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1st NFS248 lecture

Friday 1-5, Fitzgerald Building FC142 150 office hours


Canadian Community conducts a national survey to
generate information on what are people eating = how are
Canadians doing with intake of calcium, protein, etc
Higher the number is, the worse the diet is
Cancer and heart disease = delay the development of
diseases with nutrition (1:33:08)
Essential means essentiall to h
Suboptimal intakes mean
Minerals, must get is from environment and cant
biosynthesize
Rely on plants and animals to make these nutrients forus
Deficiency symptoms = acute = few months to several years
and short period of time
Macronutrient
Amino acid
Energy kcalories
Know these numbers = kcalorie content of macronient
4kcal/g carbo, 9kcal/g fat (lipids) and very concentrated
source of energy, 4 kcal/g proteins, 7kcal/g alcohol
2100 kcal : carb 300 g x 4, 60g x 9, 90 x 4
Question or two on the term test on these calculations
Half of the planet gets calories from rice ; start of civiliz
Glycerol of three fatty acid = triglycerides or triacylglycerides
Fatty acid with double bonds/conal = polyunsaturated fatty
acids (PUFA) and olive oil is monounsaturated fatty acid
(MUFA) and omega 9 (look at this) 1:44
Essential fatty acids = must get these 2 fatty acids into their
diet
EPA and DHA = carbon chains of 20-22 carbons
Saturated and trains fatty = if you reduce saturated and
increase ur polyunsaturated (comes from plants and conola)
then beneficial trade off
But if u increase ur carbo, then 6 of 1 ..
Indigestible carbo = dietary fiber
Glucose = our metabolism is designed to preserve glucose for
the brain .brain must have glucose
Sucrose and huge fructose (in Canada u see glucose/fructose)
but it's a 1 to 1 mixture and made out of corn syrup , cheaper
sweetener than fructose (1:52)
Micronutrients
Vitamins
Can be stored in the liver = fat soluble vitamins

Not stored in the body = the water soluble vitamins depleted


more rapidly (1:54)
Calcium
Sodium
Iron
Iodine
Required reading = page 402-408
Look at what she says about phtyto and stuff EDA/PHA
=zoochemical
Undernutrition vs. overnutrition , nutrition all about
moderation
(malnutrition)
diet gene interaction = slightly different genes and different
mutatations in our body.some produce proteins and some
have active enzymes compared to other individuals
2nd Lecture (33 on)

some people metabolize food efficiently and theres interaction


between our diet and genes
how many nutrients are in a food relative in calorie
content.eat nutrient dense food
empty calorie food = opposite of nutrient dense food
eat of small amounts of a lot of kinds of food = balanced diet
and everything in moderation
portion distortion = refers to the fact that if you look at food at
last 50 years, track the size of a hamburger .doubled or
tripled
increase size by reducing portion size(look at this) and 12:17
or 07
subpackaging = servings that in 100 kcal.need hit of
chocolate,
Chapter 2:
nutrient based approach = problem is we dont eat nutrients
and we consume foodtranslate nutrient requirements into
dietary patterns
came up with new nutrient requirements on better
science.dietary reference intakes = XXXXXXXXXX
first guide in 1942 =
DRI is used for nutrient req for different stages for life
Infant doesnt need same vitamin C compared to middle age
adult
Other nutrients = macronients and dietary fibre
Normal distributeon graph.red line = medianblue arrow =
standard deviation or variance

Median is the same and stanfard deviateon is different


Half of the curve shaded = probability of 50% that their intake
is adequate on inadequate
50% of individuals = median 50 meets and 50 doesn't meet
the requirements
if u do it for a group of individuals = generate requirement
distribution
how much of vitamin x does a person need to consume
blood and tissue tends to be equilibriumwhen the vitamin x
(12:34)
thisapproach works well for vitamin c
deplete a group of indivudiuals who volunteered for ur
experiment.so u feed them vitamin xfollow vitamin x in
the blood and will have low levels of vitamin x in blood
as increase the intake of vitamin x, the blood levels will go up
and will elvel off
saturated line = that's the requirement of vitamin x
how do u have to deplete a population = u need to get levels
low enough.so u can see that inflection or curve and u might
miss that inflection
there will be variation
concept = EAR or median is 100 mg and 50% meets and 50%
doesnt
if ur intake is equivalent to EAR.
Two concepts
Intake that meets the requirement **..EAR is the median of
this distributeon.if ur intake is equal to EAR 12:43
A = probability is less than 50% and we would know this
individual has 12% of probs to meet his req.
That individual has higher intake of vitamin x, his intake is
above EAR so we know probability is meeting his re qis gonna
greater than 50%
RDA = if ur intake is equal to RDA, then ur meeting ur
req.since its 98%
It's a personal target and ur viturally certain that ur perfectly
ok
EAR cut point method
Blunt end like that = we dont know for sure which indivula is
meeting their reqbut we can calculate the proportion of the
group.we are interested in how populations are doing.
Less than EAR = we have two groups of people in EARwe
have groups with low intake and we have group of ppl with
high intake but not meeting their req.and they are equal in
numberlooking at this intake distributionwe have 100
mg90% of the population is not meeting its requirement
Top is poorly nourished and bottom is well nousished
populationcut off or threshold

