CHAPTER 1

Key Nutrition Concepts and Terms

A. What is Nutrition?
 How would you define nutrition?
 Is the typical American diet “nutritious”?
(And, by whose standards?)
 Most Americans think nutrition is too
complex… and they just give up.
A. (cont)
 Nutrition is the study of foods and
health.
 Involves studying food choices, and the
effects that specific food choices have on
health
 Involves chemistry, biology, and
behavioral/social science
 Socialscience: what we eat is also based upon
social setting!
Why Do We Choose The Food We
Choose?

 Taste/personal preference
 Habit
 Ethnic heritage/tradition
 Social interactions
 Convenience/availability
 Emotions (boredom? stress?
depression?)
B. What Does Our Food
Provide?
 Calories: a Calorie (or kilocalorie) is a unit of measure of the
energy supplied by food.
 Nutrients: chemical substances in food that are used by the
body for growth and health. Provide energy, form structures,
regulate body processes.
 Include lipids (fats and oils), proteins, carbohydrates, vitamins,
minerals, and water
 Phytochemicals: chemicals found in plants, giving them
color. Consumption of these has been linked with lower risk
of cancer and heart disease.
 Research on these is still relatively early-stage
 Antioxidants: chemicals that prevent or repair damage to
cells caused by oxidizing agents (naturally found in the
environment—we can’t avoid oxidizing agents)
1. Categories of Nutrients (Provided By Food).
We Will Look At Each In More Detail Later…

 Carbohydrates: consist of either a single sugar

molecule, or multiple sugar molecules linked
together. Provide the body with energy (our primary
source of fuel).
 Simple sugars: glucose, sucrose (table sugar). One or
two sugar molecules.
 Starches: complex carbohydrates consisting of a long
chain of glucose units (multiple sugar molecules linked
together)
 Dietary fiber: complex carbohydrates found mostly in
plant cell walls. Humans don’t have the enzymes required
to break apart the glucose units
 This is why the fiber stays intact/solid and cleans out our colon!

Simple and Complex
Carbohydates
1. Categories of Nutrients
 Proteins are composed of amino acids.
 Fats/lipids are not water soluble; they are soluble in
oil/fat.
 Saturated fats are found mostly in animal products. Diets
high in sat fats may elevate blood cholesterol levels.
 Unsaturated fats are found mostly in plants. They tend to
lower blood cholesterol levels.
 Essential fatty acids are unsaturated fats that are required in
the diet. (example: omega-3)
 Trans fats are unsaturated, but they have been found to
significantly increase the risk of heart disease. (found in
hydrogenated oil products… in the process of being banned by the
US!)
 Cholesterol is a colorless fat-soluble liquid found mostly in
animal foods.
1. Categories of Nutrients
 Vitamins: Humans require 13 different
vitamins in their diet. Vitamins are carbon-
based (structurally) chemical substances
found in food that perform specific functions
in the body.
 Minerals are also chemical substances (non-
carbon-based) that perform specific
substances in the body. Humans require 15
different minerals in their diet.
 Water: most humans require 11-15 cups of
water each day from food and fluids.
Note
 At this point in class, vitamins and
minerals (as broad categories) have the
same basic overall function. As
categories, their chemical structures are
different. We will learn more of the
details later.
a. Micro vs. Macro
 Macronutrients = carbohydrates, proteins,
and fat. Called macronutrients because we
need relatively large amounts of them in our
diet.
 Contain calories therefore supply the body with
energy.
 Micronutrients = vitamins and minerals. Still
necessary, but only in small amounts
(milligram or microgram per day). Provide no
energy for the body (because they contain
no calories).
What Do You Think…
 … about the name of this supplement?
Can it actually provide “new energy”?
Following Up…
 …on the previous slide. Supplements
that don’t contain calories CANNOT
provide energy!
 However, they may do so indirectly by
helping break down macronutrients more
easily!
2. Essential/Nonessential Nutrients

 Essential nutrients are those which we are required to

consume in our diet, since our bodies cannot assemble
them from other components or produce them elsewhere.
 Examples: vitamin D, calcium, iron
 Different people need different amounts based on age, biological
sex, disease state, body type, if they’re pregnant, drug use,
exposure to environmental contaminants, genetic traits…
 Nonessential nutrients are also required for normal
growth and health, but our bodies can manufacture them
from other dietary sources, so we do not need to consume
them.
 NOTE! “Nonessential” does not mean that we don’t need these
nutrients! (Just that we don’t need to consume them…)
 Example: cholesterol, some amino acids
Essential Nutrients for Humans
Quick Check…
 Are trans fatty acids saturated or
unsaturated?

 (answer on slide 8)
a. Nutrient Intake Standards
 First developed in response to high
rejection rate of WWII recruits! (1943—
they were weak/lacked muscle)
 The intake standards are continually
updated. Used to be called RDAs
(Recommended Dietary Allowances), but
now called DRIs (Dietary Reference Intakes)
 DRIs are designed to meet the nutrient
needs of 97-98% of healthy people as well as
promote health and reduce risk of chronic
disease
DRIs
 Consist of several categories, but we’ll
only learn 2 in this class:
 The Recommended Daily Allowance (RDA) of
a nutrient, sufficient for 97% of healthy
individuals, calculated from scientific
research: how much should I consume?
 Tolerable Upper Intake Levels (UL)—the
highest average daily intake level likely to
pose no risk of adverse health effects to
almost all individuals in a defined group:
what is the limit?
 Dietary Reference Intakes (DRIs)

 Recommend intake
levels and safe upper
intake levels that:
 Meet the needs of 97%
of healthy people
 Promote health and
reduce risk of chronic
disease
a. Nutrient Intake Standards
(cont)
 Tolerable Upper Intake Levels (ULs) are the
maximum recommended amount of a nutrient.
Consuming more than the UL could cause toxicity
reactions and other adverse effects.
 The EER – Estimated Energy Requirement – is the
average amount of energy (kilocalories) required to
maintain healthy weight for a particular category of
person (height, weight, age, biological sex)
 Special categories such as pregnancy (need for
additional calories for breastfeeding) and childhood
(need for additional calories to support growth) are
taken into account
Note The Difference!
EER refers to number of Calories.

