Nutrition

KPE162 Module 08 I have a gut feeling this is important…

 Outline Digest This.
• 5 Big Questions about nutrition • Appetite Regulation

• Alimentary Tract • Body Mass and Composition

• Nutrients • Big Questions revisited

• Fuel Metabolism • Guidelines

• Foods • Bottom Lines

Unless otherwise specified, diagrams in this presentation are from: Frank Netter, MD, CIBA Collection of Medical Illustrations, Volume 3 – the Digestive Tract
5 Big Questions.
One answer (for now).
Five Big Questions

?
1) Why do we (need to) eat?

2) What should we eat?

3) How much of it should we eat?

Definitely
4) When should we eat it?
on the
5) How are the answers to Q1-4 related? final exam!
Why Do We (Need to) Eat?

We have to eat

what we need

that we cannot synthesize

≡ essential nutrients
Essential Nutrients
• Water – the basis of life
• Energy – stored in chemical bonds
in food molecules

• Substrates – molecular building blocks niagarafallslive.com

• Co-factors – molecules needed

to drive chemical reactions

• Gut Health – foods needed to keep our

gut / microbiome healthy wikihow.com
Answering the Big Questions
• In order to contemplate answers to the remaining 4 Big Questions,
we need to cover some significant preliminary material:
• Alimentary tract function – how foods are processed by the gut
• Nutrients – types of macro- and micro-nutrients, and
how they are metabolized and used by our cells
• Foods – how the things we choose to eat are made up of nutrients
• Health effects of nutrient / food intake – the results of our food choices
The Alimentary Tract
Through the donut hole again, this time with a view of function and disease…
Alimentary Tract Functions
• motility – moving food through the gut
• digestion – making food absorbable (breaking large molecules up)
• absorption – bringing food into our bodies (crossing our external surface)
• excretion – getting rid of undigested food and fat-soluble wastes
• appetite regulation – sending signals to the brain to indicate
whether (more) food is needed
• immunity – 50% of our external surface area;
 our primary interface with the external world
Oral Cavity & Pharynx
• Motility
• Voluntary initiation of deglutition (swallowing)

• Digestion
• mastication (chewing) – types of teeth
• salivary amylase digests CH2Os
but not much, and this seems not important

• Absorption
• tiny bit of sugar absorbed – effect on brain!

• Appetite
• taste buds and smell stimulate appetite
• Immunity
• pharyngeal, adenoidal, and lingual tonsils
 Esophagus
• Motility – its only function
• Deglutition (swallowing) – move the food!
• voluntary start, involuntary completion

• LES (Lower Esophageal “Sphincter”)

• keep the food in the stomach!
• both a muscular sphincter and
mechanical valve (flap)
at gastro-esophageal junction
Stomach
• Motility
• acts as a hopper / holding tank
• pyloric sphincter = outflow valve
• gastric emptying can be
delayed by up to 12 hours
- fats and proteins delay emptying

• Digestion
• minimal / preparatory digestive role
• HCl (hydrochloric acid @ pH 1-4)
- denatures (cooks / marinates) proteins
Stomach
• Absorption
• alcohol & water are readily absorbed;
minimal absorption of other molecules

• Appetite
• gastric satiety (fullness or emptiness)
is critical in regulating appetite
• empty stomach secretes ghrelin,
a hormone that stimulates appetite
Small bowel (intestine)
• 3 parts:
• duodenum – first 30 cm.
• jejunum – middle part – ~9 metres long
• ileum – last 50 cm.

• Motility – peristalsis in all 3 parts

• involuntary wave of muscle contraction
• always present; increases with food intake
• bowel sounds – gas bubbles moving
Duodenum
• Digestion
• pancreatic enzymes & bile enter here

• primary site of intra-lumenal digestion

• Absorption – some digested foods

• Excretion
• fat-soluble wastes in bile
Jejunum
• Digestion
• villi & microvilli  massive surface area!!
• enzymes on surface of mucosal cells
• site of muscosal digestion
= most of our digestion occurs here

• Absorption – most food absorbed here

• Appetite
• foods digested here cause secretion of PYY
(and leptin), hormones that decrease appetite

• Immunity – majority of our immune cells

Ileum

• special absorptive functions

(e.g.- Fe, Vit B12 – important for red blood cells)

• auto-immune ileitis

(Crohn’s disease) can

cause malabsorption  anemia

Large bowel (intestine)
• Cecum, vermiform appendix, ascending, transverse,
descending & sigmoid colon, rectum & anus

• Motility
• up to sigmoid colon - involuntary peristalsis
• rectum is a holding tank
• ano-rectal voluntary initiation and
reflex completion of defecation

• Digestion
• microbiome digests soluble fibre
into short-chain fatty acids (SCFAs)

• Absorption - H2O and SCFAs

Liver
• hepato-biliary tree
(liver, gall bladder, bile ducts)

• All material absorbed into

veins from the gut flow into
the portal vein which goes
to the liver
• “first pass effect”
= liver gets first pass at
everything absorbed from gut
 Liver
• The body’s biochemist:
• bile secretion - solubilization of fats in gut
• detoxification / excretion of fat-soluble toxins
• synthesis of cholesterol, systemic proteins, etc.
• fat-soluble vitamin metabolism and storage
• storage of glycogen, amino acids
• gluconeogenesis (makes glucose from protein and glycerol)

• Appetite – low blood sugar causes liver to

secrete glucagon  stimulates appetite (and mobilizes glycogen and stimulates gluconeogenesis)
Pancreas
• Exocrine pancreas manufactures
digestive enzymes and secretes them
into lumen of gut
• amylases for carbohydrates

• lipases for lipids (fats)

• proteases or aminases for proteins

• Endocrine pancreas manufactures insulin and secretes it into bloodstream

Nutrients
The molecules in our food
Nutrients = The Molecules in Food
• Water
For each of
• Micronutrients these, ask:
• Vitamins
• fuels?
• Minerals
• substrates?
• Macronutrients – types / sub-types of each • co-factors?
• Carbohydrates
• essential or not?
• Lipids (fats and oils) • which foods?
• Protein
Water
The ambient medium of life on Earth – we are ~65-70% water!

