Chapter 1 Pages 1-11:

- Non-essential nutrients are what we make enough of in our bodies

- Essential nutrients are what we need from our diet because we don’t make enough
- Micronutrients don’t contribute calories or energy but we need them
- Macronutrients mostly supply energy and structural components of our bodies
- Phytonutrients are plant chemicals that we obtain from fruits and vegetables
- Nutrients are needed to sustain homeostasis. Maintain pH, body temp, fluids
- Malnutrition refers to over or undereating, essentially any abnormality.
- Obesity relates to overnutrition and is a fairly new concept. Too much fats/calories
- Overconsumption is associated with slow progressing chronic illness (#1 killer)
- DRI’s are quantitative estimates of nutrient intakes to be used to plan and assess diets
- DRI’s take four values into account to recommend nutrient intake for most people
- EAR’s are estimated averages. This is what the people in the 50 percentile need.
- RDA represents the average daily amount of a particular nutrient that meets or exceeds
the requirements of nearly all (97–98%) healthy individuals
- First RDAs were made to prevent deficiencies in 1943
 - When there’s insufficient evidence to make an EAR for a nutrient, the RDA for that
nutrient cannot be set and the committee establishes the Adequate Intake (AI)
- Because there are so many ways to get nutrients, an upper limit is set which dictates the
maximum amount of one nutrient an individual should consume to be healthy.
- Nutrients should fall between the RDA and UL.
- EERs are energy recommendations (how many calories and individual should eat) and
how much physical activity they should have for their weight.
- Imbalanced macronutrient intake can increase prevalence of chronic disease
- AMDRs were made showing good percentages of macros for health
- AMDRs are expressed as percentage of daily calories
- Carbs are between 45% and 65% of total calories, protein intake falls between 10% and
35% of total calories, and fat intake is within 20% and 35% of total calories
Food Access/Choices:
- Epigenetics: study of cross-generational toxins, nutrients, behaviors
- Food deserts: places where access to grocery stores or healthy, fresh food is limited.
Urban areas without grocery store in a mile or rural without a store in 10 miles.
- Moderation is key to preventing obesity like in the US
- Variation in foods ensures that people get a wide range of nutrients
- It is a good idea to eat a “rainbow” of foods (different colors)
- Balance is also a huge factor in in keeping a healthy diet
- High nutrient density foods have high nutrients in relation to calories
- Energy dense foods are foods with high calories in relation to amount.
- In general, as energy density increases, nutrient density decreases.
- Water, fiber, and fat determine energy density. Fat makes higher, others lower.
- Food deserts started in the 1950’s when the wealthy left cities and took stores w them.
- Rural areas develop food deserts when farms close down or stop producing things.
- Closing of stores in cities is due to business decisions. Money can’t be made.
- On average Americans get 1/4 of their calories from added sugars or solid fats
- Solid fats are meat, butter, shortening, etc.
- Solid fats are high in saturated fats and low in fiber/nutrients. 15% of american diet
- The government has issued Dietary Guidelines for Americans (advice preventing chronic
- DGA is updated every 5 years by USDA and HHS. Core of nutrition in US.
- 2015 DGA focus on patterns and what we eat over time rather than specific nutrients
- 2015 DGA had 3 diets : vegetarian, mediterranean, and US diet
- Current diet focuses on small shifts like replacing refined grains w whole grains
- Sodium limits are set at 2300 mg to prevent hypertension but if history, 1500 mg.
- 2015 DGA also specified sugar should be 10% of diet or less for the first time.
- Food pyramid and MyPlate give guidance in regard to portions for food groups.
- Food desert residents tend to be more prone to disease, diabetes, and obesity.
- Not only is making good choices a concern, access to food is too
- It is estimated that undernutrition is a significant factor leading to nearly half of all
deaths of children under the age of 5
- Obesity is more common in leading to death than undernutrition right now
- In the world, over 1 billion people are overweight or obese, whereas roughly 860 million
suffer from hunger, with nearly 2 billion more deficient in micronutrients
- Poverty is a common cause of malnutrition worldwide.
- Interestingly, poverty stricken areas have more grocery stores than wealthy ones
- Although food deserts imply correlation they don't guarantee causation.
- Food swamps are areas with a high density of places selling high calorie food
- Urban food swamps are better predictors of obesity than food deserts
- In 1990, after several years of effort, the U.S. Congress passed the Nutrition Labeling and
Education Act (NLEA) giving the Food and Drug Administration (FDA) the authority to
require products sold in the United States to provide detailed nutrition information
- For fats, cholesterol, and sodium, the % Daily value represents the maximum we can eat
- For carbohydrates and nutrients, the % Daily value represents the minimum we can eat
- The NLEA regulates claims such as “healthy” to ensure nothing is misleading.
