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Ch. 1 Nutrition- process by which living things use food to obtain nutrients for energy, growth, development, and maintenance Nutrients - Biochemical substances that can be supplied only in adequate amounts from an outside source, normally from food. Enrichment: process by which iron, thiamin, riboflavin, folic acid and niacin removed during processing are restored to approximate their original levels. have removed nutrients (usually during processing—typically B vitamins) that were added back in. Fortification: process by which nutrients not present in the natural product are added or increased in the original product Macronutrients Water (most Important!) Proteins Carbohydrates Fats Micronutrients Vitamins Minerals Only Proteins, CHO& Fats provide energy BMI <18.5=underweight 18.5-24.9= normal weight 25.0-29.9=overweight
30.0=obese Sugar Alcohols (aka- Polyols) Sorbitol, mannitol & xylitol (found in plants) Advantages: Do not cause a sudden increase in blood glucose levels Do not contribute to tooth decay (less cariogenic) Not readily metabolized by bacteria Some may contribute to re-mineralization of enamel More dangerous with children or infants (diarrhea) Ch. 4 CHO
Physiological roles CHO
- Energy (4kcal)
- Fat Storage
- Protein Sparing
- Oxidation of Fats
Ch. 5 PROTEINS Amino Acids = building blocks; all proteins made of combo of 20 AAs Essential Amino Acids (EAA) - AAs that must be supplied by diet (Indispensable) Dispensable - can be produced from indispensable AAs from food
Complete Protein - has all Indisp. AAs - meat, fish, milk, eggs, cheese, soy, quinoa Nitrogen Balance: the balance of reactions in which protein is broken down, destroyed, and rebuilt -Nitrogen balance: healthy individuals excrete (in feces, urine, and from skin) same amount of nitrogen as consumed from their food -Negative nitrogen balance: person with a burn or illness excretes more nitrogen than is ingested -Positive nitrogen balance: in periods of growth (a child or pregnant woman), more protein retained than lost Physiological roles of Proteins -Build and Repair -Produce essential compounds -Regulate fluids -Transport lipoproteins -Energy 4 kcal Protein Deficiencies Noma- progressive necrosis manifests as small ulcer on the gingiva and spreads to produce extensive destruction of lips, cheeks, and jaw NUG- characterized by erythema and necrosis of the interdental papilla Underconsumption Development/Growth- smaller salivary glands result in diminished salivary flow, impaired wound healing and suppressed immune response; more susceptible to infection Kwashiorkor- acute form of Protein Energy Malnutrition from lack of HIGH-quality protein (at risk children in famine stricken areas, 18-24 months) Marasmus- from long-term protein and energy deficits (at risk children, homeless, elderly, substance abusers) Ch. 6 LIPIDS Physiological roles of Fats -Concentrated source of energy (9kCals) -Satiety Value -Palatability -Provides insulation and maintains body temperature Too much Fats: -Obesity -Increase risk of CVD, cancers -Blood lipid levels (hyperlipidemia) —> Cardiovascular Disease High-density lipoproteins (HDLs) ----”H”= Happy or Good (fish, vegetables, fruits) More of a lifestyle than the food we eat Composed of greater amounts of protein and less lipid Protective agent against CHD Low-density lipoproteins (LDLs) ----”L”=Loser or Bad (Potato chips, fried foods, saturated fats, cream, butter, ice cream
Health Application 7 - Diabetes Mellitus (132) African, Hispanic & Native Americans = highest incidence of DM CDC predicts 18.8 million US have DM Type II can be prevented or delayed through lifestyle changes for high-risk individuals Type I = little or no insulin production; common in young people HBA1C - 3 month measure of blood glucose At risk for hyperlipidemia and hypertension Renal Failure - inability of kidneys to excrete toxic waste materials Ch. 8 Vitamins for Calcified Structures Fat-soluble vitamins Vitamins A,D,E,K Water-soluble vitamins Vitamin C, and B-vitamins Vitamin A Retinol is the dietary source of Vitamin A from animal sources Beta-carotene is the principal carotenoid present in plant pigments Retinoic acid is the form of vitamin A involved in the development of teeth especially in the formation of: ameloblasts (in enamel), odontoblasts (in dentin), bone growth Retinoids: found in fortified foods HYPO states: Impaired dark adaptation & night blindness, possible death, enamel hypoplasia Enriched foods have removed nutrients (usually during processing—typically B vitamins) that were added back in. Fortified foods add more nutrients to the food, rather than replacing the removed nutrients. Example: Breakfast cereals Vitamin D (Calciferol) Called a vitamin, but more appropriately classified as a hormone HYPO states: Osteoporosis - Vitamin D deficiency interferes with mineralization, decreased bone density and increased risk for fracture, enamel hypoplasia, dental decay, perio Vitamin E (Tocopherol)
- (^) Antioxidant
- (^) Anticoagulant in large amounts (Warfarin/Blood thinners contraindicated)
- (^) Enhance release of prostaglandin
- (^) ALL promote resistance of periodontist to inflammation Sources: vegetable oils, soybean oil HYPO: peripheral neuropathy Vitamin C (Ascorbic Acid)
