Lecture Notes For Wardlaw's Contemporary Nutrition, 11th Edition

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CHAPTER 1
NUTRITION, FOOD CHOICES, AND HEALTH
OVERVIEW
This introductory chapter provides an overview of the study of nutrition. Nutrients and their
roles in the body are discussed. Energy and how it is measured is described. Helpful math skills
used in the study of nutrition are reviewed. The scientific method is explained with particular focus
given to its application in the study of nutrition. The typical North American eating pattern is
presented along with methods the government uses to monitor consumption. U.S. health objectives
included in Healthy People 2020 are briefly described. Recommendations for promoting healthy
behaviors and lifestyles are also discussed. The Nutrition and Your Health section, “Eating Well in
College,” investigates common nutritional concerns faced by college students, including choosing
foods, weight gain, alcohol and binge drinking, eating disorders, the vegetarian lifestyle, dietary
concerns of student athletes, and tips for eating well on a budget.
KEY TERMS
Alcohol
Amino acid
Animal model
Appetite
Atom
Bond
Cancer
Carbohydrate
Cardiovascular disease
Case-control study
Cell
Chemical reaction
Chronic
Complex carbohydrate
Control group
Diabetes
Double-blind study
Electrolyte
Enzyme
Epidemiology
Essential nutrient
Fat-soluble
Fiber
Gene
Genomics
Glucose
Hunger
Hypertension
Hypotheses
Inorganic
Kilocalorie (kcal)
Lipid
Macronutrient
Major mineral
Metabolism
Micronutrient
Mineral
Nutrient
Obesity
Osteoporosis
Peer review
Phytochemical
Placebo
Protein
Registered dietitian (RD)
Registered dietitian
nutritionist (RDN)
Risk factors
Satiety
Scurvy
Simple sugar
Solvent
Starch
Stroke
Theory
Trace mineral
Vitamin
Water
Water-soluble
STUDENT LEARNING OUTCOMES
Chapter 1 is designed to allow you to:
1.1 Describe how our food choices are affected by the flavor, texture, and appearance of
food; routines and habits; early experiences and customs; advertising; nutrition and health

concerns; restaurants; social changes; economics; and physiological processes affected by
meal size and composition.
1.2 Identify eating pattern and lifestyle factors that contribute to the 15 leading causes of
death in North America.
1.3 Define the terms nutrition, carbohydrate, protein, lipid (fat), alcohol, vitamin, mineral,
water, phytochemical, kilocalorie (kcal), and fiber.
1.4 Determine the total calories (kcal) of a food or eating pattern using the weight and calorie
content of the energy-yielding nutrients, convert English to metric units, and calculate
percentages, such as percent of calories from fat in an eating pattern.
1.5 Understand the scientific method as it is used in forming hypotheses and theories in the
field of nutrition, including the determination of nutrient needs.
1.6 List the major characteristics of the North American eating patterns, the food habits that
often need improvement, and the key “Nutrition and Weight Status” objectives of the
Healthy People 2020 report.
1.7 Describe a basic plan for health promotion and disease prevention and what to expect
from good nutrition and a healthy lifestyle.
1.8 Identify food and nutrition issues relevant to college students.
LECTURE OUTLINE
1.1 Why Do You Choose the Food You Eat?
A. What influences your food choices?
1. Food is more than nourishment.
2. A mix of biological and social factors influences your food choices (see Figure
1-1).
a. Food flavor, texture, and appearance are the most important factors.
b. Early exposure to various people, places, and events
c. Routines and habits
d. Marketing and advertising by the food industry
e. Restaurant dining
i. Larger portions, nutrient poor, and more calorie dense than home
cooked meals
ii. Federal regulations require health information on menus of some
restaurants.
f. Time and convenience
g. Cost and economics
i. Food cost is second reason why people choose their foods.
ii. Young adults and those with higher incomes spend the most on
food.
h. Nutrition
i. Well-educated, middle class professionals make more health-
related food choices.
ii. A greater percentage of women read food labels than men.
B. Why are you so hungry?
1. Hunger is the physiological (internal) drive to eat.

2. Appetite is the psychological (external) influences that encourage us to eat, often
in absence of hunger.
3. Satiety is the state in which there is no longer a desire to eat, a feeling of
satisfaction.
4. The feeding center and satiety center of the brain work to promote adequate
nutrient intake.
C. Putting our food choices into perspective
1. Satiety regulation is not perfect.
2. Decrease portion sizes slowly to allow the body (appetite and satiety) time to
adjust.
1.2 How Is Nutrition Connected to Good Health?
A. What is nutrition?
1. Science that links food to health and disease
2. Ingestion, digestion, absorption, transport, and excretion of food substances
B. Nutrients come from food
1. Nutrients are substances found in food that provide energy and are vital for
growth and maintenance of body.
2. An essential nutrient is required by the body to meet its needs. The body
cannot produce it, or produces it in too little quantity to meet its needs.
3. Essential nutrients must satisfy three criteria.
a. One specific biological function of the nutrient must be identified in
the body.
b. Omission of the nutrient must lead to decline in biological functions.
c. Replacing the omitted nutrient before permanent damage occurs
restores normal biological functions.
C. Why study nutrition?
1. Poor eating patterns and a sedentary lifestyle are risk factors for life-
threatening chronic diseases (see Figure 1-4).
2. Cardiovascular disease, hypertension, diabetes, cancer, and related disorders
account for two-thirds of all deaths in North America (see Figure 1-4).
3. Combination of poor eating patterns and a lack of physical activity may be the
second leading cause of death in the United States.
4. Obesity is second leading cause of preventable death in North America.
1.3 What Are the Classes and Sources of Nutrients?
A. Overview
1. The six classes of nutrients can be categorized by function (see Table 1-1).
a. Provide calories to meet energy needs
b. Promote growth, development, and maintenance
c. Regulate body processes
2. The six classes of nutrients are also categorized by daily needs.
a. Macronutrients are needed in gram or cup quantities each day.
b. Micronutrients are needed in milligram or microgram quantities each
day.
B. Carbohydrates

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1. Simple sugars (monosaccharides and disaccharides)
2. Complex carbohydrates (polysaccharides)
a. Starch (digestible)
b. Fiber (indigestible)
3. Primary source of energy (4 kcal/g)
C. Lipids (i.e., fats, oils)
1. Energy yield: 9 kcal/g
2. Primary form of energy storage
3. Animal fats (butter and lard) are solid at room temperature
4. Plant oils are liquid at room temperature
5. Essential fatty acids
a. Not produced by the body and must be consumed (essential nutrient)
b. Roles in blood pressure regulation and synthesis/repair of cells
c. Small amount required
i. Four tablespoons oil per day
ii. Serving of fatty fish at least twice a week.
D. Proteins
1. Functions
a. Structural components of muscle and bone
b. Blood components
c. Body cell structure
d. Enzymes
e. Immune factors
2. Energy yield: 4 kcal/g (limited use for energy)
3. Building blocks of proteins are amino acids
4. Dietary sources
a. Animal
b. Plant
5. Typical North American consumes up to two times daily requirement.
E. Vitamins
1. Enable chemical reactions
2. Provide no energy (0 kcal/g)
3. 13 vitamins categorized by solubility
a. Fat-soluble (vitamins A, D, E, and K)
i. Main sources: dairy products, nuts, seeds, oils, breakfast cereals
ii. Not readily excreted from the body
iii. Some may accumulate in the body toward toxic levels (i.e.,
vitamin A)
b. Water-soluble (B vitamins and vitamin C)
i. Main sources: fruits and vegetables
ii. Easily destroyed by cooking
iii. Most are readily excreted from the body
F. Minerals
1. Inorganic—do not contain carbon
2. Not destroyed by cooking, but can be lost in cooking water
3. Provide no energy (0 kcal/g)

