiencies. -Fad Diet Updated : 07/2022 blending, straining, and dehydrating fruits and vegetables. -This eating method includes consuming foods that are high in fiber and nutrients, and low in calories and saturated fat. -Offers little in the way of protein, dairy, or fats, which can cause deficiencies of the vitamins A, D, E, and K. -Not all foods are healthier uncooked, such as spinach and tomatoes. -People who primarily eat raw foods should thoroughly clean all fruits and vegetables before eating them. -Poultry and other meats should always be cooked before eating. Vegetarian and Vegan Diets -Have been followed for -May reduce some -Guidelines regarding thousands of years for chronic diseases such fat and nutrient different reasons, including as cancer, heart consumption must be as part of a spiritual disease, and Type 2 followed. practice, to show respect diabetes. -Higher risk for for living things, for health -May help with weight nutrient deficiencies reasons, or because of reduction and weight such as protein, iron, environmental concerns. maintenance. zinc, omega-3, vitamin -For many people, being a B12. vegetarian is a logical -Consumption of a outgrowth of “thinking high fiber diet green.” interferes with mineral -A meat-based food system and nutrient requires more energy, bioavailability. land, and water resources -Vegetarian and vegan than a plant-based food protein sources are system. lower quality with the -This may suggest that the majority missing at plant-based diet is more least one essential sustainable that the amino acids. average meat-based diet in the US. -By avoiding animal flesh, vegetarians hope to look after their own health and -Fad Diet Updated : 07/2022 that of the planet at the same time. -Vegetarians eat beans, grains, and fruits and vegetables, and do not eat red meat, poultry, seafood,or any other animal flesh. -Some vegetarians, known as lacto vegetarians, will eat dairy products. -Others, known as lacto-ovo vegetarians, will eat dairy products and eggs. -A vegan diet is the most restrictive vegetarian diet-vegans do not eat dairy, eggs, other animal products, and some do not eat. -Well-balanced eating plans can lower the risk of a number of chronic conditions, including heart disease, diabetes, and obesity. -Help to promote sustainable agriculture. -If a vegetarian does not vary his food choices, the diet may not vary his or her food choices, the diet may be insufficient in calcium, iron, omega-3 fatty acids, zinc, and Vitamin B12. -People who follow these diets do not plan out their meals, they may gravitate toward foods high in fats. 2. CARBOHYDRATES: The chemical nature of this macronutrient, how it is digested and absorbed, and how it functions in the body. Define and give examples of the following types of carbohydrates: ● Monosaccharide – The simplest unit of a carbohydrate. Ex:Glucose,galactose, and fructose. ● Disaccharide –Composed of pairs of two monosaccharides linked together. Ex: Sucrose, lactose, and maltose. ● Polysaccharide – Complex carbohydrates are long chains of monosaccharides. Ex: Starches and fibers Updated : 07/2022 ● ● Starch –Carbohydrate molecules found in plants that can be digested in the small intestine, give glucose molecules to use for energy. Ex: Grains, legumes, and root vegetables, such as potatoes.---Amylose and amylopectin are two starch molecules. Fiber –Polysaccharides that are highly branched and cross-linked. Ex: Pectin, gums, cellulose, and hemicellulose. Digestion and Absorption of Carbohydrates ● Describe the mechanical and chemical digestion of carbohydrates from: o Mouth to stomach – Begins in the mouth. Chewing, also known as mastication, crumbles the carbohydrate foods into smaller pieces. The salivary glands in the oral cavity secrete saliva that coats the food particles. Saliva contains the enzyme, salivary amylase. This enzyme breaks down the bonds between the monomeric sugar units of disaccharides, oligosaccharides, and starches. The salivary amylase breaks down amylose and amylopectin into smaller chains of glucose, called dextrins and maltose. The increased concentration of maltose in the mouth that results from the mechanical and chemical breakdown of starches in whole grains, is what enhances their sweetness. Only five percent of starches are broken down in the mouth (this is a good thing as more glucose in the mouth would lead to more tooth decay). When carbohydrates reach the stomach no further chemical breakdown occurs because the amylase enzyme does not function in the acidic conditions of the stomach. But mechanical breakdown in ongoing-the strong peristaltic contractions of the stomach mix the carbohydrates into the more uniform mixture of chyme. o Stomach to small intestine – The chyme is gradually expelled into the upper part of the small intestine. Upon entry of the chyme into the small intestine, the pancreas releases pancreatic juice through a duct. This pancreatic juice contains the enzyme, pancreatic amylase, which starts again the breakdown of dextrins into shorter and shorter carbohydrate chains. Additionally, enzymes are secreted by the intestinal cells that line the villi. These enzymes, known collectively as disaccharidase, are sucrase, maltase, and lactase. Sucrase breaks sucrose into glucose and fructose molecules. Maltase breaks the bond between galactose and glucose. Once carbohydrates are chemically broken down into single sugar units they are then transported into the inside of intestinal cells. When people do not have enough of the enzyme lactase, lactose is not sufficiently