×
Log in to StudySoup
Get Full Access to AU - NTRI 2000 - Study Guide - Final
Join StudySoup for FREE
Get Full Access to AU - NTRI 2000 - Study Guide - Final

Already have an account? Login here
×
Reset your password

AU / Nutrition / NTRI 2000 / What does malnutrition mean?

What does malnutrition mean?

What does malnutrition mean?

Description

School: Auburn University
Department: Nutrition
Course: Nutrition and Health
Professor: Greene
Term: Spring 2016
Tags: nutrition and final
Cost: 50
Name: NTRI 2000 FINAL EXAM Study Guide
Description: This is the final draft of the study guide for the nutrition final Tuesday. It includes all the material we've covered from Week 1 to Week 15 (this week), as well as diagrams, charts, and pub quizzes. Everything that has been on the prior three tests is covered in this study guide. Good luck!
Uploaded: 04/26/2016
90 Pages 77 Views 18 Unlocks
Reviews

Patrick Rodriguez DVM (Rating: )

Loved these! I'm a horrible notetaker so I'll be your #1 fan in this class



1


What does malnutrition mean?



NUTRITION FINAL STUDY GUIDE  

Nutrition- the science that links food to diseases and focuses on the process of ingestion,  digestion, absorption, transportation, metabolism, and excretion

1. Note: by age 65 you’ll eat around 70,000 meals (50 tons of food)  

2. Food has a cumulative effect

Nutrient- component of food that are indispensable to the functioning of the body  1. Provide energy


What are the main causes of death?



We also discuss several other topics like How do athletic departments mask, hide or spread their revenue?

2. Building blocks

3. Support growth

4. Maintains/repairs body  

Essential Nutrient- nutrients our bodies can’t make or make in sufficient amounts that MUST  be obtained from the diet and must have the following criteria:

1. A specific function in body

2. Omission of these lead to decline in the functions of the body

3. Replacing these restores normal function


What are the six essential nutrients?



Malnutrition- any condition caused by a deficiency or excess of nutrient intake 1. The only thing that has a bigger effect on your health is tobacco If you want to learn more check out What is the difference between north africa and sub saharan africa?

2. Many nutritionally-related diseases are chronic and take years to show up clinically

Leading Causes of Death

1. Heart disease  

2. Cancer

3. Lung Disease

2

Nutrition and Disease

1. Poor diet is a risk factor for many chronic diseases  Don't forget about the age old question of What is buccopharyngeal respiration and which animals use it?

A. Cardiovascular Disease

B. Some forms of cancer

C. Hypertension

D. Lover disease

2. These diseases account for about 2/3 of all deaths in North America  3. All of these deaths are linked with obesity

4. Obesity is the second leading cause of preventive death  

The Six Classes of Essential Nutrients  

1. Carbohydrates (C, H, O)- macronutrient

2. Lipids aka fats (C, H, O)- macronutrient  

3. Proteins (C, H, O, N)- macronutrient

4. Water (H, O)- macronutrient  

5. Vitamins- micronutrient

6. Minerals- micronutrient

NOTE: most energy comes from proteins, most carbohydrates, and most lipids We also discuss several other topics like What is the meaning of beat in music?

Phytochemicals If you want to learn more check out What is protestants accourding to durkheim

1. Plant compounds that are thought to cause health benefits  

2. Energy comes from the SUN through light  

3. CO2 + H20 + light -> CHO + O2 (photosynthesis)

4. CHO + O2 -> CO2 + H2O + energy (metabolism)

5.example: carotenoids (such as in lycopene tomatoes)

6.example: resveratrol (such as in red wine and grape juice)  

Measure of Energy in Nutritions  Don't forget about the age old question of What are need to consider when you define a social problem?

1. calorie/Kcal

2. These are units that describe the energy contents of food  

3. 1 kcal is the heat needed in order to raise the temperature of 1000 mL of water 1*C 4. 1 kcal = 1000 calories = 1 Calorie

3

Energy in Nutrients (4-9-4 rule)

1. Carbohydrates (4 kcal/gram)

2. Fat (9 kcal/gram)

3. Proteins (4 kcal/gram)

4. NOTE: alcohol is not a nutrient but a TOXIN. 7 kcal/gram

Objectives for Our Society’s Diet (for those 2 years and older)

1. increase fruit intake/varriety

2. increase calcium levels in diets

3. increase vegetable intake/variety  

4. increase amount of whole grains  

5. reduce calorie intake

6. decrease levels of saturated fats/added sugars  

7. decrease sodium levels

8. reduce iron deficiency (maintain healthy levels)

Reasons to Select A Particular Food  

1. Positive Association  

2. Region/County

3. Social Pressure

Wellness in College  

1. Develop a plan  

A. Eating habits  

B. Food choices  

C. Weight control, especially when faces with unlimited food

D. Exercise regularly  

2. How to avoid the Freshman 15:

A. Eat breakfast

B. Plan ahead

C. Limit liquid calories

D. Stock the fridge with healthy choices

4

Why Do We Choose the Food We Eat?

1. Biological Drives- very complex

A. Hunger- a physiological drive to eat  

B. Appetite- A psychological drive to eat

C. Satiety- a feeling of being full, which halts the drive to eat

2. Cultural/Social Reasons

A. Social needs

B. Network of family and friends

C. Food customs/cultures

D. Cost of food  

E. Education/Knowledge

F. Occupation and Income

G. Routines/Habits

H. Lifestyle/Health

I. Nutrition concerns

J. Benefits

K. Food Marketing

L. Food availability  

M. Food flavor, texture, appearance

N. Preferences  

O. Psychological needs

The Challenge of Choosing Foods

1. There are more foods to choose from than ever before

2. Ironically, this variety has made it more difficult to elect a nutritious diet  3. However, we now have more technology that helps live healthier lives, such as   product websites, apps, and online calculators.

When given the protein, carb, and fat count of a dish, know how to determine the  calories in a dish and the percentages of the count based off the total.

Food Philosophy: Consume a variety of foods balanced by a moderate intake of each food.

5

Characteristics of a healthy diet:

1. Adequacy

2. Balance  

3. Moderation

4. Nutrient density

5. Energy content  

6. Variation- choosing a number of different food groups.  

7. NOTE: supplements don’t have every component you need. Phytochemical's are   found in variety. No one food can meet your nutritional needs.

Variety- tips for boosting phytochemical intake

1. Use veggies in main/side dishes

2. Use grain in side dishes

3. Opt for fruit-filled cookies

4. Get creative at the salad bar (go for the rainbow)

5. Eat fresh/dried fruit for snacks  

6. Add vegetables to sandwiches  

7. Try to eat vegetarian meals once or twice a week

8. Use different lettuces (romaine over iceberg)  

9. Use fresh salsa for dips instead of something creamy

10. Eat whole grain cereals

11. Use herbs and spices such as ginger or rosemary over salt

12. Try to incorporate tofu, soy milk, and soybeans into meals

Adequacy- obtaining all the essential nutrients in order to meet all the bodys need plus  storage

Balance- select food from 5 major food groups every day

1. Grains  

2. Vegetables

3. Fruits

4. Milk/Dairy

5. Protein

6

Moderation- can refer to portion size (calories, diet composition)

1. Fats (saturated fast and trans fats)  

2. Salt

3. Cholesterol (saturated fats)  

4. Refined carbohydrates (added sugars)

States of Nutritional Health

1. Your body’s nutritional health is determined by considering the nutritional state of   each needed nutrient  

2. Three categories:

A. Desirable Nutrition

B. Undernutrition

1. Intake of nutrient does not meet the body’s needs  

2. If the body’s surplus is ned, health declines

3. It can take years to develop clinical symptoms  

C. Overnutrition

1. In the short run, it has few symptoms

2. If excess intake continues, nutrients may develop to toxic amounts (an   excess in vitamin A can cause birth defects; excess in calories can lead   to obesity, CV disease, diabetes, stroke, some cancers)

3. The amount of each nutrient needed to maintain a state of desirable nutrition is the   basis for dietary intake recommendations  

4. The state of undernutrition and overnutrition are both considered to be malnutrition

7

How is Nutritional State Measured?

1. It is done by a physician and/or a registered dietician  

2. Determines background factors  

A. Family Health History

B. Medical History

C. Medication/supplements intake

D. Social History

E. Level of Education

F. Economic Status  

3. Assessments (ABCDEs)

A. Anthropometric (height, weight, body composition, circumference)

B. Biochemical (enzyme or nutrient by-product in blood and urine)

C. Clinical (appearance of skin, eyes, hair, etc.)

D. Dietary (food intake)

E. Environmental (ability to purchase/prepare foods, education, etc.)

4. Limitations- a long time may elapse before symptoms can be diagnosed as clinical

Specific Nutrient Standards  

A. The overarching goal of any healthy diet is to meet nutrient needs

B. To do this we must determine what amount of each essential nutrient is needed to   maintain health  

C. These standards are based on populations of healthy people  

The Scientific Method  

A. Used to gain knowledge  

B. Steps

1. Make observations and use knowledge of what is assumed to be true  2. Make a hypothesis (must be testable)

3. Preform experiments (epidemiological, case-control)

4. Report results (either support or refute hypothesis)

C. The experiment must be independent of particular opinion

D. The test must purposely test itself and criticize, correct, and improve itself

8

DRI- Dietary Reference Intakes

A. The umbrella term for dietary standards

B. Recommended Dietary Allowance (RDA)

1. Nutrient intake sufficient to meet the needs of 97%-98% of individuals in a   specific stage of life

2. What if you consume more or less? Being 70% above or below the RDA for an   extended time (3 times longer for some nutrients) can result in a deficiency or   toxicity

C. Adequate Intake (AI)

1. Nutrient intake set for any nutrient for which insufficient research is available   for RDA

2. AIs are based on estimates of intakes that appear to maintain a defined   nutritional state in a specific life stage  

D. Estimated Energy Requirements (EER)

1. estimated energy (in kcal) intake needed to match the energy use of an   average person in a specific life stage  

2. Needs to be specific, taking into account age, gender, height, weight, physical   activity  

3. Serves as a starting point for estimating calorie need  

E. Tolerable upper intake limit (UL)

1. Maximum chloric intake daily level of a nutrient that is unlikely to cause   adverse health affects in almost all people in a specific life stage  

2. Problems arise from using many fortified foods and excess doses of vitamins   and minerals  

F. Daily Value (DV)

1. DV is the nutrient standard used on the nutrition facts portion of a food label  2. The percent DV for each nutrient is based on consuming a 2000 kcal diet  3. Set at or close to the highest RDA value or related nutrient standard  4. DVs have been set for vitamins, minerals, protein, and other dietary  

 components  

5. Allow intake comparison from a specific food to desirable (or maximum)   intakes

9

Dietary Guidelines for Americans  

A. What is a healthy eating pattern?

1. Variety of vegetables

2. Fruits, especially whole fruits  

3. Grains, half of which are whole grains  

4. Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy   beverages  

5. variety of lean protein  

6. oils- high in monounsaturated fat and polyphenols (make sure not to buy olive   oil in clear bottles because the sunlight will break apart the polyphenols) B. A healthy eating pattern limits:

1. Saturated fast and trans fats- less than 10%

2. Added sugars- less than 10%

3. Sodium- 2,300 mg

C. Healthy also includes the physical activity guidelines for Americans (ages 18-64) 1. Avoid inactivity  

2. Get at least 150 minutes per week of moderate exercise, but aim for 300

Recommendations for Food Choice  

A. How do we translate the science of nutrition into practical terms  

B. 1992: the plan was illustrated using a pyramid shape (Food Guide Period)  C. 2011: a plate was used to illustrate a guide  