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4. Functions: role in nervous system, water balance, structural systems, and other
cellular systems
5. Sixteen or more essential minerals
6. Categorized by dietary need
a. Major minerals (needed in amounts greater than 100 mg)
b. Trace minerals (needed in amounts less than 100 mg)
7. Electrolytes—minerals that function based on electrical charge when
dissolved in water (sodium, potassium, and chloride)
G. Water
1. Functions
a. Solvent
b. Lubricant
c. Transport of nutrients and wastes
d. Medium for temperature regulation and chemical processes
2. Human body is approximately 60% water
3. Human needs
a. Men: 13 cups/day
b. Women: 9 cups/day
4. Sources
a. Beverages
b. Foods
c. By-product of metabolism
H. Other important components in food
1. Phytochemicals
a. Found in foods from plant sources, and especially in fruits and
vegetables
b. Not essential nutrients
c. Provide a variety of health benefits and may reduce risks for certain
diseases
d. Foods with high phytochemical content are referred to as
“superfoods.”
e. Table 1-2 lists common food sources of some phytochemicals.
2. Sphingolipids and conjugated linoleic acid (CLA)
a. Found in meat and dairy products
b. Show some health benefits
I. Sources of nutrients
1. 500g (1 pound) protein, fat, and carbohydrates consumed daily
2. 20g minerals (in total) consumed daily
3. 300mg vitamins (in total) consumed daily
4. Genetic material directs the use of nutrients in the body.
1.4 What Math Concepts Will Aid Your Study of Nutrition?
A. Calories
1. Sources
a. Carbohydrates (4 kcal/g)
b. Lipids (9 kcal/g)

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c. Proteins (4 kcal/g)
d. Alcohol (7 kcal/g; not an essential nutrient, therefore not required)
2. Most foods provide more than one calorie source
3. Energy (kcal) is used to
a. Build new compounds
b. Perform muscular movements
c. Promote nerve transmission
d. Maintain electrolyte balance within cells
4. Energy derived from food is measured in kilocalories (kcal)
a. 1 calorie = heat energy needed to raise the temperature of 1 gram of
water 1°C
b. 1 kilocalorie (Calorie) = 1000 calories (1 kcal) = heat energy needed to
raise the temperature of 1000 grams of water 1°C
c. On food labels, “calories” without a capital “C” means kcal.
d. Figure 1-5 is a food label example of whole wheat bread.
B. Calculating calories
1. Use the 4-9-4 estimates to calculate calories from carbohydrate, fat, and
protein.
2. Use the 4-9-4 estimates to determine what portion of total calorie intake is
contributed by carbohydrate, fat, and protein.
C. Percentages
1. Percent refers to a part of the total when the total represents 100 parts.
2. Nutrition relevance: Used often when referring to menus and nutrient
composition
D. The metric system
1. 1 ounce = 28 grams
2. 1 kilogram = 2.2 pounds
3. 1 millimeter is approximately the thickness of a dime
4. 1 inch. = 2.54 centimeters
5. 1 quart = 0.946 liters
1.5 How Do We Know What We Know About Nutrition?
A. The scientific method (see Figure 1-6)
1. Make observations and ask questions.
2. Develop hypothesis
a. Generated by observing natural phenomenon
b. Generated by studying patterns among population groups
3. Epidemiology is the study of diet and disease patterns among various
populations.
4. Controlled experiments are conducted to test hypotheses.
a. Double-blind placebo controlled study design is the most rigorous type
of experiment—neither researcher nor participant is aware of the group
assignment.
i. Experimental group
ii. Control group

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b. Case–control study design involves comparisons made between
individuals with and without certain conditions.
B. Testing a hypothesis: can a high-fat diet cause weight loss? (see Figure 1-6)
1. Observations made and questions asked
2. Hypothesis generated
3. Research experiments conducted
4. Results evaluated by other scientists and published.
5. Follow-up experiments conducted to confirm or extend the findings
6. Accept or reject hypothesis?
C. Types of experiments (see Figure 1-7)
1. Human studies provide strong evidence about relationships between nutrients
and health.
2. Animal model
3. Case–control studies
4. Epidemiological studies
a. Study eating and disease patterns among populations.
b. Suggest hypothesis that then needs to be tested by controlled
experiments.
1.6 What Is the Current State of North American Eating Patterns and Health?
A. Does obesity threaten our future?
1. Obesity is defined as having an excessive amount of body fat relative to lean
tissue.
2. It is estimated that more than 36.5% of adults are obese.
3. Two-thirds of adults and 1/3 of children are overweight or obese.
4. Robert Wood Johnson Foundation report: F as in Fat: How Obesity Threatens
America's Future 2013 (see Further Reading 12).
a. Self-reported, state-by-state obesity data from the CDC (see Figure 1-
8)
b. Calls for national commitment to the prevention of obesity by 2030.
5. Obesity plays a role in chronic illnesses.
a. Heart disease
b. Stroke
c. High blood pressure
d. High cholesterol
e. Diabetes
f. Arthritis
g. Certain cancers
6. Problem: Consumption of too many energy dense, nutrient poor foods while
living a sedentary lifestyle
B. Assessing the current North American eating pattern
1. National Health and Examination Survey (NHANES) data from 2009 to 2012
indicates:
a. 16% of calories as proteins (FNB recommends 10% to 35%)
b. 50% of calories as carbohydrates (FNB recommends 45% to 65%)
c. 33% of calories as fats (FNB recommends 20% to 35%)

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2. Majority (2/3) of protein intake for most North Americans is from animal
sources
3. Approximately half of carbohydrates are from simple sugar sources, with the
remaining coming from starches such as pastas, breads, and potatoes.
4. Approximately 60% of dietary fats are from animal sources.
5. NHANES 2011–2012 results show positive trends toward healthier lifestyles.
a. Daily calorie consumption is declining
b. Soda (full-calorie) intake has declined 25% since late 1990s.
6. Consume a variety of nutrient-dense foods within and across the food groups,
especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk
products, and lean meats and other protein sources
7. Balance calorie intake with energy needs.
a. Increase intake of nutrient-dense fruits and vegetables
b. Decrease intake of energy-dense foods such as sugary beverages and
fatty foods
C. Health objectives for the United States for the year 2020
1. Healthy People 2020 is issued by the U.S. Department of Health and Human
Services’ (DHHS) Public Health Service.
a. Health objectives for our nation released every 10 years
b. Contains more than 600 health objectives across 42 topic areas
c. Outlines national standards to:
i. Eliminate health disparities
ii. Improve access to health education and care
iii. Strengthens public health services and efforts
2. Overarching goals
a. Attain high-quality, longer lives free of preventable disease, disability,
injury, and premature death.
b. Achieve health equity, eliminate disparities, and improve health of all
groups.
c. Create social and physical environments that promote good health for
all.
d. Promote quality of life, healthy development, and healthy behaviors
across all life stages.
3. See www.HealthyPeople.gov for more information
4. Nutrition and Weight Status
a. Topic area specific to nutrition
b. Includes targeting individual behaviors
c. Focuses on policies and environments that impact these behaviors in
community settings
d. Maintaining a healthy weight
e. Supporting the benefits of a healthful eating pattern
i. Consuming a variety of nutrient-dense foods within and across
the food groups, especially whole grains, vegetables, fruits, low-
fat or fat-free milk or milk products, and lean meats and other
proteins.

