Nutrition for Healthy Living 3rd Edition

Schiff Solutions Manual

Visit to Download in Full: https://testbankdeal.com/download/nutrition-for-healthy-livin
g-3rd-edition-schiff-solutions-manual/
 CHAPTER 6
FATS AND OTHER LIPIDS

OVERVIEW

Chapter 6 focuses on the roles of lipids in the diet and in human physiology. The chapter begins with an
overview of lipid chemistry, including functions and sources of fatty acids, triglycerides, phospholipids,
and cholesterol. The digestion, absorption, and metabolism of dietary fats are presented. The
essentiality of lipids in the diet is described, but the chapter also includes a thorough review of the
negative health consequences of consuming excess lipids. There is a particular emphasis on the
relationship between dietary lipids and the development of cardiovascular disease. Many food and
nutrition tips are provided for achieving a healthy balance of fats in the diet. The Chapter 6 Highlight
reviews the broad range of health effects, both positive and negative, of alcohol use or abuse.

CHAPTER OUTLINE

I. Understanding Lipids
A. General characteristics
1. Insoluble in water
2. Less dense than water
B. Fatty acids
1. Provide energy for cells
2. Chemical structure consists of a hydrocarbon chain
a. Methyl group at one end (omega end)
b. Acid group at the other end
c. In nature, most fatty acids have an even number of carbons in their hydrocarbon
chains
d. Short-chain fatty acids: 2 – 4 carbons
e. Medium-chain fatty acids: 6 – 12 carbons
f. Long-chain fatty acids: 14 – 24 carbons
3. Saturation
a. Saturated fatty acid: each carbon in the hydrocarbon chain is filled with hydrogen
atoms
b. Unsaturated fatty acid: contains at least one carbon-carbon double bond within the
hydrocarbon chain; missing hydrogen atoms
i. Monounsaturated fatty acid: has one double bond in the hydrocarbon chain
ii. Polyunsaturated fatty acid: has two or more double bonds in the hydrocarbon
chain
4. Fats versus oils
a. Fats are solid at room temperature; usually have a high proportion of saturated
fatty acids
b. Oils are liquid at room temperature; usually have a high proportion of unsaturated
fatty acids
5. Essential fatty acids
a. Lipids that must be supplied by the diet; not made by human metabolism
b. Two types of essential fatty acids in human diet:
i. Linoleic acid
a) Omega-6 fatty acid
 b) Dietary sources: vegetable oils, margarine, salad dressing, whole grains
c) Used to synthesize arachidonic acid (AA) in the body
d) AI: 17 g/d for men or 12 g/d for women
ii. Alpha-linolenic acid
a) Omega-3 fatty acid
b) Dietary sources: fatty fish
c) Used to synthesize eicosapentaenoic acid (EPA) and docosahexaenoic acid
(DHA) in the body
d) AI: 1.6 g/d for men or 1.1 g/d for women
c. EPA, DHA, and AA are used to synthesize prostaglandins that influence body
processes such as:
i. Uterine contractions
ii. Regulation of blood pressure
iii. Inflammatory response
d. Signs of essential fatty acid deficiency
i. Poor growth in infants
ii. Scaly skin
iii. Hair loss
iv. Poor wound healing
e. Dietary requirements for essential fatty acids can be met by consuming 2 – 3
tablespoons of vegetable oils daily (e.g., canola oil, soybean oils); and meals that
contain fatty fish at least twice per week
6. Trans fats
a. Unsaturated fatty acids that have at least one trans double bond
b. In trans configuration, hydrogen atoms are on opposite sides of the double bond,
resulting in a relatively straight chain
c. In cis configuration (more common in nature), hydrogen atoms are on the same side
of the double bond, resulting in a kink in the hydrocarbon chain
d. Figure 6.3 illustrates cis and trans fatty acids
e. Trans fats result from partial hydrogenation of liquid oils to make them solid at
room temperature
i. Improves shelf-life; less susceptible to oxidation/rancidity
ii. Shelf-life could also be improved by adding antioxidants to foods instead of
trans fats
f. Trans fats resemble saturated fats and have many of the same health effects
g. Dietary sources:
i. Natural: whole milk and whole milk products, butter, meat
ii. Manufactured: margarine with hydrogenated vegetable oil, commercially-
prepared baked goods, deep-fried foods
h. Health effects
i. Increase blood cholesterol levels
ii. Increase risk for cardiovascular disease
i. Trans fat content of foods is now required on the Nutrition Facts label
j. Some cities have banned trans fats from being used in restaurants
k. Replacing hydrogenated fats with interesterified oils may also have negative health
effects
i. Increased blood cholesterol
ii. Increased blood glucose
 C. Triglycerides
1. Three fatty acids attached to a glycerol backbone
2. Triglycerides make up 95% of the lipids in the body and in food
3. Although one type may predominate, most triglycerides contain mixtures of saturated
and unsaturated fatty acids (see Table 6.1)
a. Saturated: beef, dairy, coconut oil, palm oil
b. Monounsaturated: olive oil, canola oil
c. Polyunsaturated: sunflower oil, safflower oil, soybean oil
4. Consuming a high proportion of saturated fatty acids promotes cardiovascular disease
D. Phospholipids
1. Glycerol backbone with two fatty acids and a phosphate-containing group
2. Primary dietary phospholipid is lecithin
3. Water-soluble because the phosphorus-containing portion is hydrophilic
4. Dietary sources (of lecithin): egg yolks, liver, wheat germ, peanut butter, soybeans
5. Physiological functions
a. Component of cell membranes
b. Nerve cell function
c. Emulsifier: mixes water-soluble and fat-soluble compounds
d. Production of acetylcholine, a neurotransmitter
6. Phospholipid supplements are not necessary because phospholipids are widely
distributed in food and a healthy body can make phospholipids
E. Cholesterol
1. Physiological functions
a. Component of cell membranes
b. Synthesis of vitamin D
c. Synthesis of estrogen and testosterone
d. Synthesis of bile
2. Dietary sources: egg yolks, liver, meat, poultry, whole milk, cheese, ice cream (only
found in animal products)
3. The body also produces cholesterol

