1
Q
What is the first law of thermodynamics?
A
Energy cannot be created or destroyed, it can just be tranferred from one form of energy to another. (chemical, mechanical, electrical or heat)
2
Q
What is the second law of thermodynamics?
A
All energy used by the body degenerates as heat
3
Q
What is a calorie?
A
The amount of heat required to raise the temperature f 1g of water by 1’C
4
Q
How many calories in each macronutrient?
A
1g carbs: 4kcal, protein: 4, Fat; 9, Alcohol: 7, Fibre: 2.
5
Q
What are the key nutrients for energy production?
A
Mg, Manganese, Fe, Sulphur, COQ10, Copper, Vit B1, b2, B3, B5, Alpha-lipoid acid
6
Q
What substances can interfere with energy production?
A
Heavy metals - mercury, arsenic etc. Toxins
7
Q
What are the three variables of total energy expenditure?
A
Basal metabolic rate (60-75%), physical activity and the thermic effect of food
8
Q
What factors can raise basal metabolic rate?
A
stress, caffeine, nicotine, exercise, meds, fever, injury, genetics, hyperthyroidism
9
Q
What are the two thyroid hormones?
A
Thyroxine (T4), Triiodothyronine (T3)
10
Q
Which nutrients are needed for thyroid hormone production?
A
Iodine, tyrosine, zinc, selenium and iron
11
Q
What is subclinical hypothyroidism?
A
Raised TSH but normal T4 and T3
Can have some hypothyroid symptoms
12
Q
Which food groups have the largest thermic effect?
A
Proteins (20-30%)
Carbs (5-10%)
Fats (0-3%)
13
Q
How much energy does it take to store carbs as fat?
A
30% - except fructose which converts easily
14
Q
What macronutrient ratios are best for gaining muscle and losing weight?
A
gaining muscle: high carb and high protein
losing weight: high protein lower carbs
15
Q
What is the process of ketosis?
A
When glucose is insufficient, the brain sees it as a stressor and cortisol increases this causes a drop in insulin causing an excess supply of fatty acids from adopose tissue which are turned into ketones
16
Q
What causes a feeling of satiety?
A
GI distension activates mechanoreceptors, CCK is released, liver detects nutrients - sent back to brain by the vagus nerve
17
Q
Which part of the brain controls appetite?
A
The arcuate nucleus of the hypothalamus
18
Q
Which neurotransmitters/hormones increase appetite?
A
neuropeptide Y, Insulin, Ghrelin
19
Q
Which neurotransmitters/hormones decrease appetite?
A
CCK, Glucagon, GLP-1, Bombesin, Leptin
20
Q
What causes CCK to be released?
A
The presence of food in the duodenum, especially with high fat and protein
21
Q
What are the actions of CCK?
A
Stimulates the gallbladder to release bile, and pancreas to release enzymes, delays gastric emptying, stimulates satiety centres
22
Q
What are the actions of insulin?
A
- lowers blood sugar
- stimulates glycogen synthesis and storage, storage of fats in adipose tissue, stimulates gluconeogenesis, stimulates glucose uptake into muscles, stimulates hunger via hypothalamus
23
Q
what is adiponectin?
A
An adipose-specific protein hormone that increases the oxidation of fatty acids, promotes the clearance of excess fat in tissues and improves insulin sensitivity
24
Q
What does visceral fat release?
A
Inflammatory cytokines - TNF-a and IL6 which further promotes insulin resistance and obesity
25
How is fructose metabolised?
It gets converted directly to fat in the liver
26
When is ghrelin produced?
In the stomach when it is empty, it's secretion is suppressed after a meal. (it is often raised when trying to lose weight)
27
What factors increase ghrelin secretion?
poor sleep, high cortisol, no exercise, losing weight
28
What factors decrease ghrelin?
Exercise, good sleep, high protein meals
29
when is leptin released?
when there are white adipose cells, the more fat cells the more leptin released - this should suppress appetite, but many individuals are leptin resistant
30
What can you do to increase leptin sensitivity?
- Go Gluten free (gluten can stop leptin binding to the receptor)
- reduce fructose consumption
- Prebiotic foods
- anti-inflammatory diet
- regular exercise and good sleep
31
What are the differences in gut flora in obese vs lean individuals?
lean individuals have more bifidobacterium, and more diversity.
Higher ratio of firmicutes to bacteriodetes phyla in obesity.
32
How does intestinal permeability impact weight gain?