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ii. Limiting intake of solid fats, cholesterol, added sugar, sodium
(salt), and alcohol.
iii. Limiting intake of calories to meet caloric needs.
f. Table 1-3 presents a list of the six categories of objectives for Healthy
People 2020 Nutrition and Weight Status with 22 specific objectives.
g. Table 1-4 presents a detailed sample of Nutrition and Weight Status
Objectives and details about the current status and target goals for
2020.
5. New topic areas included in Healthy People 2020
a. Highlights and focuses on changes in health needs of certain life stages
i. Early and middle childhood
ii. Adolescence
iii. Older adults
b. Genomics
i. Investigating the relationship of nutrition and genetics
ii. Nine out of 10 leading causes of death have a genetic
component.
1.7 What Can You Expect from Good Nutrition and a Healthy Lifestyle?
A. Healthy weight
1. Seek a lifestyle to promote weight maintenance.
2. Recognize that weight gain can be associated with overweight/obesity and
risks for chronic illnesses.
3. Increased options for food as result of continual innovation by food
manufacturers
4. Incorporate physical activity into the daily routine as much as possible
B. Longer, healthier lives
1. North Americans live longer and enjoy better health.
2. Improve health by decreasing intake of animal fats and cholesterol and
increasing intake of fruits and vegetables.
C. The total diet
1. There are no “good” or “bad” foods.
2. “The total diet or overall pattern of food eaten is the most important focus of
healthy eating” (American Academy of Nutrition and Dietetics).
3. Other ways to promote health and prevent chronic diseases
a. Consume enough essential nutrients while moderating energy, solid
fat, added sugar, and alcohol intake.
b. Obtain regular physical activity (30–60 minutes most days).
c. Minimize alcohol intake.
d. Obtain adequate sleep (7–9 hours per night).
e. Consume recommended amounts of water daily.
f. Reduce stress.
g. Use medications only when necessary.
h. Abstain from illicit drug use.
i. Maintain healthy relationships.

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1.8 Nutrition and Your Health: Eating Well in College
A. Overview
1. Habits of college students fall short of recommendations for whole grains,
vegetables, fruits, milk, and meat; include too much fats, sweets, and alcohol.
2. Health behaviors formed during young adulthood are likely to persist
throughout life.
B. Food choices
1. Stress may negatively impact nutrition and activity habits.
2. Abundance of energy-dense, nutrient-poor food choices on college campuses
3. Meals are a time for socialization.
C. Weight control and the “Freshman Fifteen”
1. A recent study (see Further Reading 17) of 7000 U.S. college students found
that students gain 2.4–3.5 pounds during their first year away from home.
a. Heavy alcohol consumption
b. Working during college
2. Maintaining healthy weight and losing excess weight will improve short-term
and long-term health.
3. Losing excess weight
a. Set several, small, achievable goals.
b. Monitor foods and activities (Use interactive tools on
www.ChooseMyPlate.gov).
c. Gradual weight loss of 1–2 pounds per week (deficit of 500 kcal/day
below needs)
d. Eat a balanced breakfast.
e. Moderate use of alcohol and sugary beverages (including gourmet
coffee beverages)
f. Exercise regularly
i. Enjoyable activities
ii. Work out with a friend
D. Alcohol and binge drinking
1. Binge drinking
a. Five or more drinks in a row for men
b. Four or more drinks in a row for women
2. Moderate alcohol intake
a. Two drinks a day or less for men
b. One drink a day for women
3. 39% of students on college campuses participate in binge drinking.
4. Alcohol-related health risks
a. Accidents/injuries
b. Unsafe sex and its consequences
c. Long-term health problems
d. Suicides
e. Academic problems
f. Legal troubles
g. Alcohol abuse or dependence
5. 20% of college students meet criteria for alcohol use disorders.

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E. Eating disorders
1. 30% of college students are at risk of developing an eating disorder.
2. Short-term disordered eating patterns may progress to an eating disorder.
3. Food becomes the focus of emotional issues.
4. Risks
a. Limited academic performance
b. Loss of menstrual periods
c. Thinning bones
d. Gastrointestinal problems
e. Kidney problems
f. Heart abnormalities
g. Death
F. Choosing a vegetarian lifestyle
1. Plant-based eating patterns can be a healthful lifestyle, but require appropriate
planning
2. Fortified breakfast cereals provide many vitamins and minerals.
3. Many vegetarian options available
4. Tips to optimize nutritional benefit of plant-based eating patterns.
a. Choose baked, steamed, or stir-fried rather than deep-fried.
b. Choose whole grains rather than refined carbohydrates.
c. Consume foods fortified with vitamins and minerals.
G. Fuel for competition: student athletes
1. Increased calorie and nutrient needs.
2. Avoid severe calorie restriction—carbohydrate and fat supply energy to
exercising muscles.
3. Emphasis on fluids—sports drinks are ideal for events lasting longer than 60
minutes
4. Losing fluid intentionally is an unhealthy practice.
5. Expensive supplements are not necessary.
H. Tips for eating well on a college student’s budget
1. Participate in a prepaid campus meal plan.
2. Planning ahead will save money and improve nutrient intake.
3. Never shop on an empty stomach.
4. Buy store brands.
5. Make use of canned and frozen fruits and vegetables and dry foods.
6. Purchase concentrated fruit juices and mix at home.
7. Eggs and peanut butter are inexpensive sources of protein.
RATE YOUR PLATE
I. Examine Your Eating Habits More Closely
Choose a day of the week that is typical of your eating pattern. Using the first table found
in Appendix C, list all foods and drinks you consumed for 24 hours. In addition, write
down the approximate amounts of food you ate in units, such as cups, ounces, teaspoons,
and tablespoons. Place the corresponding abbreviation from the list below in the Reason

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Choice column to indicate why you picked that food or drink. There can be more than
one reason for choosing a particular food or drink.
FLVR Flavor/texture ADV Advertisement PEER Peers
CONV Convenience WTCL Weight control NUTR Nutritive value
EMO Emotions HUNG Hunger $ Cost
AVA Availability FAM Family/cultural HLTH Health
Application
Ask yourself what your most frequent reason is for eating and drinking. To what degree
is health or nutritive value reason for your food choices? Should you make these higher
priorities?
I choose many foods because they are considered healthy and will help with my health
goals and weight maintenance. Other times I am choosing foods that I am used to eating
or because I am craving something sweet (taste). I should start to think of the nutrients
provided by different foods, and some new foods I have not tried, in order to add some
variety to my eating pattern. This variety will help me meet more of my nutrient
requirements. I could add variety at breakfast, for example, with fruit. I could add a
healthy snack in the afternoon, such as low fat yogurt and granola, rather than drinking
regular cola. I noticed that this a time I am often hungry. This will also help me meet
more of my nutrient requirements, such as calcium, and fiber.