II. What Happens to Lipids in Your Body?

A. Digestion
1. Very little digestion of lipids in mouth or stomach
2. Small intestine (primary site of lipid digestion)
a. Presence of fat in the duodenum stimulates small intestinal cells to secrete
cholecystokinin (CCK)
i. CCK signals the pancreas to secrete digestive enzymes into the duodenum
ii. CCK signals the gallbladder to release bile, which emulsifies fat to improve the
efficiency of fat digestion
b. Pancreatic lipase digests triglycerides to fatty acids, monoglycerides, and glycerol
c. Phospholipase removes fatty acids from phospholipids
d. Bile is secreted from the gallbladder and keeps the lipids dispersed into small
particles to aid digestion
3. Large intestine
a. Small amount of lipids escapes absorption and may pass through the large intestine
to be excreted in feces
B. What are Lipoproteins?
 1. Glycerol, fatty acids, monoglycerides, cholesterol, and phospholipid fragments are
absorbed by the small intestinal cells
2. Most short- and medium-chain fatty acids enter the bloodstream directly
3. Long-chain fatty acids, glycerol, monoglycerides, and phospholipid fragments are
reassembled into triglycerides and phospholipids within the small intestinal cells and
coated with a thin layer of protein, phospholipids, and cholesterol to form chylomicrons,
which move through lacteals to enter the lymphatic system
4. Lymphatic vessels empty into the bloodstream through the thoracic duct
5. Lipoprotein lipase, an enzyme in capillary walls, removes fatty acids from chylomicrons
(and other lipoproteins)
C. Recycling Bile Salts
1. Most bile salts are reabsorbed from the ileum and return through the bloodstream to
the liver to be recycled
2. Interfering with enterohepatic circulation is one way to reduce blood cholesterol levels
3. Soluble fiber and plant sterols and stanols interfere with enterohepatic circulation
4. Functional foods containing plant sterols and stanols (e.g., TakeControl or Benecol
margarine spreads) can reduce mildly elevated blood cholesterol
D. Using Triglycerides for Energy
1. Most cells can metabolize fatty acids for energy
a. A gram of fat has 9 kcal
b. A gram of carbohydrate or protein has 4 kcal/gm
2. Adipose cells store triglycerides
3. Eating too much energy from protein and carbohydrate can also increase fat stores
a. The body can convert excess glucose and amino acids into triglycerides
b. Alcohol also stimulates triglyceride synthesis
III. Lipid Consumption Patterns
A. From the early 1900s to late 1900s, fat consumption increased approximately 60%, mainly
due to increased consumption of fast foods and processed foods
B. Cholesterol intake has declined due to lower consumption of eggs and whole milk
C. Fat contributes 1/3 of total daily calorie intake
D. AMDR: 20 – 35% of total kcal
E. Dietary Guidelines for Americans recommendations:
1. Emphasize sources of mono- and polyunsaturated fatty acids (e.g., fish, nuts, vegetable
oils)
2. Consume <10% of kcal as saturated fatty acids (average American consumes ~21% of
total kcal as saturated fatty acids)
3. Limit cholesterol intake to 300 mg/d (average American consumes ~280 mg
cholesterol/d)
4. Avoid trans fatty acids (average American consumes ~2% of total kcal as trans fatty
acids)

