Nutrition and metabolism

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A

Dietary Reference Intakes (DRI)

NOTE: For all nutrients, values for infants are AI. Dashes indicate that values have not been determined. aThe water AI includes drinking water, water in beverages, and wa- ter in foods; in general, drinking water and other beverages contrib- ute about 70 to 80 percent, and foods, the remainder. Conversion factors: 1 L = 33.8 fluid oz; 1 L = 1.06 qt; 1 cup = 8 fluid oz. bThe Estimated Energy Requirement (EER) represents the average dietary energy intake that will maintain energy balance in a healthy person of a given gender, age, weight, height, and physical activity level. The values listed are based on an “active” person at the refer- ence height and weight and at the midpoint ages for each group

until age 19. Chapter 8 provides equations and tables to determine estimated energy requirements. cThe linolenic acid referred to in this table and text is the omega-3 fatty acid known as alpha-linolenic acid. dThe values listed are based on reference body weights. eAssumed to be from human milk. fAssumed to be from human milk and complementary foods and beverages. This includes approximately 0.6 L (∼21⁄2 cups) as total fluid including formula, juices, and drinking water. gFor energy, the age groups for young children are 1–2 years and 3–8 years.

hFor males, subtract 10 kcalories per day for each year of age above 19. iBecause weight need not change as adults age if activity is main- tained, reference weights for adults 19 through 30 years are applied to all adult age groups. jFor females, subtract 7 kcalories per day for each year of age above 19.

SOURCE: Adapted from the Dietary Reference Intakes series, National Academies Press. Copyright 1997, 1998, 2000, 2001, 2002, 2004, 2005, 2011 by the National Academies of Sciences.

Age (yr)