Levels of Organization  

1. Chemical level (atoms combine to form molecules)

2. Cell level (molecules form organelles)  

3. Tissue level

4. Organ level  

5. Organ system level

6. Organism level

10

Food Labels (check out figures in book)

A. What is required?

1. Name of product  

2. Who the manufacturer is aka where it’s coming from  

3. How much you’re buying (in ounces and in grams)

4. Ingredients (in order by weight)

5. Nutrition Facts  

a. Serving size

b. Number of servings

c. Calories  

d. Calories from fat  

e. Percent of daily value  

f. Fat (both saturated and trans)

g. Cholesterol

h. Carbohydrates (dietary fiber, sugar)

i. Protein  

B. They can choose to add additional stuff on the packages, such as different levels of   vitamins or nutrients, but don’t be fooled if the serving size is inconsistent C. The FDA is in charge of the nutritional claims  

1. “good source” means 10-19% of daily value for nutrient  

2. “excellent source” means one serving contains 20% or more of the daily value 3. “reduced” means at least 25% less per serving than in the referenced food  4. “low-____” means 3 grams or less in one serving

5. “____-free” means less than 0.5 grams in one serving

Cell Metabolism

1. Entire collection of chemical processes involved in maintaining life  

2. Biochemical reactions take place in the cell cytoplasm and organelles  3. Anabolic requires energy (we need this to grow)  

4. Catabolic takes more molecules apart, releases energy

11

Multicellular Organisms

A. Same tissue as a singular cell

B. Whole body metabolism is similar to a cell’s

Organ Systems

A. Respiratory  

B. Cardiovascular  

C. Lymphatic  

D. Digestive  

E. Urinary  

Cardiovascular System

A. Carries blood  

B. Regulates blood supply  

C. Transports nutrients, waste products, cells, gases  

D. Regulates blood pressure  

E. Plays a role in immune responses and body temperature  

F. Components

1. Heart- muscular pump for blood  

2. Blood vessels- arteries leave the heart; veins enter the heart

3. Capillaries- exchange of nutrients, oxygen, waste products, and gases   between blood and cells

4. Blood- made up of plasma, red and white cells, platelets  

5. Portal circulation  

a. Artery to capillary to vein to portal vein to capillary to vein  

b. Nutrients absorbed by capillaries in the small intestine (go to the liver)

12

Digestive System  

A. Gastrointestinal Tract  

1. Tube from your mouth to your anus  

2. Responsible for the digestion and absorption of nutrients  

B. Accessory Digestive Organs

1. Salivary glands

2. Liver  

3. Gall bladder (can be removed)

4. Pancreas

C. Check out the digestive system figure in your book

D. Check out the mouth diagram in your book  

E. Esophagus

1. Muscular tube connecting the pharynx (throat) to your stomach

2. Food moves by a series of coordinated constructions known as peristalsis 3. Esophageal sphincter  

a. Regulates the movement through the esophagus

b. Must relax to allow food to enter the stomach  

c. Prevents back flow of food (unless necessary)

F. Stomach

1. Large sac for holding food

2. Stomach contains gastric juice (water, hydrochloric acid, enzymes, and the   intrinsic factor)

3. Muscle of stomach church gastric contents into chyme  

4. Pyloric sphinter controls the rate of chyme entering the small intestine  5. What keeps the stomach from breaking down/digesting itself?  

a. Mucous- stomach is lined with a thick layer of mucous so gastric juice   doesn't come into contact with the tissue of the stomach  

b. HCL and enzymes are primarily released only after eating

13

G. Small Intestine

1. Site of most of the digestion sand absorption of nutrients  

2. Check out the diagram in your book  

3. Intestinal hormones released (getting chyme ready)  

a. Secretin- released bicarbonate from pancreas  

b. Cholecystokinin (CCK)- releases digestive enzymes from pancreas   and regulates the release of bile (made in the liver and is important to   the digestion of fats) from the gall bladder into the small intestine 4. Because of folds in the mucosa, villi, and microvilli on cells, the   surface area for absorption is huge  

5. Capillaries absorb the water soluble compounds  

6. Lymph vessels absorb the fat soluble compounds  

7. Undigested food passes on the large intestine (colon) via the ileocecal   sphincter  

8. Look up the small intestine diagram in your book

H. Large Intestine  

1. Only a minor amount of carbohydrates, proteins, and fast escape the  absorption and reach large intestine  

2. No villi or enzyme (no digestion or major absorption)  

3. Some absorption of water, some vitamins, some fatty acids, and the minerals   sodium and potassium  

4. Home to a large population of bacteria (over 500 species), yeast, and viruses  5. Look at large intestine diagram in your book  

6. As water is absorbed, contents become semi-solid  

7. Becomes feces (water, undigested fiber, tough connective tissue, bacteria,   dead intestinal cells, and body waste)

8. Contractions occur as a mass movement  

9. The rectum fills

10. Anal sphincters control waste management  

11. TABLE 3.4 IN BOOK

14

I. Liver  

1. Releases number of unwanted substances that travel with bile to the   gallbladder

2. End up in the small intestine, eventually in the large intestine for excretion (you   can’t live without a liver)

J. Gallbladder

1. Organ attached to the underside of the liver

2. Bile storage, concentration, and secretion

3. Bile- released through common bile duct into the first segment of the small   intestine that is essential for digestion and the absorption of fat 4. Enterohepatic circulation (hepatic = anything with the liver) - continual   recycling of compounds like bile acids between small intestine and liver K. Pancreas

1. Has both endocrine and digestive functions  

2. Manufatures hormones- glucagon and insulin

3. Produces “pancreatic juice”- a mixture of water, bicarbonate, and a variety of   digestive enzymes  

Lymphatic System

A. Brings fluid back to the cardiovascular system

B. Fluid is lymph (plasma, white blood cells (and absorbed fat), lymph nodes  C. Drains back into the CV system near the heart  

D. Remove foreign substances from blood and lymph

E. Maintain tissue fluid balance  

F. Adds in fat absorption

G. Forms white blood cells and provides defense against pathogens

15

Urinary System  

A. Kidneys, ureter, bladder, urethra

B. Kidney

1. Produces urine, which is the modified ultra filtrate of he blood

2. Functional unit of kidney is the nephron

3. Nephron is involved in the processes of filtration, reabsorption, and secretion 4. Look at nephron/urinary system diagram in your book

5. Kidneys are used in the formation of vitamin D  

6. Kidneys produce a hormone, erythrpoitin, that stimulates the production of   red blood cells

7. Helps regulate blood pressure and fluid balance  

Nutrient Absorption  

A. Passive Absorption (diffusion)- concentration dependent  

B. Facilitated Absorption ( transport)- carrier or receptor dependent  

C. Active Absorption (transport)- carrier/receptor and energy dependent  D. Phagocytosis/pinocytosis- form of active transport; often cancer cells take advantage   of these cells in order to grow rapidly and feed off nutrients

Digestive disease case

Problem: An elderly woman sees her doctor and complains of pain 2 hours after eating,  weight loss, nausea, vomiting, and loss of appetite.  

What condition does she have? An ulcer caused by helicobacter pylori, which is an  excess of the bacterium which causes peptic ulcer disease. Barry Marshall and J.  Robin Warren were awarded the Nobel Prize in Medicine in 2005 for discovering  it. They did it themselves, then took antibiotics and were cured.  

What are the potential therapies? Antibiotics.

16

Diseases Related to the Digestive System  

A. Constipation

1. Difficult or infrequent evacuation of the bowels

2. Increase fiber consumption such as dried fruit to stimulate peristalsis 3. Drink adequate fluids, especially water  

4. Relaxation/regular exercise

5. Probiotics/laxatives can lessen constipation (consult a health professional first) B. Irritable Bowel Syndrome (IBS)

1. As many as 25 million Americans suffer from this syndrome

2. Symptoms include cramps, easiness, bloating, irregular towel function,   diarrhea and constipation, or alternating episodes of both

3. Visible abdomen distention

4. Hard to pinpoint exact causes, but possible that it’s caused by altered   intestinal peristalsis or decreased pain threshold  

5. Treat it through elimination diet, moderate caffeine, low-fat, small, frequent   meals, stress reduction  

C. Celiac Disease and Gluten Sensitivity  

1. Chronic, immune-mediated disease precipitated by exposure to dietary protein   gluten

2. **Genetically predisposed people**

3. Found in certain grains, wheat, rye, barley

4. Affects about 1% of U.S. population  

5. Flattens villi

6. Limits absorption of nutrients  

7. Treatment should include a blood test for antibodies to gluten

D. Gastroesophageal Reflux Disease (GERD)  

1. Fancy way of saying heartburn  

2. Half of North American adults experience occasional heartburn  

3. Heartburn can damage the lining of the esophagus

17

Central Dogma of Biology

A. DNA <—> RNA —> Protein

B. There is an emerging field of genomics in nutrition  

C. Nutritional Genomics- interactions between nutrition and genetics  

1. Important because there are variations in nutrient requirements  

2. Studies the responsiveness to dietary modifications  

3. Helps us understand the impact of food on the gene expression  

4. Helps us know our susceptibility to nutritionally related diseases

18

Diagrams

Stomach

Digestive Tract  

Small Intestine

Mouth

19

Large Intestine Urinary Tract  

Peristalsis

20

 Carbohydrates

A. Main fuel source for:

1. The brain

2. Nerve cells  

3. Red blood cells (RBCs)  

4. Exercising muscle

B. Form of carbohydrates (for all cells)

1. Blood Glucose

2. Glycogen

C. What’s the ultimate source of carbohydrates? The sun.

D. Metabolism: H2O + O2 ——> energy + H2O + CO2

E. Simple Carbohydrates (Sugars)  

1. Monosaccarides

a. Mono = ONE sugar  

b. Basic unit of all carbohydrate structures

c. Mainly glucose, fructose, galactose  

d. Check out the structures of the sugars (“not on test just  

 good to know”)

e. Dextrose- the major monosaccharide found in the body, called the  

 blood sugar, and derived from the digestion of starches and  

 disaccharides 

f. Fructose- converted to glucose and other compounds, also called fruit   sugar. It is sweeter than the others; one dietary source is high-fructose   corn syrup (in soft drinks it is made up of approximately 55%  

 fructose and 45% glucose)  

g. Lactose- part of the disaccharide lactose (known as milk sugar)

Image of the brain showing activity  

before and after consuming  

glucose and fructose

21

2. Disaccharides

a. di = two, meaning there is  

 chemical bonding of two

 monosaccharides  

b. *Glucose is always one of the  

 2 sugars*  

c. Maltose = glucose + glucose  

d. Lactose = glucose +fructose  

e. Sucrose = glucose + fructose  

F. Complex Carbohydrates (Starches and Fiber)

1. Called polysaccharides or starch

2. May contain 1000 or more glucose units  

3. Found in grains, vegetables, and fruits  

4. On food labels, “other carbohydrates” refers to starch content  5. Starches are found in plants, especially potatoes

a. They are digestible by humans

b. Amylose makes up 20% of starches

c. Amylopectin makes up 80% of starches

d. Glycogen

1. Identified in 1858  

2. Highly branched, which is good for quick energy  

3. 1800 kcal present in humans  

4. 1400 kcals are stored in the muscle, but can be  

 depleted (muscle fatigue/ “hitting a wall”