I. Understanding Nutritional Labeling: Lipids

A. Required information
1. Total fat
2. Saturated fat
3. Trans fat
4. Cholesterol
B. Optional information
 1. Polyunsaturated fat
2. Monounsaturated fat
C. If the amount of fat is < 0.5 g, it may be reported as 0
D. To determine the percentage of kcal from fat, divide the number of kcal from fat by the total
kcal

II. Lipids and Health: Cardiovascular Disease

A. Cardiovascular disease includes diseases of the heart and blood vessels
1. Coronary artery disease
2. Stroke
B. From atherosclerosis to cardiovascular disease
1. Most cases of HD and stroke result from atherosclerosis
2. Immune response produces inflammation inside the artery
3. Cholesterol and other substances are deposited into the arterial lining, leading to plaque
formation
4. As plaque accumulates, the vessels become narrow (atherosclerosis)
5. Blood clot or thrombus (fixed bunch of clots) may block artery
a. Heart: chest pain or myocardial infarction (heart attack)
b. Brain: stroke
c. Limb: gangrene
6. Embolus: part of plaque that breaks from thrombus, travels through bloodstream, and
may block another blood vessel
7. Arteriosclerosis
a. Hardening of the arteries; reduced flexibility of arterial walls due to plaque buildup
b. Contributes to hypertension, a major risk factor for CVD
c. Hypertension may cause hardened arteries to tear or burst
C. Risk factors for Atherosclerosis (summarized in Table 6.3)
1. Nonmodifiable risk factors
a. Family history of CVD (especially before age 60)
b. Increasing age
c. Race/ethnic background (African, Mexican, Native American)
d. Male sex
e. Menopause
f. Genetics and CVD
i. Homocysteine is an amino acid associated with heart disease
ii. A genetic abnormality may cause homocysteine to accumulate in blood and
increase risk for CVD
2. Modifiable risk factors
a. Hypertension: silent disease; 1/3 of American adults has hypertension
b. Diabetes mellitus: increases risk of CVD 2 to 4-fold
c. Elevated blood cholesterol (especially LDL cholesterol)
d. Excess body fat
e. Physical inactivity
f. Tobacco use: increases risk of CVD 2 to 4-fold
g. Chronic stress causes physical changes in the body that contribute to
atherosclerosis; also may lead to unhealthy food choices, physical inactivity, and
overuse of alcohol
D. Lipoproteins and Atherosclerosis (Figure 6.22 illustrates the lipid content of major
lipoproteins)
1. High-density lipoprotein (HDL)
a. Transports lipids from tissues to liver to be processed and eliminated
b. Carries 20% of cholesterol in the bloodstream
c. “Good” cholesterol
2. Low-density lipoprotein (LDL)
a. Carries 45% of cholesterol in the bloodstream
b. Transports lipids to tissues, including cells in arterial walls that make atherosclerotic
plaques
c. Although some is necessary, excess is unhealthy
d. Free radicals damage (oxidize) LDL, contributing to atherosclerosis
e. “Bad” cholesterol
3. Very-low-density lipoprotein (VLDL)
a. Carries 15% of cholesterol in the bloodstream
b. High triglyceride content
c. Thought to contribute to atherosclerosis
4.
E. Assessing your risk of atherosclerosis
1. Lipid profile (summarized in Table 6.4)
a. Total cholesterol (<200 mg/dl is desirable)
b. HDL cholesterol (≥60 mg/dl is desirable)
c. LDL cholesterol (<100 mg/dl is desirable)
d. Triglycerides (<150 mg/dl is desirable)
e. Total cholesterol:HDL ratio (<5:1 is desirable)
2. High-sensitivity C-reactive protein (hs-CRP)
a. Protein produced by liver in response to inflammation
b. Early warning sign for CVD
3. Coronary calcium
a. Calcium deposits in arteries of the heart
b. Associated with increased risk of atherosclerosis
c. Detectable by computed tomography (CT) scans
F. Reducing your risk of atherosclerosis: Dietary changes
1. Limit saturated fat intake to less than 10% of total kcal (U.S. Dietary Guidelines 2010)
a. Populations with diets rich in saturated fats have higher rates of heart disease than
populations with diets low in saturated fats
b. Saturated fats alter liver cell function, reducing clearance of cholesterol from the
bloodstream (increase HDL and LDL)
2. Limit trans fat intake as much as possible