Males

0–0.5 — 62 (24) 6 (13) 0.7e 570 60 — 31 4.4 0.5 9.1 1.52

0.5–1 — 71 (28) 9 (20) 0.8f 743 95 — 30 4.6 0.5 11 1.20

1–3g — 86 (34) 12 (27) 1.3 1046 130 19 — 7 0.7 13 1.05

4–8g 15.3 115 (45) 20 (44) 1.7 1742 130 25 — 10 0.9 19 0.95

9–13 17.2 144 (57) 36 (79) 2.4 2279 130 31 — 12 1.2 34 0.95

14–18 20.5 174 (68) 61 (134) 3.3 3152 130 38 — 16 1.6 52 0.85

19–30 22.5 177 (70) 70 (154) 3.7 3067h 130 38 — 17 1.6 56 0.80

31–50 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 38 — 17 1.6 56 0.80

>50 22.5i 177 (70)i 70 (154)i 3.7 3067h 130 30 — 14 1.6 56 0.80

Females

0–0.5 — 62 (24) 6 (13) 0.7e 520 60 — 31 4.4 0.5 9.1 1.52

0.5–1 — 71 (28) 9 (20) 0.8f 676 95 — 30 4.6 0.5 11 1.20

1–3g — 86 (34) 12 (27) 1.3 992 130 19 — 7 0.7 13 1.05

4–8g 15.3 115 (45) 20 (44) 1.7 1642 130 25 — 10 0.9 19 0.95

9–13 17.4 144 (57) 37 (81) 2.1 2071 130 26 — 10 1.0 34 0.95

14–18 20.4 163 (64) 54 (119) 2.3 2368 130 26 — 11 1.1 46 0.85

19–30 21.5 163 (64) 57 (126) 2.7 2403 j 130 25 — 12 1.1 46 0.80

31–50 21.5i 163 (64)i 57 (126)i 2.7 2403 j 130 25 — 12 1.1 46 0.80

>50 21.5i 163 (64)i 57 (126)i 2.7 2403 j 130 21 — 11 1.1 46 0.80

Pregnancy

1st trimester 3.0 +0 175 28 — 13 1.4 46 0.80

2nd trimester 3.0 +340 175 28 — 13 1.4 71 1.10

3rd trimester 3.0 +452 175 28 — 13 1.4 71 1.10

Lactation

1st 6 months 3.8 +330 210 29 — 13 1.3 71 1.30

2nd 6 months 3.8 +400 210 29 — 13 1.3 71 1.30

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The Dietary Reference Intakes (DRI) include two sets of values that serve as goals for nutrient intake—Recommended Dietary Allowances (RDA) and Adequate Intakes (AI). The RDA reflect the average daily amount of a nutrient considered adequate to meet the needs of most healthy people. If there is insufficient evidence to determine an RDA, an AI is set. AI are more ten­ tative than RDA, but both may be used as goals for nutrient intakes. (Chapter 9 provides more details.)

In addition to the values that serve as goals for nutrient in­ takes (presented in the tables on these two pages), the DRI in­ clude a set of values called Tolerable Upper Intake Levels (UL). The UL represent the maximum amount of a nutrient that ap­ pears safe for most healthy people to consume on a regular ba­ sis. Turn the page for a listing of the UL for selected vitamins and minerals.

Estimated Energy Requirements (EER), Recommended Dietary Allowances (RDA), and Adequate Intakes (AI) for Water, Energy, and the Energy Nutrients

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B

Infants 0–0.5 0.2 0.3 2 5 1.7 0.1 65 0.4 125 40 400 400 (10 µg) 4 2.0 0.5–1 0.3 0.4 4 6 1.8 0.3 80 0.5 150 50 500 400 (10 µg) 5 2.5 Children 1–3 0.5 0.5 6 8 2 0.5 150 0.9 200 15 300 600 (15 µg) 6 30 4–8 0.6 0.6 8 12 3 0.6 200 1.2 250 25 400 600 (15 µg) 7 55 Males 9–13 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 600 (15 µg) 11 60 14–18 1.2 1.3 16 25 5 1.3 400 2.4 550 75 900 600 (15 µg) 15 75 19–30 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 600 (15 µg) 15 120 31–50 1.2 1.3 16 30 5 1.3 400 2.4 550 90 900 600 (15 µg) 15 120 51–70 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 600 (15 µg) 15 120 >70 1.2 1.3 16 30 5 1.7 400 2.4 550 90 900 800 (20 µg) 15 120 Females 9–13 0.9 0.9 12 20 4 1.0 300 1.8 375 45 600 600 (15 µg) 11 60 14–18 1.0 1.0 14 25 5 1.2 400 2.4 400 65 700 600 (15 µg) 15 75 19–30 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 600 (15 µg) 15 90 31–50 1.1 1.1 14 30 5 1.3 400 2.4 425 75 700 600 (15 µg) 15 90 51–70 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 600 (15 µg) 15 90 >70 1.1 1.1 14 30 5 1.5 400 2.4 425 75 700 800 (20 µg) 15 90 Pregnancy ≤18 1.4 1.4 18 30 6 1.9 600 2.6 450 80 750 600 (15 µg) 15 75 19–30 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 600 (15 µg) 15 90 31–50 1.4 1.4 18 30 6 1.9 600 2.6 450 85 770 600 (15 µg) 15 90 Lactation ≤18 1.4 1.6 17 35 7 2.0 500 2.8 550 115 1200 600 (15 µg) 19 75 19–30 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 600 (15 µg) 19 90 31–50 1.4 1.6 17 35 7 2.0 500 2.8 550 120 1300 600 (15 µg) 19 90

NOTE: For all nutrients, values for infants are AI. a Niacin recommendations are expressed as niacin equivalents (NE), except for recommendations for infants younger than 6 months, which are expressed as preformed niacin. bFolate recommendations are expressed as dietary folate equivalents (DFE).

cVitamin A recommendations are expressed as retinol activity equivalents (RAE). d Vitamin D recommendations are expressed as cholecalciferol and assume an absence of adequate exposure to sunlight. eVitamin E recommendations are expressed as α-tocopherol.