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II. Observe the Supermarket Explosion
Today’s supermarkets carry up to 60,000 items. Think about your last grocery shopping
trip and the items you purchased to eat. Following is a list of 20 newer food products
added to supermarket shelves. For those items you have tried, use the key from Part I to
identify why you chose those products.
Answer choices may vary. Below are examples of why one might choose the following
food products.
CONV Prepackaged salad greens (variety packs other than iceberg lettuce)
HLTH Gourmet or sprayable salad oils (e.g., walnut, almond, olive, or sesame oil)
CONV Precooked frozen turkey patties, precooked bacon
PEER/CONV Microwavable sandwiches (e.g., Hot Pockets or frozen sandwiches)
CONV Microwavable meals in a bowl (e.g., mac and cheese, or soup)
CONV Refrigerated precooked pasta (e.g., tortellini or fettuccini) and accompanying
sauces (e.g., pesto or tomato basil)
HLTH Imported grain products (e.g., risotto, farfalle, gnocchi, or fusilli)
$____ Whole-grain pasta or rice

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CONV Frozen dinners (list your favorite of any of the wide variety)
WTCL Bottle water (flavored or unflavored)
ADV Trendy juices (e.g., draft apple cider, acai, or pomegranate)
ADV/FLVR/CONV Roasted and/or flavored coffees (e.g., beans, ground, instant, or K-
Cups)
CONV Instant hot cereal in a bowl (add water and go!)
CONV “Fast-shake” pancake mix (add water, shake, and ready to cook)
FLVR/HUNG Breakfast bars or cookies (e.g., granola or fruit-flavored bars)
HLTH Dried fruit and nut mixes
HLTH Meal replacement/fitness products (e.g., “energy” bars, high-protein bars, or
sports drinks)
HLTH/ADV Low-calorie muffin tops or bagel thins
CONV/HLTH Packaged yogurt smoothies
HLTH/ADV Milk substitutes (e.g., rice milk or soy milk)
Finally, identify three new food products not on this list that you have seen in the past
year. Discuss the appeal of these products to the North American consumer.
Some other new food product examples include, but are not limited to:
• Ready to eat, microwavable side items (e.g., mashed potatoes, macaroni and
cheese, green beans casserole) appeal to individuals and families that value
convenience.
• Vitamin enhanced water offers a health advantage to plain water, for individuals
who may not be meeting nutrient needs.
• “Take and bake” breads appeal to individuals and families that desire hot baked
bread with a meal but lack the time to prepare and bake it fresh. There are a
variety of brands including organic, multigrain, sourdough, Italian, etc.
• Prepackaged, washed, and cut fruit and/or vegetables allow individuals to eat
fresh produce without spending time to wash, and/or cut.

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CHAPTER 2
DESIGNING A HEALTHY EATING PATTERN
OVERVIEW
This chapter explores the components of healthy eating patterns, namely those that will
minimize the risks of developing nutrition-related diseases. Three principles of a healthful eating
pattern (variety, proportionality, moderation) as well as nutrient and energy density are discussed.
The purpose and key recommendations of the Dietary Guidelines and Physical Activity Guidelines
for Americans are explained. Tools for planning and evaluating dietary intake are discussed,
including the Dietary Reference Intakes (DRI), the Dietary Guidelines, ChooseMyPlate.gov, the
Mediterranean Diet, nutrient standards, and food labels. An overview of nutritional status and its
assessment is provided. Suggestions are outlined to highlight the best approach to evaluate
nutrition information.
KEY TERMS
Adequate intake (AI)
Anthropometric assessment
Biochemical assessment
Clinical assessment
Dietary assessment
Dietary Reference Intakes (DRIs)
Environmental assessment
Energy density
Estimated Energy
Requirement (EER)
Functional foods
Heart attack
Malnutrition
Megadose
Nutrient density
Nutritional state
Overnutrition
Phytochemical
Recommended Dietary
Allowance (RDA)
Subclinical
Symptom
Undernutrition
Tolerable Upper Intake Level
(UL)
STUDENT LEARNING OUTCOMES
Chapter 2 is designed to allow you to:
2.1 Use variety, proportionality, and moderation, as well as nutrient and energy density, to
develop a healthy eating plan.
2.2 List the purpose and key recommendations of the Dietary Guidelines and the Physical
Activity Guidelines for Americans.
2.3 Design a meal that conforms to the MyPlate recommendations as well as to the
Mediterranean diet and/or other diet planning guides.
2.4 Describe the three states of nutritional health.
2.5 Outline the measurements used (ABCDEs) in nutritional assessment: Anthropometric,
Biochemical, Clinical, Dietary, and Environmental status.
2.6 Describe the specific nutrient recommendation categories within the Dietary Reference
Intakes.
2.7 Identify reliable sources of nutrition information.

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2.8 Describe the components of the Nutrition Facts panel and the various health claims and
label descriptors that are allowed.
LECTURE OUTLINE
2.1 A Food Philosophy That Works
A. Overview
1. Consume a variety of foods balanced by a moderate intake of each food.
2. Principles of variety, moderation, and proportionality
B. Variety means eating many different foods
1. Choose foods from all the food groups and subgroups.
2. Use MyPlate as a guide.
a. Vegetables
b. Fruit
c. Grains
d. Protein
e. Dairy
3. No single food meets all nutrient needs.
4. Various phytochemicals are present in fruits and vegetables.
a. Provide health benefits beyond nutrient needs.
b. Some phytochemicals can reduce the risk of disease.
c. Table 2-1 provides tips for boosting the phytochemical content of the
eating pattern.
5. Functional foods provide health benefits beyond those supplied by the
traditional nutrients that the food contains.
C. Proportionality means eating more nutrient-dense foods
1. Proportionality is also referred to as balance.
a. Increased intake of nutrient-dense foods (fruits, vegetables, whole
grains, low-fat dairy products).
b. Decreased intake of foods that are high in certain fats, sugars,
cholesterol, salt, and alcohol.
c. Match calorie intake with energy expenditure to achieve or maintain a
healthy weight.
2. Nutrient density is the ratio of the amount of one or more nutrients (e.g.,
protein, vitamins, and minerals) in a food relative to the calorie content of the
food.
a. Figure 2-1 illustrates how to choose more nutrient dense foods.
b. Menu planning should focus on the total diet: overall, choose more
nutrient-dense foods and fewer empty-calorie foods.
c. Nutrient density is particularly important for those who consume few
calories (e.g., on a weight-loss diet, children, older adults).
D. Moderation refers mostly to portion size
1. Don’t overconsume a specific nutrient.
2. Moderate intake of fat, sugars, salt, alcohol, and calories.
3. Energy density: compare the calorie content with the weight of the food.
a. High energy density foods include nuts, fried food, cookies.