a. Increase LDL
b. Decrease HDL
3. Dietary Cholesterol
a. Increases LDL
4. Monounsaturated fatty acids
a. Lower LDL without lowering HDL
b. Dietary sources: peanuts, peanut oil, canola oil, olives, olive oil, almonds, avocados
5. Polyunsaturated fatty acids
a. Lower LDL and sometimes HDL
 b. Dietary sources: safflower, corn, soybean, cottonseed, and some types of sunflower
oils
6. What about omega-3 and omega-6 fats?
a. Linoleic acid, an omega-6 fatty acid, increases inflammation and blood clotting
b. Consuming omega-3 fatty acids (e.g., from fatty fish) can reduce inflammation
triglycerides and blood clotting
c. Experts recommend consuming 8 ounces of cold water fatty fish per week (sardines,
salmon, and tuna)
d. Plant sources of omega-3 fatty acids (e.g., walnuts and walnut oil, flaxseeds and
flaxseed oil, soybean oil) are not as effective as fish oil in reducing deaths from heart
disease
e. Large species of fish (e.g., shark, swordfish, king mackerel, tilefish) may contain toxic
levels of mercury; should be avoided by women who are likely to become pregnant,
but up to 12 ounces per week of other fish may be consumed safely
f. Fish oil supplements may increase risk of bleeding
7. Should you avoid eggs?
a. Egg yolks are the most concentrated source of cholesterol in the diet
b. In a healthy person, the liver produces less cholesterol in response to large intakes
of dietary cholesterol
c. Eating large amounts of saturated fat increases the liver’s cholesterol production
d. Egg whites, egg substitutes, or reduced-cholesterol eggs are available
8. Is it safe to eat butter?
a. Butter contains saturated fat and cholesterol
b. Margarine contains some trans fat, but also contains more polyunsaturated fat and
less saturated fat and cholesterol than butter
c. Soft (tub) margarine contains little or no trans fats, may lower LDL
d. Moderate use of butter is acceptable
9. Will weight loss and exercise help?
a. Excess body fat, particularly abdominal body fat, is associated with elevated LDL and
triglycerides
b. Performing moderate-intensity physical activity nearly every day and balancing
calorie intake with calorie needs helps people maintain a healthy body weight and
reduce LDL and triglycerides
10. Food selection and preparation
a. Choose leaner cuts of meat and adjust cooking techniques to increase tenderness
(e.g., roasting, pressure cooking, reduced oven temperature)
b. Avoid eating visible fat
c. Do not use pan drippings to make gravy or sauces
d. Steam meats and vegetables
e. Stir fry in small amount of vegetable oil
f. Drain fat after browning ground beef
g. Avoid deep frying because batter holds extra fat and some fatty acids are converted
to trans fats
h. Remove some/all breading before eating fried food
i. Reduce hidden fats from milk products, cream cheese, margarine, butter, salad
dressing, bacon, sausage, luncheon meats, hard cheeses, nuts
j. See Food & Nutrition Tips on pages 179 and 181 for other ideas for reducing total
fat, saturated fat, trans fat, and cholesterol intakes
 11. Fat replacers
a. Synthetic fats have properties of fats in foods but provide fewer kcal
b. Examples
i. Oatrim
ii. Simplesse
iii. Olestra
c. Possible limitations
i. Diarrhea
ii. Reduced absorption of fat-soluble vitamins (many products with fat replacers
are fortified with fat-soluble vitamins)
d. Reduced fat ≠ calorie free: food manufacturers may increase simple sugars to
improve taste and texture
12. Other dietary modifications
a. Consume fiber-rich diet, especially soluble fiber to reduce LDL without affecting HDL
b. Limit intake of refined carbohydrates and alcohol to reduce triglycerides
c. Lose excess weight to reduce triglycerides
d. 1 to 2 drinks per day of alcohol can increase HDL, but excess alcohol contributes to
hypertension and damages organs
e. Mediterranean diet
i. Foundation of phytochemical-rich whole grains, fruits, vegetables, beans, and
nuts
ii. Fish and poultry emphasized rather than red meats as sources of protein
iii. Monounsaturated fats (olive oil)
iv. Moderate wine consumption
v. Regular physical activity recommended