- Structure function claims like “heart healthy” or “bowel supporting” not regulated
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- More than half of people have trouble understanding food labels.
Food Safety:
- In 2011 there was a listeria outbreak involving infected cantaloupes
- Two categories of foodborne illness: intoxication and infection
- Foodborne intoxication: caused by ingestion of foods contain toxins that could be
naturally present such as bacteria/fungal growth or chemical contaminants.
- Chemical contaminants include pesticides, herbicides, and cleaning agents.
- Some mushrooms and fish have natural toxins in them
- Two most common bacterial sources: staphylococcus aureus and bacillus cereus
- S. aureus comes from nasal bacteria. Contamination occurs from improper handling.
- B. cereus comes from the environment/uncooked produce. Cross contamination.
- Both S. aureus and B. cereus are heat stable toxins that can withstand boiling.
- Foodborne infection is more common. Microorganism consumed and multiply.
- One of the most common sources of infection: animal or human feces in food/water
- Consuming feces and getting sick is fecal-oral transmission.
- Pathogens causing infection can also result from cross contamination like raw meats.
- Disease causing microorganisms refer to viruses, parasites, and bacteria.
- Viruses are genetic material encased in protein. They can only multiply inside the
human body meaning that they cannot multiply inside food products.
- parasites are microorganisms that grow by feeding off of their host. Like viruses, they
cannot multiply in food only in living host organisms.
- Bacteria are single-celled microorganisms that can multiply in food.
- Diarrhea, vomiting. and nausea are the most common foodborne illness symptoms.

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- People with weak immune systems are most at risk for foodborne illness.
- Pregnant women are particularly warned about listeria as it can cause miscarriage.
- Women are 10 times more likely to be infected with listeria than the General Public.
- The first documented case of E. coli occurred in 1982 but went largely unpublicized.
- Nasa created the HACCP which detailed safe handling practices for food.
- NASA also began to irradiate meat given to astronauts. This involves killing bacteria
viruses and parasites by damaging DNA. This was later extended to all produce.
- Irradiated foods are not readily available but spices are.
- HACCP is now required by the entire meat industry and is used in slaughterhouses.
- The meat industry had to employ scientific testing for infectious items.
- Fruits and vegetables are not under USDA jurisdiction so the HACCP does not apply to
them meaning that there was no regulated way to prevent illness during 2006 outbreak.
- Food safety modernization act was created in response to 2006 outbreak.
- FSMA gave the FDA jurisdiction to make decisions regarding food safety.
- FSMA requires inspection of critical points of infection and prevention.
- facilities must post risk management procedures and policies.
- FSMA gave FDA power to promote food defense which prevents intentional
contamination of food rather than unintentional.
- Meat must be cooked to kill possible bacteria. Ground meats harbor more bacteria.
- For people that consume sushi, it's recommended that it is frozen prior.
- Hot and cold foods should not be mixed for long periods of time.
- Additives are regulated by the FDA. Direct food additives include spices and herbs
whereas in direct food additives include BPA or chemicals from Packaging.
- The GRAS list is a list of additives that is generally recognized as safe. These don't have

to be reported to the FDA every single time they are used. Food and Nutrition
Security:
- How to provide food to everyone and maintain planet health is one of UN’s concerns
- UN goal: eliminate worldwide hunger by 2030.
- There was a steady decline of world hunger from 2010-2015 but in 2016 it went up 11%
- Food security refers to practices and policies that ensure people have adequate access to
food and a healthy and active lifestyle.
- Availability is adequate production and distribution of food.
- Access refers to affordability and accessibility of food, ensuring that needs are met.
 - Utilization refers to the ability of the body to make adequate use of nutrients. By
providing a wide variety of food and feeding practices, this can be achieved.
- Stability refers to having all three of these things consistently over time.
- nutrition security refers to the fact that individuals consume the nutrients that they
need rather than just having access to them.
- Food security is a prerequisite to nutrition security.
- Food insecurity refers to when people lack access to safe, nutritious food.
- U.s., Ireland, and the United Kingdom topped the list at being the best at Food security.
- Africa was the country with the lowest amount of food security mostly due to poverty
- Overnutrition affects more people worldwide than undernutrition.
- Overnutrition and undernutrition often occur in the same areas.
- Food stamps or SNAP is the largest program in the United States catering to
undernutrition. It allows disadvantaged families to gain access to food.
- Undernutrition is most common in children (accounts for ⅓ of deaths under age 5)
- Stunting and wasting are the two most common signs of undernutrition. Stunting refers
to a severe lack of height and wasting refers to a serious loss of muscle mass and weight.
- Wasting is most common in southern Asian countries.