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b. Low energy density foods contain high amounts of water and fiber (e.g.,
fruits and vegetables) and promote satiety without high calorie content.
c. People tend to consume fewer calories when eating low energy dense
foods.
d. Table 2-2 presents the energy density of common foods.
e. Foods can be nutrient dense and energy dense at the same time.
2.2 Dietary and Physical Activity Guidelines
A. Dietary Guidelines—the basis for meal planning
1. Designed to inform the development of food, nutrition, and health policies and
programs.
2. Five foundational guidelines of the 2015–2020 Dietary Guidelines
a. Follow a healthy eating pattern across the lifespan.
b. Focus on variety, nutrient density, and amount.
c. Limit calories from added sugars and saturated fats and reduce sodium
intake.
d. Shift to healthier food and beverage choices.
e. Support healthy eating patterns for all.
3. Figure 2-2 shows Key Recommendations that accompany the Dietary
Guidelines and further details healthy eating patterns.
4. Healthy eating patterns are the hallmark of the 2015–2020 Dietary Guidelines.
a. Goal: support healthy weight and reduce the risk of chronic disease.
b. Follow Healthy U.S.-Style Eating Pattern (see Table 2-5).
c. American eating patterns are low in vegetables, fruits, total grains,
dairy, protein foods, and oil; intake is added sugars, saturated fats, and
sodium (see Figure 2-3).
5. Meeting nutrient needs within calorie limits could alleviate many chronic
diseases.
6. Figure 2-4 shows estimated daily calorie (kcal) needs based on age and activity
level.
7. Nutritional needs should be met primarily from foods.
8. Increase intake of vegetables, fruits, whole grains, fat-free or low-fat dairy,
seafood, lean meats and poultry, eggs, beans and peas, nuts and seeds, and oils.
a. Contribute to nutrient adequacy
b. Lower intake of problem nutrients
c. Improve gastrointestinal function
d. Aid in weight management
e. Decrease the risk of chronic diseases
9. Limit intake of added sugars (less than 10% total kcal/day), saturated fat (less
than 10% kcal/day), trans fats, and sodium (less than 2300mg/day).
10. Table 2-3 provides the examples of recommended changes to the eating pattern
based on Dietary Guidelines.
B. Physical Activity Guidelines for Americans (see Table 2-4)
1. Regular physical activity produces long-term health benefits
2. Guidelines for children (6+) and adolescents
a. ≥ 60 minutes of physical activity per day

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b. Include aerobic and muscle-strengthening and bone-strengthening
exercises.
c. Activities that are appropriate for age, enjoyable, and offer variety.
3. Guidelines for adults
a. Avoid inactivity.
b. ≥ 150 minutes per week of moderate-intensity or ≥ 75 minutes per week
of vigorous-intensity physical activity.
c. Include muscle-strengthening activities 2 or more days per week.
4. Guidelines for safe physical activity
a. Understand the risks and choose appropriate activities for fitness level
and health goals.
b. Use appropriate gear and exercise in safe environments
c. Consult with health care provider if there are chronic conditions and
symptoms
2.3 MyPlate—A Menu-Planning Tool
A. Overview
1. MyPlate was released in 2011 and is a visual depiction of healthy eating for
Americans.
2. MyPlate shapes Dietary Guideline recommendations into a visual place setting
(see Figure 2-5).
B. Dishing up MyPlate
1. MyPlate provides a visual representation of a healthy plate at mealtimes.
2. The MyPlate icon emphasizes five food groups.
a. Fruits and vegetables cover half of the plate.
b. Grains cover slightly more than one-fourth of the plate; half of your
grain intake should be from whole grain products.
c. Protein covers the remaining portion of the plate; emphasize variety of
protein foods including seafood, lean meats and poultry, eggs, legumes,
(beans and peas), nuts, seeds, and soy products.
d. Dairy appears as a cup next to the plate; consume 2 to 3 cups of fat-free
or low-fat dairy products or other rich sources of calcium.
e. There is no separate group for fats or oils; limit solid fats and emphasize
oils.
C. Build a healthy eating style
1. All food and beverage choices matter—focus on variety, amount, and nutrition
2. Choose an eating style low in saturated fat, sodium, and added sugars
3. Make small changes to create a healthier eating style
a. Each change is a personal “win,” and each MyWin is a change to build a
healthy eating style.
b. Start with a few small changes
4. Support healthy eating for everyone
D. MyPlate daily checklist
1. ChooseMyPlate.gov features an interactive tool, MyPlate Daily Checklist, for
individuals to estimate their calorie needs and suggests a food pattern based on
age, gender, height, and weight.

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2. Table 2-5 presents the Healthy U.S.-Style Eating Pattern: recommended
amounts of food from each MyPlate food group at 12 kcal levels.
3. Helpful visual aids for estimating servings sizes are illustrated in Figure 2-6.
4. MyPlate sets the limits for empty calories; MyPlate Daily checklists allow for
some empty calories throughout the day (usually 120-160 kcal per day).
E. Additional MyPlate resources
1. USDA’s Ten Tips Nutrition Education series
2. What’s Cooking? USDA Mixing bowl – help with meal planning, cooking, and
grocery shopping
3. Food-A-Pedia
4. SuperTracker
F. Menu planning with MyPlate (see Table 2-7)
1. MyPlate guidelines are not intended for infants or children under 2 years of age.
2. Variety is key, as each food will provide different nutrients and each food group
is important (see Table 2-6).
3. There can be variation in the amount of nutrients and calorie content of foods
within each food group.
4. Choosing fat-free or low-fat dairy options allows for greater amounts of foods
from other groups in your daily plan.
5. Plant foods can be good sources of protein.
6. Focus on colorful fruits and vegetables to increase the nutritional quality of
these choices.
7. Choose whole grain products instead of refined grains.
8. Include healthy oils from plants and fish as part of your weekly dietary pattern.
G. Limitations of MyPlate
1. The MyPlate icon does not provide information about overall calories, serving
sizes, or number of servings.
2. The MyPlate icon does not address types of food choices to make within each
food group.
3. The MyPlate icon does not address total diet, which includes foods eaten
between meals.
4. Public health campaign may not reach all of its intended audience.
H. How does your plate rate?
1. Use SuperTracker tool to compare your overall intake to your personalized
daily food plan.
2. Use NutritionCalc software to compare your intakes to the DRIs.
I. The Mediterranean Diet Pyramid (see Figure 2-8)
1. Useful alternative to MyPlate
2. The 2015–2020 Dietary Guidelines includes the Healthy Mediterranean-Style
Eating Pattern.
3. Dietary pattern is linked to low rates of chronic disease and increased life
expectancy.
4. Emphasizes minimally processed, plant-based foods at each meal
5. Emphasizes healthy fats (e.g., olive oil, avocado, nuts) and limits saturated fats
6. Fish and seafood consumed 2x/week
7. Encourages 5–10 servings of fruits and vegetables each day