How much? What type? When?

How Much?
• Daily requirement (without PA)
• current guideline is 2.7-3.7 litres total water / day
• depends on body weight (BW)
• includes ~800mL in food, so drink ~2-3 L / day depending on your size

• evidence that more water helps reduce urinary tract disorders

• >1% BW dehydration impairs physical and mental performance
• slight dehydration (<1% BW) may effect us… significantly? many truth claims – any evidence?

• Need more with PA - replace sweat losses

• also need to replace lost electrolytes if hot / sweating heavily for > 60 minutes of PA
What Source or Type of Water Treatment?
• free of bacteria and other micro-organisms
• halogenation (chlorination / iodination), ozonation, radiation…
• controversy about methods
• lesser of evils? definitely better than the bacteria! pollution?

• free of toxic chemicals and heavy metals

• filtration, adsorption, reverse osmosis, distillation
• potential for bacterial contamination when halogens removed

• nonsense claims about “oxygenated” water LOL

When to Drink?
• when you are thirsty!
• during and after physical activity –
• with electrolytes if long duration of PA, or if hot / sweating heavily
• drinking too much water during endurance exercise [Noakes et al] can cause
exercise-associated hyponatremia (EIH) often confused with heat disorder

• with food
• after alcohol (better still, drink water instead of alcohol, not after it!)
• before you are thirsty? before PA? Evidence suggests not! [Noakes et al]
Micronutrients 101
Vitamins and Minerals

How much? When? Foods or supplements?

Micronutrients
• Organic (carbon-based) essential co-factors = vitamins
• some pseudo-vitamins; e.g. – “Vitamin” D

• Inorganic / Elemental micronutrients = minerals

• Electrolytes – Na+, K+, Ca++, Mg++, Cl-
• maintain compartmental volumes and pressures by osmosis
• create electric voltages and currents in nerve and muscle

• Trace Minerals – Fe, Co, Ni, Cu, Zn, P, S, Se, I

• some serve as substrates for certain molecules
• some act as essential metabolic cofactors
• may be present in foods as ions or in larger molecules google.com
Vitamins
• Water-soluble
• B group & related molecules, C
• not stored – ∴ must consume regularly!
(preferably at every meal / snack)
• acute overdose possible

• Fat-soluble
• A, D, E, K
• stored in fatty tissues
• chronic overdose possible
How Much?
• Source of much controversy

• Canadian and US governments make recommendations based upon

availability of evidence – Dietary Reference Intakes:
• Estimated Average Requirement (EAR) = median daily requirement
• Recommended Daily Allowance (RDA) = evidence-based (?) optimal dosage
• Adequate Intake (AI) = recommendation if evidence insufficient to specify RDA
• Tolerable Upper Intake Level (UL) = more than this may cause overdose / harm
Micronutrient Deficiencies
• Mostly uncommon in Canadians who eat a variety of “real” foods
(unprocessed, non-junk) such as is recommended in guidelines;
more common in mal-nourished populations in poorer countries; one exception:
• Vitamin D deficiency at latitudes > 40° (all of Canada ) not enough sunlight

• Some specific deficiencies are not uncommon in some populations:

• Folate, Vitamins B2, B3 deficiency in alcoholics
• Iron and Vitamin B12 deficiency in vegans
• Iron deficiency in female athletes (~30% deficient, higher in endurance sports)
Foods or Supplements?
• Generally no need to take micronutrient supplements,
with a few exceptions:
• Vitamin D – every Canadian should supplement ~1,000-2,000 IU / day IMO
• Iron – females and athletes should get levels tested; supplement if needed
• Vegans – consider taking iron and Vitamin B12 supplements
• Special populations (e.g. - alimentary tract disorders, alcohol abuse, food
intolerances) – should consult a Registered Dietician or physician
Macronutrients
Large Food Molecules: Fuels and Substrates
Macronutrients

•Carbohydrates

•Lipids

•Proteins / Peptides

• Others (e.g. – alcohols)

Carbohydrates
• molecules with formula (CH2O)n = carbon + water
• our primary fuel O
C
• preferred by all tissues, required by some H H
1-carbon carbohydrate

• 4 kcal/g if completely oxidized

• substrates for complex molecules O H

• mucopolysaccharides C
H C OH
• glycoproteins
H
• glycosaminoglycans 2-carbon carbohydrate
Sugars
• CH20s with n = 3 to 6; rings or chains
• monosaccharides (one ring)
• glucose (D-glucose = “dextrose” – many foods)
D-glucose (dextrose)
• fructose (fruits, honey, veggies)
• galactose (in milk as part of lactose)

• disaccharides (two rings joined)

• maltose = glucose + glucose
• sucrose = glucose + fructose
• lactose = glucose + galactose
sucrose
Polysaccharides
• polysaccharide ≡ molecule of many sugars
• Digestible: α-bonds
• starches
• α-amylose - chain of α-bonded glucose residues
• amylopectin - branched every 24-30 glucose residues
• glycogen - branched every 8-10 glucose residues
• Indigestible (≡ dietary fibre): β-bonds

quora.com
Digestibility of α-bond CH2Os
• All α-bonds within CH2Os can be digested by our α-amylases, but
some are not as easily accessed by the digestive enzymes as others,
depending on other properties of the food

• For example, in durum semolina (hard wheat) pasta, a protein called gluten
forms around globules of starch, such that the starch cannot be digested until
the protein has been digested first
• this means that α-amylose is slowly digested when it is found in wheat pasta
• in some breads with less-enclosed starch, it is digested more quickly
Glycemic Index
• A ranking system for CH2Os or foods developed by Jenkins et al (1981) @ U of T

• Glycemic Index (GI) of a food is its tendency to elevate blood glucose levels
after 100g of CH2O taken in that food relative to 100g glucose syrup (=100)

• more complex CH2Os are more slowly digested & absorbed, so are less glycemic
• e.g. – CH2O in durum semolina pasta more slowly digested than CH2O in baguette