- Hidden hunger refers to micronutrient deficiencies that are not always easily seen.
- The agricultural system is producing enough food to sustain hunger but ensuring proper
access as well as proper nutrients is an issue that the world is still struggling with.
- Estimated that the demand for food will rise 70 to 100% by the year 2050.
- About 12 percent of households are food insecure in the US (in 2016).
- WIC, NSLP, and SNAP are all food assistance programs.
- Marasmus: starvation, extreme thinness
- Kwashiorkor: 2nd child gets breastfed, first doesnt get enough food (protein) as a result.
Results in extreme edema and can be overlooked because they have round tummies.

Digestive system:
- In recent decades celiac disease has become more common. (Immune response to gluten)
- The presence of gluten in the digestive tract of those with celiac disease causes immune
system to attack the lining of the small intestine, which can impair nutrient absorption.
- 4 steps of digestion: Ingestion, digestion, absorption, elimination.
- Inside Space of the GI tract is called the Lumen. The Lumen has tiny mucosa which
transport nutrients to the blood or other places they need to go in the body
- GI tract extends from the mouth to the anus and includes the mouth, esophagus,
stomach, small intestine, and large intestine.
- In total it's about 26-30 feet long.
- The digestive system includes the GI tract and accessory organs such as the pancreas,
liver, gallbladder, and salivary glands which secrete fluids to break down food.
- There’s mechanical digestion which is physical forces breaking down food and chemical
digestion which involves the cleavage of bonds in food to produce smaller fragments.
- Mechanical digestion starts in the mouth with teeth chewing and crushing food and then
proceeds to the stomach where food is churned around through contractions.
- Oftentimes mechanical digestion is sufficient for the extraction of nutrients
- Peristalsis is the contraction of the GI tract to push food down it
- Segmentation is when circular muscles in the small intestine contract to slosh food
around with digestive fluids to aid in breakdown. No net forward movement.
- Hormones are chemical messengers whereas enzymes serve to break down molecules
- Bolus: soft, moist, mass of food
- When you chew food, surface area is increased allowing enzymes to act.
- Saliva is released by salivary glands. Amylase digests carbs. Lipase for fats.
- Bolus travels through the esophagus to the esophageal sphincter and to the stomach.
- Sphincter is a one way valve which is mostly tightly closed.
- Stomach secretes gastric juices containing Hydrochloric Acid to unfold proteins in food.
- Gastric juices have enzymes like protease (proteins) and lipase (fats). Also contain mucus
to protect the stomach lining from the acids.
- Food is grounded into a chyme (liquid mixture) and then passed to intestines slowly.
- Pyloric sphincter before small intestine is a sieve, allows v small particles through.
- How quickly food empties into the small intestine depends on composition and amount
- small intestine primary site for absorption of nutrients and digestion of food.
- The small intestine has three sections: the duodenum, the first portion of the small
intestine after the stomach; the jejunum, the middle portion; and the ileum, the last and
longest portion.
- The internal circular folds of the small intestine carry finger-like structures called Villi
which increase the surface area.
- Villi in the small intestine are covered in microvilli which further increase surface area
- Villi are responsible for absorption of nutrients.
- Water soluble nutrients are going through the capillaries/portal vein to the liver
- Fat soluble vitamins go through lacteals in villi and go to lymphatic system

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- The lining of small intestine is often called the brush border due to villi
- Chyme that enters the stomach is very acidic and pancreatic juices are needed to
neutralize it so that it does not denature enzymes required for digestion.(bicarbonate)
- Liver produces bile which is stored in the gallbladder necessary for lipid digestion
- CCK stimulates gallbladder to release bile and pancreas to secrete juice.
- Gastrin = hormone released when food is in stomach
- Water and small nutrients can pass through cells via simple diffusion.
- Most nutrients require facilitated diffusion/active transport to go to the mucosal lining
- Circulatory system and lymphatic system are responsible for transport of nutrients.
- Some of the nutrients in the body go through the liver first and are metabolized.
- Metabolism in the body refers to all of the processes that convert one molecule to
another molecule in the interest of creating energy or synthesizing essential nutrients
- In Celiac disease, gluten elicits an immune response in which the body's cells attack the
Villi in the small intestine. This creates a flattened small intestine that can interfere with
absorption of nutrients and lead to a higher risk of GI disease or cancer.
- Celiac is an autoimmune disease because the body attacks itself. Anywhere in tract.
- The large intestine is the end of the gastrointestinal tract. There are no Villi and very
little absorption takes place. It's lined with mucus so that poop can be excreted easily
- Large intestine will extract electrolytes, vitamins, fatty acids, and water
- Large intestine also contains bacteria that are necessary for digesting fibers.