G. What if lifestyle changes don’t work?

1. Prescription medications
a. Interfere with cholesterol metabolism in the liver (e.g., statins)
b. Interfere with cholesterol absorption in the small intestine (e.g., Zetia)

III. Chapter 6 Highlight – Drink to Your Health?

A. Alcohols have one or more hydroxyl (OH) groups in their chemical structures
1. Ethanol
2. Glycerol
3. Cholesterol
B. Alcohol production
1. Some types of bacteria and yeast produce alcohol from carbohydrate sources under
warm, anaerobic (absence of oxygen) conditions
2. Common sources of carbohydrate used in alcohol production
a. Grains
b. Fruit
c. Potatoes
d. Lactose in milk
i. Koumiss (fermented mare’s milk)
ii. Kefir (fermented camel’s milk)
3. Alcoholic beverages are mostly water, but vary in the amount of alcohol
a. Beer: 3 – 6% alcohol
 b. Wine: 8 – 14% alcohol
c. Wine coolers: 10% alcohol
d. Distilled spirits (e.g., whiskey, bourbon, vodka): 40 – 50% alcohol
e. % alcohol can be determined by dividing “proof” by 2
4. Yeast used to produce alcohol die when concentration of alcohol reaches 14 – 16%, so
distilling is used to increase alcohol content of some beverages
5. Nutritional value
a. Alcohol provides 7 kcal/g but is not classified as a nutrient because the body doesn’t
require it
b. Beer and wine contain some minerals and B vitamins
c. Mixed drinks may have some nutritional value, depending on the other ingredients
d. Table 6.7 provides nutrient contents of various alcohol beverages
e. A standard “drink” = 12 fl oz beer, 5 fl oz wine, or 1.5 fl oz liquor
C. How the body processes alcohol
1. Requires no digestion, readily absorbed into the bloodstream through mouth,
esophagus, stomach, and small intestine
2. Food delays alcohol absorption
3. Alcohol is detoxified to decrease its toxic effects on body cells
a. Gastric alcohol dehydrogenase metabolizes up to 20% of alcohol
b. Alcohol dehydrogenase and acetaldehyde dehydrogenase in the liver
c. When liver’s detoxification pathways are overwhelmed, the microsomal ethanol
oxidizing system (MEOS) takes over; dissipates energy in the form of heat
4. Factors that influence alcohol metabolism
a. Amount and timing of alcohol consumption
b. Sex
i. Men produce more gastric alcohol dehydrogenase than women
ii. Women have higher risk of health problems that stem from heavy drinking
iii. Men have larger body size and more body water than women
c. Age
d. Body size and composition
e. Prior drinking history
i. Regularly drinking increases liver enzymes to metabolize alcohol
ii. Tolerance refers to requiring progressively more alcohol to achieve the desired
mind-altering effects of alcohol
5. Blood alcohol content (BAC) reflects the percentage of alcohol in the blood (0.08% is the
legal limit for operating a motor vehicle for adults age 21+)
6. Classifying drinkers (summarized in Table 6.8)
a. Abstainer: <12 drinks/y
b. Light drinker: 1 – 13 drinks/mo
c. Moderate drinker: 4 – 14 drinks/wk
d. Heavy drinker: ≥3 drinks/d
e. Binge drinker: ≥5 drinks/occasion for men or ≥4 drinks/occasion for women
7. Binge drinking
a. 1 in 4 college students participates in binge drinking
b. Influences risk of alcoholism
c. Symptoms of alcohol poisoning
i. Confused, passed out, unable to be aroused
ii. Slow, irregular breathing
 iii. Pale or bluish skin
iv. Depressed heart and lung function
v. Aspiration of vomit
d. If alcohol poisoning is suspected, seek immediate medical attention
D. Alcohol abuse and dependence
1. Drinking to an extent to harms mental and physical health and relationships
2. Alcoholic (alcohol-dependent)
a. Uncontrollable need to drink
b. Unable to limit alcohol consumption
c. Suffers withdrawal symptoms
d. Experiences tolerance
3. Alcohol abuse (Table 6.10 summarizes signs of alcohol abuse)
a. Has control over intake
b. No powerful craving
c. No withdrawal symptoms
d. Experiences problems at home, work, and school that are associated with drinking
habits
E. Alcohol and health
1. General characteristics
a. Central nervous system depressant
b. Mild intoxication produces pleasant sensations and relaxes inhibitions
c. Consuming large amounts of alcohol depresses normal motor function
d. 3rd leading cause of preventable death
e. Figure 6.28 summarizes physiological effects of alcohol
2. Alcohol and the gastrointestinal tract
a. Irritates lining of GI tract
b. Contributes to formation of ulcers, which may lead to bleeding and infection
c. Increased risk of pancreatitis