Median is same or standard distributeon is different but its


also dependent on standard deviateon
EAR cut point method
If 10% or less than EAR..then it's a good population
10% or lower tends to be better

slide 30
dri = set of numbers that define how much nutrient should
someone be consuming for good health
depleteon and repleteion curve Is not the only way to see the
requirements
rda = ear + 2 sd
if intake is equal to ear = there is 50% chance of meeting ur
requirement
if ur intake is equal to rda = there is 90% chance of
adequate intake = AI =
you take a population and see how much they are eating
=adequate intake
infant that is getting breast fed is uniquely getting its
requirements
if your intake is greater than adequate intake, then its ok
AI = good personal target.RDA and AI are personal targets
Habitual = every once in a while, creep above of level (just
dont do it for months and years)
If you go above that, you can go to harm (11:21 so 11
minutes)
Get info about UL
We consume energy from food.energy balance = u will have
a constant weight
Negative energy balance = consuming less calories than
expending
No need to calculate
Pa = physical activity, body size, age, height in meters
Very well designed to conserve energy
Energy requirement will decrease == 1750 kcal === decline
in thyroid hormones and decrease in body pump positions ,
decrease in muscle mass,
2250 kcal (muscle expands more energy) = 2500 kcal for 510
male
bmi 25 = 2250 kcal =
why do we have that exponential decay or plateu = body size
gets smaller and energy requirement also decreases
once a person reaches that last point = they can say im
happy with their weight loss and maintain that intake of 1500,
you can stop and say I need to loose more weight..reducing

ur intake too much then u will have to watch out with nutrient
intakeor exercise more to expend energy
macronutrients = AMDR= how much protein, carbohydrates,
and fat individuals are consuming
saturated fat = recommendation is low as possible
trans fat must be less 1 percent = to get naturaly occurring
transfat is beef and milk
11:46-11:48 , vegetable oils = transfat made from
hydrogenateon from vegetable oils are those transfat that bad
for u
where did these numbers = what kind of foods have fats and
proteins = it's a range or number of different ways to create a
balanced diet
1200 + 360 + 540 = 2100
57%, 17%, and 25.7%....confirm to admrs yes 45-56, 10-35,20-35
kcal of proteins are the same

small amounts of large variety of food


simulations
reducing salt is good for u
is there a 90% probability that nutrients are metEAR cut
point method
one of the requirements is to eat green vegetables = in early
iteration of Canada food guide..then there wasnt enough
vitamin a
CFC is almost 10 years old..is it beginning to show its age?
When people increased their saturated fat, it wasnt
Nutrients = unlike the classical experiment with changing one
variable, u cant do that
Low fat and high carb diet = equal amount of risks
You change ur oils and margarins, like soybean oil, olive oil,
canova oil, animal based products to plant based products
Salad dressings to your vegetables
Low pufa is the least = switching from animal products to
plant products
No debate on high dietary trans fat..low intake of omega 3
fatty acid
Sucrose = glucose and fructose

==================
most of our sugar comes from fruits = fruits come in combinations
with a lot of other nutrients
keep the fat down means keep the calories down

ultra processed food = foods that are low in nutrient density


somewhat disagree = disagree = disagree
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Week 2 Lecture 2

Juice = concern is among children since they drink a lot due to


conception of healthiness
125 ml = half a cup = juice = its always about the dose and
too much of a good
comparison between fruit juice to while fruit = apple juice vs.
apple
sugar content is very similar and u add vitamin c in apple juice
to relate it
lots of potassium
whole fruit vs juice is based on the fiber content

so what is the problem with juice


355 ml = 2.8 CFG serving
serving is Canadas food guide serving (look at up at the
guide 125ml)
portion is the amount of food you eat at any particular
meal
those portions of individual food is getting larger and larger
meat= refers to it as lean meat and its pictured as 75 g
often
processed meat = never positive
2 servings of fish can reduce it
meat has harmful health outcomes
processed = consume more salt or sodium
WHO said it causes cancer
They said that evidence that it was related to cancer was
very strong but it didnt get reported that it's a weak
carsenegian
NFT = packaged food
A is more nutritious compared to B
First one is the glass of milk and chocolate milk
Plant based products have 0 to very low cholesterol
It's a rich soy beverage
It's an almond beverage
White bread vs whole wheat bread
Fortified 35 15 and that's naturally occurring

