FN 110 Notes (2nd exam)

Nutritional Assessment

A- Anthropometry
B- Biochemical
C- Clinical
D- Dietary (24-hr food recall, food diary, 3-day food diary)
E- Ecological

COMPUTATION IN NOTES (Tan Rauser, Filipino Method, BMI, DBW %, PASOO, etc.)

Water

 The most versatile medium for all kinds of chemical magic

 Enables chemical reaction to occur in the body
 It forms the greatest component of the human body
 Makes up about 50% to 60% of the body’s weight
 Lean muscle tissue- about 75%
 Fat tissue- about 10%
 An adult can survive only a few days without drinking water
 The body can neither store nor conserve water as well as it can the other
components of diet

The Body’s Fluid Compartments

Extracellular volume- outside cells Intracellular volume- inside cells

17 litters total 25 litters total
3 litters, 14 litters Found inside cells of every kind of tissue
Blood plasma (blood cells, bone cells, muscle cells, fat
Fluid between cells cells, etc.)
Lymph
Gastrointestinal fluid
Spinal column fluid

H20 and Ions: A Love Affair

 H20 is attracted to ions

 The body controls the amount of H20 in both compartments by controlling ion
concentrations
 Where ions go, H20 follows

Water, water everywhere?

 Not so
 The body needs to regulate and equalize the proportion of water in cells and in the
blood stream
 Osmosis
 The passage of solutions through a semipermeable membrane
 Operates when fluids containing different ion concentrations are separated by a
semipermeable membrane

Water, Ions, and Osmosis

 Because of the action of osmosis, water is forced to move across membranes to

balance changes in ion concentrations
  Cells have pumping mechanisms that constantly draw potassium ions into the cells
and pump sodium ions out

Fluid Loss as Sweat

 The amount of fluid lost as sweat varies between individuals and is dependent on the
following factors:
 Exercise intensity
 Exercise duration
 Temperature
 Humidity
 Hydration status
 Training status
 Acclimatisation
 Type of clothing
 Altitude
 Individual person

The Physiology of Hydration

 During exercise, total body metabolism is typically increased to 5-15 times the
resting rate
 Approximately 70-90% of this energy is released as heat
 As a means of heat dissipation, the body produces sweat
 A substantial volume of water is lost especially in hot climates
 Some electrolytes are also lost
 Replacing both fluid and electrolyte losses may avert the effects of dehydration

The Risks of Dehydration

 Thirst is a poor indicator of hydration. By the time your thirst ensures dehydration
has already set in
 Increased core body temperature: the body begins to overheat
 Strain on the heart as the heart rate increases for a given workload due to the
increased viscosity of blood
 Perceived effort is greatly increased and concentration, skills and mental
functioning diminished
 Rehydration is much more difficult to achieve because of the subsequent
gastrointestinal discomfort and upsets
 Even mild dehydration can result in reduced sporting and performance
 For each litter of water lost, heart rate is elevated by about 8 beats per
minute, cardiac output declines by 1 L/min, and core body temp rises by 0.3
degree Celsius
 A 2% dehydration, when measured by body weight, decreases performance by
6-7%
 Dehydration of about 4% will produce a decline of 20-30%

Signs of Dehydration

 Early on
 Fatigue
 Dry mouth/eyes
 Loss of appetite
 Headache/irritability
 Flushed skin
  Dark scant urine with strong odor
 Weakness
 Dizziness/ light-headedness
 Cramp
 Profuse sweating/ heat intolerance
 Advanced stage
 Difficulty in swallowing
 Impaired mental performance
 Stumbling/ dizziness/ clumsiness
 Shriveled/ numb skin
 Sunken eyes/ dim vision
 Muscular spasm
 Nausea
 Delirium
 Painful urination

Can I Drink Too Much?

 Yes
 Slower athletes, overzealous with their fluid consumption, are especially at risk
 Large intakes of water will dilute the blood; this then stimulates urine output and
effectively dehydrates the body
 Hyponatremia- a potentially fatal condition of low blood sodium levels that
primarily results from the consumption of excessive intakes of water and
inadequate sodium replacement
 Signs of Overhydration
 Nausea
 Vomiting
 Extreme fatigue
 Respiratory distress
 Dizziness
 Confusion
 Disorientation
 Edema (rings, watches and shoes may feel tight)
 Coma
 Seizures
 Avoid overhydration by:
 Being sensitive to the onset of thirst as the signal to drink, rather 'staying
ahead of thirst’
 Ensuring adequate salt intake in the fluids consumed
 Monitoring weight- weighing more after training than before is a sign of
developing water intoxication
 Being aware that non-steroidal anti-inflammatory drugs and pain relievers can
contribute to developing a water overload
 Women should drink at least 3 litters of water. Men should drink 3.5 litters of water.