- Bacteria in the GI tract are essential for many things. our gut microbiome determines a
lot. It is no surprise that diet is the major contributing factor to the microbiota.
- probiotics are considered live ingestible bacteria. probiotics can shift the balance
bacteria in the gut to a healthy one composed of mostly harmless bacteria.
- Probiotics have relatively small effects on the microbiota but prebiotics have a large one
- Prebiotics are essentially food for the helpful bacteria in your gut.
- some sources of prebiotics are oats, onions and garlic.
- People with celiac disease normally have low Prebiotic levels which can contribute to
illness.
- Amylase digests starches and lysozyme kills bacteria (both in mouth).
- Number of taste buds declines with age.
- Pepsinogen is a protein digesting enzyme activated by HCL to form pepsin. Digest
proteins
- Chyme goes from stomach to duodenum
- CCK is made in upper part of small intestine. It is a hormone responding to fat/protein
- Cck stimulate gallbladder to release bile
- Water soluble nutrients are carried through capillaries
- Lymphatic circulation occurs with fat soluble vitamins through lacteals.
Digestive Illness:
- Diarrhea is defined as watery stools more than 3 times in a day.
- Constipation is defined as pooping less than 3 times a week. increasing fiber intake as
well as water intake can help prevent constipation.
- Painful, inflamed veins in the lower anus is called hemorrhoids.
- Acid reflux is caused by weakness in the lower esophageal sphincter. This allows
stomach acid to bounce back up into the esophagus creating a burning sensation.
- Gastroesophageal acid reflux (GERD) is a more serious form of acid reflux in which the
tissues of the esophagus begin to get irritated and inflamed. They also start to wear
down. Over the counter drugs can be used to treat this.
- GERD symptom is heartburn which is caused by hydrochloric acid in esophagus.
- Cells in esophagus don't have mucus producing cells to protect like stomach does.
- Peptic ulcers: when chyme from stomach enters small intestine it is very acidic. This acid
can erode away tissues causing ulcers. Associated with H.Pylori (not sure why but people
with H pylori infection more often see ulcers). Also associated w NSAID use.
- Treatments for peptic ulcers: antacids for neutralizing and antibiotics for h pylori
- Gallstones are hard crystallized forms of bile in the gallbladder. These can cause pain in
the upper abdomen as the gallbladder cannot properly empty.
- Diverticulosis is when the inner linings of the digestive tract push on the weaker parts of
the outer lining causing out-pockets. This is very common with almost one-third of the
population getting these by age 60 but having a high fiber intake can prevent it.
- Diverticulitis: Infection inside the diverticula pockets.
- Food allergies: reaction of immune system to certain foods. Symptoms vary, can affect
any area of the digestive tract. Treatment: avoid food, and epi pens.
- Food intolerances: Not a response of immune system. Milk, wheat, and soy are most
common. We see GI symptoms, not immune. Lactose is most common (75 percent)
- Lactose intolerance is mostly caused by inadequate production of lactase enzyme which
leads to lactose sitting in the gut being diluted with water causing symptoms.
- Irritable bowel syndrome (IBS) is a group of symptoms, including abdominal pain,
bloating, diarrhea, and other discomforts, caused by changes in how the GI works. This
disorder affects the muscle contraction of the colon (large intestine).
- IBS does not lead to progression of more harmful illness or cancer.
- Inflammatory bowel disease (IBD): broad term that describes serious, chronic conditions
that are caused by an abnormal response by the body’s immune system, which causes
inflammation of the GI tract.
- Most common IBDs are ulcerative colitis and Crohn’s disease.
- In ulcerative colitis, the mucosa of the large intestine becomes irritated and swollen and
ulcers (open wounds) develop. Ulcerative colitis is often most severe in the rectum.
- Crohn’s disease most often affects the lower portions of the small intestine and parts of
the large intestine. However, it can attack any part of the digestive tract.
Carbohydrates:
- Derived from plant food like fruits, veggies, grains, beans
- Composed of hydrogen, oxygen, carbon
- Photosynthesis turns light energy into carbohydrates and oxygen
- Complex carbohydrates: Grains, legumes, some vegetables
- Simple carbohydrates: fruits, lactose in milks, many veggies

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- Glucose circulates through the bloodstream. Most common monosaccharide. Found in
fruits and vegetables and honey.
- Fructose found in fruits and vegetables and honey. Converted to glucose by liver.
- Galactose is milk sugar. Found bound to glucose to make lactose. Also converted.
- Sucrose aka table sugar - glucose and fructose
- Simple carbs add flavor, increase energy density and decrease nutrition, lead to obese
- Simple carbs can be sugar, honey, corn syrup, molasses, eyc.
- Sugar sweetened beverages contribute to most sugar intake as a population.