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Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) for Vitamins

Age (yr)

Infants 0–0.5 120 180 400 200 100 30 0.27 2 110 15 200 0.003 0.01 0.2 2 0.5–1 370 570 700 260 275 75 11 3 130 20 220 0.6 0.5 5.5 3 Children 1–3 1000 1500 3000 700 460 80 7 3 90 20 340 1.2 0.7 11 17 4–8 1200 1900 3800 1000 500 130 10 5 90 30 440 1.5 1.0 15 22 Males 9–13 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.9 2 25 34 14–18 1500 2300 4700 1300 1250 410 11 11 150 55 890 2.2 3 35 43 19–30 1500 2300 4700 1000 700 400 8 11 150 55 900 2.3 4 35 45 31–50 1500 2300 4700 1000 700 420 8 11 150 55 900 2.3 4 35 45 51–70 1300 2000 4700 1000 700 420 8 11 150 55 900 2.3 4 30 45 >70 1200 1800 4700 1200 700 420 8 11 150 55 900 2.3 4 30 45 Females 9–13 1500 2300 4500 1300 1250 240 8 8 120 40 700 1.6 2 21 34 14–18 1500 2300 4700 1300 1250 360 15 9 150 55 890 1.6 3 24 43 19–30 1500 2300 4700 1000 700 310 18 8 150 55 900 1.8 3 25 45 31–50 1500 2300 4700 1000 700 320 18 8 150 55 900 1.8 3 25 45 51–70 1300 2000 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45 >70 1200 1800 4700 1200 700 320 8 8 150 55 900 1.8 3 20 45 Pregnancy ≤18 1500 2300 4700 1300 1250 400 27 12 220 60 1000 2.0 3 29 50 19–30 1500 2300 4700 1000 700 350 27 11 220 60 1000 2.0 3 30 50 31–50 1500 2300 4700 1000 700 360 27 11 220 60 1000 2.0 3 30 50 Lactation ≤18 1500 2300 5100 1300 1250 360 10 13 290 70 1300 2.6 3 44 50 19–30 1500 2300 5100 1000 700 310 9 12 290 70 1300 2.6 3 45 50 31–50 1500 2300 5100 1000 700 320 9 12 290 70 1300 2.6 3 45 50 NOTE: For all nutrients, values for infants are AI.

Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) for Minerals

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C

Infants

0–0.5 — — — — — 600 1000 (25 µg) —

0.5–1 — — — — — 600 1500 (38 µg) —

Children

1–3 10 30 300 1000 400 600 2500 (63 µg) 200

4–8 15 40 400 1000 650 900 3000 (75 µg) 300

9–13 20 60 600 2000 1200 1700 4000 (100 µg) 600

Adolescents

14–18 30 80 800 3000 1800 2800 4000 (100 µg) 800

Adults

19–70 35 100 1000 3500 2000 3000 4000 (100 µg) 1000

>70 35 100 1000 3500 2000 3000 4000 (100 µg) 1000

Pregnancy

≤18 30 80 800 3000 1800 2800 4000 (100 µg) 800

19–50 35 100 1000 3500 2000 3000 4000 (100 µg) 1000

Lactation

≤18 30 80 800 3000 1800 2800 4000 (100 µg) 800

19–50 35 100 1000 3500 2000 3000 4000 (100 µg) 1000

Infants

0–0.5 — — 1000 — — 40 4 — 45 — — 0.7 — — — —

0.5–1 — — 1500 — — 40 5 — 60 — — 0.9 — — — —

Children

1–3 1500 2300 2500 3000 65 40 7 200 90 1000 2 1.3 300 3 0.2 —

4–8 1900 2900 2500 3000 110 40 12 300 150 3000 3 2.2 600 6 0.3 —

9–13 2200 3400 3000 4000 350 40 23 600 280 5000 6 10 1100 11 0.6 —

Adolescents

14–18 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0 —

Adults

19–50 2300 3600 2500 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8

51–70 2300 3600 2000 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8

>70 2300 3600 2000 3000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 1.8

Pregnancy

≤18 2300 3600 3000 3500 350 45 34 900 400 8000 9 10 1700 17 1.0 —

19–50 2300 3600 2500 3500 350 45 40 1100 400 10,000 11 10 2000 20 1.0 —

Lactation

≤18 2300 3600 3000 4000 350 45 34 900 400 8000 9 10 1700 17 1.0 —

19–50 2300 3600 2500 4000 350 45 40 1100 400 10,000 11 10 2000 20 1.0 —

aThe UL for niacin and folate apply to synthetic forms obtained from supplements, fortified foods, or a combination of the two. bThe UL for vitamin A applies to the preformed vitamin only.

Tolerable Upper Intake Levels (UL) for Vitamins

dThe UL for magnesium applies to synthetic forms obtained from supplements or drugs only. NOTE: An Upper Limit was not established for vitamins and minerals not listed and for those age groups listed with a dash (—) because of a lack of data, not because these nutrients are safe to consume at any level of intake. All nutrients can have adverse effects when intakes are excessive.

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Tolerable Upper Intake Levels (UL) for Minerals

cThe UL for vitamin E applies to any form of supplemental α-tocopherol, fortified foods, or a combination of the two.

SOURCE: Adapted with permission from the Dietary Reference Intakes series, National Academies Press. Copyright 1997, 1998, 2000, 2001, 2002, 2005, 2011 by the National Academies of Sciences.

Age (yr)

Age (yr)

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ADVANCED NUTRITION AND HUMAN METABOLISM

SEVENTH EDITION

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ADVANCED NUTRITION AND HUMAN METABOLISM

SEVENTH EDITION

Sareen S. Gropper FLORIDA ATLANTIC UNIVERSITY

AUBURN UNIVERSITY (PROFESSOR EMERITUS)

Jack L. Smith UNIVERSITY OF DELAWARE

Timothy P. Carr UNIVERSITY OF NEBRASKA-LINCOLN

Australia • Brazil • Mexico • Singapore • United Kingdom • United States

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To my children Michelle and Michael, and to my husband, Daniel, for their ongoing encouragement, support, faith, and love and to the students who continue to impress and inspire me.

Sareen Gropper

To my wife, Carol, for her continued support, constant inspiration, and assistance in the preparation of this book.

Jack Smith

To my family—Rebecca, Erin, and Marion—for their unwavering support and to the many students who have made my career so enjoyable.

Tim Carr

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Copyright 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202

Copyright 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

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vii

BRIEF CONTENTS

Preface xvii

SECTION I Cells and Their Nourishment 1 The Cell: A Microcosm of Life 1 2 The Digestive System: Mechanism for Nourishing the Body 29

SECTION II Macronutrients and Their Metabolism 3 Carbohydrates 61 4 Fiber 107 5 Lipids 125 6 Protein 175 7 Integration and Regulation of Metabolism and the Impact

of Exercise 245 8 Energy Expenditure, Body Composition, and Healthy Weight 273

SECTION III The Regulatory Nutrients 9 Water-Soluble Vitamins 299 10 Fat-Soluble Vitamins 369 11 Major Minerals 425 12 Water and Electrolytes 455 13 Essential Trace and Ultratrace Minerals 479 14 Nonessential Trace and Ultratrace Minerals 543

Glossary 557 Index 563

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ix

CONTENTS

Preface xvii

SECTION I Cells and Their Nourishment

CHAPTER 1 The Cell: A Microcosm of Life 1 Components of Cells 1 Plasma Membrane 1 Cytoplasmic Matrix 4 Mitochondrion 4 Nucleus 6 Endoplasmic Reticulum and Golgi Apparatus 10 Lysosomes and Peroxisomes 11 Selected Cellular Proteins 11 Receptors 11 Catalytic Proteins (Enzymes) 13 Apoptosis 16 Biological Energy 17 Energy Release and Consumption in Chemical