• more complex meals (same CH2Os) are also less glycemic for the same reason
• e.g. – CH2O in durum semolina pasta more slowly digested if eaten with olive oil
– CH2O in baguette more slowly digested if eaten with butter or meat
Blood Glucose after Meal
Glycemic Index of Some Common Foods
Much disagreement! See http://www.glycemicindex.com/

GI
Classification Examples
Range
breads made of rye (incl. pump’l), oats,
spelt wheat, multi grains, “sourdough”
(48-55), oatmeal & multigrain cereals
Low GI < 55 (48-55), durum semolina pasta (44-55),
most unsweetened juices (35-55),
most fruits and vegetables
Basmati rice (55-60), croissant (70),
whole wheat breads, bagel (~65),
Intermediate GI 56 - 69 pom/bb/grape & sweetened juices (~70),
soft drinks ? (55-65)
simple cereals (corn, rice, wheat),
white breads (baguette 95),
High GI > 70 cakes / donuts / muffins,
many types of rice & rice noodles
Glycemic Load

• Glycemic load (GL) is a ranking system for foods / meals

that takes into account amount eaten and how glycemic

• Calculated as:
• grams of food eaten * GI (food) / 100

• High GL > 120 / day; Low GL < 80 / day

 Examples of Glycemic Load / 100g Serving

Food GI % CH2O GL
French
baguette
~95 ~50% ~48

Banana ~52 ~20% ~10

Carrots ~47 ~7.5% ~10

Corn tortilla ~52 ~48% ~25

Potato ~50 ~19% ~9.3
White Rice ~64 ~24% ~15.4
Watermelon ~72 ~5% ~3.6
 Blood Glucose Levels After Eating
Desired Response
glucose
insulin

0 1 2 3 4 time
(hours)

Undesired Response
glucose
insulin
glucagon
(CH2O)n ingestion
Glycemicity, Insulin & Health

• All CH2O absorption stimulates endocrine pancreas to release insulin

• Glycemic load of a meal / diet is a strong correlate of insulin secretion

• Too much insulin secretion is a bad thing

• Increasing evidence GL is a risk factor for metabolic syndrome & CVD

Insoluble Dietary Fibre
• β-bonded polysaccharides that are insoluble in H2O

• indigestible by us and by our microbiome

• hydrophilic - doesn’t dissolve, but holds water in our faeces which is

good for alimentary tract health (short transit time / regular BMs)
 reduced colo-rectal Ca and other problems

• e.g. - cellulose, hemicelluloses

• found in true veggies (roots, stems, leaves) & most grain brans
Soluble Dietary Fibre
• β-bonded polysaccharides that are soluble in H2O

• fermentable by microbiome in large bowel

 gases (flatus) and short chain fatty acids (SCFAs) that we absorb

• SCFAs have many health benefits:

• intestinal health, lower cholesterol, better glucose regulation,
boosted immune function, others?

• e.g. - pectins, dextran, lignins, gum arabic

• found in fruit pulps (includes “veggies”), beans, nuts, psyllium, chia & oat brans
Lipids
• fats (solid at room temp) and
oils (liquid at room temp)

• 2 major categories of lipid:

• triglycerides
• glycerol + 3 fatty acids

• steroids & terpenes

• cholesterol & steroid hormones (4 rings)
• fat-soluble vitamins & related compounds
Dietary Lipids
• Fuel:
• most dense energy form (9 kcal/g if completely burned)
• not preferred fuel of tissues - second choice

• Substrate:
• cholesterol essential in children → membranes
• some fatty acids essential at all ages
Cholesterol
• Substrate for membranes and synthesis of
steroid hormones (adrenal and gonadal)

• We need about 500 mg/day

• Readily synthesized in liver if not in diet

• Dietary intake essential only in children

Triglycerides

Glycerol

3 Fatty Acids
 O OH
Fatty Acids
C
• carboxylic acids of aliphatic hydrocarbons Ω-n-1
= COOH (acid) group attached to a chain of C + H H C H

• # of carbons (n – typically even # of C) H C H

• short chain – n ≤ 6 H C H
• medium chain – n = 8 to 14
…
• long chain – n = 16 to 22
Ω-1
• very long chain = n ≥ 24 H C H
• Over 100 types in nature - 8 essential in diet H
 H H H H
Fatty Acids
C C C C
• # of double bonds H H
H H H H C C
• saturated (SFA) - none saturated with H
H H
• monounsaturated (MUFA) - one @ n9 (Ω-9) C cis- double bond
C
H H
• polyunsaturated (PUFA) – ≥ 2
- first @ n3 (Ω-3) or n6 (Ω-6)

• orientation of double bonds

• usually cis in nature
• trans with artificial hydrogenation
trans- double bond
Examples
• linoleic acid : Ω-6 PUFA

• oleic acid : Ω-9 MUFA

• stearic acid : SFA

Amino Acids
• peptides – carboxylic acid (COOH) + amine (NH2) + side chain (CH-R)

• 24 (?) found in human proteins

• 20 common, 4 rare

• 8 (?) essential
• cannot be synthesized

• 2 (?) pseudo-essential
• can be synthesized, but usually lack substrate

• 8 non-protein AAs in humans (1 essential)

Proteins
• Polypeptides = many amino acids
• primary structure = amino acid sequence

• secondary to quaternary structure = 3D geometry

• Substrate (to make human proteins)

• Fuel (4 kcal/g if completely oxidized)

• not a preferred fuel - more on this next class

© 2010 Pearson Education, Inc.