The other reference values (RDA, UL) refer

to amounts of nutrients (g, mg, mcg)
Optimal Nutrient Intake
True or False:
 Nonessential nutrients are nutrients that
our body does not need.

(answer is on slide 14)

b. Nutrient Function at the Cellular Level

 Cells are the building blocks of our body tissues,

and they use the nutrients that we eat
 Problems arise when a cell’s need for nutrients
differs from the available supply
 Metabolism: the chemical changes that take
place within and outside of cells. Requires precise
amounts of various nutrients.
 Too little folate (required for protein synthesis within
cells)? Proteins with abnormal shapes and functions
are produced.
 Too much iron? The excess reacts with, and
damages, cell components.
 CHAPTER 2

Understanding Nutrition Labels

True or False?
Foods labeled as “fat free” have few or no
calories.
And The Answer Is…
 FALSE! The flavor has to come from
somewhere… right? So, food
manufacturers often add sugar to
replace the fat they’ve taken out.
(Not to mention this food is heavily
processed and manufactured.)
A. Nutrition Labeling
 Nutrition labeling regulations involve
 The “Nutrition Facts” panel
 Nutrient content claims
 Health claims
 Structure/function claims
 The Nutrition Facts panel is required on
most grocery store foods. Rules for the
other categories must be followed if/when
a claim about the product is made on the
packaging.
 1. Nutrition Facts Panel
 Foods containing more than one ingredient must
have one—with the exception of foods sold in
very small packages or in small, local stores
such as bakeries
 Individual fresh foods don’t have a label (head of
lettuce, apple) but grocery stores are encouraged to
present information on posters
 These contain specific info such as food’s caloric
content, serving size, nutrient content,
ingredients
 Serving size as listed must be based on a standard
serving size as defined by the FDA
Meats/Seafood and Produce

 Nutrition information
for single foods may
be presented on
posters—you may see
this at a grocery store
 Nutrition Facts Panel

 Foods containing more

than one ingredient
must display a
Nutrition Facts Panel

 Specific information is
required
a. What Info is on Every Nutrition Facts
Panel?
 **RIGHT NOW this is in the process of changing! You may be
seeing two different kinds of labels until all manufacturers
change.
 New label
https://www.fda.gov/downloads/food/labelingnutrition/ucm51164
6.pdf
 Serving Size (described in a common household
measurement, i.e. 1 cup)
 These servings are based on what the typical person eats,
defined by the FDA
 Servings per container
 Calories per serving
 Calories per serving from fat (you can thus calculate the percent
of calories per serving from fat: if you have 90 fat calories per
serving and 320 total calories per serving, (90/320) * 100)
a. What Info is on Every Nutrition Facts
Panel?

 Amounts of macronutrients and sodium per

serving, and % Daily Values
 Trans fat also included in the list
 % DV for four other micronutrients
 (A, C, calcium, iron were initially defined as 4
micronutrients that Americans don’t consume
enough, therefore featured on the nutrition
label)
 % Daily Values for many of the nutrients—
explained more fully on Slide 37
 Footnote, to explain the % Daily Value
2. Daily Values (DVs)
 Standard levels of dietary intake of nutrients,
developed specifically for use on nutrition labels
 Based on recommendations and RDAs
 Based on a daily intake of 2000 calories, and
dietary recommendations of 30% calories from
fat (10% from saturated fat), 60% of calories
from carbohydrates, and 10% from protein.
If you eat more or less than 200 calories, you will
need to adjust the DVs on the nutrition labels to suit
you!
How Can Food Labels Be Used In Everyday Life?
Food Labels

Copyright 2010, John Wiley & Sons, Inc.

A Sample DV Calculation
100% of the DV of calcium is 1000 mg.
But… this is based on a 2000-calorie diet.
What if you need to eat 2500 calories per
day?
You’re eating an extra 500 calories = 25%
extra.
Thus, you should also be consuming 25%
extra calcium per day.
1000 * (0.25) = 250
1000 + 250 = 1250 mg is your DV of
calcium, if you consume 2500 calories per day.
a. Nutrient Content
 How many nutrition claims on packaged
food are actually telling the truth?
 Some statements (“high fiber”,
“healthy”, “low fat”) must conform to
standard definitions
 Some labels specifically mention the % fat
free (“99% fat free”)
 Some terms have no FDA definition (such
as “natural” and “pure”) and can therefore
mislead the consumer
For Example: “Natural”
Cheetos?
Claims Not Approved by FDA
Nutrient Content Claims: Legal Definitions
Nutrient Content Claims
Do You Remember?
 Which foods don’t require Nutrition Facts
Panels?