Eating Disorders

1. Binge Eating Disorder

 Eating one particular food
 In secret and with guilt
 Purging
 Oral-forced vomit, abuse laxatives and diuretics
 Non-oral- excessive exercise, extreme fasting
 2. Anorexia Bulimia
 High feelings of guilt after eating large amount of food
3. Anorexia Nervosa
 Abnormally body weight, an intense fear of gaining weight and a distorted
perception of weight
 Not eating
4. Orthorexia Nervosa
 Fixated to eat within a standard
 Eating healthy, counting calories

List of non-eating disorders

1. Obesity
2. Diabetes
3. Hormonal Imbalances
4. Mental disorders

Noncommunicable diseases (NCD) Risk Factors

 Unhealthy diets in urban areas: fast food, canned goods, processed food, soft drinks
 Sporadic Intermittent Physical Activity (SIPA)- hindi naka schedule kung kalian ang
exercise
 Alcohol can be taken  because of high anti-oxidant levels of red wine
 Intermediate risk factors:
 Know the density lipoprotein (DL)  high or low
 Okay lang: high cholesterol, high HDL, low LDL

90% of the Filipinos has one or more of these 6 prevalent risk factors

 Physical inactivity (60.5%)

 Smoking (34.8%)
 Hypertension (22.5%)
 Hypercholesterolemia (8.5%)
 Overweight (20%)
 Obesity (4.9%)
 Diabetes (4.6%)

Low in Fruits Consumption Among Filipinos

 Dangerously low fruit and vegetable intake

 Only 19% of national population eat fruit and vegetables more than four times
a day
 Recommended standard 100% eating FIVE servings DAILY
 Total daily requirement must be 400g/capita
 Actual consumption is only 111g/capita

The Obesity Problem

 Globally
 1.6 B overweight
 400 M obese
 Philippines
 20% in 1998
 25% in 2003

Consequences of Weight Gain

  Obesity has been associated with
 Type 2 DM, Hypertension, and Cardiovascular Diseases
 Breast, endometrial, and colon cancers
 Insulin resistance
 Peptides and hormones
 Adipocytokines, leptins and Adiponectines
 Obesity reduces life expectancy by 5 years
 Interventions:
1. Increase physical activity
2. Promote healthy choices—do not smoke
3. Promote healthy places
4. Support health at all stages of life

NUTRITION IN EXERCISE

Sports Nutrition-application of eating strategies to promote good health and adaptation to

training, to recover quickly after each exercise session, and to perform optimally during
competition

Principles of Nutrition for Exercise

 A healthy, balanced diet

 Increase total energy intake
 Keep dietary carbohydrate intake high (55-70%)
 Drink large amounts of fluid
 Vitamins and mineral supplements are not needed
 Ergogenic aids should be studies

The Link Between Nutrition and Physical Performance

 Physical activity puts increased demands on your body

 Eating the right foods and drinking the right fluids can:
1. Increase endurance
2. Improve performance and recovery
3. Help you stay fit
4. Help prevent injury
5. Help prevent dehydration

Know Your Nutrients- The foods that we at are broken down into the following nutrients:

1. CHO
2. Protein
3. Fat
4. Vitamin
5. Mineral
6. Water

General Principles of Sports Nutrition

Recommended balanced diet for average sports person is…

 55-60% Carbohydrates
 25-30% Fats
 10-15% Protein

Recommended balanced diet for more strenuous athlete is…

  10% Carbohydrates
 15-20% Fats
 10-15% Protein

Carbohydrates= FUEL

 Carbohydrates are your bodies preferred energy source

 45-65% of your calories should come from carbohydrates
 Choose sources that also provide other nutrients such as vitamins, minerals and fiber
 Good choices include:
 Whole grain cereals
 Whole grain breads
 Brown rice
 Whole grain pasta
 Vegetables
 Fruits and 100% fruit juice
 Effects of Inadequate Carbohydrates in the Diet
 Lack of energy
 Muscle fatigue
 Muscle Breakdown
 Confusion
 Lack of concentration

Sugars: Caution

 Causes low blood sugar if taken before exercise, resulting in fatigue

 Slows down the emptying of fluids from the stomach and may cause cramping
 Deprives muscles of much needed water
 Inhibits fat utilization
 7 teaspoons=recommended maximum daily amount of sugar
 Tax? Sugar-sweetened beverages?

Fiber Can Be Your Friend (What’s so great about fiber?)

 “Speeds things up”

 Binds cholesterol
 Helps you feel full
 Takes longer to digest
 Resists the “insulin surge”

Protein

 Do athletes have greater protein needs than non-athletes? YES

 Should athletes eat more protein to meet their needs? NO
 Protein is needed by our body for many functions including:
 Helping to rebuild muscle and tissue after exercise
 To make hormones, enzymes and other body chemicals
 Transporting nutrients throughout the body
 Contributes energy for exercise lasting longer than 4 hours
 But… Inefficient energy source. High protein diets DO NOT increase muscle
size and are not recommended
 How much Protein do you need?
 10-35% of your calories should come from protein sources
 Excess protein beyond what is recommended provides no additional benefits
towards athletic performance or muscle building
  Only athletic training builds muscle
 Good protein sources include lean meat, lean poultry, fish, milk, cheese and
yogurt, beans, eggs, nuts, seeds and peanut, butter
 In strength athletes the higher the degree of training, the less protein a
person uses during activity at a given intensity
 How much do I need? 15-20% of total calories

How much Fat do you need?