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8. Choose plant proteins more often and moderate intake of lean proteins and low-
fat dairy products.
9. Red meats and sweet desserts are consumed less often
10. Includes regular physical activity
11. Incorporates moderate wine consumption
12. Water is the beverage of choice.
2.4 States of Nutritional Health (see Figure 2-9)
A. Desirable nutrition
1. Body tissues have enough of a nutrient to support normal metabolic function.
2. Surplus of nutrients can be used in times of need.
B. Undernutrition
1. Form of malnutrition in which nutrient intake does not meet nutrient needs.
2. When nutrient levels fall sufficiently low, health declines and biochemical
evidence appears.
3. Subclinical deficiency shows no outward signs to reflect low nutrient levels and
slow metabolic processes.
4. Clinical deficiency develops within months or years of the undernutrition;
clinical symptoms often evident in skin, hair, tongue, or eyes.
C. Overnutrition
1. Form of malnutrition characterized by prolonged consumption of more nutrients
than the body needs
2. Example: too much vitamin A can have negative effects during pregnancy
3. Excess calorie intake is most common in developed nations.
4. The difference between desirable and overnutrition is usually large, but is the
smallest for vitamin A, calcium, iron, and copper.
2.5 Measuring Your Nutritional State
A. Analyzing background factors
1. Family health history
2. Medical history
3. Medication list
4. Social history
5. Education level
6. Economic status
B. Assessing nutritional status using the ABCDEs (see Table 2-8 and Figure 2-10)
1. Anthropometric assessment: height, weight, body composition, circumferences.
2. Biochemical assessment: measuring nutrients or by-products in the blood and
other body fluids.
3. Clinical assessment: looking for physical evidence (e.g., high blood pressure).
4. Dietary assessment: examining dietary intake.
5. Environmental assessment (from background analysis).
C. Recognizing the limitations of nutritional assessment
1. Clinical symptoms of nutrient status may take years to develop.
2. Many clinical symptoms are not specific to only a nutrient deficiency.
D. Concern about the state of your nutritional health is important

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1. Maintaining nutritional health can lead to a long and vigorous life.
2. Maintaining nutritional health can reduce disease risk.
2.6 Specific Nutrient Standards and Recommendations
A. Overview
1. Dietary Reference Intakes (DRI) is the umbrella term that describes four
standards for nutrient needs.
2. Table 2-9 explains the usage of the DRI’s and Daily Value.
B. Recommended Dietary Allowances (RDA)
1. Amount of a nutrient that meets the needs of ~97% of all healthy individuals
in a particular age and gender group
2. Intakes slightly above or below the RDA are of no concern
3. Intakes below 70% RDA or 3x or more above the RDA for an extended period
can lead to deficiency or toxicity, respectively.
C. Adequate Intake (AI)
1. Set if there is not sufficient information on human needs to set an RDA
2. Further research is required before scientists can establish a more definitive
number
3. Derived from dietary intakes of people who appear to be maintaining
nutritional health (no deficiency apparent)
D. Estimated Energy Requirement (EER)
1. Not set higher than average need (as for vitamins and minerals) because this
would lead to excess calories and weight gain; starting point for estimating
calorie needs.
2. Takes into account age, gender, height, weight, and physical activity.
3. Also accounts for additional needs during growth and lactation.
E. Tolerable Upper Intake Level (UL)
1. The highest amount of a nutrient that is unlikely to cause adverse health
effects in the long run for most people.
2. Usually seen with eating patterns promoting excess intake of a limited variety
of foods, many fortified foods, or megadoses of specific vitamins or minerals.
F. Daily Value (not part of DRIs)
1. Generic standard used on food labels—usually reflects the highest RDA (or
related nutrient standard) seen in various age and gender categories for the
nutrient.
2. Based on a 2000-kcal diet.
3. Allows consumers to compare intake from a specific food to desirable (or
maximum) intake levels.
G. How should these nutrient standards be used?
1. The type of standard that is set depends on the quality of available evidence.
2. Eating patterns should strive to meet the RDA or AI without exceeding the
UL.
3. AI should not be used alone to evaluate individual needs.
4. EER is an estimate and may need to be adjusted.

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5. Standards for each nutrient are found in appendix G of the text or at the link
for Dietary Guidance at the Food and Nutrition Information Center’s website
(https://fnic.nal.usda.gov/dietary-guidance/dietary-reference-intakes)
6. Daily Values, which appear on food labels, serve as rough guidelines for
comparison of nutrient content of foods to approximate human needs; set at or
close to highest RDA value.
7. Figure 2-11 illustrates how the various nutrient standards relate to each other
and the risk for deficiency or toxicity.
2.7 Evaluating Nutrition Information
A. Ensure that the nutrition claim adheres to basic principles of nutrition (e.g., Dietary
Guidelines for Americans)
B. Examine background and scientific credentials of the individual, organization, or
publication making the nutritional claim.
C. Beware of bad science
1. Possible disadvantages are ignored
2. Claims sound too good to be true; claim a “cure”
3. Evidence of bias against medical community
4. Touted as a “breakthrough”
D. Consider the study
1. Note the size and duration of the study; larger study and longer duration are
better.
2. Note the type of study (i.e., epidemiology, case–control, double-blind).
E. Beware of hype
F. Expect a nutrition professional to
1. Inquire about medical history, lifestyle, and current eating habits
2. Formulate an individualized eating pattern
3. Schedule follow-up visits to monitor progress
4. Involve social support
5. Consult with other health professionals
G. Avoid megadoses of nutrient supplements.
H. Examine product labels carefully.
I. Seek advice from reputable professional, including a primary care physician or
registered dietitian nutritionist (RDN).
2.8 Nutrition and Your Health: Food Labels and Diet Planning
A. Overview
1. Labels must include product name, manufacturer name and address, amount of
product in package, ingredients in descending order by weight.
2. Monitored by FDA
3. Nutrition Facts panel (Figure 2-12) must include
a. Total calories (kcal)
b. Total fat
c. Saturated fat
d. Trans fat
e. Cholesterol

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f. Sodium
g. Total carbohydrate
h. Fiber
i. Total sugars
j. Added sugars
k. Protein
l. Vitamin A, vitamin D, calcium, iron, and potassium
m. Monounsaturated or polyunsaturated fats, potassium, and others listed if
health claims are made about them or if food is fortified with them.
4. Percentage of the Daily Value usually listed for each nutrient per serving
5. Serving sizes must be consistent among similar foods but are not necessarily the
same as what is recommended by MyPlate’s Daily Food Plans.
6. Nutrient claims must follow legal definitions (see Table 2-10).
B. Changes to nutrition labels approved
1. Figure 2-13 illustrates the new Nutrition Facts Labels with changes noted that
were approved May 2016.
2. Increased type size for “Calories,” “Servings per container,” and the “Serving
size” declaration.
3. The number of calories and “Serving size” declaration will be in bold.
4. Daily value information for nutrients will be updated and will include the actual
amount for vitamin D, calcium, iron, and potassium.
5. “Added Sugars” is an addition to the label.
6. “Calories from fat” will be removed.
7. Serving size information will more accurately reflect how much is consumed in
one sitting.
8. Larger packages will have two columns on label to note “per serving” and “per
package.”
9. July 2018 is the deadline for implementation for manufacturers with $10
million in food sales per year.
C. Menu planning with labels
1. Daily Values generally align with RDAs and AIs for nutrients.
2. Food labels are useful for identifying nutrient-dense foods.
D. Exceptions to food labeling
1. Fresh foods (e.g., fruit, vegetables, and fish) are not required to have Nutrition
Facts labels.
2. As protein deficiency is so rare in the US, %DV for protein is not required for
the products designed for people aged 4 years or older
3. If % DV is included, the product must be analyzed for protein quality
4. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA)
requires manufacturers to label food products that contain an ingredient that is
or contains protein from a major food allergen.
E. Health claims on food labels
1. Four categories of claims are used on food labels
a. Health claims – closely regulated by FDA
b. Preliminary health claims – regulated by FDA but evidence may be
scant for the claim