Protein’s “Fingerprint”
• Protein from each genus or species of plant or animal
0.12

has characteristic 0.1

0.08
Human

amounts of each 0.06 Dairy

Meat
0.04
Legume
0.02 Cereal

amino acid in it 0
Val
Leu
Ile
Met
Phe
Trp
Thr
Lys
His

Arg*

Cys

Ala

Pro

Gly

Ser

Tyr

Asn

Gln

Asp

Glu
Protein Bioavailability

• The bioavailability of dietary protein is the percentage

of it that can be used as substrate for protein synthesis

• Limited by 2 factors

• least available essential AA – when you run out, synthesis stops

• limited AA storage (only several grams in liver and blood stream)

Fuel Metabolism
How much of which fuels are used by which cells at what times?
Energy Systems and Fuel Metabolism
• 2 ways for cells to use energy:
ATP, or Cr-P (made from ATP)

• 2 ways of making ATP:

aerobic (TCA cycle  ETC)
and anaerobic glycolysis

• We speak of three “systems”

of fuel metabolism: aerobic,
lactic anaerobic (glycolysis),
and alactic anaerobic (Cr-P)
Which Fuels in Which System?
• Aerobic Respiration

Source: Lehninger Biochemistry

(Tricarboxylic Acid Cycle) can
use any 3-carbon fragments that
can be converted into acetyl-Co-A
– all macronutrients

• Anaerobic Glycolysis
– limited to sugars
 Fuel Storage
• 4 levels of energy storage:

Source: Lehninger Biochemistry

• long term - triglyceride / protein (tissues)

• intermediate – glycogen (muscle / liver)

• short term – circulating fuels (blood)

• e.g. - sugars, FFAs, AAs, ketones, TCAs

• ultra-short term - ATP / Cr-P (cells)

• Energetic costs of putting circulating fuels back into storage

Making and Storing Fuels
• We can make (non-essential) amino acids (AAs) and free fatty acids
(FFAs) from acetyl CoA but not glucose

• We can make proteins from AAs

• We can make triglycerides (TGs) from FFAs

• We can make glycogen from glucose

Gluconeogenesis

• If we need to make glucose, we cannot build it directly from acetyl-Co-A

• Our liver can make glucose from glycerol + AA

• This is called gluconeogenesis

• It only happens when there is a shortage of sugar in our blood

• Note that it requires both fat and protein to make sugar

Tissue Preferences
• Nervous system and blood cells – picky eaters! need glucose! 24/7!

• Muscles and viscera – not so picky

• glucose > TCAs (FFA, AA) > ketones

• for muscle only it depends on metabolic power

• >80% of energy from fat at very low power output

• >95% of energy from glucose at maximal power output

Providing Answers to Big Questions

• Which fuels are used or stored by which tissues and

when depends on:

• which fuels you ate, how much, and when

• how much you exercise, how intensely, and when

Fed State
• Fuels in gut currently being digested and absorbed

• Just-absorbed fuels extracted from circulation by tissues

• Tissues can use preferred fuels – “fully stocked buffet”

• all they want of whatever they want

• Excess fuels get stored

• excess sugar  glycogen / TG
• excess protein or fat stored as TG
Fasting State
• Empty gut - no digested fuels being absorbed into circulation
• Breakdown of stored fuels
• glycogen (muscle and liver) → glucose
• TG (many tissues) → glycerol + FFAs  ketones
• protein (muscle)  AAs

• If we run low on glycogen, we need to make sugar!

• gluconeogenesis: glycerol + AA  glucose
 Fasting fuel metabolism

Source: Lehninger Biochemistry

Tissues’ Fuel Usage in Prolonged Fasting
Tissue Fuel Preferences in Prolonged Fasting

Source: Lehninger Biochemistry

Fuel Use and Storage
Fuel Usage Fuel Storage
Tissue When How Short-term Mid-term Long-term
All tissues, All times TCA cycle, Blood and glycogen in converted to
(CH2O)n esp. vital anaerobic tissue liver & TG
organs glycolysis glucose muscle

Mostly Increases in TCA cycle Blood and TG

TG muscle fasting state tissue FFA
& ketones

Mostly All times TCA cycle Blood and converted to

Amino muscle tissue (esp. TG

acids All tissues, Fasting gluco- liver) AA
esp. vital states neogenesis and TCAs
organs
Hormonal regulation
• Complex control system involving hormones made by

brain, liver, gut and endocrine pancreas

• It’s a “two-way street”:

• Fuels eaten affect hormones

• Hormones affect fuel usage and storage

Effects of Fuels on Hormones
• any food → GIP & GLP-1 → ↑insulin and ↓glucagon

• dietary CH2O → ↑insulin

• dietary protein → ↑somatotropin (hGH)

• starvation → ↑glucagon & ↑ghrelin

• stored fat → ↑leptin secretion

• complex meal → ↑peptide YY secretion

Effects of Hormones on Fuels
• insulin  fuel storage (all formats)

• glucagon  glycogen breakdown + gluconeogenesis

• somatotropin (hGH)  less glucose use by carcass & viscera; TG breakdown

• ghrelin  stimulates appetite

• leptin  suppresses appetite

• PYY  suppresses appetite, delays gastric emptying

Foods
Food Groups & Nutrient Content
Foods
• We (should) choose foods, not nutrients…

• “Real” foods / food groups

• based loosely on zoo-botanical classification,
but terms “fruit, seed, nut, vegetable, berry”
and others differ between botany and food
• Plants – vegetable (root, stem, leaf),
fruit, grains, nuts, legumes
• Animals – meat, fish, dairy, seafood, offal
Macronutrient Content of Food Groups
• Almost all foods contain some of each of macronutrient, and some micronutrients
• We can generalize about macronutrient content of food groups,
but it varies across each group; e.g. - celery and yam are not the same!