- short chain fatty acids increase the secretion of appetite-suppressing neuropeptides
- permeability causes enhanced lipopolysaccharide absorption, inflammation and insulin resistance
33
Which families of bacteria are best at improving blood glucose control?
lactobacilli and Bifidobacteria
34
What is the difference between appetite and hunger?
appetite: psychological reaction that stimulates a physiological response - a conditioned response to food
Hunger: a physical reaction that includes chemical changes in the body from time without eating (the need for food)
35
Which foods stimulate the dopamine reward system?
sugars and fats primarily, tolerance builds up with excessive intake
Dairy and wheat - as has peptides similar to opioids
36
Which area of the brain causes sugar cravings?
Nucleus Accumbens - causes sugar cravings due to sharp rises and drops in blood sugar
37
What are some strategies to regulate food intake?
Increasing plant foods, fibrous/water filled foods, higher proteins, higher nutrient dense foods may decrease cravings
38
What are some ways to improve stress levels?
- identify root cause
- vagus nerve stimulation exercises
- balance blood sugar
- use adaptogenic and nervine herbs: ashwagandha, chamomile and passionflower
- reduce stimulants
- Epsom salt baths
- increase magnesium, b-vits, vit C
39
What are some good sleep hygiene tips?
- avoid stimulants and alcohol
- plan for 8-9 hours of sleep, before 11
- ensure room is dark, cool and well ventilated
- lower lights, or use red lights, switch off devices
- 3hrs before, finish eating and exercising
- same time each day
40
How does intermittent fasting help with weight loss?
It lowers insulin levels and helps your body use fat for fuels, it increase growth hormone which can lower body fat
41
How does the ketogenic diet help with weight loss?
Lowers insulin levels, mobilising fat and reducing it's storage. Lower inflammatory burden.
42
Why is HIIT good for weight loss?
Creates an oxygen debt which causes increased oxygen consumption and energy consumption post exercise
43
What are some non-food strategies for weight loss?
- smaller plates
- tracking food and snacks
- timing of eating
- mindful eating
- focus on health gain goals rather than appearance (waist measurement>weight)
44
Breast-fed babies have lower incidence of which illnesses?
eczema, asthma, allergies and respiratory infections
45
What are the benefits for mothers breast feeding?
- cheap and convenient
- delays the return of ovulation
- conserves iron stores
- protective against breast and ovarian cancer (low oestrogen and ovulation)
- aids post-birth weight loss
- support mother-baby relationship, and recovery from post-partum depression
46
Which lipids are present in breast milk?
Linoleic, linolenic acid, arachidonic acid and DHA
46
What is the composition of breast milk?
88% water, 6-7% carbs, 3-5% fat, less than 1% protein. digestive enzymes
47
Which lipids are present in breast milk?
Linoleic acid, linolenic acid, arachidonic acid and DHA
48
Which antibodies are high in colostrum?
IgA
49
Which factors affect breast milk microbiota?
overweight = less diversity
C-section birth = less diversity
50
Which components of breast milk have immune function?
secretory IgA, vitamin A, zinc, lactobacillus bifidus, lactoferrin, lactadherin
51
Which minerals are present in breast milk?
high calcium, high zinc and iron bioavailability, low sodium for immature kidneys
52
What are the benefits of delayed cord clamping?
It helps babies get up to 30% more iron-rich blood, RBCs and WBCs.
53
How long should women breast feed?
6 months exclusively and 2 years with addition of food.
54
Which nutrients are very important for breastfeeding mothers?
- protein (extra 11g a day)
- iron (increased blood volume)
- zinc (needed for hormone production and to reduce PPD)
- B vitamins and Mg- ATP production, NO can deplete B12
- EPA/DHA - needed for neural and eye development of foetus
- Vit C - co-factor for collagen synthesis, needed for iron absorption and thyroxine production
- vit D - helps reduce PPD
- probiotic foods - beneficial for recolonising gut
55
What are the eastern traditions in the postpartum period?
one month-40 days of warming foods, rest, spending times with baby and feeding
56
What is Congee?
A traditional post-partum meal of brown rice in broth, in south-east asia.
57
What is korean seaweed birthday soup?
soup with seaweed, onion, garlic and can add beef and mushrooms. eaten post-partum and on birthdays
58
What food types are good during pregnancy?
Dry and warm foods
59
What are some key nutritional goals during lactation?
- eat to satisfaction, chew well
- avoid colder foods and drinks
- do not skip meals
- eat well-cooked, easy to digest food
- include probiotics and omega-3s
- avoid caffeine and alcohol as can pass into breast milk
60
How does smoking affect breastfeeding?
It decreases milk volume
It alters the taste of the milk
Higher risk of SIDS
61
Which common medications are contraindicated during lactation?
chemo, lithium, retinoids, amiodarone, codeine, decongestants, aspirin
62
Which herbs can help with milk supply?
Fenugreek and fennel seeds. best thing is to feed more.
63
What are the issues with infant formulas?
usually highly-processed ingredients, no antibodies or immune components. heavy metals have been found in infant formula
64
What are the signs of weaning?