broken down resulting in a condition called lactose intolerance. The undigested lactose moves to the large intestine where bacteria are able to digest it. The bacterial digestion of lactose produces gasses leading to symptoms of diarrhea, bloating, and abdominal cramps. o Small intestine to large intestine – Almost all of the carbohydrates, except for dietary fiber and resistant starches, are efficiently digested and absorbed into the body. Some of the remaining indigestible carbohydrates are broken down by enzymes released by bacteria in the large intestine. The products of bacterial digestion of the slow-releasing carbohydrates are short-chain fatty acids and some gasses. The short-chain fatty acids are either used by the bacteria to make energy and grow, are eliminated in the feces, or are absorbed into cells of the colon, with a small amount being transported to the liver. Colonic cells use the short-chain fatty acids to support some of their functions. The liver can also metabolize the short-chain fatty acids into cellular energy. The yield of energy from dietary fiber is about 2 kilocalories per gram for humans, but is highly dependent upon the fiber type, with soluble fibers and resistant starches yielding more energy than insoluble fibers. Since dietary fiber is digested much less in the gastrointestinal tract than other carbohydrate types (simple sugars, many starches) the rise in blood glucose after eating them is less, and slower. These physiological attributes of high-fiber foods (i.e. whole grains) are linked to a decrease in weight gain and reduced risk of chronic diseases, such as Type 2 diabetes and cardiovascular disease. Updated : 07/2022 Digestive Enzyme Amylase Maltase Sucrase Lactase Where Enzyme is Produced Salivary glands Intestinal mucosa The small intestine The small intestine What the Enzyme Breaks Down Starch Glucose Sucrose and maltose Lactose End Products of Digestion Maltose Glucose Glucose and fructose Glucose and galactose ● How does glucose get absorbed into the bloodstream after it is broken down in the small intestine? ● -After glucose is breaking down in the small intestine it gets transported into the liver where it is either used there or further distributed to the rest of the body. Where does glucose go after it is absorbed? -It goes to the liver. What happens to the extra glucose when it is consumed in excess? ● -When glucose is in excess it is stored away in the form of glycogen in a process that is stimulated by insulin. Maintaining Blood Glucose Levels: The Pancreas and the Liver ● What is insulin and how does it regulate the amount of glucose in the blood? -Insulin is a hormone produced in the pancreas which regulates the amount of glucose in the blood. Insulin helps control blood glucose by signaling the liver, muscle, and fat cells to take in glucose from the blood. ● What is glucagon and how does it regulate the amount of glucose in the blood? -A hormone formed in the pancreas which promotes the breakdown of glycogen to glucose in the liver. Glucagon triggers your liver to convert stored glucose into a usable form and then releases into your bloodstream. Glycemic Index ● What is the glycemic index (GI)? -A rating system for foods containing carbohydrates. It shows how quickly each food affects your blood sugar level when that food is eaten on its own. ● What are the limitations to using GI for choosing healthy carbohydrates? -Glycemic response to a particular food varies between individuals as well from day to day and even throughout different points within the day. Functions of Carbohydrates in the Body ● What is the main role of carbohydrates in the body? -Act as an energy source, control blood glucose and insulin metabolism. Also participate in cholesterol and triglyceride metabolism and helps with fermentation. ● What are the other functions of carbohydrates in the body? Energy production, energy storage, building macromolecules, and assisting in lipid metabolism. ● What is ketosis and how is it related to carbohydrate intake? Updated : 07/2022 -Ketosis is a metabolic condition resulting from an elevation of ketone bodies in the blood. It can be related to carbohydrate intake because it typically reduces carbohydrates. Health Consequences and Benefits of High-Carbohydrate Diets ● Define added sugars? Give examples of foods that may contain added sugars. -Sugar carbohydrates are added to food and beverages at some point before their consumption. Examples would be tea, coffee, fruit drinks, candy, deserts, etc. ● What is the connection between added sugar, obesity and chronic disease in the United States? -Added sugar consumption has been found to increase obesity and chronic disease rates. ● A teaspoon of added sugar is approximately ___ grams. -4 grams ● Why are whole grains part of a healthy diet? -They provide fiber, vitamins, minerals, and other nutrients. Carbohydrates and Personal Diet Choices ● Give examples of foods that contain slow-releasing and fast-releasing carbohydrates. ● ● ● -Glucose drinks and tablets, and pasta. What is the effect on nutrient density when "added sugars" are added to a product? -Decrease the nutrient density. How can the ingredient list on the nutrition facts label help you determine whether a carbohydrate is refined or not? -By checking the ingredients list. What are the benefits and health concerns of sugar substitutes? -Benefits would be fewer calories, but some studies do show that they might cause weight gain and cause an increase in some health conditions. 