- Oligosaccharides: between disaccharides and polysaccharides. 3-10 sugar units.
Common in beans and legumes. Causes gas via fermentation in intestines.
- Complex carbohydrates: digestible and indigestible polysaccharides. Digestible:
starch(amylase) or glycogen. Indigestible: fiber
- Most complex carbohydrates come from plants

- Plants store glucose as starch. Amylose: big, long, linear chain of glucose
- Amylose pectin: branching chain of glucose
- Animals store glucose in the form of glycogen in the liver and muscles.
- Refined grains are more desirable because they have better texture however most of the
nutrients and vitamins within the outside of the grain are lost in this process
- Fiber has more rigid bonds between molecules. Humans don’t have enzymes to break.
- Soluble fibers: less rigid than insoluble. Comes in fruit, veggies, rice, oats.
- Functions of soluble fiber: delay poop, lower cholesterol, lower glucose absorption.
- Delaying poop is good because it gives more time to absorb nutrients.
- Insoluble fiber is cellulose. Speeds up poop, increases fecal bulk. Whole grains, fruits
- Fiber promotes softer and larger stool/regularity. It also regulates diverticula .
- Salivary amylase breaks starch molecule chains into smaller pieces.
- Amylases are inactivated by stomach acids so carb digestion occurs in mouth not tummy
- Americans actually do consume the recommended daily amount of carbohydrates
however the sources that we get it from are not necessarily recommended.
- Once carbs are broken down capillaries join to transport them via portal vein.
- Two types of sweeteners: those that are a source of calories, the nutritive sweeteners, and
those that are not, called the nonnutritive sweeteners.
- Nutritive sweeteners are made from naturally occurring sugars in plants but they are
poorly digested by the body so they can cause bad GI symptoms
- Non Nutritive sweeteners are things like aspartame. safe in small amounts. These are
normally way sweeter than natural sweeteners so we need less of them
- Daily fiber intake for men: 38g/day women: 25g/day
- Dietary fiber is indigestible fiber found naturally in plant foods. General fiber is
non-digestible carbohydrates that have been added to a food to stimulate the effects of
 fiber.

Blood Sugar:
- The liver is extremely important because it decides what to do with the broken down
fructose or galactose molecules that are changed to glucose related molecules.
- The liver will store some glucose in the form of glycogen for energy of cells.
- With the leftover sugar, it travels to the bloodstream affecting blood glucose levels.
- Blood glucose levels are too high it can lead to comas death or dehydration. If blood
glucose levels are too low it can lead to unconsciousness and death.
- If blood glucose is high then insulin signals to use up/store glucose
- If blood glucose levels are low then glucagon signals to create more.
- Beta cells in the pancreas create insulin and alpha cells create glucagon.
- Insulin and glucagon are like a seesaw if one goes up the other goes down.
- Insulin increases glucose uptake by cells to decrease the amount in the blood. It
decreases the amount of glucose being produced. Promotes storage as well.
- insulin promotes glycogen synthesis (glycolysis) reduces gluconeogenesis reduces
glycogenolysis.
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- Glucagon accesses glycogen in the liver to raise blood glucose.
- Glucagon enhances gluconeogenesis
- For people with prolonged fasting or very low carbohydrate diet, glucose cannot come
from carbohydrates so instead glucagon accesses muscle protein.
- Over time, fat molecules are used instead of muscle but then fat becomes too much
because there is not glucose to power the breakdown
- Tissues and muscles instead use Ketones. Ketogenesis: production of ketones
- Ketones reduce the body's need for glucose by providing energy source.
- Ketones are an adapted survival technique. Gives brain some source of energy.
- Glycemic index is a food's potential to raise blood glucose levels. Varies with food
preparation methods like cooking and varies with food composition such as protein, fat,
fiber content.
 - Limitations of glycemic index include the fact that it is based on gram equivalents of
carbohydrates such as 50 grams and it is only for one type of food when people typically
consume many types of food.
- Glycemic load refers to ranking of elevation in blood glucose for typical portions

- High fiber diets delay gastric emptying which leads to less fluctuation of blood glucose.
- Fructose and galactose commonly have less of an effect on blood glucose than starches
because they have to go through the liver before being able to raise blood glucose.

Diabetes:
- Type 1 diabetes occurs when the pancreas does not produce enough insulin.
- Type 2 diabetes occurs when the body's tissues become insulin-resistant.
- Diabetes results in an abundance of glucose in the blood that causes damage to blood
vessels and can often be life-threatening or fatal.
- The number of people with diabetes is increasing. 95% of people with diabetes have type
2 diabetes.
- Obesity is the main driver of diabetes.