(answer on Slide 29)

b. Labeling Foods “Enriched” or
“Fortified”
 Refers to increasing vitamin and mineral content of
foods
 Enrichment pertains to refined grain products:
replacement of the thiamin, riboflavin, niacin, and iron lost
when grains are refined during processing
 By (US) law, producers of products using refined grains must
use enriched flours
 Any food product can be fortified with vitamins and
minerals
 Fortification: the addition of one or more vitamins and/or
minerals to a food product
 Enrichment/fortification are sometimes done to reduce
the risk of chronic disease, but sometimes to increase
sales of a product…
c. The Ingredient Label
 All foods with more than one ingredient must
have an ingredient label.
 Listed in order by weight (from most
contribution of weight to least)
 Major allergens must be listed (milk, eggs, fish,
shellfish, tree nuts, wheat, peanuts, soybeans)
 You will also see a bold-print warning after the
ingredient list: “contains wheat” etc. Makes it
easier to see! (Now you know that there’s a legal
obligation to list “contains peanuts” after the
ingredient list on a jar of peanuts…)
Because They Have To.
The Ingredient Label
d. Food Additives On The
Label
 A food additive is any substance added to the food that
becomes part of the food or affects its characteristics
 Often a substance added to enhance flavor, color,
texture, shelf life, nutrient content…
 Food additives on the FDA’s GRAS (Generally

Recognized As Safe) list can be used without

preapproval. Anything not on this list has to be
approved by the FDA prior to use.
 Most common additives: sugar/salt. (as flavoring; but
salt can also be a preservative, and sugar attracts
moisture, so it helps with texture)
3. Dietary Supplement
Labeling
 A dietary supplement is a product taken orally that contains
an ingredient intended to supplement the diet.
 May include vitamins, minerals, herbs, proteins, enzymes,

hormones, organ tissues

 Labeling regulations categorize these as foods, not drugs!

 So, they can’t (legally) make claims that the products

cure/treat/prevent disease.
 Instead, they can include structure/function claims:

effects that the supplement may have on body structures or

functions (“supports the immune system”)
 But if such a claim is made, must include the statement
somewhere on packaging: “This statement has not been
evaluated by the FDA. This product is not intended to
diagnose, treat, cure, or prevent any disease.”
Dietary Supplement Labels

Copyright 2010, John Wiley & Sons, Inc.

4. Organic Foods
 Foods certified as organic by the USDA (if the
growers and processors qualify according to the
certifying organization) can display the “organic”
seal on packaging.
 Labeling regulations:
 “100% organic” if it contains entirely organically
produced ingredients
 “Organic” if it contains at least 95% organic ingredients
 “Made with organic ingredients” if it contains at least
70% organic ingredients
 “Some organic ingredients” if it contains less than 70%
organic ingredients
 Organic Foods

 If organic growers are

certified according to
USDA rules, they can
place the USDA
Organic seal on their
labels (there is a
similar label in
Canada)
Rules For Organic
Production
 Plants:
 Must be grown in soils not treated with synthetic fertilizers,
pesticides, and herbicides for at least three years (note!
There are allowable chemicals in organic farms)
 Cannot be fertilized with sewer sludge
 Cannot be treated by irradiation
 Cannot be grown from genetically modified seeds or
contain genetically modified ingredients (non-GMO)
 Animals:
 Cannot be raised in factory-like confinement conditions
 Cannot be given antibiotics or hormones to prevent
disease or promote growth
 Must be given feed products that are 100% organic
CHAPTER 3
Healthy Diets, Dietary Guidelines,
MyPyramid
True or False?
Over half of U.S. adults fail to consume
five servings of vegetables and fruits daily.
And The Answer Is…
 You can probably guess this one, right?
 It is TRUE that most Americans don’t eat
more than even one serving of fruits
and/or vegetables each day… and it’s
most commonly french fries.
A. Characteristics of
Healthful Diets
 Healthful diets share three basic characteristics:
 Adequacy: adequate diets include a wide variety of foods that
together provide sufficient levels of calories (to maintain healthy
body weight) and essential nutrients (in line with recommended
intake)
 Getting enough. Interestingly, even though we have many obese people in
this country, some of them eat enough junk food that they are
undernourished (lack of essential nutrients)!
 Variety: consumption of a variety of foods increases the probability
that you’ll get sufficient nutrients
 For example, you may be eating vegetables, grains, meats… but are you
only eating one type of vegetable? This may limit your nutrient availability.
 Balanced: getting calories and nutrients in the right proportions—
neither too much nor too little.
 The AMDRs—Acceptable Macronutrient Distribution Ranges—are guidelines
that have been set to help us eat within proper ranges of fat, protein, carb
AMDRs and Average Adult Intake
1. The Standard American
Diet
 Only 14% of Americans consume 3+ servings
of vegetables and 2+ servings of fruits daily.
 The “vegetable” most commonly consumed in
the US is the French fry.
 Americans consume too few whole grain
products, and instead consume breads and
cereals made from refined grains
 Average daily calorie intake in the US has
increased by about 500 calories since 1970…
but not through eating nutrient-rich food.
B. Dietary Guidelines for
Americans
 Goals: promote health and reduce the
risk for major chronic diseases through
diet and physical activity
 Importance of selecting nutrient-dense
foods, balancing caloric intake with
output, and increasing physical activity
Examples of Other Countries’ Dietary
Guidelines

 Norway: Food + Joy = Health

 Ireland: Enjoy your food!
 Japan: Happy eating makes for happy
family life. Sit down and eat together
and talk.