 20-35% of your total calories should come from fat, with the majority coming from
unsaturated fats and less than 10% from saturated fats
 Unsaturated fat sources include:
 Oils such as canola, olive, peanut or soybean oil
 Nuts
 Seeds
 Fatty fish such as salmon or tuna

Vitamins and Minerals

 Vitamins and mineral supplements are not needed

 Vitamins and minerals are essential for health and for every process that takes place
in your body. Although they are only needed in small amounts, they are very
important. Some of the things they do for you include:
 Help produce energy from fat, carbohydrates and protein
 Help to prevent and repair damage to your body cells
 Help keep your bones strong and healthy
 By eating a wide variety of foods from all food groups, you can help to ensure that
your diet provides all the vitamins and minerals that you need

Vitamins and Minerals: Calcium and Iron

 Athletes should pay extra attention to their intake of calcium and iron:
 Calcium
 Bone health and to prevent fractures
 Most teenagers are deficient on this nutrient
 Good sources are milk, cheese
 Iron
 Produces energy
 Good sources of iron include lean red meat and iron fortified cereals

Hydration and Rehydration

 Urine color chart

 Assess hydration
 1,2, or 3: well hydrated
 7 or darker: dehydrated

Myths about Water, Fluid and Beverages

 Myth: The need for water and fluids could be ignored by our sensation of thirst
 Fact:
 Thirst is a physiological response to need for fluid;
 Thirst comes late; when one feels thirsty, one is already dehydrated to some
extent
 Especially true when under heavy physical and environmental stress and in
the elderly
 When to drink Approximate amount of fluid
2 hours prior to activity 2-3 cups
15 minutes prior to activity 1-2 cups
Every 15 minutes during activity ½-1 cup
After activity At least 2 cups for each pound of body weight
lost

How to calculate % dehydration

100 x (pre-exercise weight (kg) – post-exercise weight (kg)

(pre-exercise weight)

If you are 80 kg before sport and 78kg afterwards, then your % dehydration is

100 x (80-78)

80

=2.5% *Aim to keep this well under 2%

Signs of Dehydration

-Thirst, general discomfort, headache, nausea, vomiting, heat sensation in head or neck,
chills, decreased performance, dizziness, confusion

Timing of protein and carbohydrate

 To enhance protein synthesis in muscle and replace glycogen stores…

 Don’t exercise in fasted state
 Eat immediately after exercise (window of opportunity)

Refueling after Exercise

 Very important for athletes

 For those in multiple events in one day
 For those training daily
 “Window” for Refueling
 First 30 minutes after exercise is critical
 Glycogen repletion occurs faster after exercise
 Increased blood flow to the muscle
 Enzymes that produce glycogen are most active
 Facts:
 Muscles replace glycogen at 5%/hour
 20-24 hours post exercise to maximally replenish glycogen stores
 How?
 0.5 g/kg CHO immediately after activity
 0.5 g/kg CHO in next 90 min.
 Rest

WEIGHT MAINTENANCE

What is Weight Management and Why Is It Important?

 Weight management is maintaining body weight in a healthy range (BMI 18.5-24.9)

 Underweight and overweight can both be of concern
Regional Distribution

 The regional distribution of body fat affects risk factors for the heart disease and type
2 diabetes

Body Fat Distribution: Gynecoid

 Lower-body obesity- Pear shape

 Encouraged by estrogen and progesterone
 Less health risk than upper-body obesity
 After menopause, upper-body obesity appears

Body Fat Distribution: Android

 Upper-body obesity- Apple shape

 Associated with more heart disease, HTN, Type II Diabetes
 Abdominal fat is released right into the liver
 Encouraged by testosterone and excessive alcohol intake
 Defined as waist measurement of >40’’ for men and >35’’ for women

The Concept of Energy Balance

Energy expenditure= Energy intake

Set Point Theory

 Body tends to preserve a given weight

 Energy expenditure increases and decreases with weight loss and gain
 Effect may be temporary, e.g. energy needs drop during calorie restriction and
normalize when energy balance is achieved

Components of Energy Expenditure

 Resting energy expenditure: expressed as RMR

 Energy expended in voluntary activity
 Thermic effect of food (TEF) or diet-induced thermogenesis (DIT)
 Related to energy value of food consumed and adaptive response to
overeating
 TEF may decline as day progresses

Resting Metabolic Rate

 Increases with increased muscle mass

 Declines with age
 Declines during restriction of energy intake (up to 15%)
 Explains 60-70% of total energy expenditure

Voluntary Energy Expenditure (activity thermogenesis)

 The most variable component of energy expenditure

 Accounts for 15-30% of total
 Most of us will require increasing voluntary energy expenditure as we age to offset
declining fat free mass and RMR in order to maintain weight

How Can You Lose Weight Healthfully?

 Overweight individuals should aim to lose 10% of their body weight over 6 months
 The keys to long-term weight management