3. Alcohol and the brain (effects are summarized in Table 6.29)
a. Depressant – slows transmission of nerve signals
b. Low BAC: relaxation and decreased inhibition
c. BAC of 0.08 – 0.15%: loss of control over some voluntary muscles leads to slurred
speech and difficulty walking and driving
d. BAC of 0.20 – 0.30%: brain is unable to process information
e. BAC of 0.30 – 0.50%: loss of consciousness, coma, death
f. Alcohol is toxic to neurons, may result in confusion and memory loss
4. Alcohol and the liver
a. End products of alcohol metabolism by the liver are mostly used to produce fatty
acids, which accumulate in the liver (fatty liver)
b. Fatty liver is reversible
c. With continued heavy drinking, scar tissue may accumulate, leading to cirrhosis
(hardening of the liver)
d. Increased risk for hepatitis (inflammation of the liver) and liver cancer
e. Extensive liver damage limits the liver’s ability to repair itself, may require
transplantation
5. Alcohol and the cardiovascular system
a. Moderate drinking (1 – 2 drinks/d) reduces risk of heart disease
 b. Excess consumption can damage heart muscle (enlarged, but weakened) and
elevate blood pressure (stroke)
6. Alcohol and cancer
a. Chronic drinking increases risk of cancers of the mouth, esophagus, stomach, liver,
pancreas, colon, and breast
b. In combination with smoking, drinking greatly increases risk of cancers of the mouth
and esophagus
7. Alcohol and drug interactions
a. Alcohol’s harmful effects may be amplified by use of prescription or over-the-
counter medications
b. Interactions of alcohol with medications can lead to liver damage or death
8. Effects of alcohol on nutritional status
a. In moderation, alcohol stimulates appetite
b. Lowers blood glucose and raises triglycerides
c. Excessive alcohol consumption may displace nutritious foods from diet, leading to
deficiencies of vitamin A, vitamin C, thiamin, and folate
d. Alcohol may interfere with absorption, metabolism, and storage of some vitamins
e. Alcohol increases excretion of some nutrients (e.g., fat, magnesium)
f. Wernicke-Korsakoff syndrome is a brain disorder resulting from thiamin deficiency
i. Mental confusion
ii. Memory loss
iii. Uncoordinated muscular movements
g. Bone health
i. Increased risk of bone loss and fractures with excessive consumption
ii. Light to moderate consumption may improve bone density and decrease
fracture risk
9. Alcohol and body water
a. Alcohol is not a good thirst-quencher because it suppresses production of
antidiuretic hormone by the pituitary gland, causing kidneys to produce more urine
b. Increased urine production may also deplete body’s supply of water-soluble
vitamins and some minerals
10. Fetal alcohol spectrum disorders (FASD)
a. Alcohol passes freely from mother’s bloodstream into embryo/fetus’ bloodstream
b. Most devastating effects during first 2 months of pregnancy
c. Characteristics of FAS
i. Facial defects are illustrated in Figure 6.31
ii. Heart defects
iii. Nervous system damage leading to mental retardation
iv. Delayed and abnormal physical development
d. Abstinence is recommended during pregnancy; no safe level has been defined
F. Health benefits of alcohol
1. Cardiovascular benefits of moderate drinking
a. Increased HDL
b. Reduced fibrinogen (reduces blood clotting)
c. Decreased platelet stickiness (reduces blood clotting)
2. Red wine and beer have antioxidants and some B vitamins (purple grape juice confers
similar benefits)
 3. It is a challenge to balance the benefits of moderate drinking with the risks of alcohol
abuse (e.g., addiction, hypertension, heart failure, cancer, liver cirrhosis, and motor
vehicle accidents)
G. Alcohol and physical performance
1. Even at low BAC, alcohol reduces hand-eye coordination and slows reaction times
2. Effects on strength and endurance are controversial; some studies show detriment,
some show no effect
3. Alcohol has dehydrating effects
a. Impairs muscle function
b. Contributes to heat stroke and heat exhaustion
4. Chronic alcohol abuse induces muscle wasting
5. American College of Sports Medicine recommends avoiding alcohol within 48 hours
before an event, after exercise, and until normal fluid status is regained
H. Where to get help for alcohol abuse or dependence
1. Personal physician
2. National Drug and Alcohol Treatment Referral Routing Service
3. Alcoholics Anonymous
4. National Clearinghouse for Alcohol and Drug Information
5. Al-Anon/Alateen
HELPFUL TEACHING IDEAS