Group Carbohydrate Fat Protein

Vegetable High Low Low
Fruit High Low Low
Grain High Low (PUFA, MUFA) Low
Legume Moderate Low Moderate-High
Nut Moderate High (MUFA, PUFA) Moderate-High
Meat Low High (SFA) High
Fish Low High (PUFA) High
Dairy Moderate Varies High
 Macronutrient Ratios in Some Diets
% calories % calories % calories
Diet from CH2O from Protein from Fat
Typical non-
vegetarian NA 40 20 40

Typical vegan 80 10 10

“Mediterranean” 55 15 30

"Diabetic" diet 60 20 20

Low carbohydrate
"Atkins" / ketogenic 20 40 40
 “Fast” Foods or “Fat” Foods?
% calories % calories % calories
Food
from CH2O from Protein from Fat
Whopper with
26 18 56
cheese

Big Mac 33 20 47

French Fries 47 5 48

Taco Supreme 24 15 61

Pep. Pizza 45 20 35
Carbohydrates in Foods
• Virtually all foods contain
at least some carbohydrates

• Types of carbohydrates in foods:

• Sugars – glucose, fructose, sucrose, lactose
• Polysaccharides
• α-bonded – starches & glycogen
• β-bonded – soluble and insoluble dietary fibre α-bonded polysaccharides = carbohydrate – (sugar + fibre)
canada.ca

• Energy from CH2Os = 4 kcal/g * (total carbohydrates - dietary fibre)

Refined vs. Whole Grains
• cereals / grains are the seeds of grasses
• Like all seeds, they have three parts:
• embryo (germ / cotyledon)
• endosperm (farina / flour)
nagwa.com
• seed coat (bran / husk)

• Most of the food energy (α-bonded CH2O) is in farina (endosperm)

• Most of the protein, lipids, and micronutrients are in germ (embryo)
• Most of the dietary fibre (β-bonded CH2O) is in bran (seed coat)
Sugars in Foods
• Most CH2O in (non-junk) food comes
in the form of polysaccharides

• Sugars are present, more in some foods;

monosaccharides are “pre-digested”
CH2Os, ready for absorption  glycemicity

• Types and amount of sugars in

NA diet has changed over the years
 more glycemic diet
Dietary Fibre in Foods
• Insoluble fibre found in significant quantities in:
• true vegetables – root, stem and leaf
• most whole grains (their brans); e.g. – wheat, oat, corn, psyllium, rye, etc.
• some in fruits, nuts

• Soluble fibre
• fruit pulps, legumes, nuts, other seeds
• some whole grains (their brans); e.g. – oat, chia, psyllium
• some in true vegetables
Lipids in Foods
• Various foods contain:
• Different relative amounts of lipids
(i.e. % of calories from fats / oils)
• Different types of lipids i.e.:
• cholesterol
• triglycerides with different Fas
(SFA, MUFA, Ω-3 PUFA, Ω-6 PUFA)
Food labels specify total TG, SFA, trans, cholesterol
with trans- or cis- double bonds but do not specify MUFA/PUFA or types thereof
canada.ca
Why do different FAs exist?
• The melting point of a fat depends on the saturation of its fatty acids
• TGs high in SFAs tend to be fats (solids @ RT)
• TGs high in PUFAs tend to remain oils (even in cold)

• Cold water animals have high levels of PUFAs (EPA, DHA) in their fats
• cold water fish, cold ocean mammals > tropical fish

• Cold climate plants have higher levels of PUFAs (ALA) in their seed oils
• flax, canola, barley >> tropical palm, coconut, etc.
 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

Safflower
HO safflower
Canola
Flax
HO sunflower
Sunflower
Corn
Olive
Sesame
Soybean
Seal
Peanut
Margarine (regular…
Salmon
Cottonseed
"Vegetable" oil…
Fatty Acids in Dietary Fats and Oils

Lard (grain fed)

Palm
Cocoa butter…
Butter
Palm kernel
Coconut
Palm kernel…
Fatty Acid Distribution in Dietary Fats and Oils

Coconut…
SFA
Other

PUFA

MUFA
 0
10
20
30
40
50
60
70
80
Safflower
Flax
Sunflower
Soybean
Corn
Cottonseed
Sesame
Salmon
Peanut
Canola
Margarine…
Seal
HO safflower
Lard (grain fed)
Olive
Palm
"Vegetable" oil…
HO sunflower
Butter
Cocoa butter…
PUFA Content in 100g of Fat or Oil

PUFA Breakdown in Dietary Fats and Oils

Coconut
Palm kernel
Palm kernel…
Coconut…
ALA

GLA
EPA
DHA
Other

linoleic
Cooking Oils
• Cooking with fats and oils is a different issue than which fats or oils are
in complex foods that you eat (meat, fish, dairy, legumes, etc.) or that you may
eat raw, such as in salad dressings, margarine or butter
(the previous slide speaks to which are good or bad in that context)

• When cooking with fats or oils, which is best depends on temperature

• Unsaturated fatty acids (MUFA and PUFA) can partially hydrogenate

and convert to trans-fatty acids at high heat – trans fats are bad
Cooking Oils
• To cook at high heat – above smoking point, which may cause
hydrogenation / trans-FA formation (e.g. - searing, stir frying, etc.):

• use oils that are stable at high temperatures (>450°F)

(e.g. - avocado, cottonseed, soybean, corn, canola, peanut oils, ghee)

• To cook at lower heat (<400°F) – below smoking point of

most oils (e.g. - slow sautéeing):
• use MUFA-rich oils (e.g. – olive, canola oils)
Bioavailability of Proteins in Common Foods
• Animal source proteins generally highly bioavailable
• human milk = 100%; cow milk ~ 95% 0.09

0.08

• eggs ~ 95%; meat / fish ~ 90-92% 0.07

Human
0.06

• Legumes rich in methionine 0.05

Dairy

Meat

• soy highest ~ 85-90%; others ~ 80% 0.04

Legume

0.03 Cereal

• Cereals deficient in methionine 0.02

0.01

• generally ~ 60% 0
Val Leu Ile Met Phe Trp Thr Lys His Arg*

Fraction provided by each essential AA in proteins from different species

[multiple data sources]
Appetite Regulation
Homeostasis of Blood Sugar and Other Factors
Homeostatic Control Systems
• Homeostasis ≡ maintenance of internal equilibrium

• Components of control system:

• set-points, feed-back and feed-forward loops

• Common example - indoor climate regulation

• Biologic examples:
• regulation of blood sugar, blood sodium, blood pressure, blood oxygen, etc.
Example of Homeostasis
• Indoor climate regulation
• set point = thermostat
• heat source = furnace
• heat sink = window
• controller = human who over-rides system

• Problem = too hot

• solution 1 - open window (fight the system)
• solution 2 - lower thermostat (control the system)
Homeostasis of Body Mass / Composition
• Extremely complex!