 (In the US, we rush through our food,

and there is no official guideline placing
emphasis on enjoyment or spending
time with family. Perhaps this should
change?)
1. Implementation of the Dietary
Guidelines

 MyPlate tool: major tool to help the

public implement the guidelines
 For those with hypertension: DASH diet
(Dietary Approaches to Stop
Hypertension) is also consistent with the
Dietary Guidelines
 But doesn’t cover physical exercise
C. MyPlate Food Guide
 Created by USDA. Food group guides to
help us plan our daily diet choices
 Previous versions included the Basic Four
Food Groups, Food Guide Pyramid
 ChooseMyPlate has replaced MyPyramid
 Plateicon shows proportion of
veg/fruit/grains/protein that should be on your
plate
Choose MyPlate
1. MyPlate Healthy Eating Messages

 Make at least half your plate fruits and vegetables.

 Enjoy your food, but eat less.
 Make half your grains whole grains.
 Eat fewer foods that are high in sat fats, trans fats,
added sugar, and sodium.
 Avoid oversized portions.
 Switch to fat-free or lowfat milk.
 Drink water instead of sugary drinks.
 Choose lower-sodium versions of foods.
 Importance of physical activity (but food is
emphasized much more…)
2. Food Groups
 The current version (MyPlate) doesn’t
recommend serving sizes or number of servings
in each food group—big change from previous
food guides!
 If you use one of the personalized interactive tools
on the website, it will recommend serving sizes for
individual users
 There used to also be a food tracking component,
called SuperTracker, which worked really well.
However, with so many commercial competitors
(MyFitnessPal etc), the government decided it wasn’t
worth their time, and took it down in June 2018. 
How Much Food Is A Cup Or Ounce?

 Vegetables: 1 c = 1 c raw or cooked vegetables,

or 2 c leafy salad greens
 Fruits: 1 c = 1 c raw or cooked fruit or 100%
juice, or ½ c dried fruit
 Dairy: 1 c = 1 c milk, yogurt, or fortified soy
milk, or 1 ½ oz natural or 2 oz processed cheese
 Grains: 1 oz = 1 slice of bread, ½ c cooked rice,
cereal, or pasta; or 1 oz cold cereal
 Protein: 1 oz = 1 oz lean meat, poultry, or fish; 1
egg; 1 T peanut butter; ½ oz nuts or seeds; ¼ c
cooked dried beans or peas
D. The DASH Diet
 Dietary Approaches to Stop Hypertension
(abbreviation)
 Originally meant to control mild/moderate
hypertension (high blood pressure), later also
found to reduce risk of cancer, osteoporosis,
and heart disease
 Emphasis on produce, lowfat dairy products,
whole grains, nuts, poultry, fish. Not much fat,
red meat, sweets, or sugary beverages. (Diet
does not specifically reduce sodium, but
controls hypertension anyway!)
The Mediterranean Pyramid
F. Mediterranean Diet
 Originally based on foods consumed by
Mediterranean areas (Greece, Crete, southern
Italy) where life expectancy is long and chronic
disease (namely, cardiovascular) rates are low
 Diet is primarily based on plant foods
(fruits/vegetables, grains, beans, nuts). Fish and
seafood consumed at least twice a week.
 Poultry and eggs only 2 times a week (or less),
cheese/yogurt 1-7 times a week.
 Smallest part of the pyramid = top = meat and sweets
 Wine in moderation is encouraged
 Physical activity is also encouraged
F. Eating Out and Staying
On Track
 50% of Americans eat out every day (lower
nutrient content, higher fat—also, harder to
control what you consume)
 Strategies:
 Decide what to eat ahead of time—if you can look
at the menu before you leave, better yet (avoid
“impulse ordering”)
 Split an entrée with someone else (oversized
portions)
 Have a healthy snack before going to a party where
food may be unlimited, so that you don’t arrive
hungry
Fast Food: Fat and Calories
Estimating Portion Size
 1 cup = size of baseball
 ½ cup = size of tennis ball
 ¼ cup = golf ball
 1 tsp = fingertip
 3 oz meat = palm of your hand
Other Everyday Items For Estimation
CHAPTER 4
Digestion and Absorption
True or False?
Most stomach ulcers are caused by
overeating spicy foods.
And The Answer Is…
 FALSE—while spicy foods make a pre-
existing ulcer feel worse, the majority of
ulcers are caused by bacterial infection,
or overconsumption of oral anti-
inflammatory medications
A. The Body Is Constantly
Changing
 Tissues in the body (bones, blood
vessels, etc) continually recycle
themselves.
 Raw materials for building these tissues =
the nutrients we eat
 Cells lining the intestine are replaced every
1-3 days. Red blood cells only last 120
days. Skin cells are replaced monthly. So,
even as adults, we need to eat well!
1. How Do Nutrients Become Available?