1. Bring in samples and/or package labels of foods that contain fat replacers and regular products.
Allow students to taste the different products and ask students to compare the tastes of
reduced-fat products to regular products. Using the food labels, have students examine the
differences in total fat, saturated fat, trans fat, sugars, and sodium between reduced-fat and
regular products.

2. Ask students to recall their most recent meal. Have students outline the general pathway of
digestion, absorption, and metabolism taken by the lipids from that meal.

3. What can be done to decrease the impact of binge drinking on college campuses? Have
students research this topic by reading articles and interviewing students, campus
administrators, local business owners, etc. Allow time for students to present their ideas to the
class.

4. Have students prepare a poster, brochure, or public service announcement to inform their peers
about alcohol poisoning or alcohol abuse. Ask students to distribute the information on
campus.

5. What is a “fat tax?” Have students research this topic and come to class prepared to debate the
usefulness of such a tax.

6. Present students with the one-day intake of a “typical” college student and have them make
modifications to improve the profile of fat intake.
STUDENT ASSIGNMENT
Cardiac Case Study

Jacob is a 58-year-old male salesman who spends a great deal of time traveling for his job. He usually
eats toaster pastries or doughnuts on the go for breakfast, dines regularly at fast food restaurants for
lunch, and eats a big, home-cooked dinner when he returns home after work. He also smokes 2 packs of
cigarettes per day, drinks 2 – 3 cans of beer while watching television after dinner, and does not exercise
regularly. Last week, Jacob visited his doctor to talk about the chest pains and shortness of breath he’s
been experiencing lately. At this visit, his height was 5’8” and his weight was 256 lbs. His doctor made
some blood measurements and told him he must make some lifestyle changes to reduce his high
cholesterol levels and high blood pressure. The results of his blood measurements are displayed below.

Lab Results

Test Result Units

Triglycerides 466 mg/dl
Cholesterol 257 mg/dl
HDL Cholesterol 40 mg/dl
LDL Cholesterol 139 mg/dl
TChol:HDL 6

1. What risk factors for CVD can you identify for Jacob?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

2. How could Jacob modify his food choices at breakfast?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

3. How could Jacob modify his food choices at lunch?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

4. Based on what you’ve learned about alcohol use, what would you tell Jacob to change about his
drinking habits?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
 5. Besides altering his intake of dietary lipids, what other lifestyle modifications should Jacob make
to reduce his risk for CVD?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________