5. 400 kcals are stored in the liver, and can be depleted  

 in 18 hours

6. It is also stored in the fat and brain

Carbohydrates Conceptual Map 22

23

Carbohydrate availability  

A. Cooking- softens fibrous parts of plants  

B. Starch granules swell with water making it easier to digest  

C. Mouth- the enzyme salivary amylase helps break down starch (not very  

 important) and starts digestion as well as in the esophagus  

D. Stomach- the acid inactivates amylase, so no further starch digestion  

E. Small intestine- the alkaline environment promotes CHO digestion through enzymes  

Enzymes

A. The suffix -ase is used in biochemistry to indicate enzymes  

B. In the small intestine, pancreatic amylase breaks starches in sugars like di-   and tri- saccharides  

C. Maltase, sucrase, lactase, dextrose (disaccharides)  

D. They are located in the brush border of the cells that line the inside of the small   intestine

24

Lactose Intolerance- caused by a decrease in lactase production  

A. Lactase is high in infants then reduced in adults  

B. If the lactase production does not decrease, it’s called lactase persistence,  which often develops in early childhood  

C. Symptoms include abdominal pain, gas, cramps, and diarrhea after consuming   an amount of lactose  

D. NOTE: how much is consumed is KEY

E. Highly associated with region/genetics  

Carbohydrate Absorption

A. Monosaccharides go to intestinal cells via transporter proteins  

B. They are then absorbed by capillary into the liver via the portal vein  

C. In the liver, fructose and galactose are converted into glucose  

D. Glucose goes into the blood, is stored as glycogen, or converted into fat  

Functions of glucose in the body  

A. Supplies fuel (kcal)

1. In RBCs, the brain, and exercising muscle  

2. Present in all cells  

B. Spares body proteins  

C. Maintains acid-base balance (pH) to prevent ketosis- a buildup of keno in blood from   fat breakdown  

Blood glucose concentrations  

A. How do we regulate blood glucose?

1. Primary control- liver and pancreas  

2. Secondary control- adrenal glands, brain, muscle

B. High blood glucose- pancreas releases hormone insulin into blood  C. Low blood glucose- pancreas releases hormone glucagon into blood  D. Discovery of insulin- 1921; won the Nobel Prize of Medicine; before the 1920s,   there was no cure

25

1. Experiment 1: removed the pancreas from a dog (practically gave the dog   diabetes) which resulted in raised blood sugar, extreme thirst, frequent   urination, and increasing weakness until finally, the dog died

2. Experiment 2: Scientists removed the pancreas, sliced it up, then froze it into   a mixture of water and salts. When the pieces were half frozen, they were   ground up and filtered. The extract was then injected into the diabetic dog and   the its diabetes was temporarily reversed (aka blood glucose went down)  

Functions of Insulin  

A. The net effect is that it lowers blood glucose

B. How? Promotes glycogen synthesis

C. Where? Muscle, liver and fat, but more often muscle

D. What does it do? Increases glucose uptake by the cells and reduces   glycogenesis  

Glucagon action in the liver

A. Causes the liver to breakdown liver glycogen into glucose and releases it into the   blood (glycogenolysis)  

B. Causes the liver to synthesize glucose from noncarbohydrate precursors   (glycogenesis)

Blood glucose and the adrenal glands

A. Adrenal gland is located on kidneys  

B. Releases epinephrine which causes quick conversion of glycogen to glucose in the   liver  

Improper regulation of blood glucose concentrations  

A. Hyperglycemia- high blood glucose  

diabetes- type 1, type 2, gestational

B. Hypoglycemia- low blood glucose  

reactive hypoglycemia, fasting hypoglycemia

26

Type 1 Diabetes

A. Often begins in late childhood (also called juvenile diabetes)  

B. Generally associated with a decreased release of insulin from pancreas  C. Immune system disorder (auto-immune disease) resulting in destruction of the   insulin-producing cells  

D. Occurs when the body attacks beta cells thinking its a foreign cell  

E. Treated by insulin therapy- through pumps/shots, different types of insulins,   NOT oral medications  

Type 2 Diabetes  

A. Most common form of diabetes, accounting for 90-95% of all cases

B. Affects about 9% of the population in the United States  

C. Alabama ha the highest rate at 12.7% (Mississippi is 12.0%)

E. Development- Why is it more prevalent in older folks? It is associated with obesity F. Genetics play a role in the development  

G. There is a stage before being diagnosed with Type 2 called “pre-diabetes” where   the body becomes resistant to the effects of insulin so the body attempts to make   more but fails. Then the pancreas produces less insulin which causes   hyperglycemia. You can do a glucose tolerance test to assess glucose clearance. 1. Oral glucose tolerance test- 140 mg/dL but below 200 mg/dL

2. Fasting plasma glucose- above 100 mg/dL but below 126 mg/dL

Diabetes outcome

A. Increases the risk of cardiovascular disease, stoke kidney diseases, certain forms of   cancer, and blindness  

B. Sometimes, complications lead to adult blindness and lower limb amputation  

Diabetes treatment

A. If associated with obesity, attempt to lose weight  

B. In general, diet, exercise, oral medications, insulin, and bariatric surgery   (shrinks stomach/ removes sections from the stomach)

27

Glycemic Index

A. Ratio of the blood glucose response to a given food compared to a standard  B. Based on 50 grams of carbohydrates  

C. Influenced by starch structure, fiber content, food processing and physical structure,   and other macronutrients in food  

Carbohydrate need  

A. Recommendations vary widely  

B. RDA recommends 130 grams/day for adults

C. Food and Nutrition Board: 45-65% of calories need to be from carbs D. High carbohydrate intake  

1. Grains- 15 g/serving

2. Fruits- 18 g/serving

3. Milk- 12 g/serving

E. Low carbohydrate intake

1. Nuts- 4 g/serving

2. Meat and eggs- 0 g/serving

3. Vegetables- 5 g/serving

Glycemic Load  

A. Takes the glycemic index and multiples that amount of carbohydrates then divides it   by 100  

B. Can better predict blood sugar response

C. More useful than glycemic index because it’s based on the serving  

Problems with high glycemic index/ load foods

A. Very high glucose levels  

B. Chronically increased insulin levels

C. Leads to high blood triglyceride levels and increased fat production  

D. A more rapid return of hunger after a meal, increased tendency for blood clots

28

Sweeteners  

A. Nutritive sweeteners- sugar, high fructose corn syrup, honey

B. Sugar alcohol- sorbitol/xylitol which equals about 2.6 kcal/g and slows the   metabolism to glucose  

C. High fructose corn syrup- made form corn, 55% fructose, cornstarch mixed with acid   and enzymes, some glucose is converted to fructose, improved shelf-stability and   food properties; average American consumes 60 lbs/year  

D. Alternative sweeteners yield no kcal, but are there safety issues?  

1. GRAS- extensive research has demonstrated the safety of the 5 low-

 calorie sweeteners currently approved for use in foods in the U.S. 2. Equal- complaints of sensitivity such as headaches, dizziness,  

 seizures, nausea, etc.

3. Acceptable daily intake is 50 mg per 1 kg of body weight, as stated by   the FDA (14 cans of diet soda for average adult per day)

4. PKU

NOTE: Artificial sweeteners are not associated with weight loss because they train us to enjoy  sweet products which enhances our appetite for sweets.  

How much fiber do we need?

A. AI is 25 grams/day for women

B. AI is 38 grams/day for men  

C. AI has been set to reduce the risk of CV disease and perhaps diabetes  D. DV is 25 grams for 2000 kcal diet  

E. Average U.S. intake: 14 grams/day for women, 17 grams/day for men

How much is too much fiber?

A. >60 grams/day

B. Extra fluid needed  

C. May decrease availability of some minerals  

` D. Unmet energy needs on children

29

Dietary Fiber  

A. Starches are digestible  

B. Fiber is not digestible

1. Therefore, it arrives at the colon intact  

2. Why? Because we don't produce the correct digestive enzymes to break the   chemical bonds that hold these polysaccharides together  

C. It is a group of polysaccharides

D. Similar characteristics- made up of indigestible plant polysaccharides  

Types of Fiber

A. Insoluble/non-fermentable fiber  

1. Cellulose  

2. Hemicellulose  

3. Lignins  

B. Soluble/viscous fiber  

1. Pectins, Gums, Mucilages  

2. Fruit, vegetable, rice bran, psyllium seed  

C. Functional Fibers  

1. Examples; inulin, oligofructose  

2. *Added to food*

3. Resistant to digestion but fermentable  

4. Stimulates the growth of beneficial bacteria (prebiotic)  

5. Evidence based for designation  

Whole Grains  

1. 9/10 people don't meet whole grain recommendation of 3 servings/day  2. Look beyond the label to the list of ingredients  

Food Labels

1. Don’t separate insoluble and soluble fiber  

2. Total Fiber= dietary fiber + functional fiber (according to the Institute of   Medicine)

30

Healthy benefits of adequate fiber in the diet  

1. Insoluble fiber adds mass to the feces, preventing constipation

2. Constipation can increase the risk of developing hemorrhoids and diverticula  3. Soluble (fermentable) fibers  

1. Attracts water  

2. Delays the stomach from emptying which promotes satiety  

3. Slows the glucose absorption from the small intestine which lowers the need   for insulin  

4. Inhibits the absorption of cholesterol and bile acids in bile, lowering blood   cholesterol concentrations  

5. Both soluble and insoluble fibers

1. Aid in body weight control

2. Reduce the risk of colon cancer

Monounsaturated fatty acid structure figure- 1 double bond (MUFA) Polyunsaturated fatty acid structure figure- 2+ double bonds (PUFA)

Composition of Fats  

A. Fats are complex  

B. Composed of both saturated and unsaturated fats

C. Many different types/species of fatty acids (determined by chain length)

31

Lipids

A. They do not dissolve well in water

B. Types  

1. Triglycerides  

a. Storage form of lipids in the body  

b. Fats and oils in food are typically triglycerides  

c. Triglyceride = glycerol + 3 fatty aids  

d. Fatty acids are a chain of carbon atoms flanked by  

 hydrogen atoms and an acid group at one end. The omega

 side is the methyl side; the alpha side is the acid side  

e. Look at the figure of glyceride

2. Phospholipids  

3. Sterols (cholesterol)  

4. “Lipids”- generic term for fats and oils and other molecules  

a. “Fat”- lipid that is solid at room temperature

b. “Oil “- lipid that is liquid at room temperature  

Essential Fatty Acids

A. Our bodies can only make certain types of fatty acids  

B. Have a double bond after the 4th carbon from the omega end

C. Therefore, omega-3 and omega-6 fatty acids are essential fatty acids  1. Omega-3 fatty acids- alpha linolenic acid (ALA) has a double bond after the   3rd carbon atom  

2. Omega-6 fatty acids- linoleum acid (LA) has a double bond after the 6th   carbon atom  

D. Different forms  

1. Saturated fatty acids (SFA)- solid form

2. Unsaturated fatty acids (UFA)- liquid form

a. Cis form- causes the backbone of a molecule to bend (looks like a C)   such as oleic acid

B. Trans form- straight line, such as eladic acid

32

Fats vs Oils

A. These are the physical properties of triglycerides (TG)

B. Depends on the makeup of the fatty acids

C. For triglycerides to be oils, they must have short chain lengths and/or a lower  degree of saturation

D. For triglycerides to be fats, they must have long chain lengths and/or a higher  degree of saturation

Essential Fatty Acids

A. Must be supplied by the diet to maintain health

B. Omega-3 fatty acid (alpha-linolenic acid)

1. Primarily from nuts, seeds, fish oil, flax seed oil

2. Also found in canola, walnuts, mussels, crab, shrimp, and soybean oil 3. Recommended intake of about 2 servings of fish per week