• Primary physiologic set point is blood sugar

• regulation of appetite, mass, %BF probably
by-products of blood sugar regulation

• Control system involves

• nervous system (hypothalamus & other centres)
• alimentary tract (esp. stomach, small intestine)
• multiple hormones secreted by stomach, jejunum, liver, pancreas, fat, brain…
 Blood Sugar and Appetite Control
(massively over-simplified!)
Non-Appetite-Driven
Restriction
Stored fuel
glucagon
mobilization

Leptin PA Ghrelin

Food in
Stomach Psycho-
Stored Blood
Appetite Eating Social
Fat Sugar Factors
Food in
Incretins
small
(GIP & GLP-1)
intestine
Fuels being
absorbed
Fuels
being PYY
stored Insulin

Other Brain Factors: Non-Appetite-Driven

Taste, Smell, Eating
Drugs, etc.
Physical Activity and Appetite
• Apparently complex relationship

• Significant PA uses fuels   blood sugar   appetite

• Some experiments in animals suggest

moderate PA   appetite compared to sedentary state

• Control system operates at stable equilibrium in a

range of ~1-5 hours of PA/day in rats
• PA outside of that range takes system out of its best operating range
Effect of Exercise on Caloric
Intake

Mayer et al American Journal of Physiology (1954)

Weight Loss with “Dieting” &/or Exercise

Source: Paffenbarger and Lee et al – Harvard Alumni Study

Problems with “Diets”
• Food restriction (fighting appetite) - wrong way to control the system!

• Metabolic adaptations (reduced REE / kg)  “yo-yo” effect

• Associated nutritional deficiencies

• Lose the wrong tissue (muscle and fat)
• Part of societal obsession with “body image” (body dysmorphia, DE / ED, RED-S)
The Problem of Portions
• Evidence that people tend to eat what is in front of them
regardless of appetite (to some extent)

• Critical issues include sizes of plates, utensils and

portions of food put on them [e.g. – Painter et al] – restaurants are brutal!

• Make good choices at the fridge / counter and you

won’t have to fight your appetite control system at the table!

• Learn (and teach kids) appropriate portions!

“Houston, we have a problem”
• On one hand, we have evidence that eating too much
is a common problem, and that this is unhealthy

• On the other, we have evidence that food restriction (fighting your

appetite) is a common problem, and that it is unhealthy

• What should we do?

• Manage the control system – work with it, don’t fight it!
Body Mass and Composition
Definitions, Health Correlates, Related Disorders
Body Mass and Composition
• In theory, we can divide our total mass into “compartments”
(not like the compartments in Module 2 – not separated by barriers)

• Simplest model = “2 compartment” model

𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀 = 𝐿𝐿𝐿𝐿𝐿𝐿𝐿𝐿 𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀 + 𝐹𝐹𝐹𝐹𝐹𝐹 𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀

𝐹𝐹𝐹𝐹𝐹𝐹 𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀
% 𝐵𝐵𝐵𝐵𝐵𝐵𝐵𝐵 𝐹𝐹𝐹𝐹𝐹𝐹 = ∗ 100
𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀

• Lean Mass also called “fat-free mass” (FFM) or “lean body mass” (LBM)
Tests of Body Composition
• Variety of techniques, mostly indirect estimates

• DEXA (dual energy x-ray absorbimetry)

most accurate, but expensive & radiation (very little)

• Hydrostatic (underwater) weighing

inconvenient, slightly inaccurate

• “Bod Pod” (air displacement plethysmography)

somewhat inaccurate (2-6% error)

• Skinfold calipers inaccurate (and demeaning!)

• BIA (bioelectric impedance analysis) inaccurate

Risks of Testing Body Composition
• Tests of mass or BC may have unintended consequences
• cause subjects to focus on wrong issue

• negative psychological effects

• Problems caused by these body composition analyses

typically outweigh benefits, especially in females

• CASEM (1999) recommended against BCA in HP athletes (let alone others)

• this advice not followed  ongoing problems / issues in sport and “fitness” industry
Body Mass / Composition & Health
• Many studies show correlation of some measures of
body mass or composition with risks of some disorders:

• Height : Weight Ratio (HWR)

• Body Mass Index (BMI)

• Waist Circumference (WC) & Waist : Hips Ratio (WHR)

• % Body Fat (%BF)

Body Mass Index
• BMI BMI Classification Health Risks

= mass / height2 < 18.5 Underweight increased

(kg·m-2) 18.5 – 24.9 Normal Weight least

25.0 – 29.9 Overweight increased

• Classification 30.0 – 34.9 Obese Class I high

of BMI 35.0 – 39.9 Obese Class II very high

(WHO 2000) > 40.0 Obese Class III extremely high

BMI of Canadian Men (2007-09)

Statistics Canada (www.statcan.gc.ca)

BMI of Canadian Women (2007-09)

Statistics Canada (www.statcan.gc.ca)

Average BMI of North Americans (2007-09)

Statistics Canada (www.statcan.gc.ca)

Health Correlates of Body Composition
• Studies have used various measures

(BMI, WC, HWR, WHR, %BF) etc. – hard to compare

• %BF may be best correlate (?) of risks, but…

• BMI most available measure,

so risks most commonly related to BMI Classification

Correlates of Overweight / Obesity
• Metabolic Syndrome (type 2 diabetes, hypertension, atherosclerosis, dyslipidemia)

• Gall Bladder Disease

• Obstructive Sleep Apnea

• Some Cancers

• Degenerative Arthrosis (more about this in KPE363)

Correlates (Causes?) of Obesity
• Genetics (~40% of variance in PCA / MVA)
• brain factors, endocrine factors, brown fat

• Learned eating habits - total calories > fuel requirements

• more important than macronutrient ratios, types of each
• timing of nutrient intake? / metabolic switching

• Sedentary lifestyle

• Psycho-social factors
Problems with Underweight
• “Undernutrition” (WHO / Gov Can) affects 2/3 of world
• fuel malnutrition / hypocalorism
• substrate malnutrition (most often protein)
• micronutrient malnutrition (vitamins, minerals)

• Failure to thrive / develop fully

• Low Bone Mineral Density

• Infertility

• Immune incompetence
Relative Energy Deficiency Syndrome (RED-S)
• Energy intake deficient relative to energy demands
• Resting Energy Availability < 30 kcal/kg-FFM per day
 brain (hypothalamus) slows some body functions to save energy

•  sex hormones  menstrual irregularity in females

•  growth factors   bone mineralization ,  muscle accrual

• other issues (GI, cardiac, mental, etc.)