Physiological roles: Important for production of collagen Formation of fibroblasts, osteoblasts & odontoblasts Enhances iron absorption HYPO: poor tooth development, poor bone, scurvy Health Application 8 - Antioxidants (156) Good source = beans, fruits, pecans, potatoes Phytochemicals- biologically active substances found in plants May prevent CHD, cancer, eye disease, other aging conditions Ascorbic Acid- strongest antioxidant Ch. 9 Organic matrix of bone is 90%–95% collagen fibers Formation of collagen requires protein, vitamin C, iron, copper, and zinc Once collagen is formed, mineralization begins: Calcium, phosphorus, magnesium, sodium, potassium, and carbonate ions form mineral matrix After eruption, NO more enamel forms Mineral exchange occurs slowly in response to the oral environment 1) Calcium - Most abundant mineral in the body; 99% in teeth and bones Sources: milk/dairy, fortified soy/rice, orange juice, supplements Calcium to Phosphorous Ratio (1:1) Serum levels of calcium and phosphorus inversely related If calcium level goes up, phosphorus level goes down Ideal calcium/phosphorus ratio for adults is 1: Excessive intake of phosphorus compared with calcium reduces serum calcium concentration Best absorbed when consumed in smaller amounts & ingested several times during the day Factors decreasing absorption of Calcium: Oxylates and phytates in grains, vegetables Reduced gastric acidity/ increased age Excessive fiber Low-protein, low-phosphorus diets Postmenopausal women due to decreased estrogen Decreased levels of Vitamin D 2) Phosphorous Second-most abundant mineral in the body; about 85% in the skeleton and teeth Best sources are milk products and meats 3) Magnesium 3rd most abundant mineral in the body Bones contain almost two thirds of body’s magnesium
Slowly progressive disease characterized by deterioration of judgement, orientation, memory, personality, and intellectual capability Problems with nutrition: Ch. 11 first signs of nutritional deficiency (B-complex vitamins, vitamins C and K, iron, and protein) frequently evident in the oral cavity Angular cheilitis or cheilosis (cracks around the corners of the mouth) and glossitis (inflammation of the tongue) are commonly associated with nutrient deficiencies The oral cavity is lined with nonkeratinized mucosa except for what structures? Palate, tongue, gingiva Keratinized: palate, tongue, part of gingiva Non-keratinized: cheeks, buccal mucosa, floor of mouth (moveable) What are these structures covered with? Filiform=smooth, threadlike on dorsum of tongue Fungiform=red, mushroom-shaped; scattered throughout filiform Taste buds located on foliate papillae (vertical grooves on lateral borders of tongue Circumvallate papillae (large mushroom-shaped forming a V) Loss of which papilla types result in loss of taste buds and changes in taste acuity? Foliate and Fungiform (elderly: lose sweet taste buds last) Vitamin B’s (Know Name not just Number- matching of deficiency)) Thiamin (B1) Functions: Coenzyme for metabolism of CHO and amino acids (pork, egg yolk) Hypo states seldom seen in US because of enriched grains in foods (exception alcoholics) Beriberi; means “I cannot” (move easily) - hypo state (ON FINAL)
- Peripheral neuropathy and muscle wasting
- Cardiovascular symptoms--tachycardia and enlarged heart
- Impairment of sensory & motor function w/o CNS involvement Riboflavin (B2) HYPO: Glossitis: progressive papillary atrophy and patchy, irregular denudation (sluffed off, smooth) Niacin (B3) Sources: The body can synthesize niacin from the AA tryptophan HYPO: Pellagra -Dementia -Diarrhea -Dermatitis (rash) -Death Folate (B9) most common Vit. B Deficiency
Role: Proper formation of neural tubes during fetal development HYPO:
- (^) Neural tube defects, cleft lips & palates (if deficient during pregnancy)
- (^) Perio At risk = pregnant/lactating Absorption of B12 occurs at specific receptor sites in the ileum only if bound to intrinsic factor Cobalamin (B12) What type of diet may cause a Vitamin B12 deficiency? - VEGAN HYPO: -Pernicious anemia = Macrocytic (large), immature red blood cells -Glossopyrosis (unexplained pain of the tongue) -Altered taste sensation -Glossitis (smooth, beefy-red tongue)
- Cheilosis
- Gastrointestinal disturbances -Weakness Vitamin C Improving the host defense mechanism Role in collagen formation and optimal wound healing Vitamin A Maintaining integrity of epithelial tissues Vitamin E Antioxidant to neutralize free radicals and promote integrity of cell membranes of the mucosa Health Application 11 - Vitamin and Mineral Supplements (203) Ch. 18 Caries Process Critical PH 5. Cariogenic- A fermentable CHO that can reduce salivary pH to less than 5. Ex: sucrose, glucose, fructose, maltose Cariostatic -Foods that cannot be metabolized by microorganisms in plaque; they are caries-inhibiting Ex: Proteins & Fat Anticariogenic - Reduces the risk of caries by preventing bacteria from recognizing a cariogenic food Ex: Xylitol, proteins, fats, phosphorous, calcium Fermentable CHO - CHO that can be metabolized by bacteria in plaque All sugars and cooked/processed starches Caries results from a combination of factors -Susceptible host or tooth surface -Sufficient quantity of cariogenic microorganisms in the mouth—strep.mutans & lactobacillus -Presence of fermentable carbohydrates