4. Health related effects of DHA, EPA (omega-3)

a. Decrease blood clotting

b. Reduce heart attacks

c. Decrease inflammation

d. Excess may cause hemorrhagic stroke

e. Other possible uses: lower triglycerides, rheumatoid arthritis,  

behavior disorders

C. Omega-6 fatty acid (linoleic acid)

1. You need to have about 2-4 tablespoons a day

2. Functions:

a. Supports immune system function and vision

b. Help form cell membranes

c. Produce eicosanoids, which are involved in practically all  

important functions in the body

3. Health Related Effects of archidonic acid (Omega-6)

a. Increases blood clotting

b. Increases inflammation responses

33

D. Signs and symptoms of essential fatty acids deficiency

1. Flaky, itchy skin

2. Diarrhea

3. Increased risk of infection

4. Stunted growth and reduced wound healing

E. Use of omega-3 supplements in the U.S.

1. Most commonly used natural product (nonvitamin/nonmineral) in adults 2. About 37% of adults and 31% of children (last 30 days)

3. Side effects and risks

a. From the FDA: GRAS-- "generally recognized as safe"

b. Minor gastrointestinal upsets, including diarrhea, heartburn,  

 indigestion, and abdominal bloating

c. In high doses, can interact with blood thinners and drugs used for  

 high blood pressure

d. What about high levels of mercury, pesticides, or polychlorinated  

 biphenyls (PCBs)?

e. Omega-3 supplements do not appear to contain these  

 substances

Triglyceride

A. Glycerol and 3 fatty acids

B. Synthesis occurs stepwise by specific enzymes

C. Diglyceride- the breakdown product of triglyceride consisting of two fatty acids  bonded to a glycerol backbone

D. Monoglyceride- the breakdown product of a triglyceride consisting of one fatty acid  attached to a glycerol backbone

Question- is it oil or fat?

A primary saturated fatty acid is 26:0 (26 carbons and 0 bonds)

A primary monounsaturated fatty acid is 8:1 (8 carbons and 0 bonds)

34

Phospholipid

A. Structurally similar to triglyceride  

B. Except a fatty acid has been removed and replaced by a phosphate-containing group  

Lecithin- an emulsifier that is produced in the liver, then goes to the gallbladder, then to the  small intestine

Phospholipid functions  

A. Forms part of the cell membrane  

B. Is a component of bile  

C. It is an important emulsifier of fats in cooking  

1. Egg yolk

2. Wheat germ

3. Peanuts  

4. Soy beans

5. It is added to many foods in baking  

Cholesterol  

A. Has a multi-ring stricture

B. Only found in animal products  

C. Sterols

1. Part of the cell membrane  

2. Component of bile  

3. Precursor of bile acids (begins digestion)  

4. Making hormones such as estrogen and testosterone (sex hormones)  5. Precursor to Vitamin D

35

Digestion of fats

A. Starts in the mouth with enzymes in saliva  

B. Continues in the stomach with enzymes  

C. Further digestion in the small intestine by emulsification and with

 enzymes

1. Small intestine = primary site of fat digestion

2. Fat is emulsified by bile into smaller particles  

3. Forms small lipid droplet called micelles

4. Bile is recycled  

D. Enzymes that break down fats- lipases

1. There are salivary, stomach, and pancreatic lipases

2. They only work on fatty acids with short/medium chain lengths  

3. The hormone cholecystokinin (CCK) stimulates the release of  

 pancreatic lipase, which digests triglycerides into monoglyceride and   fatty acids

Fat absorption- take place in the mucosal cells- enterocytes  

A. In long-chain fatty acids  

1. Monoglycerides and long-chain fatty acids diffuse into intestinal cells  2. The current view is that proteins mediate uptake through facilitated transport  3. Some of the transporters are stimulated by insulin (example: FATPs)  4. They are used to reform triglycerides in the mucosal cells (enterocytes)  5. They are packaged in chylomicron (a lipoprotein)  

6. Then, they are taken into the lymphatic system  

B. In short-chained fatty acids  

1. Diffuse into the enterocytes  

2. Water soluble  

3. Taken by capillary to liver via the portal vein

36

Digestion of Phospholipids  

A. Enzymes are released:

1. From the pancreas

2. From the cells of the small intestine  

B. Broken down to:

1. Glycerol  

2. Fatty Acids

3. Remaining parts  

Digestion of Cholesterol  

A. Enzymes are released from pancreas  

B. Cholesterol is absorbed through specific transport proteins

Check out this video of digestion and absorption of fats:  

https://www.youtube.com/watch?v=O1XToe78zxs

37

Transporting fats in a water environment

A. Lipoproteins serve as transport vehicles for lipids

B. We know a lot about them because they are associated with heart disease  C. They go from the small intestine and the liver to the cells of the body  D. Four classes of lipoproteins  

1. Chylomicrons

2. VLDL- very low density lipoprotein  

3. LDL- low density lipoprotein

4. HDL- high density lipoprotein  

Chylomicron

A. Triglyceride is broken down into glycerol and fatty acids by lipoprotein lipase B. Fatty acids are taken up by the cells of the body  

1. Diffusion  

2. Facilitated Transport- protein mediated  

C. Most of the glycerol is taken up by the liver  

Chylomicron

A. Triglyeceride is broken down into glycerol and fatty acids by lipoprotein lipase on the   inside walls of capillaries  

B. After much of the triglyceride is removed from the chylomicron, it is called a  chylomicron remnant  

C. It is removed from the circulation by the liver and its components recycled to make   other lipoproteins or bile  

D. Large particle that carries dietary lipid  

E. Exogenous pathway for lipid metabolism

38 VLDL  

A. Carries lipids from the liver to tissues  

B. Endogenous pathway for lipid metabolism  

C. Liver packages lipid in a lipoprotein called VLDL  

D. Lipoprotein lipase breaks down the triglyceride in VLDL to release fatty acids  E. Fatty acid uptake into cells by diffusion  

F. VLDL becomes LDL when the content of cholesterol is greater than that of TG G. LDL is a cholesterol-rich lipoprotein that transports cholesterol to tissues

Transport of cholesterol from tissues to liver

A. HDL is made by liver and intestine

B. HDL picks up cholesterol from dying and other cells and transfers it out other   lipoproteins

C. HDL delivers the cholesterol to the liver

39

CV Disease and Lipids

A. HDL- “good cholesterol”

B. LDL- “bad cholesterol”

C. But isn't cholesterol the same?

D. The actual molecule is the same  

Atherosclerosis  

A. Clinical condition

B. Artery wall thickens as a result of plaques  

C. Plaque is made up of fat, cholesterol, calcium, and other substances found in the   blood

CV Disease and Science  

A. Epidemiology is the study of the patterns, associations, and effects of health and   disease in defined populations

B. A meta-analysis refers to methods focused on contrasting and combing   results from different studies, in the hope of identifying patters among them

Optimal or desirable levels (KNOW THESE NUMBERS)

A. Low LDL-C < 100 mg/dL

B. High HDL-C > 60 mg/dL

C. Low total cholesterol < 200 mg/dL

D. Low triglycerides < 150 mg/dL

A better measure of cholesterol: Non- HDL-C  

A. Provides an estimate of cholesterol in VLDL, IDL, LDL, and Lp(a)

B. The difference between the total cholesterol and the HDL-C concentrations  C. Lp(a) is an LDL like particle

D. Takes into account all atherogenic particles  

Why all these recommendations?

A. Idea is to reduce the levels of atherogenic particles, but why?

B. Limit the built up of plaques

40

Current method to assess CVD Risk (AHA): ASCVD Risk Estimator A. Gender

B. Age

C. Race

D. Total cholesterol levels  

E. HDL-cholesterol levels  

F. Systolic blood pressure  

How to raise HDL-C  

A. Consume fish (fatty fish

B. Increase omega-3s (soy foods, green vegetables, nuts  

C. Eat more purple skinned fruits and juices  

D. Choose lower glycemic index/load foods

41

Raising HDL

A. Physical activity (at least 43 mins/day, 4 days a week)  

B. Don’t smoke  

Storage of lipids in the body  

A. Adipose Tissue  

1. White Fat or WAT (white adipose tissue)  

a. Usually one lipid droplet  

b. Large storage capacity for lipids (triglyerides)  

c. Source for fatty acids  

d. White fat does more than store fat; it secretes factors which lead  

 to metabolic disease  

2. Brown Fat or BAT (brown adipose tissue)  

a. Has LOTS of mitochondria- produces energy  

b. Abundant in newborns and hibernating animals  

c. Also found in adults  

d. Functions as a means of generating body heat so it burns energy  

B. Adipocytes

1. Cells that are up fat  

2. Actual storage of energy  

Fat Rancidity  

A. Contains products of decomposed oils

B. Breakdown of the C=C bonds by UV light and/or O2  

C. Unpleasant odor and flavor  

D. Polyunsaturated fatty acid more susceptible  

E. Limited shelf life of food products  

Hydrogenated Fat  

A. Sometimes, food producers want the physical properties of the lipid  B. Good for making pastries, biscuits, pie crust

42

Prevention of Rancidity  

A. Hydrogenation  

1. Process used to solidify an oil  

2. Addition of H to C=C double bonds  

C. Increases shelf life of food product  

B. Addition of vitamin E (antioxidant)  

C. Chemicals added such as BHA (butylated hydroxyanisol) and BHT (butylated   hydroxytolune)  

D. Formation of trans fatty acid  

1. Trans fat is very similar to the shape of a saturated fatty acid  

2. Presents health risk similar to saturated fats

In other tissues with oils, consider the smoke point  

A. Smoke point is the temperature at which oil starts to smoke  

B. It produces harmful chemicals

Recommendations for fat intake  

A. No specific RDA for total fat intake in adults

B. Food and Nutrition Board recommends 5% of your calorie intake comes from   the total of both essential fatty acids (omega-3 and omega-6 fatty acids)  C. 2015 Dietary Guidelines- intake of oils should be around 12% of total calories  D. AHA- 25-30% of calories from fat but no more than 7% of calories come from   saturated fat; no more than 1% come from trans fat 

E. DRI for omega-6 and omega-3- how much should you have of the essential   fatty acids? There are no RDA’s but there are adequate intakes  

1. Omega-6 for females 14-30 years in 12 g/day

2. Omega 3 for females 14-30 is 1.1 g/day

3. The ratio is 11:1. Is it a good ratio?

a. A Typical western diet is 15:1 to 20:1  

b. 4:1 ratio in total mortality from DC

c. 2:5:1- beneficial for colon cancer and rheumatoid arthritis  

d. What ratio is best?? Closer to 1:1 seems best.

43

What fats/lipids/oils should you consume?

1. Replace extra virgin olive old for vegetable oils and butter

2. Seek out omega-3s through fish/seafood or nuts or green vegetables 3. Limit saturated and trans fat  

Fatty Acid Structure  

A. Alpha End  

B. Omega End

Why is atherosclerosis harmful?

A. Atherosclerosis is a clinical condition  

 that leads to heart attack and stroke

B. Artery wall thickens as a result of plaques  

 (fat, cholesterol, calcium, and other substances found in the blood)

What leads to atherosclerosis?