 Nutrients are the food components that

make new body parts.
 They are made available through the
processes of digestion and absorption.
a. Overview: Transit of Food Through the
Digestive Tract

 Digestive system consists of a 25-30-foot-

long muscular tube, plus organs such as the
liver and pancreas which secrete digestive
juices
 Digestive juices break food down into very small
particles, which can then be absorbed and used
by the body
 Carbohydrates are absorbed as monosaccharides
 Proteins are absorbed as amino acids
 Fats are absorbed as fatty acids and glycerol
 Vitamins and minerals are not broken down before
they are absorbed (they are already relatively small)
Digestive System
Digestive Tract Organs
 Salivary glands (in mouth) produce enzymes
that help break down starch and fats.
 Tongue helps mix food with saliva.
 Esophagus passes food down to the stomach
via waves of muscular contraction.
 Liver produces bile, a substance that helps fat
digestion.
 Stomach mixes and liquefies food. Also secretes
enzymes that breaks down proteins and fats.
 Gallbladder stores and secretes bile (after the
liver makes it).
Digestive Tract Organs
 Bile duct conducts bile from the liver and
gallbladder to the small intestine
 Pancreas secretes enzymes that break down
carbohydrates, fats, and proteins
 Pancreatic duct conducts pancreatic juice into the
small intestine
 Small intestine delivers enzymes (to food) that
break down carbohydrates, proteins, fats; site of
the majority of nutrient absorption (as well as some
water)
 Large intestine (colon) is where most intestinal
bacteria live; also, site of absorption of water
Digestive Tract Organs
 Rectum (end of large intestine) stores
waste products for elimination
 Anus holds rectum closed, but opens
(voluntarily!) to allow elimination
The Digestive System
Closeup of Pancreas, Liver
a. Overview: Transit of Food Through the
Digestive Tract

 Enzymes perform a lot of the work of

digestion
 Manufactured by salivary glands, stomach,
and pancreas
 Enzymes: proteins which speed up
chemical reactions
 Each type of macronutrient has its own set
of digestive enzymes
 Lipid
digestive enzymes won’t work on
carbohydrates, for instance
Quick Quiz:
 What is bile? Where is it produced?

(answer on slide 81)

b. Digestion In More
Detail…
 When you chew, glands under the tongue release
saliva.
 Food gets lubricated so that it can be swallowed easily
(contains mucus which aids lubrication)
 Saliva also contains amylase, an enzyme which starts to
break down carbohydrates, and lipase, an enzyme which
starts to break down fats.
 Then, the food is swallowed and passed down the
esophagus to the stomach.
 There are muscular valves at the entrance and exit of the
stomach to make sure the food stays inside until it’s
liquefied and mixed with digestive juices.
 Solid foods stay in the stomach 2-4 hours, and liquids pass
through in about 20 minutes.
b. In More Detail…
 When the stomach is done, 1-2 teaspoonfuls at a
time of liquefied food are ejected into the small
intestine.
 This stimulates the muscles in the small intestine
walls to contract/relax, which in turn mixes the food
as it continues to digest with enzymes
 High fiber causes the bulge of food in the intestine
to be larger = higher level of intestinal muscle
activity = pass through the intestine more quickly
 Finger-like projections called villi line the inside of
the small intestines, increasing surface area. This
enhances nutrient absorption.
Surfaces of Small and Large Intestines
b. In More Detail…
 Completion of digestion: when carbohydrates, fats,
and proteins are broken down into substances that
can be absorbed, and vitamins and minerals are
released from food.
 40-70% of alcohol consumed with a meal is absorbed from
the stomach.
 Water and sodium are absorbed in the large intestine.
 Most nutrient absorption takes place in the small intestine.
 Large intestine: houses many strains of bacteria that
consume undigested fiber
 They excrete gas as a byproduct
 Substances in food that can’t be digested or absorbed
collect in the large intestine and are excreted in stools.
c. Absorption
 The process of digestion is complete when
macronutrients are broken down into substances that
can be absorbed, and when food’s vitamins and
minerals have been released.
 Primary absorption products of each macronutrient:
 Carbohydrate: glucose
 Fat: fatty acids and glycerol
 Protein: amino acids
 Most nutrient absorption occurs in the small intestine
(small amount of absorption in the stomach and large
intestine)
 Water, sodium, chloride are absorbed by large intestine
 Anything that can’t be absorbed or digested gets excreted as
stool
d. The Lymphatic and Circulatory System

 How do nutrients get distributed to cells?

 Nutrients get picked up by the lymphatic system
and circulatory system for eventual distribution.
 The lymphatic system runs parallel to the circulatory
system and carries lymph (fluid that may have escaped
the capillaries, and returns to the circulatory system
after passing through the lymph nodes)
 Lymphatic vessels line the inside of the intestinal villi.
They absorb primarily fatty acids.

Description of the Lymphatic System (about 10 Minutes)