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B is more nutritious (A was white rice and brown rice) ; germ


or embryo corner
(A is brown rice and B is Quingal/quindal)
There is no sodium and a lot sodium in other; lots of fiber and
protein, modest amount of calcium, and respectable amount
of iron = (A is more nutrious since A is raw kidney beans and
B is canned kidney beans)
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Nutrition research
RCT- randomized control trial = randomizeation reduces the
problem of confounding
Interventrion trials = are considered stronger than
observantional studies
Blood pressure is a risk factor
Because they are observational and keep it steady like this
and maintain this for many many yearskeep these studies
go for many long timesome went for 15-20-40 years even
Limitation = that's due to confounding factor = low intake of a
nutrient compared to high nutrient intake
Residual confounding
Review articles = articles that take summarize from all the
studies
Make quantitative estimate = whats the latest systematic
review
Historical perspective = role of diet and its role in
cardiovascular disease
Started in 1950s and its hard to imagine it todaylead
scientist ansel peas and wanted to study cardiovascular
diseaselooked at body weight, looked
Frist study = went onn 40 years = population of 12,000 mean
= 80 and 99 years of age = 10% of that cohort was still alive
40-59 = design a study you have to becareful of the age
range = in the time u do study = u want enough disease
occurences
wide range of dietary habits and different dietary intakes
this is a serum cholesterol and most enduring risk factor =
refined it a little bit
they normalized it
RCT = inverse association between PUFA and serum
cholesterol
Saturated fat is a player = limitations of this study = anzel
pease didn't have a database

Your sample size is the number of cohort and not number of


individuals and that's a limitation of ecological study =
individuals with low saturated fat were the risk of saturated
disease
Dietary intake in each individual = single point
Death rate increases as
Mortality differs within the countries = northern Europeans
What is protecting those southern Europeans = what southern
Europeans were eating = developed Mediterranean diet
pyramid
Mainly vegetables and plants = two major sources of fat that
are olive oil and fish = mostly vegetarian diet with mostly
plants in it
Consume a lot of wine
Dash dietary pattern = relative risk = approximately
One will have low nutrient intake and other will have high
nutrient intake
You see 4 of them getting sick and 2 people getting sick
Relative risk = you have to decide on the reference group =
low intake group
If relative risk is greater than 1, increase risk; less than 1 is
decrease risk
They wanted to look at dietary pattern, trend in nutrition
today; its difficult to isolate the effect of single nutrient; what
advice overall about the food that they eat
One is a reference group and as number goes down; if relative
risk is less than 1, then there is reduction in risk
Quintiles = population divided by 5
You can subdivide those groupslooking at those gradual
intakes
People with the highest score had the reduction in risk
Relative risk went to reduction of 39% from 100 to 61
1.4 is increase in 40%
are the differences in relative risk; are they statistically
indifferent
there are lot of conventions on statistical analysis = since
always calculating probability = 5%
significant = they did statistical analysis
theres a 95% chance that a true value is in that interval =
sample gives you an average of 0.14 and true value is in that
range
it also allows you to determine statistical significant
relative risk of 1high intake of 1.5 = there numbers do not
include in that range = reference group would not be part of
interval = statistically significant result

confidence intervals = typical of data = relative risk of 1 =


technicaly not statistically significant
these intervals do not include number 1
P trend = that looks at the pattern for 5 quintiles = is that a
meaningful downward trend
Plot them against relative risk = every quintile would be
relative risk of 1/ is that pattern different from the front line
Food frequency questionere = asks questions about how often
people eat food
Is this food frequency questionere validated = how you
compare it with other methodology
Lots of validated food frequency questionnaire = measureing
outcomes = risk factors vs heart disease outcomes
Fatal vs non fatal events
Cardiovascular disease = mainly heart attack and stroke
Risk factors of cardiovascular disease = RCT = that might be
looking at blood pressure/inflamemation/sea reactive
protein/various blood lipids/ instead of ldl
There arent that many risk factors =
Dietary intake was assessed = not a 100% but vast majority
times you are looking at food frequency questions.is it a risk
factor or disease///studies that are too short wont display any
effects
RCT = how they randomized their sample = abstract =
scoring system = observantional = epic = European
Massive database = studies in multiple European countries =
41 participants
Hazard ratio than relative risk = good score which means you
adhere to mediteranean diet = core of mediteranean diet =
hazard ratio is 0.6 so 40% in reduction of risk
Low score relative to 1 and 40% reduction confidence interval