Reactions 18 Expressions of Energy 18 The Role of High-Energy Phosphate in Energy

Storage 21 Coupled Reactions in the Transfer of Energy 21 Reduction Potentials 23 Summary 24 PERSPECTIVE Nutritional Genomics: A New Perspective on Food by Ruth DeBusk, PhD, RD 26

CHAPTER 2 The Digestive System: Mechanism for Nourishing the Body 29 The Structures of the Digestive Tract And the Digestive and Absorptive Processes 29 The Oral Cavity 32 The Esophagus 33 The Stomach 35 The Small Intestine 40 The Accessory Organs 43 The Absorptive Process 49 The Colon (Large Intestine) 51

Coordination and Regulation of the Digestive Process 55 Neural Regulation 55 Regulatory Peptides 55 Summary 58 PERSPECTIVE The Nutritional Impact of Roux-En-Y Gastric Bypass, A Surgical Approach for the Treatment of Obesity 59

SECTION II Macronutrients and Their Metabolism

CHAPTER 3 Carbohydrates 61 Overview of Structural Features 61 Simple Carbohydrates 62 Monosaccharides 62 Disaccharides 65 Complex Carbohydrates 66 Oligosaccharides 66 Polysaccharides 66 Digestion 67 Digestion of Polysaccharides 68 Digestion of Disaccharides 68 Absorption, Transport, and Distribution 68 Intestinal Absorption

of Glucose and Galactose 68 Intestinal Absorption of Fructose 71 Post-Absorption Facilitated Transport 71 Glucose Transporters 71 Glucose Entry into Interstitial Fluid 74 Maintenance of Blood Glucose

Concentration 75 Glycemic Response to Carbohydrates 75 Glycemic Index and Glycemic Load 75 Integrated Metabolism in Tissues 77 Glycogenesis 77 Glycogenolysis 80 Glycolysis 81 The Tricarboxylic Acid Cycle 84 Formation of ATP 87 The Pentose Phosphate Pathway (Hexose

Monophosphate Shunt) 94

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x C O N T E N T S

Gluconeogenesis 95 Regulation of Metabolism 98 Allosteric Enzyme Modulation 98 Covalent Regulation 99 Genetic Regulation 99 Directional Shifts

in Reversible Reactions 99 Metabolic Control of Glycolysis and

Gluconeogenesis 100 Summary 101 PERSPECTIVE What Carbohydrates Do Americans Eat? 104

CHAPTER 4 Fiber 107 Definitions 107 Fiber and Plants 108 Chemistry and Characteristics of Fiber 108 Cellulose 108 Hemicellulose 111 Pectins 111 Lignin 111 Gums 111 b-Glucans 111 Fructans 112 Resistant Starch 112 Mucilages (Psyllium) 112 Polydextrose and Polyols 113 Resistant Dextrins 113 Chitin and Chitosan 113 Selected Properties of Fiber and Their Physiological Impact 113 Solubility in Water 114 Viscosity and Gel Formation 114 Fermentability 115 Health Benefits of Fiber 115 Cardiovascular Disease 115 Diabetes Mellitus 117 Appetite and/or Satiety and Weight Control 117 Gastrointestinal Disorders 117 Food Labels and Health Claims 119 Recommended Fiber Intake 119 Summary 120 PERSPECTIVE The Flavonoids: Roles in Health and Disease Prevention 122

CHAPTER 5 Lipids 125 Structure and Biological Importance 126 Fatty Acids 126 Triacylglycerols (Triglycerides) 130 Phospholipids 131 Sphingolipids 133 Sterols 133

Dietary Sources 136 Recommended Intakes 138 Digestion …