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c. Nutrient claims – closely regulated by FDA (see Table 2-10)
d. Structure/function claims (not FDA approved, or necessarily valid)
2. FDA permits some health claims with restrictions
a. There must be a significant scientific agreement that a relationship
exists between the nutrient and the disease.
b. Food must be a “good source” of fiber, protein, vitamin A, vitamin C,
calcium, or iron.
c. Single serving of the food product cannot contain more than 13 grams
of fat, 4 grams of saturated fat, 60 milligrams of cholesterol, or 480
milligrams of sodium
3. Current allowed health claims
a. Calcium and vitamin D for reduced risk of osteoporosis
b. Low total fat intake and reduced risk of some cancers
c. Low saturated fat and cholesterol intake for reduced risk of cardio-
vascular disease (CVD)
d. Fiber from fruits, vegetables, and grains for reduced risk of cancers
e. Low sodium and high potassium for reduced risk of hypertension and
stroke
f. Fruits and vegetables and reduced risk of some cancers
g. Folate for reduced risk of neural tube defects
h. Sugarless gum for reduced risk of tooth decay
i. Fruits, vegetables, and grain products that contain fiber for reduced risk
of CVD; oats and psyllium can be singled out in reduction of CVD risk
j. Eating pattern rich in whole grains and other plant foods, low in total
fat, saturated fat and cholesterol for reduced risk of CVD
k. Soy protein and reduced risk of CVD
l. Fatty acids from fish for reduced risk of CVD
m. Plant stanols and sterols for reduced risk of CVD
4. Table 2-10 describes allowable nutrient claims in detail, such as
a. Sugar free: <0.5 grams per serving
b. Reduced fat: 25% less fat than the reference product
c. Fortified or enriched: vitamins or minerals have been added back to at
least 10% of what is normally present
d. Good source: serving of food contains 10–19% of the DV for a
particular nutrient
RATE YOUR PLATE
Does Your Diet Compare to MyPlate?
Using your food-intake record from Chapter 1, place each food item in the appropriate group of
the accompanying MyPlate chart. That is, for each food item, indicate how many servings it
contributes to each group based on the amount you ate (see Food Composition Table Supplement
for serving sizes). Many of your food choices may contribute to more than one group. For
example, spaghetti with meat sauce contributes to three categories: grains, vegetables, and
proteins. After entering all the values, add the number of servings consumed in each group.

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Finally, compare your total in each food group with the recommended number of servings shown
in Table 2-5 or obtained from the ChooseMyPlate.gov website. Enter a minus sign (–) if your
total falls below the recommendation or a plus sign (+) if it equals or exceeds the
recommendation.
Indicate the number of servings from MyPlate that each food yields:
Food or beverage Amount Eaten Grains Vegetables Fruits Dairy Protein
Orange juice 1 cup 0 0 1 0 0
Crispix 1 cup 1 0 0 0 0
Nonfat milk ½ cup 0 0 0 0.5 0
Sugar 2 tsp 0 0 0 0 0
Black coffee 1 cup 0 0 0 0 0
Diet cola 12 oz 0 0 0 0 0
Chicken sandwich with
lettuce and mayonnaise
3 oz chicken,
2 slices white
bread,
2 tsp
mayonnaise
0
2
0
0
0
0
0
0
0
0
0
0
3
0
0
Pear 1 medium 0 0 1 0 0
Nonfat milk 1 cup 0 0 0 1 0
Regular cola 12 oz 0 0 0 0 0
Pork chop 3 oz 0 0 0 0 3
Baked potato 1 medium 0 1 0 0 0
Margarine 2 tbsp 0 0 0 0 0
Lettuce and tomato salad 1 cup 0 0.75 0 0 0
Ranch dressing 2 tbsp 0 0 0 0 0
Peas (green) ½ cup 0 0.5 0 0 0
Whole milk 1 cup 0 0 0 1 0
Cherry pie 1 piece 1.5 0 0 0 0
Iced tea 12 oz 0 0 0 0 0
Apple 1 medium 0 0 1.5 0 0
Water 1 cup 0 0 0 0 0
Group totals 4.5 2.25 3.5 2.5 6
Recommended servings
(2000-kcal plan)
6 2.5 2 3 5.5
Shortages/overages in
numbers of servings
- - + - +

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CHAPTER 3
THE HUMAN BODY: A NUTRITION PERSPECTIVE
OVERVIEW
This chapter examines the anatomy and physiology of the human body as it pertains to
nutrition. Comprehensive descriptions of the structure and functions of cells and organ systems
are described, including the circulatory system, urinary system, nervous system, endocrine
system, immune system, and digestive system. A brief section describes the storage capabilities
of the body. An introduction to digestion and absorption is presented as part of the discussion of
the digestive system. The science of nutritional genomics and its emerging application in
personalized nutrition is introduced. The Nutrition and Your Health section reviews common
problems with digestion, including heartburn, ulcers, constipation, hemorrhoids, irritable bowel
syndrome, diarrhea, gallstones, celiac disease, and nonceliac gluten sensitivity.
KEY TERMS
Absorptive cells
Absorption
Active absorption
Adenosine triphosphate (ATP)
Adipose tissue
Anal sphincters
Antibody
Antigen
Anus
Amylase
Artery
Ascending colon
Bile
Bile acid
Bolus
Capillary
Cardiovascular system
Catalase
Cecum
Celiac disease
Cell nucleus
Cholesterol
Chromosome
Chyme
Connective tissue
Constipation
Cytoplasm
Descending colon
Deoxyribonucleic acid
(DNA)
Diarrhea
Digestion
Digestive system
Duodenum
Endocrine gland
Endocrine system
Endoplasmic reticulum
(ER)
Enterohepatic circulation
Enzyme
Electrolyte
Epiglottis
Epinephrine
Epigenetics
Epigenome
Epithelial tissue
Erythropoietin
Esophagus
Facilitated diffusion
Feces
FODMAPs
Gallbladder
Gastroesophageal reflux
disease (GERD)
Gastrointestinal (GI) tract
Gene
Gene expression
Gluten
Golgi complex
Hemorrhoid
Hepatic portal circulation
Hepatic portal vein
Ileocecal sphincter
Ileum
Insoluble fiber
Insulin
Intrinsic factor
Jejunum
Lacteal
Laxative
Lipase
Lower esophageal sphincter
Lumen
Lymph
Lymphatic system
Lysosome
Microvilli
Mitochondria
Motility
Muscle tissue
Myelin
Nervous system
Nervous tissue
Neuron