• Formerly called Female Athlete Triad (ouch); females > males

• Mostly aesthetic and endurance sports (~50% of athletes at highest levels)

Disordered Eating / Eating Disorders
• Diagnoses defined in DSM-5 based on presence / extent of 4 components:

• restriction of intake (called anorexia nervosa if severe enough)

• purging of food eaten by vomiting / laxatives

• binge eating (called bulimia nervosa if severe and mixed with purging)

• compulsive exercise

• Often with related / concurrent / underlying body dysmorphic disorder

• Some (not all) people with RED-S have some DE / ED / BDD

How Much?
The Biggest Question
How Much?
• How much food / macronutrient should we eat?

• Three reasons for eating macronutrients:

• Energy – fuel for life / cellular metabolism
• Substrate – building blocks to make molecules we need
• Dietary Fibre – for gut health & other benefits of soluble fibre

• We’ll focus on the first two of these three issues here

How Much?
• Energy
• conventional wisdom says “just enough fuel to meet energy requirements”
= REE (~1 kcal/kg/hour) + PA Expenditure (varies)

• more than this associated with obesity, metabolic syndrome

• less than this is a topic of hot debate / controversy (next slide)

• Substrate – it depends on PA (tissue turnover, muscle synthesis)

• almost no North Americans are substrate deficient (except some athletes)
Caloric Restriction (CR)
• Deliberately eating less than normal REE + PA Expenditure
• causes a reduction in REE to reach equilibrium at lower intake level

• Associated with some positive outcomes: (next slides) increased lifespan

& reduced inflammation (anti-aging?) in short-lifespan animal models
(small but growing body of evidence from human trials such as CALERIE underway)

• Associated with some negative outcomes: potential for RED-S,

loss of muscle & bone mass, reduced immune function (more infections)

• CR is NOT for children, adolescents, young adults, or athletes!

• RCT in humans
• CR* vs. AL (ad libitum) diets
• *aimed for 25%, achieved 11% CR

• 2-year follow-up

• Improved multiple CV risk factors:

• BMI, BP, C-reactive protein, insulin
sensitivity, metabolic syndrome score
Which?
Macronutrient Ratios
Macronutrient Ratios
• What percentage of the energy in (or mass of) your food
should come from each of the 3 macronutrient groups?

• Historically lots of theories, some evidence, no consensus

• complexity – so many variables in an extremely complex system!
• descriptive data – prospective cohort studies, need to be very long-term

• Specific issue of glycogen recovery after glycogen-depleting PA

• best with ~ 2.5 – 3 CH2O : 1 protein
High Carb? Low Carb?
• Long-term cohort studies / meta-analyses
[e.g. - Seidelmann et al Lancet Public Health 2018]

• Lowest mortality ~50-55% cal from carbs

• Low-Carb (<40% cal) - HR mortality 1.20

• depends a bit on what replaces the carbs!
• proteins and fats from meats
worse than legume, nut & seed

• High-Carb (>70% cal) HR mortality 1.23

• issue of which carbs (glycemic?) not addressed
Seidelmann et al LPH 2018
Which Carbohydrates?

• Avoid sugars (refined / pre-digested carbohydrates) except during vigourous PA

• Dietary fibre – benefits from lots of both soluble & insoluble fibre

• Digestible Polysaccharides (starches & glycogen)

• Avoid glycemicity (except during vigourous exercise)

 more about food and meal structure than the carbs per se
Dietary Lipids
• Growing body of evidence
suggests that which fats is more
important than how much fat
• high % calories from fat not
necessarily bad – depends on source!

• Significant risk factor for CVD,

metabolic syndrome, Ca (?),
inflammatory diseases (?),
other disorders (?)
 Good and Bad Fatty Acids
LOTS of disagreement - this represents my view of current dogma

Health
Type of FA Common Sources
Effects
artificially hydrogenated
Trans FA
“vegetable” oils
Bad meat & dairy
SFA
tropical seed

Ω-6 PUFA safflower & sunflower oils

Good
mid-length Ω-3 PUFA flax oil

Best Ω-9 MUFA olive & canola oils

cold water fish,

long-chain Ω-3 PUFA
seal & whale oils
Which Proteins?
• Not generally an important issue if the amount of protein in diet is adequate

• May be important for some vegans (strict vegetarians)

• legume protein is ~80% bioavailable when consumed alone
• cereal protein is ~60% bioavailable when consumed alone
• consumed together, their protein is ~85% bioavailable
• Must be combined in each meal, since AA’s are not stored in quantity

• Recovery after RET – some evidence that whey (dairy) is best

possibly because of high leucine and branched-chain AA content
Bottom Lines on Macronutrient Ratios?
• Growing body of evidence suggests moderation
• extreme diets (very high or very low in carbs, proteins, or fats)
probably do more harm than good
• eating a balanced selection of whole / real foods
will provide a balanced ratio of macronutrients

• Other related issues (i.e. - types of fat, glycemicity of meals)

may be more important than overall macronutrient ratios
• The question of which macronutrients is sometimes related to the
question of when you eat them…
When?
Timing of Food / Macronutrient Intake
Big Questions about When
• When should you consume macronutrients (regardless of type)?
• When should you eat different macronutrients?
• The question of “when” has multiple sub-questions:
• frequency of ingestion – how many meals / snacks
• when in relation to sleep or PA?
• same every day? or some days different?
• is it the same for every age?
• what if people have a disorder or disease?
• what about high performance athletes?
“Conventional Wisdom”
• This issue is yet another that highlights the frailty of “expert opinion”

• For decades “experts” in nutritional science and medicine have preached

that we should eat small amounts frequently to avoid fasting states –
thought to keep insulin levels steady, improve metabolism, improve
performance, avoid too much hunger leading to binging /
overconsumption, etc., etc.