A. Main cause is unknown  

B. Thought to be an inflammatory process  

C. Involves oxidation of LDL and the deposition of oxidized cholesterol  

Lipid changes associated with atherosclerosis  

A. Elevated LDL-C

B. Low HDL-C

C. Elevated cholesterol  

D. Elevated triglycerides  

Omega-6 to omega-3 ratios

A. Consensus is that omega-3 fatty acids are good for your health  

B. Seek out foods with high amounts of omega 3  

1. Flaxseed oil, soybean oil, canola oil

2. Fatty fish  

C. If more omega 3 consumption than the ratio will improve

44

PUB QUIZ #1

1. Name the type of carbohydrate that stimulates insulin secretion. Monosaccharides.

2. What is gluconeogenesis? The production of glucose that you produce when you fast  and is released by the liver.

3. Name the monosaccharides in sucrose/maltose: Glucose and fructose. 4. T or F Fructose is considered lipogenic. TRUE

5. What is the sugar that is measured in “blood sugar”? Glucose.

6. What is lactase? And what happens if you don’t have enough lactase? Lactase is an  enzyme (-ASE) that breaks down lactose and can lead to lactose  

intolerance/persistence.

7. Name the two organs that primarily control blood glucose? Liver and pancreas. 8. Write the general chemical structure for a carbohydrate. CHO.

9. Name 3 characteristics of functional fiber  

1. Resistant to digestion

2. Fermentable

3. It is added to food  

4. Stimulates the growth of beneficial bacteria (prebiotic)  

10. What is in “other carbohydrates”? Starch content (complex carbs)

11. What does “Total Fiber” consist of? Dietary fiber + functional fiber.

12. What is in “Sugars”? Simple sugars.

45

13. What can influence glycemic index? The glycemic index is the ratio of a standard blood  glucose, the food that you're eating, your structure, and the whole package of what  you're eating.

14. In the experiment of insulin experiments, what happened to the dogs in which the pancreas  was removed? The dogs got diabetes, the scientists tasted the urine (too sweet), and they  drank a lot more water and peed excessively.

15. Name 2 food groups that are high in carbohydrates. Grains, Milk, Fruit  16. T or F fiber arrives at the colon intact. TRUE because it resists digestion.

17. What organ secretes glucagon? Glucagon is the hormone released from the  pancreas by the alpha cells (insulin created from beta cells.

18. What hormone is released by the adrenal glands to rapidly control  

bladder functions? Adrenaline and the steroids aldosterone and cortisol. 19. What carbohydrate is stored in the liver? Glycogen.

20. Name the four organs that principally mediate insulins action. Pancreas, liver,  stomach, adrenal glands.

46

PUB QUIZ #2

1. What property do all lipids share? They are hydrophobic.  

2. Name an essential omega-6 fatty acid. Linolenic acid.

3. By what mechanism of transport would you expect this fatty acid (CH3(CH2)6COOH) to be  taken up by cells? Since it is saturated and short, it will be taken up by  diffusion and won't have to go through the lymphatic system.

4. T or F: Minor gastrointestinal upsets including diarrhea, heartburn, indigestion, and  abdominal bloating is a side effect of omega-3 supplements. True.  

5. What do you call a lipid that is solid at room temperature? Fat.  

6. What is an adipocyte? An adipocyte is fat cell that can either be white or brown.  It stores fat as well as secretes many substances that can lead to diseases later  in life.

7. Lecithin is what type of lipid? A phospholipid.

8. What type of fat has lots of mitochondria? Brown fat because it burns energy.  

9. What are functions of cholesterol? It keeps cell membrane fluid, makes bile,  vitamin D, and sex hormones.

10. What does emulsify do to lipids? It helps dissolve the oils and aids in digestion.  11. What organ is the major site of fat digestion? The small intestine.  

12. What is a meta-analysis? It is when you take a lot of studies and compare the  conclusions drawn from all of them as a means of gathering information.

47

13. TG is broken down into which two molecules? Glycerol and fatty acids.

14. Why is HDL-C a key player in CV disease risk? It collects cholesterol which  lowers it.  

15. What is the function of a lipoprotein lipase and where is it found? On the inside  walls of capillaries.  

16. T or F: Protein mediated uptake is important in fatty acid transport in enterocytes. T. 17. What is a lipoprotein? A transporter for triglyceride and cholesterol.  

18. How can you increase your HDL? Don't smoke, try to exercise, eat fish, and eat  food with lower glycemic index.  

19. Name two factors you should consider when choosing a vegetable oil? It’s smoke  point, what types of fatty acids are in it, and if it has polyphenols and  vitamins.

20. What are the desirable or optimal levels  

LDL-C < 100

HDL-C > 60

Total cholesterol < 200

Triglycerides < 100

21. A biotech company working on a new medication for a skin disease found in clinical trials for  a skin disease found in clinical trials that the new drug stimulates the growth of brown fat.  Should he be happy or frustrated? They should buy more stock so they can burn more  energy which allows people to lose weight.

48

*Chemistry Exam 3*

Protein Overview  

A. The body is made up of thousands of proteins

B. They contain nitrogen, carbon, hydrogen, & oxygen  

C. General functions

1. Regulates & maintains body functions  

2. Provides essential form of nitrogen (in the form of amino acids)  

D. In the developed world:

1. Diet is typically rich in protein (is this an issue?)

2. Association between protein intake & mortality  

3. Age 50-65 —> decrease in overall, cancer, & diabetes mortality

4. Ages 66+ —> increase in overall/cancer mortality, decrease in diabetes   mortality  

E. In the developing world:  

1. Protein deficiency is an issue

2. Important to focus on protein intake in diet planning  

3. Aside from water, protein makes up the major part of the lean body tissue  

Protein structure  

A. Amino acids are the building blocks of proteins  

B. Contain nitrogen bonded to carbon  

C. Makes them unique from carbohydrates and fats  

D. The proteins in our bodies are made up of 20 different amino acids (actually 21, but   standard science says 20)  

E. Nine are essential (Some are limiting, meaning they have very low amounts in   particular foods)  

F. Eleven are nonessential  

G. New category  

1. Conditionally or acquired indispensable  

2. Infants or disease states

49

H. Structure  

1. Central carbon

2. Acid group  

3. Amino group  

4. Side group (Different for each amino acid - gives own characteristics) 5. Hydrogen  

6. Peptide bond  

a. Amino acids are connected together by a peptide bond  

b. Two amino acids - dipeptide; three amino acids - tripeptide, etc  

c. Many amino acids - polypeptide  

d. Some proteins contain multiple polypeptide chains  

I. Sequence of amino acids is called the protein primary structure (coded in DNA)  J. Primary structure leads to the protein higher order structure  

K. Higher order structure causes the protein to get into a specific shape (native   conformation)  

L. Shape is necessary for the protein to work properly  

Disruption of normal structure  

A. Denaturation  

1. Heat  

2. Strong acids  

3. Bases  

4. Heavy metals  

B. Protein basically unfolds  

1. Structure is important in proper functioning  

2. Only have to change structure a little bit for it to not work properly

50

Protein primary structure  

A. Determined by the genes (DNA) - kept in the cell’s nucleus  

1. Info of the primary structure gets transcribed into messenger RNA (mRNA) 2. mRNA leaves the nucleus & goes tot the ribosome (rough ER) where the   protein gets translated (made)  

B. Protein synthesis  

1. DNA contains coded instructions  

2. Copies of codes are transferred to the cytoplasm (via mRNA)  

3. Amino acids added one at a time  

4. With aid of transfer RNA (tRNA)  

5. Requires energy  

Central dogma of biology  

A. DNA —><— RNA —> protein  

B. How to change protein structure  

1. Genetic alterations

2. Can change the protein’s primary structure  

3. Sometimes this isn't a big deal (silent mutation)  

4. Sometimes causes significant change in amino acid, which can lead to genetic   diseases, such as sickle cell anemia  

a. A single-base substitution: causes one amino acid to be changed in the   polypeptide of the hemoglobin protein  

b. Alters the higher order structure of the protein  

c. Protein doesn't work as efficiently (as unaltered version)  

d. Hemoglobin binds oxygen in red blood cells (heme actually binds)  

e. RBC have sickle shapes instead of biconcave  

Digestion of proteins  

A. Pre-digestion: cooking (slicing the meat), heat denatures proteins, softens food B. Digestion begins in the stomach  

1. Acid (HCl) denatures protein  

2. Pepsin (enzyme) breaks down peptide bond of proteins resulting protein   fragments

51

C. What controls pepsin & stomach acid release?  

1. Gastrin - hormone  

2. Released in response to thinking about food and chewing and digesting food D. Partially digested proteins and other nutrients is called chyme

E. Movement to small intestine once processed into chyme  

1. Release of CCK (hormone) movement of chyme into small intestine stimulates   cells to release CCK  

2. CCK caused pancreas to release proteolytic enzymes (trypsin, chymotrypsin)   (proteolytic: cleaving proteins)  

3. Pepsin inactivation (elevated pH)  

F. Several peptidases are found in brush border  

1. Small peptides (2-3 amino acid in length) & free amino acids are absorbed by   active transport  

2. Any intracellular peptides are digested by enzymes within cells  

3. Taken up by capillaries and taken to the liver via the portal vein  

4. Free amino acids used as building blocks for liver proteins are then broken   down for energy, released into blood, and converted to nonessential amino   acids, glucose or fat  

G. Sensitivity to proteins  

1. Gluten / Gluten sensitivity (celiac disease)  

a. Protein found in grains like wheat, rye, and barely that gives backed   goods their bought, elastic structure  

b. Incomplete gluten breakdown in small intestine leaving small peptides   and amino acids  

c. Celiac disease-inflammatory response to small peptides/ amino acids d. Autoimmune response, genetic predisposition (immune system attacks   “foreign” bodies; autoimmune: attacking self)  

e. Prevalence is 1 in 133  

f. In people with related symptoms: 1 in 56  

g. Blood test looks for antibodies which results in a biopsy of intestines h. If positive, remove all gluten from diet

52

Function of protein in body  

A. Producing vital body structures  

1. Body is in a state of constant protein turnover  

2. Producing proteins & disassembling proteins  

B. What happens with protein inadequacy?  

1. Muscles, blood proteins, & vital organs decrease in size  

2. Brain resists breakdown  

C. Maintain fluid balance  

1. Blood proteins attract fluids  

2. Fluid shifts into tissues - edema  

D. Contributes to acid-base balance  

1. Act as buffers - maintain pH within a narrow range  

2. Keeps blood slightly alkaline  

E. Form hormones and enzymes  

1. Hormones- communication between cells  

2. Enzymes- Catalyzes reactions in cells  

F. Transport and signaling receptors  

1. Transport- bring nutrients into the cell  

2. Signaling receptors and communicating in the cell  

G. Immune function  

1. Antibodies production (move DNA around to come up with new combinations) 2. What happens with protein inadequacy? Decrease in immune function H. Providing energy (direct) and indirect (glucose)

I. Contribute to satiety  

Infant digestion of proteins  

A. Up to 4 fo 5 months of age  

B. The GI tract is somewhat permeable to small proteins (whole proteins can be   absorbed)  

C. If breastfed, this allows antibodies to be passed from mother to baby (immune system   is learning difference between self and foreign)  

D. Waiting until the infant is at least 6-12 months of age before introducing some foods   than can cause allergies (introduce in a step-by-step manner)