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KEY TERMS (continued)
Neurotransmitter
Nonceliac gluten sensitivity
(NCGS)
Nonspecific immunity
Norepinephrine
NSAIDs
Nutrigenetics
Nutrigenomics
Nutritional genomics
Oleogustus
Organ
Organ system
Organelles
Passive diffusion
Perforation
Peristalsis
Peroxisome
pH
Phagocytosis
Pharynx Phospholipid
Pinocytosis
Plasma
Prebiotic
Probiotic
Proton pump inhibitor
Pyloric sphincter
Receptor
Rectum
Ribonucleic acid (RNA)
Ribosomes
Secretory vesicles
Sigmoid colon
Soluble fiber
Specific immunity
Synapse
Thyroid hormones
Tissues
Trachea
Transcription
Translation
Transverse colon
Ulcer
Umami
Urea
Ureter
Urethra
Urinary system
Vein
Villi (singular, villus)
White blood cells
STUDENT LEARNING OUTCOMES
Chapter 3 is designed to allow you to:
3.1 Understand some basic roles of nutrients in human physiology.
3.2 Identify the functions of the common cellular components.
3.3 Define tissue, organ, and organ system.
3.4 Identify the role of the cardiovascular and lymphatic systems in nutrition.
3.5 List basic characteristics of the nervous system and its role in nutrition.
3.6 List basic characteristics of the endocrine system, especially the pancreas, and its role in
nutrition.
3.7 List basic characteristics of the immune system and its role in nutrition.
3.8 Outline the overall processes of digestion and absorption in the mouth, stomach, small
intestine, and large intestine, as well as the roles played by the liver, gallbladder, and
pancreas.
3.9 List basic characteristics of the urinary system and its role in nutrition.
3.10 Understand the importance of the body storage areas for nutrients.
3.11 Understand the emerging field of nutritional genomics.
3.12 Identify the major nutrient-related gastrointestinal health problems and approaches to
treatment.
LECTURE OUTLINE
3.1 Nutrition’s Role in Human Physiology
A. The human body is composed of trillions of cells.
B. Levels of organization: cells → tissues → organs → organ systems

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1. Each cell is a self-contained, living entity
2. Cells of the same type join to form tissues
3. One or more tissues combine to form organs
a. Organs are important in nutritional health
b. Nutritional state determines how the organ functions
4. Several organs cooperate and form an organ system
C. Constant chemical reactions within living cells require:
1. Energy
2. Water
3. Building supplies (i.e., protein, minerals)
4. Regulation (i.e., vitamins)
3.2 The Cell: Structure, Function, and Metabolism (see Figure 3-1)
A. Cell (plasma) membrane
1. Holds cellular contents together
2. Regulates direction and flow of substance into and out of the cell
3. Cell-to-cell communication
4. Composed of lipid bilayer (double membrane), which contains:
a. Phospholipids—water-soluble heads and water-insoluble tails
b. Cholesterol—fat soluble; provides stability
c. Proteins—function as structural support, enzymes, channels, receptors,
and gates
d. Carbohydrates—identify cells, cell-to-cell communication, and
immune defense
B. Cytoplasm
1. Fluid material and organelles within the cell
2. Site of anaerobic metabolism
C. Mitochondria
1. “Power plants”—convert the chemical energy stored within carbohydrates,
proteins, and fats into energy that cells can use
2. Site of aerobic metabolism
3. All cells except red blood cells contain mitochondria
D. Cell nucleus
1. All cells except red blood cells contain at least one nucleus.
2. Bound by its own double membrane
3. Contains genetic material
a. DNA → genes →chromosomes
b. Gene expression—DNA directs synthesis of proteins
i. RNA carries DNA’s message to the outside of the nucleus
(transcription)
ii. On ribosomes, RNA’s message is used to synthesize a protein
(translation)
E. Endoplasmic reticulum (ER)
1. Continuous network of tubes on the outer membrane of the cell nucleus
2. Rough ER contains ribosomes—sites of protein synthesis
3. Functions of ER

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a. Protein synthesis
b. Some lipid synthesis
c. Detoxification of toxic substances
d. Calcium storage
F. Golgi complex
1. Sacs within the cytoplasm
2. Package proteins in secretory vesicles for secretion by the cell
G. Lysosomes
1. Sacs contain enzymes for digestion of foreign material
2. Active in immune function
H. Peroxisomes
1. Contain enzymes that detoxify harmful chemicals, including alcohol
2. Detoxification results in formation of hydrogen peroxide
3. Catalase prevents accumulation of hydrogen peroxide in cells
I. Cell metabolism
1. Chemical processes involved in maintaining life
a. Release and use of energy (adenosine triphosphate) from foods
b. Synthesis of compounds
c. Preparation of waste products for excretion
2. Anabolic reactions put molecules together and require energy.
3. Catabolic reactions take molecules apart and release energy (e.g., metabolism
of energy-yielding nutrients)
3.3 Body Systems (see Figure 3-2)
A. Types of tissue
1. Epithelial tissue
a. Covers surfaces inside and outside the body
b. Secretes substances
c. Absorbs nutrients
d. Excretes wastes
2. Connective tissue
a. Found in tendons, cartilage, bone, skin, blood vessels, and elsewhere
b. Supports and protects the body
c. Stores fat
d. Produces red blood cells
3. Muscle tissue
a. Found in skeletal muscles and organs
b. Designed for movement
4. Nervous tissue
a. Found in brain and spinal cord
b. Designed for communication
B. Systems may work together (e.g., digestive system aids immune system by preventing
pathogens from entering the body).
3.4 Cardiovascular System and Lymphatic System
A. Cardiovascular system

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1. Blood flows through the heart and blood vessels from pumping of the heart.
2. Blood is made of plasma, red blood cells, white blood cells, platelets, and
other substances.
3. Blood circulation through the body (see Figure 3-3)
a. Blood travels from the right side of the heart to the lungs to pick up
oxygen and release carbon dioxide, and then travels back to the heart.
b. Blood travels from the left side of the heart through the arteries and
capillaries to deliver oxygen and nutrients and pick up wastes from the
body’s cells, and then returns to the heart through veins.
i. Capillaries have web-like pores.
ii. Capillaries are only one cell-width thick.
4. Portal circulation in the gastrointestinal tract
a. Water and nutrients may be used to nourish cells of the gastrointestinal
tract, but most are taken up by capillaries in the small intestine and
stomach.
b. Capillaries merge into veins that empty into the portal vein.
c. Portal vein leads to the liver.
d. Liver processes absorbed nutrients before they enter general
circulation.
B. Lymphatic system
1. Lymph flows through the lymphatic vessels and lymph tissues.
2. Lymph consists of plasma and white blood cells.
3. Lymph flows throughout body and eventually empties into major veins near
the heart.
4. Flow is driven by muscle contractions from normal body movement.
5. Lymphatic circulation in the gastrointestinal tract (see Figure 3-4)
a. Lymph vessels that serve the small intestine are called lacteals.
b. Lymph vessels pick up most products of fat digestion and fat
absorption.
c. These products are too large to enter the bloodstream directly
3.5 Urinary System (see Figure 3-5)
A. Two kidneys
1. Remove wastes from the blood
2. Help to maintain acid/base balance of the blood
3. Convert vitamin D to its active hormone form
4. Produce erythropoietin (hormone that stimulates red blood cell synthesis)
5. Produce glucose from amino acids during fasting
6. Filter excess water-soluble nutrients and minerals
B. Urine travels from kidneys to bladder by ureters.
C. Bladder empties through urethra
3.6 Nervous System
A. Functions
1. Exercises central control over most body functions

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Lecture Notes For Wardlaw's Contemporary Nutrition, 11th Edition

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