- In type 1 diabetes, the pancreatic cells that secrete insulin are destroyed by the body’s
immune system, leading to a major deficiency of insulin that progresses until it is
 completely absent. Beta cells killed off. Type 1 diabetes is an autoimmune disease. Type
1 diabetes is not preventable, and between 5% and 10% of individuals with diabetes have
type 1. Most people are diagnosed in childhood but can occur later as well.
- Type 1 treatment: Insulin therapy to make sure insulin enters system
- About 10 percent of population in US has diabetes
- Because there's so much glucose in the body it spills over into the urine causing excess
urination. It also has to be diluted so water is coming in.
- The lack of insulin in the blood causes a buildup of ketones potentially leading to
ketoacidosis which could be very toxic as it changes blood pH.
- Type 2 diabetes occurs when cells are less sensitive to the effects of insulin and is most
common in people who are obese. 80-90% of people with this are obese.
- Genetics also play a huge role in type 2 diabetes and we can see that with twins.
- diabetes is more prominent in the United States than other parts in the world
- Type 2 diabetes begins with insulin resistance which can occur when hormone-like
substances in adipose tissues release signals that interfere with the signals of insulin in
the body.
- When insulin resistance develops, specialized cells in the pancreas begin to release more
insulin however there is a point where the pancreas cannot keep and glucose begins to
build up in the blood. Beta cell failure occurs.
- Type 2 diabetes can be prevented as people are often told that they are pre-diabetic
meaning that they have insulin resistance but can still intervene before diagnosis.
- Excess glucose blood vessels to thicken and lose elasticity leading to potential heart
issues and stroke risk.
- early onset type 2 diabetes is extremely dangerous with people having a lifetime risk of
blindness and potentially having their lifespan shortened by 15 years.
- Pregnant women, even those that have never had an issue with their blood sugar levels
can develop gestational diabetes. This can cause serious complications in the pregnancy.
- Obese women are at higher risk for gestational diabetes so theyre normally screened
early on in their pregnancies. Exercise, high fiber and low glycemic index diet can
decrease the risk of developing diabetes.
- Studies have found that children who are exposed to high glucose levels in the womb
tend to be at a higher risk for obesity and diabetes later on in their lives.
- Poverty and racial inequities can contribute to diabetes bc of food or healthcare access
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Proteins:
- Proteins are essential to the body especially in periods of growth like when we are
children however, majority of people in the US overconsume protein.
- Proteins contain nitrogen which originates from the amino acid building blocks.
- Side chains are what distinguishes one protein from another.
- All amino acids have a central carbon, an amino group, an acid group, and a side chain
- There are nine essential amino acids that we must get from food as the body cannot
produce them. Nonessential can be made by the body.
- Conditionally essential amino acids: not normally essential but with certain situations
might need to be derived from dietary sources.
- When we eat protein, the body breaks it down into amino acids that are then used to
build proteins that we need in our bodies.
- Transcription is when DNA is turned into RNA. Translation is when RNA is translated
into amino acid chains. Chains then fold into specific shapes.
- Protein shape affects protein function.
- Shape of proteins is not permanent as they can be denatured by things like heat or pH.
This means that when we have a fever or the pH of our blood is changed proteins could
be denatured.
- In our stomachs, protein is denatured by hydrochloric acid and unfolds. This allows
pepsin to access peptide bonds which can increase the digestibility of protein.
- Once the protein fragments enter the small intestine (cck and secretin hormones),
enzymes released from the pancreas, known as proteases, break the strings of amino
acids into peptides, short chains of amino acids. These peptides are digested further by
enzymes on the surface of the intestinal mucosa, and dipeptides, tripeptides, and
individual amino acids are then absorbed by mucosal cells of the small intestine with the
assistance of various transport proteins. From the mucosal cells, the amino acids are
transported into the blood by additional transport proteins.
- Many hormones are proteins. Proteins are extremely important for transport and storage
in the body. Hemoglobin is a protein that can transport oxygen for example. Antibodies
are proteins.
- Proteins help maintain fluid balance in our body preventing swelling.
- Proteins also help us feel full when we eat.
- Amino acids are only produced when our body needs them so increasing protein intake
will not necessarily increase amino acid amount.
- Excess amino acids are stored as fat or energy stores.
- Proteins are constantly being broken down and replaced. This is called protein turnover.
- While the body can reuse many proteins, sometimes when the amino acids are broken
down they are metabolized in a way that makes them unable to be reused which is why
we have to supplement protein in our diets.
- An energy source protein provides 4 kilocalories per gram.
- When amino acids are used for energy or for the synthesis of glucose or fatty acids, the
amino group that was stripped off must be disposed of; otherwise, it would accumulate
in the body as ammonia, which is toxic. To prevent this, the liver converts ammonia to a
less toxic substance called urea. Urea is then released into the blood, filtered by the
kidneys, and excreted in urine.