3. ENERGY FROM NUTRIENTS: The chemical reactions that occur within cells that take the energy stored in carbohydrates, lipids, and proteins, and convert that energy to a form that your cells can use to do the work of life. ● ● ● ● ● What is Cellular Respiration? Cellular respiration is the method with which biological fuels are transformed into energy by oxidation in the absence of an inorganic electron, such as oxygen, to power the huge synthesis of atp production. What are the different metabolic processes the cells can use to produce energy from nutrients? Anabolism is the method used to generate body tissues and energy reserves whereas catabolism is the process of destroying cellular components and energy reserves to get additional fuel for bodily processes called catabolism. Define Metabolism. the chemical reactions that take place inside a living thing to keep us alive. Define Anabolism, Reactions to generate complex organic compounds out of simpler ones are referred to as anabolic or biosynthetic. They are endergonic and entail dehydration synthesis to release of water. The breaking down of complex organic compounds into simpler ones is known as catabolism. Give an example of a body process for anabolism. The process of protein synthesis when peptide bonds are formed between amino acids is an illustration of an anabolic reaction. Updated : 07/2022 ● ● ● ● ● ● Define Catabolism. complex organic compounds are broken down into simpler ones. Catabolic or degradative reactions are exergonic, often hydrolytic, and are referred to as reactions. Give an example of a body process for catabolism. Glycolysis, in which one glucose molecule is broken down into two pyruvate molecules, is an illustration of a catabolic process. What is energy? In biology, cells frequently store energy in macromolecules, especially lipids and carbohydrates or glucose. Chemical bond creation, such as the redox processes of cellular aerobic respiration that releases energy . What types of energy does the body use in everyday functioning? Similar to how a car can only be powered by fuel, the human body can only be powered by chemical energy. The body can only employ adenosine triphosphate as a source of chemical energy or fuel while performing biological functions . What is ATP? ATP is a substance made up of adenosine and three phosphate groups, is hydrolyzed by enzymes to provide energy for several biochemical cellular activities. An amino acid is an organic monomer that is used to construct proteins. Differences between aerobic metabolism, anaerobic metabolism. Anaerobic respiration does not require oxygen, but aerobic respiration does. 4. DIABETES: Nutritional needs for certain chronic diseases (like diabetes) may be different from that of the normal, balanced person since many diseases are caused by lifestyle choices including poor nutrition. ● ● ● ● ● ● ● ● ● What is prediabetes? The definition of prediabetes means that the blood sugar level is higher than what the nromal level is supposed to be. It is not yet considered to be type 2 diabetes because the levels are not high enough. Review difference between Type 1 and Type 2 Diabetes. Review diagnostic criteria for diabetes. List symptoms of diabetes. o Loss of weight (even when not trying) o Fruity breath o Frequent urination o Increased fatigue o Feeling thirsty List risk factors for Type 2 Diabetes. o Obesity o Sedetary lifesyle o Family history List acute and chronic complication of diabetes. o Heart disease o high blood pressure o atherosclerosis o Nerve damage Know goals for glycemic control in adults. What is HgbA1c or HbA1c = glycosylated hemoglobin? o Hemoglobin test that will provide the patient with the results of their average blood sugar level over the course of the last 2 to 3 months. What are the dietary recommendations for diabetes? Updated : 07/2022 ● ● ● ● ● o Vegetables that are not starchy (ex. broccoli and carrots) o Fruits (ex. apple, bananas, and grapes) o Protein (ex. lean meats, fish, nuts, eggs, and chicken that is low in fat) o Lower sodium in the foods Understand the concept of exchange system – which foods contribute carbohydrates? o Grains- Pasta, rice, and bread o Fruits- apples, grapes, and bananas) o Dairy- milk and eggs What is Gestational Diabetes (GD)? o Diabetes that is developed during pregnancy when the patient did not have diabetes prior to pregancy How does GD affect risk for diabetes later in life? o Higher chance of developing type 2 diabetes in the future Know role of glucagon vs insulin in body. Give examples of complications a patient can experience with Type 1 and Type 2 Diabetes. o Type 1: o ● ▪ Eye problems ▪ Amputation ▪ Kidney ▪ Nerve damage ▪ Gum disease Type 2: ▪ Stroke ▪ Kidney problems ▪ Foot damage ▪ Skin conditions Explain what Diabetic Ketoacidosis is? o It is when the body is not able to produce enough insulin to allow the blood sugar in our cells to be able to use this for energy. 5. SOCIAL IDENTITIES: Know social identities to support communities in drawing strength from their intersecting social identities, finding a unique combination of qualities and capabilities that empower them. ● ● What four factors should be considered to better understand different social identities? o Culture o Location o Lifestyle o Perception What question(s) might someone ask to better understand cultural practices? Updated : 07/2022 o ● How would you describe your cultural identity? What question(s) might someone ask to better understand historical perspectives? o What led to this situation? o Do you think anything could have been done differently?