-sitting upright, taking an interest in foods, putting it in mouth
- solid foods should be introduced after 6 months of age
65
How do you wean?
Introduce one food at a time with a 3-4 day interval to observe for allergies. introduce nuts between 4-11 months. Continue breastfeeding alongside it. breastmilk icelollies for teething babies
66
What is baby-led weaning?
When you let the babies feed themselves finger foods from a selection. Good for self-regulation
67
Which foods should not be given to babies?
sweet foods, any sweeteners, canned vegetables, honey (due to risk of botulism), soy products, cows milk (iron deficiency, low linoleic acid)
68
What are the issues with disposable nappies?
Can increase risk of nappy rash due to containing irritants to the skin. best alternatives - natural cloth nappies.
69
What advice should be given about nutrition in childhood?
They may have different eating times, do not force them to eat or finish everything on their plate. Eat by example. Do not criticise eating habits. do not bribe with sweet foods as they see it as a reward
70
What are the macronutrient requirements during childhood?
High carbs (60-70%)
slightly lower fibre to help absorb food. High fat in younger children. protein requirements increase with age
71
How can iron absorption be impeded in children?
processed foods, high cows milk (due to calcium and casein)
72
Which nutrients need to be focused on if a child is on a vegan diet?
DHA rich foods, calcium, non-haem iron, vitamin B12, vitamin D
73
Why are essential fatty acids important in teenage years?
Needed to make hormones and improve skin, nail and hair health
74
How can teenagers improve bone health?
Calcium (requirement increases in teenage years), physical activity - load bearing, avoid fizzy drinks (phosphoric acid can decrease calcium absorption), caffeine and alcohol. add in magnesium rich foods and vit D
75
When is iron intake important?
During adolescence, due to growth, with heavy periods and pregnancy
76
What are some ways to support nutrition in adolescence?
cook together and teach how to cook, lead by example, encourage activity, work on good digestion (bitters, chewing etc)
77
What foods should be avoided during breastfeeding?
Caffeine, alcohol, high cruciferous veg (makes baby gassy)
78
What foods should be avoided during weaning?
Soy products, junk foods, honey
79
What are the physiological changes that occur with ageing?
Decreased hormone levels. dysregulation of immune function, loss of skin integrity, loss of muscle mass and bone density, arterial stiffening, declining neurological function, GIT slowing
80
What are telomeres?
DNA protein structures found at the ends of each chromosome. Each cell division a small part of the telomere gets lost, when it is very short the cell undergoes senescence/apoptosis
81
Which element is associated with old and mature?
Dry = mature
Cold = old age
82
Which hormonal changes can contribute to sarcopenia?
low Testosterone, low oestrogen, low growth hormone, high insulin
83
What are some reasons for malnutrition in ageing?
Dentures, poor swallow, poor memory, low appetite, immobility, cancer
84
What changes occur in the GI tract with age?
Less intrinsic factor production, reduced stomach acid, impaired gastric motility, low B12, SIBO
85
What are the cardiovascular consequences of ageing?
stiffening of arteries, decreased max HR, increase LV muscle mass
86
What are the vitamin common causes of cognitive impairment?
low folate, B12, B6
87
What immune changes are seen with ageing?
Decline in T cell function, low lymphocytes (low protein), micronutrient deficiences
88
Which micronutrient deficiencies decrease immunity?
A, C, E, Zn, Se, Fe
89
What is NAD+ and how do you increase it?
An essential co-factor in cells, NAD+ depletion is associated with ageing. Increase by exercising, sleeping well, fasting, good fats
90
What are the actions of melatonin?
circadian rhythm regulator, antioxidant, modulates NK cells
91
How much protein should elderly people consume?
1g/kg body weight/ day
92
What are the macronutrient requirements in the elderly?
high protein, un-refined carbs and lots of fibre (to prevent constipation), high omega-3 for skin and neurological health. Soft foods with fluids to aid swallow and digestion.
93
Why is CoQ10 good for healthy ageing?
Antioxidant, can be depleted by statins, used for ATP production and can help with CVD
94
According to Valter Longo what are the nutritional principles for longevity?
high plant foods, fish 2-3x a week, eating window 11-12 hours, 2-3 meals
95
What are the benefits of nettle tea?
Diuretic, relieves fluid retention, flushes out toxins, anti-inflammatory, good for hayfever, blood glucose balance
96
What are the benefits of dandelion root tea?
Enhances digestion, liver detox, mild diuretic, promotes peristalsis
97
What are the benefits of peppermint tea?
soothes digestion, pain, nausea, flatulence, helps with pain and itching topically, antimicrobial
98
What are the benefits of chamomile tea?
Relieves pain, flatulence and spasm in the digestive tract. calms NS, helps with stress and sleep
Naturopathic Nutrition
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