• More recent evidence is changing opinions

• It matters how much you eat, but it also matters when you eat it

• Time-Restricted Feeding (TRF) – eat all food in a limited time window each day

• Intermittent Fasting (IF) – occasional / regular periods of fasting of various durations

• Periods of fasting lead to “metabolic switching” to
the biochemistry of the fasting state –  insulin and
protein synthesis;  ketosis, anti-oxidant states,
autophagy, and DNA repair  “stress resistance”

• Periods of fuel availability and sleep lead to the

biochemistry of the fed state –  insulin, protein
synthesis, cell growth, tissue remodeling  growth

• We need both!
• IF and TRF may have
health effects similar
to those of aerobic PA:
 cellular resistance
to a variety of stresses

• NOT for children or

adolescents, or high
performance athletes
unless proven otherwise
When in Relation to PA?
• Before vigourous PA
• complex meal (low glycemic w CH2O, fat, protein) > 2hrs before

• During vigourous PA
• high glycemic food / beverage (fruits, sport beverages, etc.)

• After vigourous PA
• recovery meal within 60 minutes; type depends on type of PA
• endurance / intense energetic PA  glycogen recovery ~3.5:1 CH2Os : protein
• resistance training  adequate protein intake (next slide)
• In individuals engaged
in prolonged resistance
training, protein intake
< 1.6 g/kg/d will limit
protein synthesis

• More than that

does not help  used as fuel or stored as fat
Protein Recovery after RET
• In young people, MPS
(muscle protein synthesis) best if
recovery meal contains ~0.3 g/kg

• In older people, more is better

(i.e. ~.4 g/kg)

• Any more than that is oxidized

as fuel or stored as fat
Moore SM 2021
Guidelines
Canada Food Guide
“Real” vs. Processed Foods
• “Real / Whole” Foods – identifiable species of plants and animals
• cooked properly, they contain all the nutrients in that plant or animal tissue

• Processed Foods
• nutrients extracted / discarded / altered for sake of texture / preservation
• generally lacking in micronutrients, dietary fibre, etc. what else?

• “Supplements”
• isolated and pre-digested nutrients as white powders – not real food!
A Word on Farming Practices
• “You are what you eat” is an old saying…

• This is true of us, but also of the animals & plants we may choose to eat

• Animals fed healthy diets are healthier to eat!

• Free-ranging pasture-fed livestock have healthier fatty acid profiles:

• lower SFA, higher MUFA & PUFA (including Ω-3)

• And then there are drugs and poisons…

eat “naturally-raised” or “Certified Organic” foods!
Canada Food Guide
• An evolving guideline

• Early versions (1st half of 20th century)

somewhat-based on food availability

• Increasingly based on evidence

of health risks and benefits

• https://food-guide.canada.ca/en/
food-guide.canada.ca/en
Canada Food Guide
• Fruits & Veggies – ½ plate

• High Protein foods – ¼ plate

(legumes, nuts, fish, dairy, meat)

• Whole Grains – ¼ plate

• Drink Water

food-guide.canada.ca/en
Canada Food Guide
• Food-related choices
in a broad, social context
• be mindful / aware
• read food labels
• make food social
• cook at home
• drink water, not sugar
• avoid processed foods
food-guide.canada.ca/en
Our Choices
My bottom lines on the Big Questions - time for some “Dougma” 
The Big Questions and Our Choices
• How much? Which foods? When?

• These choices are made in a complex environment

of physiological and psycho-social factors
• food abundance in industrialized societies
• relative sedentarism in industrialized societies
• mass marketing of garbage foods & supplements
• social media propagation of unrealistic expectations

• How can we make good / healthy choices?

Social Context of Nutritional Choices
• Social construction of the “ideal” body
• women should be skinny (but with big breasts)
• men should be like Arnold (in his ‘roid hay days)
• contributes to BDD / DE / ED / RED-S
“Ahnold” in his ‘roid hay days

“When I watch TV and see all those starving children

all over the world, it makes me want to cry.
I mean, I’d like to be as thin as that,
but not with all those flies and death and stuff.”

Mariah Carey, June 1996, Radio 1, U.K.

Social Context of Nutritional Choices
• Misconceptions regarding causes of obesity

• Family, religious, peer and educational influences

• Market factors
• availability, cost and proximity of “real / whole” food in stores
“food deserts” in some racialized / underprivileged TO ‘hoods!
• garbage foods / excessively large portions in many restaurants
Nutrition & Other Choices
• Your nutritional choices affected by your choices about:
• physical activity
• substance use / abuse
• work / time / stress
• Your nutritional choices affect your other choices & other people:
• your choices about PA, drugs, sleep, etc.
• your peers, siblings & others around you
• society - market forces, social norms
My Bottom Lines (Opinion)
• “Eat (real) food” – avoid processed foods;
you should be able to name the species of
plant(s) and/or animal(s) you are eating

• “Not too much” – see next slide

• “Mostly plants” – evidence of negative

effects of too much meat, saturated fat

• Pay attention to how your food is

farmed, hunted or fished – you should know
My Bottom Lines (Opinion)
• Daily moderate physical activity helps to regulate appetite well
• appropriate recovery snack / meal after vigourous PA

• Practice appropriate portion control before you get to the table

• Eat low glycemic, high fibre, complex (carbs + fats + proteins) meals and snacks
• except during vigourous PA

• Open questions: issues of timing (TRF / IF) and caloric restriction (CR);
in my opinion not for < 20 y.o. / athletes
• Avoid drugs that alter appetite
My Bottom Lines (Opinion)
• Be old-fashioned (really! our ancestors ate better than us in many ways)

• Eat real / whole foods, not processed garbage or supplements (except Vitamin D)

• Buy properly-raised/-grown foods

from vendors who know its provenance

• Learn to cook

• Make time to eat

• Enjoy foods with family / friends

Time for Lunch Enjoy your Food