53

Functions of Protein in the Body  

A. Provides energy

1. Calorie restriction

2. Prolonged exercise  

B. However, cells use primarily fats and carbohydrates

1. Why? It’s efficient  

2. It wastes calories to metabolize (break down) amino acids for energy  

C. Forms glucose

1. Amino acids can be converted into glucose  

2. This happens when glucose is low  

3. Through glycogenic amino acids  

4. There are nonessential and essential amino acids  

5. In starvation, muscle wasting and edema results from protein breakdown D. Contributes to satiety  

1. Provides the highest feeling of satisfaction after eating  

2. May contribute to collie control during weight loss

54

The need for protein

A. Only need it if you aren't growing (ie adults)  

B. Only need enough protein to replace what’s been lost daily

C. This is often called protein breakdown/protein turnover  

Protein RDA  

A. 0.8 g of protein for every 1 kg of healthy body weight  

B. For an average person (150 lbs = 70 kg) this means 56 grams of protein  C. This is about 10% of total calories  

D. Food and Nutrition Board want it closer to 35%

E. In the U.S. the typical protein intake is about 100 grams for men and 65 grams for   women

F. Typical protein intake is greater than what is needed  

G. In the western diet, 70% of dietary protein comes from animal sources H. Water packed tuna is the most nutrient-dense source of protein

I. Top contributors of protein in the American diet include beef, poultry, milk, white bread,   and cheese

J. The problem with so many animal sources is that they tend to be low in fiber, some   vitamins, phytochemicals, and high in saturated fat and cholesterol  

K. Red meat is very strongly linked with colon cancer, especially in any processed form L. High protein diet is stressful on the kidneys  

M. Some studies show that high protein diets are associated with calcium losses in urine

Complete protein in plants  

A. Quinoa- grain like

B. Amaranth- seeds are ground into flour and the leafy greens rival swinish and kale for   nutrients  

C. Soybeans- made up of 47% protein  

D. Buckwheat- not wheat, but actually relayed to rhubarb; the grain is ground into flour

55

Alternatives to the typical high-protein diet  

A. Vegetarian- no meat at all

B. Semi-vegetarian- no meat typically but occasionally consume fish and poultry or   meats infrequently  

C. Vegan- no animal products, which can cause a lot of health issues  

1. Need complimentary proteins  

2. Nutrient deficiency concerns, such as iron, vitamin B12, zinc, calcium (dairy),   omega-3 fatty acids (fish/fish oil)

D. Animal proteins are considered to be complete proteins/high quality, because they   contain all essential amino acids in abundance  

E. Plant proteins tend to be incomplete proteins/low quality, because they are low in   one or more of the essential amino acids  

F. Plant sources of proteins  

1. Nuts  

2. Seeds

3. Legumes  

G. With a vegetarian diet, there are specific protein requirements  

1. Grains and nuts are low in the amino acid lysine

2. Vegetables and legumes are low in methionine

3. Complementary proteins combine two or more of the following to  

 compensate for deficiencies in essential amino acids needed for each proteins  

Protein consumption complications

A. Gluten sensitivity  

B. Allergies related to peanuts, tree nuts, shellfish, eggs, milk, soy, wheat, fish C. The immune system mistakes food protein for harmful invaders  

D. 8 foods account for 90% of food-related allergies

E. Reactions range from intolerance to fatal allergic reactions

56

Complete protein in plants  

A. Quinoa- grain like

B. Amaranth- seeds are ground into flour and the leafy greens rival swinish and kale for   nutrients  

C. Soybeans- made up of 47% protein  

D. Buckwheat- not wheat, but actually relayed to rhubarb; the grain is ground into flour

Protein-Calorie Malnutrition  

A. In the developed world, diet is typically rich in protein  

B. In the developing world, protein deficiency is an issue, which is important in diet   planning

C. It is rare to see protein deficiency in developed countries, but it is seen in certain   populations

D. In developing countries, it can stunt growth and increase the risk of infection  E. Protein-Energy Malnutrition called marasmus which is apparent in starvation or   where there is insufficient protein and calories  

F. Kwashiorkor is marginal amount of calories but severe protein deficit  G. These diseases are commonly found in Africa  

H. In the U.S., it can be found in hospital patients, long-rem care residents, community-  dwelling adults, dialysis patients (In every one of these cases, the victims are all older   adults over 65 years old)

57

Megadoses of Vitamins  

A. Beyond estimates of needs

B. Not in a balanced diet

C. 2-10x human needs  

D. Usually through supplements  

E. Increased risk for toxicity symptoms  

F. Proven useful in treating several nondificiency diseases  

G. Oversupplementation can leads to vitamin levels building up over time  H. Vitamins can be stored within the body  

I. Fat soluble vitamins (especially vitamin A) have the potential to reach toxic levels  

Vitamin Preservation  

A. The riper the food, the more vitamins

B. Vitamins lost from time picked to consumed  

C. Best to eat as soon as possible after harvest  

D. Water soluble vitamins destroyed by improper storage or excessive cooking  E. Heat, light, air, cooking in water, alkalinity  

F. How to preserve vitamins in foods

1. Freezing- best method  

2. Blanching- destroys enzymes that degrade the vitamins  

Two Classes of Vitamins  

A. Fat soluble vitamins- A, D, E, K  

1. absorbed in chylomicron

2. Stored in liver and fatty tissue  

3. Not readily excreted  

B. Water- soluble vitamins- C and B vitamins  

1. Absorbed through the capillaries  

2. In general, not stored to a great degree  

3. Excess excreted in urine

58

Vitamin A (Retinoids) and Carotenoids  

A. Vitamin A (preformed)  

1. Retinol

2. Retinal  

3. Retinoid acid  

4. Note- exist only in animal products and in supplements  

B. Carotenoids  

1. Contained in plant pigments  

2. Phytochemicals- polyphenols  

3. Principle pigments for red, orange, yellow and green colored fruits/vegetables  4. Some are precursors to vitamin A, such as provitamin A

6. Beta-carotene- carotenoid that can be sufficiently absorbed and converted   into retinol  

Functions of Vitamin A and Carotenoids  

A. Health of epitheal cells and immune function  

1. Maintains health of epithelial cells that line internal/exterbak surfaces  2. Lungs, intestines, stomach, vagine, urinary tract, bladder, eyes and skin  3. Healthy epithet tissues serve as important barriers to infection  

B. Vision  

1. Night blindness- vitamin A deficiency disorder that results in loss of ability to   see under low-light conditions  

2. Vitamin A important for light-dark vision and color vision  

3. Retina consist of rods and cones  

4. Rods detect black and white, night vision  

5. Cones responsible for color vision  

6. Lutein and zeaxanthin in high concentrations in retina  

a. Found in leafy green vegetables  

b. Help prevent macular degeneration  

c. Food sources may help decrease risk of calories  

C. Cardiovascular Disease

1. Carotenoids may decrease rise by preventing oxidation of LDL  

2. Recommendations to consume 5 servings a day of fruit and vegetables

59

Vitamin A Deficiency  

A. Leading cause of blindness worldwide

B. Eye cells affected- inability to adjust to dim light, causes night blindness C. Xerophthalmia: hardening of cornea and drying of the surface of the eye, which can   result in blindness

Vitamin A Deficiency Risk  

A. North Americans are low risk- typical American diets contain preformed vitamin A B. Worldwide, 1/3 of children suffer from deficiency

C. Attempts to reduce this problem:

1. Promote breastfeeding

2. Vitamin A megadoses 2x a year

3. Fortification of sugar and margarine

Getting Enough Vitamin A and Carotenoids

A. Preformed vitamin A: Liver, fish, fish oils, fortified mild, butter, yogurt, eggs B. Carotenoids: Dark green and yellow-orange vegetables

C. Cooking improves bioavailability  

D. RDA expressed in retinol activity equivalents (RAE)- takes into account both   preformed and carotenoid source

E. Typical American diets sufficient- supplementation unnecessary for most people  

Avoiding Too Much Vitamin A and Carotenoids

A. Excess linked to birth defects and liver toxicity- by preformed vitamin A B. Carotenoids in large amounts do not cause toxic effects

C. Hypercarotenemia: skin turns yellow-orange, particularly hands and soles of feet,;   disappears when intake decreases  

Vitamin D – Fat soluble  

A. Not just a vitamin but is also a hormone

B. Requires skin, liver, and kidneys

C. The body can make vitamin D when exposed to UVB light  

D. Exposure time depends on skin color, age, time of day, season, and location

60

Functions of Vitamin D

A. Helps regulate blood calcium levels and bone metabolism (works with parathyroid   hormone)

1. Helps regulate calcium and phosphorus absorption from intestine  

2. Regulates the deposition of calcium in bone

3. Regulates calcium excretion from kidney  

B. Helps in the development and can decrease risk of cancer in skin, colon, prostate,   ovary, and breast  

Deficiency of Vitamin D

A. In children causes rickets- bow legs, enlarged head/joints/rib cage, deformed pelvis B. In adults causes osteomalacia  

1. Softening of bones

2. Leads to fracture of hips and other bones

Vitamin D toxicity  

A. UL – 50 micrograms per day

B. Too much can cause calcium deposits in soft tissues

C. Can’t develop vitamin D toxicity because of too much sunlight

Vitamin D in foods

A. Fatty fish

B. Fortified milk and yogurt  

C. Some breakfast cereals

Vitamin E – Fat soluble  

A. A family of compounds called tocopherols  

B. Alpha Tocopherol – main form in the body  

C. Gamma Tocopherol – Foods  

D. Acts as a fat-soluble antioxidant  

E. Resides mostly in cell membranes

61

Vitamin E – Antioxidant role

A. Oxidizing agents are seeking electrons

B. Example: the double bonds of unsaturated fatty acids in phospholipids  C. Oxidizing agents can create free radicals  

D. As an antioxidant, vitamin E has electrons it can give up to the oxidizing agent  E. Result: protects components of the cell (phospholipids)  

Deficiency of Vitamin E

A. Can cause cell membrane to break down

B. This is particularly true in red blood cells, called hemolysis, which can lead to   hemolytic anemia  

C. Premature infants are particularly at risk  

D. Smokers  

Vitamin E toxicity  

A. UL – 1000 milligrams per day

B. High doses can interfere with clotting mechanism in body, leading to a hemorrhage C. Thus, people at risk are individuals taking anticoagulants, high does of aspirin or are   deficient in vitamin K

Vitamin E – in foods

A. Plant oils (salad dressings, mayonnaise)

B. Ready-to-eat cereals

C. Dry roasted sunflower seeds and almonds

D. Some fruits and vegetables

Vitamin K

A. Vitamin K is vital for blood clotting

B. The “K” of vitamin K comes from the Danish spelling of coagulation  

C. Vitamin K also activates proteins present in bone, muscle, and kidneys to give   calcium binding ability to these organs  

D. Poor vitamin K intake is associated with hip fractures in women  

E. About 10% of our vitamin K is made by bacteria living in our GI tract

62

Vitamin K in foods

A. Liver, green leafy vegetables (kale, turnip greens, dark green lettuce, spinach, brussel   sprouts) asparagus, broccoli  

B. Oils – soybean and canola  

Vitamin K Toxicity

A. There is no risk of toxicity, so no UL has been set

B. Megadoses may reduce the effectiveness of anticoagulation medications  

Water Soluble Vitamins  

A. Vitamin C

1. What is it?

a. Compounds with antiscorbutic activity

b. Dietary form is ascorbic acid

c. Similar structure to glucose

d. Essential for humans and some other species

2. Foods:

a. Citrus fruit

b. Green peppers

c. Brussel sproutS

d. Strawberries

e. Tomatoes

f. Fortified drinks

3. Stability

a. Vitamin C is rapidly lost by processing and cooking food

b. It is unstable in the presence of heat, iron, copper or oxygen

4. Functions:

a. Formation of collage- strengthens structural tissues by increasing  

 cross connections between amino acids

b. Formation of other compounds, such as the synthesis of carnitine;  

 formation of serotonin and norepinephrine

c. Antioxidant- can readily accept and donate electrons

63

B. B vitamins (function as precursors to coenzymes)

1. Thiamin, riboflavin, niacin, pantothenic acid, biotin, vitamin B6, folate,   vitamin B12

2. Occur in many of the same foods

3. So a lack of one B vitamin may mean others are also low in the diet 4. B vitamin deficiency symptoms typically occur in the brain, nervous system,   skin and GI tract