 Blood vessels also in the villi absorb amino acids and
glucose.
Absorption in Villi
e. Gut Bacteria
 Many “good” bacteria in the gut. They help us
stay healthy!
 Just by their presence, they prevent harmful microbes
from taking up residence, and they also produce anti-
microbial chemicals
 They digest some of the fiber in our diet, and excrete
gases and fatty acids as the waste products
 Some bacteria produce vitamins that are absorbed
and used by the body (Vitamin K, biotin)
 Play a major role in programming the immune system
 Also produce serotonin (so… gut bacteria keep us
happy!!)
B. Digestive Disorders
 The leading cause of hospitalization
among US adults age 54-64 years –
heartburn, hemorrhoids, irritable bowel
syndrome, duodenal/stomach ulcers
 Influenced by diet and weight
1. Constipation
 Medically defined as fewer than 3 bowel
movements per week
 Normal rate of stool production differs per person!
 Characterized by difficulty of passing stools
because they are hard and dry
 Can merely be a symptom of dehydration!
 May cause bleeding hemorrhoids (therefore blood
in stool or on toilet paper) or anal tearing
 Constipation is a symptom, not a disease: poor
diet, immobility, medication side effect, slow
transit time of food in digestive tract (fiber speeds
things up)
a. Fiber Intake
 Increasing one’s fiber intake can
decrease constipation (5+ servings of
fruit and veg per day)
 However, increasing fiber intake
increases one’s fluid needs, so drink
more water as you increase your fiber.
 Fibrous foods absorb water
 Increase your fiber intake gradually, to
allow the bacteria in the large intestine
to gradually adjust to more.
Good Sources of Fiber
 25-30 g fiber/day helps prevent constipation
2. Ulcers
 Sores that occur primarily in the stomach lining as
well as the duodenum (the first part of the small
intestine which directly connects to the stomach)—
an area of the GI tract which has been eroded away
 Caused by infection by H. pylori bacteria as well as
overuse of aspirin/ibuprofen
 H. pylori infection occurs most frequently in countries
with poor sanitary conditions--occurs when you consume
infected substances (this can happen anywhere)
 In either case, the protective layer of mucus on the
inside of the stomach/small intestine is broken down,
and the digestive juices and acid can directly contact the
organ’s inner surface
2. Ulcers (cont)
 Symptoms include abdominal pain,
reduced appetite, weight loss, and
bloated/nauseated feeling after eating
 If a bleeding ulcer, may even cause
blackened stool
 Can be treated by antibiotics that
destroy H. pylori or drugs that reduce
stomach acid.
Locations of Ulcers
3. Heartburn
 Occurs at least weekly in 20% of
American adults
 Most common symptom: painful, burning
feeling in chest or throat near the heart
(hence the name)
 Happens when the valve at the top of
the stomach relaxes too much, allowing
acidic contents to back up into
esophagus.
 Causes not entirely understood, but
contributing factors include diet, obesity,
a. GERD
 GastroEsophageal Reflux Disease
 When reflux happens more than twice
per week (chronic)
 Very common among Americans…
 To reduce, identify your trigger foods (may
be acidic, high-fat, caffeine—different for
different people) and avoid them. Also,
raising the head of the bed can help.
Smaller meal size. Medication can help, but
treating the root cause is ideal (since if
untreated, can cause esophageal cancer)
GERD
4. Irritable Bowel Syndrome
(IBS)
 Primary symptom: irritated bowel
 Trouble moving food along the intestines
 Food can either move too quickly (producing diarrhea)
or too slowly (producing constipation).
 Also experience pain and cramping
 Probably caused by overgrowth of bacteria in large
intestine, food sensitivities, stress—but a lot is still
unknown about IBS
 Diagnosed if problems recur continuously for 3+
months
 Controlled by diet, stress management, use of
probiotics, medications
Spasms In Someone With
IBS
IBS Infographic
5. Diarrhea
 Leading public health problem in many developing
countries
 Often due to contaminated food/water, lack of
immunizations, interactions between malnutrition and
infection (greater susceptibility to disease when lacking
in certain nutrients/poor diet)
 May also result from food intolerance or medication reaction
 Defined as the presence of 3+ liquid stools in a 24 hour
period
 Can cause dehydration, malnutrition (loss of water and
nutrients)
 If diarrhea lasts greater than 2 weeks, can cause
heart/kidney malfunction and death
6. Flatulence/Belching
 Can occur in the esophagus, stomach,
small intestine, and large intestine due
to swallowed air, or due to bacterial
breakdown of food in the large intestine
 May result from chewing gum, eating too
fast, gulping air
 Belching and flatulence may be
embarrassing, but they’re normal! 
 Fructose and sorbitol (sugar alcohol used as
a sugar substitute) may lead to excess gas
formation
CHAPTER 5
Calories and Energy Balance
True or False?
A teaspoon of butter has more calories
than a teaspoon of margarine.
And The Answer Is…
FALSE—in most cases. Real butter and
“real” margarine both have 100 calories
per tablespoon, because they contain the
same amount of fat.

Consider, however, the “light” margarine

and butter brands on the market: some of
them contain water as part of the
product, or another filler (often
synthetic/processed). This reduces the
number of calories per tablespoon… but
Made Light By Adding Water, Air…

… and who knows what else…

A. Energy
 Calorie = measure of food energy
 1 calorie = the amount of energy it takes to
raise the temp of 1 kilogram of water by 1
degree Celsius (calorie with a lower-case c)
A calorie (lower case c) is a scientific/laboratory
measurement. In this form, it is much too small
to measure the amount of energy that food
provides!
Kilocalorie = food Calorie = 1000 calories
(note the upper-case C in Calorie!)
Calorie vs. calorie vs kilocalorie
1. The Body’s Need For
Energy
 The body’s energy needs fall in three main categories:
 Basal metabolism (resting metabolism)
 Energy required to maintain normal body functions while at rest
 Physical activity
 Energy required for muscular work
 Dietary thermogenesis
 Energy use related to food ingestion

This is how our body uses Calories throughout the day. If

you are an athlete or very active, you will clearly have a
greater percentage of your Calories consumed by
physical activity than the other two categories.
a. Basal Metabolism
 60-75% of calorie needs in most people
 Supplies energy for breathing, heart
beat, maintenance of body temp,
recycling of bone/muscle tissue, growth
(the activities we don’t even think about!
But they happen)
a. Basal Metabolism
 Most people have a relatively normal
basal metabolic rate (few have an
excessively high or low)
 Precise calculations of BMR are costly
and time-consuming. Can be estimated
via equations.
 Men: body wt (in lbs) x 11
 Women: body wt (in lbs) x 10
So, If Anyone Calls You Lazy
b. Physical Activity
Expenditure
 An inactive person spends energy equivalent to 30% of their
BMR
 An “average” active person, 50%
 A very active person (4+ hours a day, including some
strenuous activity): 75% of their BMR