- Nitrogen balance can be calculated from urine to see how much protein is being retained
in the body and whether we are losing, gaining or maintaining protein levels.
- For non growing adults the amount of nitrogen in the body and the amount of nitrogen
outside of the body should be approximately equal.
- Negative nitrogen balance: losing weight and muscle
- Positive nitrogen balance: gaining weight and muscle
- For a growing child or pregnant woman nitrogen in should be more than nitrogen out.
- Only amino acids can leave the brush border and absorb into blood stream
- Elderly need more protein to prevent loss of muscle mass and frailty. Does not apply to
middle age adults.
- Benefits are maximized if plant based protein is high.
- Eggs have high protein quality meaning they have all 9 essential amino acids.
- Limiting amino acids: amino acid that is lowest in a food.
- Protein complementation: getting necessary protein from a mixture of foods not one
- In developed countries most protein deficiencies are associated with swapping food for
other items like alcohol or long term illnesses.
- High protein diets promote weight loss by keeping people full and eating less. Not good
in maintaining weight loss.
- The amount of protein is not as important as the source of it. High-protein diets are
often linked to being a high-fat diets so they can increase the prevalence of
cardiovascular disease. For this reason high protein diets are not recommended.
- Protein needs are determined by sex, life stage, and other factors. The RDA for adults is
0.8 g/kg/day. The AMDR for protein is 10–35% of total calories.
- The digestion of protein begins in the stomach, where proteins are denatured and
fragmented; continues in the lumen of the small intestine; and is completed within the
mucosal cells of the small intestine.
- Protein needs are higher in athletes due to recovery (sometimes muscle can break down
during activity), small amount used for energy.
 - Soy proteins like tofu are complete proteins containing all required amino acids.

Lipids:
- Fat is most energy dense (9 kcal/g) used as major energy source in body
- Fat is used for energy during exercise after glycogen is used up.
- Fat is normally stored in adipose tissue (fat tissue)
- Role of fats: Main component of cell membranes, nerve cell transmission, protection of
organs, insulation via subcutaneous fat, transportation of fat soluble vitamins.
- Fat provides texture and flavor
- Fat contributes to satiety which is prolonged digestion so less hunger.
- Lipids are hydrophobic molecules.
- 3 types of lipids: Triglycerides (3 fatty acids and carbon), phospholipids (2 fatty acids and
carbon), sterols (precursor to hormones like cholesterol)
- Fatty acids are carbon chains with hydrogen bound to them. Classified by length of
chain, saturation and shape.
- Fatty acids function: metabolized to form energy, regulate rates of gene expression, used
to synthesize hormone-like compounds.
- Length of fatty acid affects digestion absorption and metabolism
- Saturated fatty acids: fully hydrogenated so they are more solid at room temp (cheese,
coconut oil, animal fats). Takes a higher amount of energy to break apart bc rigidity.
- Saturated fatty acids = higher risk of high cholesterol and heart probs
- Monounsaturated fats: kink in chain that doesn’t allow for full saturation so more liquid
at room temp. Nuts, olive oil, avocado, etc.
- Polyunsaturated fatty acids: many places where hydrogen isn’t bonded so very liquid at
room temp. Corn oil or sesame oil.
- Trans fatty acids: more similar to saturated fats bc kink is straightened out allowing for
more compact packing. Produced via partial hydrogenation.
- Hydrogenation: adding a hydrogen to make fat more like saturated fats
- Hydrogenation allows things to spoil less because more liquidy fats spoil easier
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- Omega threes have been shown to reduce the risk of heart disease only when consumed
in fish not in supplement form.
- Omega's in general are needed for immune and inflammatory responses. Because of this
there has been research done into reducing the amount of omega sixes in the diet to
possibly reduce inflammation but this has not been fully supported yet.
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- Glycerol has three Fatty acids attached to it. It is a triglyceride.
- Lipogenesis is the synthesis of The triglyceride molecule.
- Insulin stimulates lipogenesis.
- Triglycerides provide and store energy. They're needed for insulation and protection of
organs. Most abundant lipid. Provide most of the energy in foods. Needed for transport
of fat-soluble vitamins (A,D,E,K). 3 fatty acid chains bound to a glycerol.
- Phospholipids are a three-carbon glycerol molecule consisting of two fatty acids and one
phosphate group. Are the main component of cell membranes. The body can produce
these, they are not considered essential nutrients.
- Sterols: 4 carbon rings connected to one hydrocarbon side chain. Most common in
cholesterol which is a precursor to synthesis of bile and hormones. Does not provide
energy.