5. Several b vitamins are in whole grains, but are removed during milling process 6. To counter these losses, flour in the U.S. is enriched with four b vitamins   (thiamin, riboflavin, niacin, and folate)

C. Vitamin B6- Pyridoxine

1. Needed for the activity of many enzymes such as carbohydrate,   protein, and fat metabolism; particularly important in amino acid   metabolism, aids in transferring nitrogen group

2. Necessary for the synthesis of neurotransmitters by allowing nerve   cells to communicate; important in the synthesis of hemoglobin and   white blood cells; and necessary for conversion of tryptophan to niacin D. Vitamin B12

1. Contains the mineral cobalt

2. Must bind to intrinsic factor, made by the stomach, in order to be absorbed 3. Defective B12 absorption is common in older people

4. Animal products: meat, milk, poultry, seafood, eggs, ready to eat cereals 5. Required to convert folate into its active form

6. Maintains the myelin sheaths that insulates neuron- destruction of myelin   causes paralysis and perhaps death

7. Pernicious anemia: means "leading to death;” symptoms include weakness,   sore tongue, apathy, tingling in the extremities; infants of vegans are at risk

64

E. Folate

1. The term folate encompasses a variety of forms of the vitamin

2. Folic acid is the synthetic form

3. Functions

a. Single carbon supplier or donor

b. Coenzyme helps

c. Form DNA

d. Metabolize various amino acids and their derivatives

e. Bone marrow produces immature red bloood cells (megaloblasts)   which causes megaloblastic anemia, which can cause an  

 inflammation of tongue, mental confusion, depression, and problems   with nerves

4. Deficiency

a. 10% of population has genetic defect in the metabolism of folate, and   as a result, they need up to double the RNA to compensate for the   defect, and has be linked to neural tube defects in the fetus along with   maternal folate deficiency

b. Affects about 2000 infants a year in U.S., such as spina bifia to  

 anencephaly. This occurs when the neural tube crosses within first 28   days of pregnant, which is a time when many women are not even   aware they are pregnant, therefore, it is crucial for all women of child   bearing age to have an adequate intake of folate

5. Folate in food

a. RDA- 400 micrograms per day

b. Pregnant- 600 micrograms per day

c. The name folate comes from foliage

d. Green leafy vegetables, organ meats, sprouts, other vegetables, dried   beans, and orange juice

e. Suceptible to destruction by heat

65

F. Thiamin (B1)

1. Help release energy from carbohydrates and certain amino acids

2. Beriberi ("I can't, I can’t")

3. There is no UL for thiamin

4. Pork products, whole grains, ready to eat cereals, enriched grains

G. Riboflavin (B2) and Niacin (B3)

1. Both aid in energy metabolism

2. Both are coenzymes

3. Riboflaviin - flavin adenine dinucleotide (FAD)

4. Niacin - nicotinamide adenine dinucleotide (NAD)

H. Pantothenic acid

1. Aids in the energy metabolism

2. Coenzyme - coenzyme A

3. Deficiency among healthy people who eat a varied diet is unlikely

Water

A. Life cannot exist without water  

B. Water is a solvent for chemicals in the body, allowing chemical reactions to   take place  

C. Water makes up 50%-70% of the body’s weight  

Fluid Compartments  

A. Intracellular = water inside the cell  

B. Extracellular = water outside the cell  

C. Intracellular fluid is also referred to as ICF

D. Water can move (diffuse) between compartments  

E. Ions control the movement of eater between the intracellular and extracellular   compartments  

F. Ions are minerals with an electrical charge (also called electrolytes)  G. The movement of water across a semipermeable membrane is called osmosis

66

Functions of Water  

A. Solvent for chemicals in the body, allows chemical reactions to take place  B. Contributes to body temperature regulation (sweat)  

C. Helps remove waste products by dissolving them into the water  

D. Cushions and lubricants (knees, joints, saliva, bile)

E. Water is not stored, but precisely regulated by the nervous, endocrine, digestive, and   urinary systems  

What if we don't get enough water?

A. 1-2% loss- thirst mechanism occurs  

B. Antidiuretic hormone (ADH) helps the body conserve water

1. Released by pituitary  

2. Communicated with kidney to conserve water

C. Alderstone  

1. Released from adrenal gland when blood volume decreases  

2. Communicates with kidney to conserve water  

Can you consume too much water?

A. Too much in a short period of time leads to water intoxication/poisoning  2. Dilutes sodium levels

3. Symptoms- nausea, mental confusion, vomiting, headaches, muscle weakness,   convulsions  

Bioavailability of minerals

A. Bioavailability- how much we take in  

B. Is dependent on 1) how much food and 20 our ability to absorb it  

C. The amount in a food doesn't generally reflect the bioavailability  

D. Minerals from plants  

1. Depends on the soil its grown in  

2. May be jocund by dietary fibers and other molecules

E. Minerals from animal source  

1. Are not as dependent on soil conditions  

2. Absorbed better than plant sources because fewer binders and dietary fiber

67

Mineral Binders

A. Oxalates (spinach)- binds calcium

B. Phylates (grains)- binds calcium, iron zinc, others

C. Mineral-mineral interactions- calcium-iron; zinc-copper

D. Vitamin-mineral interactions  

Mineral Toxicities  

A. Minerals can be toxic in high levels, especially trace minerals  

B. Not a problem when food is the source, but can be from mineral supplements  

Calcium (Ca)

A. Most abundant mineral in the body  

B. 99% of body calcium is in the bone  

1. Integral part of bone structure

2. Storehouse for calcium in the blood  

C. Adults absorb about 25% of the calcium in foods eaten  

D. Increases in infants and during pregnancy (60%)  

Serum Calcium (functions)  

A. Regulates transport of ions across cell membrane (important in nerve transmission)  B. Helps maintain blood pressure

C. essential for muscle contractions  

D. Essential for secretion of hormones, enzymes, neurotransmitters, etc.  E. Essential for blood clotting  

Possible Health Benefits  

A. Possible links between calcium intakes and risks of certain cancers, kidney stones,   hypertension, high blood cholesterol, and obesity  

B. Osteoporosis- decreased bone mass related to aging, genetic background, and poor   diet; leads to 1.5 million bone fractures per year just in the U.S., bones become brittle

68

Bone Density  

A. Reaches a peak in 20s

B. Levels off in 30s  

C. Lose after 40s

D. Need to build up bone density when you are young

E. How to maintain adequate bone density:

1. Adequate amount of calcium and vitamin D in your diet  

2. Exercise  

3. Estrogen  

Calcium in foods

A. AI- 1000-1200 mg per day  

B. Foods such as dairy products (milk, cheese yogurt), breads, rolls, leafy vegetables   (kale, collards, turnips, mustard greens), calcium fortified products, supplements   (calcium-based antacids)  

C. UL- 2500 mg per day (risk of kidney stones)  

Sodium (Na)

A. Absorb about 100% of Na consumed

B. 30-40% found in bone  

C. The major positive ion found in extracellular fluid  

D. Functions- fluid balance between compartments, nerve impulse conduction,   absorption of glucose  

Sodium Sensitivity  

A. For most people, the body will adjust to higher sodium intake by increasing urine   output  

B. 10-15% of adults are sodium sensitive  

C. High sodium intake leads to increased blood pressure  

D. UL- 2300 mg per day

69

Sodium Deficiency  

A. Very rare- excessive perspiration, persistent vomiting, diarrhea

B. Leads to muscle cramps, nausea, vomiting, dizziness, coma

Chloride (Cl)

A. An ion of chlorine  

B. Major negative ion for extracellular fluid  

C. Used in producing stomach acid (HCl) during immune response of white blood cells  

Potassium (K)

A. Postive ion in a intracellular fluid compartment  

B. 95% of bodys potassium  

C. Like sodium, potassium is important in fluid balance and nerve impulse transmission  D. Unlike sodium, increasing potassium intake is associated with lower blood pressure E. Increased risk of deficiency-people on diuretics to treated high blood pressure,   alcoholics, certain eating disorders

F. Can lead to heart failure  

G. Too much- due to kidney failure, can stop heart  

H. AI- 4700 mg per day  

I. Foods include unprocessed foods, potatoes, plums, avocados, bananas, cantaloupe,   honeydew melon, raisins  

Trace Minerals  

A. Iron, Zinc, Selenium, Iodine, Copper, Chromium, Fluoride, Chromium, etc.  B. All are toxic in excess

Iron (Fe)

In every cell of the body

B. Absorb about 18% of that present in food  

C. Most iron associated with hemoglobin (RBC) and myoglobin (muscle)- heme iron  D. Other types are called non-heme iron  

E. When RBCs die, iron is recycled

F. Therefore, we lose very little, except during bleeding

70

Iron Absorption  

A. Heme iron is more readily absorbed than non-heme iron  

B. Vitamin C (75 mg) enhances absorption of non-heme iron  

C. Tannins in tea and phytates in grain inhibit iron absorption  

Iron Deficiency  

A. Anemia- decreased oxygen-carrying capacity of the blood

1. Lower number of RBCs  

2. Less oxygen to the cells

3. Present in about 30% of the world population  

4. Half of which is due to low iron  

B. Neurological dysfunction called Pica, cravings for odd things such as ice, dirt, etc.  C. Result is impaired physical and mental activity  

1. Fatigue, loss of appetite  

2. Decreased learning ability  

3. Decreased attention span

Iron Toxicity  

A. Hemochromatosis  

B. Bronzing of the skin  

C. Iron builds up in the liver and the blood

D. Will lead to organ damage, especially in the liver and heart  

E. UL- 45 mg/day

F. Somach irritation, toxicity can be life threatening  

Zinc  

A. About 40% of dietary Zn is absorbed  

B. Zinc is a cofactor for up to 200 different enzymes  

C. Functions:

1. Growth, would healing

2. Sexual maturity  

3. Taste perception  

4. Immune system, indirect antioxidant

71

Zinc Deficiency  

A. First recognized in the 1960s in boys from the middle east

B. Diet low in animal protein, exclusive use of unleaded bread  

C. Had a severe impact on their growth/maturity  

D. Symptoms include acne-like rash, diarrhea, lack of appetite, delayed wound healing,   impaired immunity, reduction of sense of taste and smell, hair loss

E. RDA men: 11 mg

F. RDA women 8 mg

G. Average Americans consume 10-14 mg/day  

H. Absorption depends on body needs

1. Phytic acid binds to zinc and limits availability  

2. High calcium intake decreases zinc absorption  

3. Zinc competes with copper and iron for absorption  

How to Avoid Too Much Zinc  

A. UL: 40 mg

B. Excess interferes with copper metabolism  

C. Toxicity interferes with copper metabolism  

D. Toxicity can occur from supplementation or overconsumption of zinc-fortified foods E. If your intake is over 100 mg, you may experience diarrhea, cramps, nausea,   vomiting, loss of appetite  