 How do you define inactive/average active/very active? It

varies, depending on your reference. But here are some
reasonable definitions:
 Inactive: office person getting little or no exercise (walking around
the office)
 Average activity level: 60-90 minutes of moderate-vigorous
exercise daily
 Very active: competitive athlete, and/or 2+ hours of moderate-
vigorous exercise daily
c. Dietary Thermogenesis
 The body spends some energy digesting,
absorbing, storing nutrients, and transporting
nutrients
 For a majority of people, this equates to 10% of
the sum of BMR and physical activity calories.

 Keep in mind that these percentages are “close

enough” but not precise (i.e. don’t assume your
dietary thermogenesis expenditure is equal to
10.0000 %! It is “about” 10%, maybe 11%,
maybe 9%.)
So This Means
 For a 130 lb inactive woman:
 For basal metabolism, multiply body weight by 10
 130 x 10 = 1300 cals
 She is “inactive”, therefore multiply basal
metabolism calories by 0.30
 1300 x 0.30 = 390 cals
 Add these two (1300 + 390 = 1690) then
multiply by 0.10 for dietary thermogenesis cals
 1690 x 0.10 = 169
 Total cals needed to maintain weight =
 1300 + 390 + 169 = 1859
B. Energy Distribution In
Foods
 Any food containing carbohydrate, fat,
and/or protein contains calories and
supplies the body with energy.
 Carbohydrates and proteins: 4 calories per
gram
 Fats: 9 calories per gram
 Also, 7 calories per gram of alcohol (though
it doesn’t provide nutrition, thus not
considered a macronutrient)
Yes, there are calories in these foods!
B. Energy Distribution In
Foods
 So, if you know # grams of each
macronutrient, you can calculate how
many calories it contains.
 Example: cup of soup with 15 g
carbohydrate, 10 g protein, 5 g fat. How do
you calculate the caloric content of the
soup?
(wait for it!! It’s on the next slide…)
Calculating Caloric Content of Soup

15 g carbohydrate x 4 cals/g = 60 calories

from carb
10 g protein x 4 cals/g = 40 calories from
protein
5 g fat x 9 cals/g = 45 calories from fat

TOTAL 145 calories (add up those numbers to get

the total calories)

You can also calculate what percentage of total

calories come from carb/protein/fat…
Calculating Percentage From Each
Macronutrient

= calories from nutrient / total cals x 100

Carbohydrate: 60 cal/145 cal x 100 = 0.41
x 100
= 41%
Protein: 40 cal/145 cal x 100 = 0.28 x 100
= 28%

Fat: 45 cal/145 cal x 100 = 0.31 x 100 =

31%
B. Energy Distribution In
Foods
 Since fat is the most energy-dense macronutrient
(most Calories per gram), you might expect high-fat
foods to be highest in Calories, in general

 (This led to the anti-fat trend in the early ‘90’s. We

thought fat was the “big evil” in our foods, and lots of
fat-free foods came out. It makes sense, since we’d be
consuming more Calories if we ate more fat, right?
 We now realize that by eating all of that processed food,
that may not have been the best solution… and since fat
takes longer to digest, it makes us feel full longer. So,
some fat in the diet is fine! By eating fat, you’re more
satisfied, and you may not eat so much food overall!)
1. Most Foods Are A Mixture Of
Macronutrients

 Bread is high in carbohydrates, but also

contains protein and a small amount of
fat (whereas—we think of bread as all
carbohydrates. Gluten is a protein!)
 Steak is mostly protein but also contains
a small amount of fat. The largest
ingredient by weight is water!
2. Energy Density
 The number of calories per gram of food.
Calculated by dividing the number of calories in a
portion of food by the food’s weight in grams.
 Diets high in energy density are associated with
 Type 2 diabetes, weight gain, obesity, overeating
(chronic inflammation)
 The energy density of broccoli (for example—a food
without many calories per unit of weight) is lower than
the energy density of buttercream frosting (a food with
lots of calories per unit weight, due to the butter and
sugar)
 This doesn’t mean we can never eat frosting! Just don’t eat
it constantly. 
Comparing The Energy Density of These
Two Meals…
2. Energy Density
 Energy dense foods are typically nutrient-poor,
with few exceptions (nuts, avocado…)
 Low energy dense foods are often nutrient-rich, and
because they have low energy density, we can eat
more of them
 Diets high in energy-dense foods may interfere
with our brain/body’s normal food intake
regulation mechanisms (delaying the onset of
satiety)
 Is it because of what is contained in the less
energy-dense foods? Scientists don’t exactly
know…
3. Regulation of Caloric Intake By The
Body
 The body has ways of encouraging regular caloric
intake, since energy is necessary for survival. It’s not so
good at discouraging excess calories…
 We experience hunger during the day no matter how

fat or thin we are, when cells run low on specific

energy nutrients.
 When we reach a point when we feel full, hormones

and internal sensors (stretch sensors in some of these

organs) in the brain, stomach, intestines, liver, and fat
cells trigger satiety (we’ve had enough to eat).
 Sometimes, our appetite overrides the hunger and