- About 75% of the cholesterol in the blood is made by our own bodies. Because of this, we
do not need to get cholesterol from our diet. Only comes from animal products.
- A small amount of fat digestion takes place in the mouth and stomach via salivary
amylase. Most digestion of fat occurs in the small intestine.
- Because facts are not water-soluble they tend to clump up in the small intestines watery
environment and the body uses emulsification to combat that problem. bile from the
gallbladder which is created with the help of cholesterol, aids in emulsification.
- Lipases, produced by the pancreas and released into the small intestine, can now readily
access the triglycerides suspended in these droplets and digest them into
monoglycerides and free fatty acids. The products of triglyceride digestion, along with
bile acids and other fat-soluble dietary substances, form structures called micelles that
deliver dietary lipids to the surface of mucosal cells of the small intestine. Micelles then
release the dietary lipids, which are absorbed by the mucosal cells. Once inside mucosal
cells, fatty acids and monoglycerides (which, as their name implies, contain only onefatty
acid chain) are reassembled into triglycerides.
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- Two essential fatty acids: linoleic acid and alpha linoleic acid. (omega 3 or 6)
- Trans fatty acids raise LDL and lower HDL increasing risk of heart disease.
- Lipids require carrier proteins in the blood because they are not water-soluble. these
proteins are called lipoproteins. In the mucosal cells of the small intestine, lipids are
Incorporated by a protein called Chylomicron. Chylomicron proteins are too big to
dissolve into the blood on their own so instead they enter the lymphatic system and then
travel to the blood.
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- High-density lipoproteins or HDLs are referred to as good cholesterol because they pick
up excess cholesterol in the body and transport it to the liver where it is recycled or
turned into bile. The overall effect of this is lowering high cholesterol levels.
- Low-density lipoproteins or ldls are often known as bad cholesterol because these
proteins are primarily responsible for picking up excess cholesterol in the body and
transporting it into the blood. While ldls are needed for basic body functions, they are
often responsible for elevated levels of cholesterol.
- Omega 6 precursors are more inflammatory than omega 3 precursors
 - Lingual lipase and gastric lipase play a small role in lipid digestion prior to the small
intestine. These are highly specific.
- Bile coats the lipids and allows them to emulsify and then the pancreatic lipase breaks
them down into a form where they can be absorbed into the mucosal cells.
- Chyme is released and then cck is released in response.
- Pancreatic secretions such as bicarbonate are released prior to bile so that the small
intestine is protected from the chyme.
- If you inhibit pancreatic lipase, you will not be absorbing fat molecules that you
consume. This has often been considered as a weight loss strategy.
- Fats leave via lacteals to the lymphatic system.
- VLDLs HDLs LDLs and chylomicrons are protein carriers for fats.
- Chylomicrons transport dietary fats and cholesterol from the small intestine to muscle
and adipose tissue. Triglyceride rich.
- VLDLs carry triglycerides from liver to muscle and adipose tissue. Triglyceride rich.
- VLDL is converted into LDL which carries cholesterol to all parts of the body. This is
cholesterol rich.
- HDL picks up cholesterol from body cells and transports it to the liver. Protein-rich.

Cardiovascular disease:
- Cardiovascular disease is the leading cause of death in the world.
- long-term decrease in flexibility/thinning of the blood vessels is called atherosclerosis
- Atherosclerosis is characterized by a buildup of plaque in the blood vessels typically over
the course of decades. This plaque is caused by a high amount of ldls.
- Ldls infiltrate the lining of blood vessels and then are oxidized causing an inflammatory
reaction. Macrophages try to control the response however they take up ldls in an
uncontrolled manner eventually causing the macrophages to die off and then they just
deposit their fat inside of the blood vessels. Fat containing macrophages are called foam
cells.
- If blood flow is restricted in the coronary artery, a heart attack or a myocardial infarction
can occur. If blood flow is restricted to the brain a stroke can occur.
- It has been shown that cvd risk factors occur from childhood.
- Modifiable risk factors include diet exercise smoking and alcohol consumption.
- Non-modifiable risk factors: Age, gender, family history
- Metabolic syndrome refers to people with multiple risk factors for cvd.
- Low-fat diets with high amounts of starches can raise triglyceride levels.
- For people at risk, they should consume less than 7% of calories as saturated fat.
- Studies found that women who ate the least polyunsaturated fats were at the lowest risk
for heart disease.
- Hypertension and diabetes are risk factors for CVD.
- Inside of the artery is lined with endothelial cells. Nothing should stick to these.
- Dietary guidelines for Americans recommend less than 10% of calories to be saturated
fats and less than 2% of total calories to be trans fats.
- American Heart Association recommends that less than 7% of calories daily should be
from saturated fats.