Selenium  

A. Indirect antioxidant, works with vitamin E to help protect cell membranes from   oxidizing agents  

B. Binds to enzymes- protects against oxidation  

C. May have anticancer properties

D. Found in some areas of China  

E. People developed characters muscle and heart problems associated with inadequate   selenium intake  

F. RDA- 55 micrograms per day  

G. 400 micrograms per day (hair loss)  

H. Foods include eggs, fish, shellfish, grains, seed grown in soils containing selenium

72

Iodide  

A. Ion of iodine  

B. Used in the production of thread hormone  

C. Thyroid hormone helps regulate metabolic rate and promotes growth/development  

Iodide Deficiency  

A. Deficiency- cells of thyroid enlarged in attempt to trap more iodine (goiter)  B. People are sluggish and gain weight  

C. During pregnancy, deficiency can cause extreme and irreversible mental and physical   retardation of developing baby (cretinism)

Getting Enough Iodide  

A. RDA and DV 150 micrograms  

B. Half teaspoon od iodide-fortified salt supplies this amount  

C. Most North Americans consume more than RDA (iodized salt, dairy products, grain   products)

D. UL: 1.1 miligrams  

E. High amounts may appear can inhibit thyroid hormone synthesis and may be more   commonly seen in individuals consuming a lot of seaweed  

Copper (Cu)  

A. 12-75% of Copper is absorbed  

B. Involved in:

1. The metabolism of iron by functioning in the formation of hemoglobin and   transport of iron  

2. The formation of connective tissue  

3. Is a cofactor for antioxidant enzymes  

C. Sources include: liver, legumes, seeds, whole grains breads and cereals, cocoa D. Form found in supplements not readily absorbed  

E. Absorption highly variable- higher intakes associated with lower absorption efficiency  F. Phytates, fiber, excess zinc and iron supplements interfere with absorption  G. Average intake: 1 mg men, 1.6 g men

73

H. Single dose greater than 10 milligrams can cause toxicity, and include symptoms   such as GI distress, vomiting blood, tarry feces, damage to liver and kidney I. Toxicity cannot occur with food, only supplements

J. Wilson’s disease- a genetic disorder that results in accumulation of copper in tissues,   characterized by damage to the liver  

Should You Take A Supplement?

A. There is evidence to support the widespread use or multivitamin and mineral   supplements is mixed  

1. Little risk of harm from consuming a multivitamin

2. Most studies indicate no discernible advantage  

3. NIH concluded that the present evidence is insufficient to recommend for or   against  

B. Only a few studies of vitamin and mineral supplements prevent deficiencies or chronic   disease  

1. High dosage of one nutrient can affect the absorption and metabolism od other   nutrients  

2. Some supplements can interfere with medications

C. Safest and healthiest way to obtain it is from your food  

D. Fortified foods can help fill gaps

Which supplement should you choose?

A. Choose a nationally recognized brand  

B. Be sure not to exceed UL from supplements and fortified foods  

C. Look for UA Pharmacopeial Convention (USP) label  

D. Excess can cause damage to the lover, nervous system, and other organs

Dietary Supplements  

A. Who regulates them?

1. Dietary Supplement Health and education Act (1994) (DHSEA)  

2. Established by Congress  

3. Gives FDA authority to “regulate” them

4. Established the Office of Dietary Supplements under the DIH

74

5. DSHEA definition:

a. Vitamin, mineral, herb, or other botanical amino acid

b. A dietary substance to supplement the diet, which could be an extract   or a combination of the first four ingredients on the list  

B. Who needs them?

1. Use of dietary supplements is a common practice among North Americans and   generates about $35-36 billion annually

2. Can be sold without proof that they are safe or effective  

3. Supplement makers can make broad “structures of function” claims about their   products, but cannot claim to prevent, treat, or cure a disease  

Homeopathic Remedies  

A. Regulated by the FDA  

B. The FDA doesn't look or evaluate them for safety or effectiveness  

C. There is little evidence to support homeopathy as an effective treatment for any   specific condition  

D. Must contain active ingredients that are listed in the homeopathic Pharmacopeia of   the US (HPUS)  

Sports Nutrition

A. Close relationship between nutrition and physical fitness

B. Peak performance depends on a diet the supplies all the needed nutrients  C. Physical activity, exercise, and physical fitness are not synonymous  

D. Physical activity refers to any movement of skeletal muscles that requires energy  E. Exercise specifically refers to physical activities that are planned, repetitive, and   intended to improve physical fitness  

An Intro to Physical Fitness

A. Benefits of physical activity outweigh the risks for most Americans

B. Guidelines  

1. Adults should do 150 minutes per week of moderate-intensity  

2. OR adults should do 75 minutes per week of vigorous-intensity aerobic   physical activity

75

3. OR an equivalent combination of moderate and vigorous intensity aerobic   activity  

4. Episodes of at least 10 minutes, spread through the week  

C. The more you do, the better. There are more extensive health benefits  D. Adults should also include muscle-strengthening activity that involved all major   muscle groups on 2 or more days a week  

E. 80% of American adults fail to achieve levels of physical activity set forth in Physical   Activity Guidelines  

Types of Exercise  

A. Anaerobic  

B. Aerobic- “with oxygen”

1. Moderate intensity  

a. Elevates heart rate and breathing (5-6 on RPE scale)  

b. Brisk walking, dancing, swimming, bicycling (level terrain)  

2. Vigorous intensity  

a. Aerobic activity that greatly increases heart rate and breathing (7-8 on   RPE scale)  

b. Jogging, tennis, swimming continuously, biking (mountainous)

3. Muscle-strengthening  

a. Increases skeletal muscle strength/power/endurance/mass

b. Weight-lifting, etc.

Muscular Fitness

A. Strength is a maximal force a muscle can exert against a load at one time B. Endurance is the ability of the muscle to perform repeated, sub maximal contractions   over time without becoming fatigued  

C. Power combines strength with speed for explosive movements such as jumping or   throwing  

D. Flexibility is the ability to move a joint through its full range of motion. Poor flexibility   is often linked to chronic pain, especially lower back

76

Intensity Levels for Exercise  

A. Heart rate  

1. Estimated maximal heart rate (MHR) = 220 - age

2. Rating of Perceived Exercise (PRE) is relative

B. It’s all relative. Everyone has a different pain tolerance

Ways to Generate ATP  

A. Phosphocreatine (PCr)

1. Anaerobic metabolism mechanism  

2. High-energy compound formed and stored in muscle cells  

3. PCr + ADP —> Cr + ATP

4. Activated instantly to replenish ATP  

5. Sustains ATP  

B. Anaerobic Glycolysis  

1. Has a limited amount of oxygen (intense physical activity- sprinting)  

2. Produces 2 ATP per glucose  

3. 5% of the potential energy from glucose  

4. Replenishes ATP quickly  

5. Cannot sustain ATP production  

6. 30 seconds to make for 2 minutes of work  

C. Aerobic Glycolysis  

1. Plenty of oxygen available  

2. Low to moderate intensity  

3. 28-30 ATP per glucose  

4. about 95% of energy potential  

5. Complete breakdown of glucose

6. Replenished slowly

7. Sustained ATP production  

8. 2 minutes to make for 30 minutes of work  

7. Generates lactate buildup by changing acidity that inhibits glycolytic enzymes

77

Energy for Muscle Work  

A. ATP- chemical energy  

1. Generated from carbs, fat, proteins

2. Used by cells for muscle contractions  

3. Only small amount is stored in resting cells (2-4 seconds worth of work)  B. Other sources of energy are needed

Fuel mixture use depends on the intensity and duration of exercise  A. High Intensity

1. Sprinting  

2. Weight lifting  

3. 30 seconds-2 minutes  

4. Oxygen supply is limited (anaerobic)  

5. Primarily use carbohydrate (glucose) as the source of energy  

6. Glucose is coverted to 2 pyruvate (gain 2 ATP) which are converted to lactic   acids, which can be converted back to glucose through the liver

B. Low Intensity  

1. Oxygen supply is sufficient to meet demand  

2. Oxygen is used by mitochondria to produce more ATP from pyruvate  3. Can also use fat and protein (minor extent) to produce ATP  

C. Resting  

1. More than half of energy comes from fat  

2. Most of rest from glucose  

Metabolism of Fat for Food

A. Majority of stored energy in the body  

B. Triglyceride —> 3 fatty acids + 1 glycerol  

C. Fatty acids are covered to ATP in the mitochondria of muscle cells  

D. Can generate 108 ATP for each 16 C fatty acid chain

E. Trained muscles

1. Have more mitochondria  

2. Have greater ability to use fat as fuel

78

Fat Fuel  

A. Rate of fat use- dependent of concentration of fatty acids in the bloodstream B. Prolonged exercise-fat becomes main food source  

C. Intense activity- fat is not a major source of furor requires more oxygen  

Protein- Minor Source of Fuel  

A. During rest and low/moderate exercise (proved maybe 5% i energy needs) B. During endurance exercise (10-15% energy needs)  

C. Branched chain amino acids provide most of the energy  

Dietary Advice for Athletes  

A. Performance depends on athletic training and genetic makeup. However, diet can   help maximize their potential

B. A poor diet can seriously reduce performance

Carbohydrates  

A. Before exercise

1. Especially important for 90-120 minutes events  

2. 1-2 hour before exercise, low glycemic foods

B. After exercise, lots of protein  

Carbohydrate Loading  

A. Beneficial for athletes who compete in continuous, intense, aerobic vexerce lasting   more than 60-90 minutes  

B. The week before the event, taper down on exercise time and taper up on   carbohydrate in diet  

C. Potential problem- water is added along with glycogen  

D. Can get similar benefits from consuming carbs in the event

79

Protein  

A. Recommendation: 1-1.6 grams/kg

B. Problems with high protein diets  

1. Can increase calcium in urine  

2. Increased urine production  

3. Increased chance of kidney stones  

4. It takes the place of carbs, could lead to early fatigue  

Vitamin and minerals  

A. For the most part, the needs for athletes are the same or slightly greater to sedentary   adults  

B. Need for antioxidant maybe greater (vitamin C and E)  

Calcium  

A. Strenuous Exercise- loss through sweat  

B. Especially important to female athletes  

C. Female athletes who do not menstruate regularly are more at risk for bone fractures   and osteoporosis later in life  

Iron  

A. Women are more susceptible to low iron  

B. Distance runner are at risk- some iron is lost in sweat, feet pounds on the ground can   break red blood, intense training can lead to GI bleeding  

C. Sports anemia- inverse in blood volume  

Fluids  

A. Lose no more than 2% of body weight during exercise

B. 2.5-3 cups for every 1 pound lost during or immediately exercise  

Glycogen- glucose storage  

A. Muscle glycogen (used only by that muscle)  

B. Liver glycogen is released into the blood stream  

C. During low to moderate intensity- can sustain work for up to 2 hours

80

Glycogen Depletion  

A. “Hitting the wall”- depleted muscle glycogen  

B. “Bonking”- depleted liver glycogen  

Sports Drinks  

A. Sports drinks that require less than 60 minutes od exertion or toal weight loss is less   than 5-6 pounds, the primary concern is replacing water  

B. Exercise beyond 60 minutes replacing carbohydrates and electrolytes become   important  

Energy Bars  

A. Carbs or proteins or both  

B. Both seems to work better

C. Tips for choosing a good energy bar  

D. 40 g CHO is less than/equal to 10 g protein and 4 g fat and 5 g fiber

Health Problems Associated with Obesity  

A. Cardiovascular disease and stroke  

B. Diabetes

Obesity  

A. Currently nearly 2/3 of all North American adults are overweight to obese B. The increase in the percentage of overweight/obese adults is very recent  C. What does the relatively rapid increase in the number of overweight/obese people   suggest? Our world was rapidly changed into a technological society  D. Changing environments, linking lifestyle  

E. Is there a “cure” for being overweight? Change in lifestyle?/Medications?

Page Expired
5off
It looks like your free minutes have expired! Lucky for you we have all the content you need, just sign up here