satiety signals, merely due to the pleasure of food, not

always related to hunger.
a. Regulation and Energy
Balance
 Unless you are currently losing or gaining weight,
you are currently consuming the number of
calories that you need, and you are in a state of
energy balance.
CHAPTER 6
Obesity to Underweight:
Highs and Lows of Weight Status
True or False:
 The basic cause of obesity is calorie
intake that exceeds calorie needs.
A. Variations in Body Weight
 Human bodies come in a range of sizes…
but recently, the range has shifted
toward overweight/obese
 Humans developed ages ago when
“feast/famine” cycles were typical, and it
was favorable to be able to store excess
body fat
 Our bodies developed mechanisms,
therefore, to store excess fat
1. How Is Weight Status
Defined?
 It wasn’t until the late 20th century that
thinness was idealized
 In some poorer countries, overweight bodies
are perceived wealthier and higher class
 Over the years, ideal height/weight tables
have been calculated/recalculated—now, we
use the body mass index (BMI)
 BMI was originated in Europe, where metric units
are used. In order to be able to use pounds and
inches, note that the formula has a conversion
factor (multiply by 703)
2. Body Mass Index
 A measure of weight for height that
provides a fairly good estimate of body
fat content
 BUT does

it measure
health?
 Calculating BMI

 BMI can also be

calculated by dividing
pounds by inches2,
multiplied by 703
BMI At A Glance (Same For Both
Genders)
B. Overweight and Obesity
 Becoming America’s #1 health problem
 Over 1 in 6 children and adolescents in
the US are overweight
1. Influence of Obesity of
Health
 Obese people more likely to experience diabetes,
heart disease, cancer, hypertension
 Likely due to a higher presence of metabolic
abnormalities in many obese people, such as
 Hypertension
 Elevated triglycerides, glucose, or insulin
 Low HDL cholesterol
 High C-reactive protein (produced in the liver in
response to inflammation. This can be measured in a
blood test.)
 Weight loss of 10-15% of initial body weight, paired
with exercise, reduces metabolic abnormalities and
therefore disease risk.
2. Location of Body Fat and
Health
 Two major locations for body fat in humans:
 Under the skin over the hips, upper arms, and thighs
(“pear shape”)
 In the abdomen (“apple shape”)
 Fat stored directly under the skin is called
subcutaneous fat
 People who are pear shaped generally have more
subcutaneous fat, and their fat is not quite so bad (not that
it’s great to be fat!)
 Fat stored in the abdomen under the skin and a layer
of muscle is called visceral fat
 People who are apple shaped generally have more visceral
fat, and thus, their fat is less healthy and more dangerous!
Where Is Visceral Fat?
Pear and Apple Shapes
2. Location of Body Fat and
Health
 Typically, those who are pear-shaped are in better
health because their fat is more subcutaneous
 Abdominal visceral fat is more strongly related to
disease risk
 Metabolic processes initiated by visceral fat produce
chronic inflammation, promoting development of insulin
resistance, elevated blood glucose, and metabolic
syndrome (group of metabolic abnormalities which
include insulin resistance, high blood pressure, low HDL
cholesterol, impaired glucose tolerance—these people
are predisposed to type 2 diabetes)
2. Location of Body Fat and
Health
 Disease risk associated with visceral fat can be
reduced by regular aerobic and resistance
exercise
 Leads to weight loss, which will improve health benefits
 For men, waist circumference over 40 inches
(women: over 35 inches) indicates excess
visceral fat and increased disease risk
3. Assessment of Body Fat
Content
 BMI is often used to approximate, but isn’t always valid
 What about athletes? Their heavier weight usually isn’t due to
fat. (since they often have a lot of muscle)
 Other assessment methods include
 Skinfold thickness measurements (measuring fat folds under the
skin with calipers)
 Bioelectric Impedance Analysis (pass an electric current from
ankle to wrist; fat conducts electricity poorly)
 Underwater weighing (fat floats in water—compare to weight on
land)
 MRI (very accurate but expensive)
 DEXA scan (body fat can be calculated based on X-ray
absorption)
 Whole body air displacement (similar to underwater weighing)
Assessment of Body Fat Content
a. We Need Some Body Fat—Why?

 Roles in manufacture of hormones, in

cell membranes, cushioning for our
internal organs, “insulation” for our
nerves (myelin sheath)
 Low body fat during childhood delays
puberty/development
4. Causes of Obesity
 Caloric intake greater than caloric expenditure
 Which can be a result of diet, lack of physical activity, medications
 In general, people are not “genetically destined” to be obese
 In some cases, there can be an overproduction of appetite hormones,
causing excessive food intake
 Weak link between obesity in childhood and adulthood
 If you are an obese child, you are not destined to be
an obese adult!
 Low levels of physical activity promote obesity
 Change your environment to change your health
 For example… less snack food easily available… get
off the bus one stop earlier… stairs rather than
elevator… etc
C. Underweight
 Defined as too little body fat—less than 12% in
females and less than 5% in males. BMI below
18.5.
 Some people may just naturally be thin with a BMI just
slightly below normal, and may be healthier this way
 Severely underweight people get tired and sick
more easily
 Reduced bone density/more fractures
 Lowered immune function
 More sensitive to cold
1. Calorie Restriction for Longevity?

 Some believe that eating 1600-1700 cals/day

increases lifespan (and lab tests have shown this)
 Also decreases chronic inflammation and related
health problems
 But increased risk for iron deficiency, osteoporosis,
infertility, infections

Does Research From Rats Translate To Humans?