NUTR Exam 2 Study Guide

What is the difference between type 1, type 2, and gestational diabetes?

Carbohydrates

What is the difference between type 1, type 2, and gestational diabetes? T1: autoimmune; since childhood, body makes no insulin, not a major life change.

T2: developed, beta cells immune to insulin; preventable; life altering; main cause from obesity and poor diet (T1 & T2 can lead to vision loss, amputations, heart issues and circulation loss, loss of sensation)

Gestational: caused by baby growing, too much glucose being made; addressed with insulin shots and at times diet and exercise. (Unaddressed it can cause birth defects; both mother and child at higher risk for T2)

What are the ideal blood glucose levels, when fasting? We also discuss several other topics like How do you know if mrs is diminishing?

Fasting: below 99 is Normal; 100‐125 is Pre Diabetic; above 126 is Diabetic

What are the ideal blood glucose levels, when fasting?

Proteins

What makes proteins unique?

The nitrogen group and side chains

Describe deamination and transamination.

Deamination: the absorbing and recycling of amino acids; excretion via urea and recycling of carbon skeleton for energy

Transamination: changing one amino group into a carbon; creates carbon skeleton and non‐essential amino acids

Define essential, nonessential, and conditionally essential amino acids.

Essential: we don’t need to eat them, they are made by the body; are dispensable Non‐essential: we must get them in diet, they are indispensable

Conditionally essential: high need in infancy and illness; repair process

what is the structure of amino acids?

What makes proteins unique?

Contain a carbon, hydrogen, oxygen, and sulfur; a nitrogen (amino) and acid (carboxyl) group; and a side chain

what are the different protein levels?

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describe protein synthesis; include translation, transcription and bonding.Don't forget about the age old question of What is the u shaped learning pattern?

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what causes protein denaturation?

3D shape is changed and/or destroyed; bonds are broken down into smaller amino acids; happens in cooking, heat, and alkaline reactions and or digestion

where does protein begin to digest? what enzymes make this happen in the stomach? What enzymes are involved in protein digestion in the small intestine? where is come from? how are proteins absorbed? are whole proteins absorbed?

Are proteins stored? what is input and output? describe the amino acid pool. What do proteins do in the body? how do they maintain fluid balance? what is it kcal/g (energy)? Animal protein vs Plant protein

incomplete proteins vs complete proteins

what amino acids are limiting in beans, nuts, and grains?

what nutrients are a concern for vegetarian/vegan diets?

RDA of protein?

Describe nitrogen balance?

Describe protein­energy malnutrition.

What are the effects of too much protein

Lipids

What’s the primary storage of lipids?

Triglycerides and ester bonds

The structure of Triglycerides, DIglycerides, and Monoglycerides

Tri: Glycerol + 3 fatty acids

Di: Glycerol + 2 or more fatty acids

Mono: Glycerol + 1 fatty acid We also discuss several other topics like What is meant by totipotent cell?

Define esterification, de­esterification, and re­esterification

E: reactions forming bonds with fatty acids and glycerols

De‐E: removing fatty acids from glycerols

Re‐E: reattaching fatty acids to glycerols

How do fatty acids differ? what makes them stable and define state of matter? classify fatty acids on chain length, saturation, and hydrogen position. based on images.

Know what saturated, polyunsaturated, monounsaturated, and trans fats look like. know their major food sources.

How does hydrogenation affect their structure?

what are the essential fatty acids? be able to identify their molecules and dietary sources.

what are the functions of essential fats in the body?what do they become? how do they influence the body?

Describe phospholipids. their structure, food source, and functions; where are they made? What does bile do in lipids? what is the bile and fat called?

what does pancreatic lipase do?

what do triglycerides become before absorption?

Broken down to monoglycerides and free fatty acids If you want to learn more check out What is a level set of a function?

describe lipid digestion, absorption, and transport. know lipoproteins.

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what do you call reverse cholesterol transport?

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determine modifiable and nonmodifiable risk factors of CVD. We also discuss several other topics like How do cladograms work?

Modifiable factors: you can stop smoking, prevent obesity, and increase physical activity, change diet Non‐Modifiable factors: age gender, race and genetics

what contributes to CVD?

1) Inflammation: this is from poor diet and high levels of LDL

2) High LDL cholesterol forming plaque

3) Hypertension: damaging blood vessels and increasing chance of atherosclerosis What is atherosclerosis? describe plaque formation.

When the blood vessels are narrowed decreasing O2 and nutrients; Build up plaque can break free and block blood flow, creating dead tissue If you want to learn more check out What happens when you cut off blood supply?

Plaque occurs from oxidation of LDL; in injury and inflammation, making plaque cells which stick and build up

what fats contribute to CVD?

Trans Fats and high LDL

what are the normal levels or HDL, LDL

LDL: less than 100mg/dl is normal; 130+ is abnormal

HDL: above 50mg/dl is good; 30 mg/dl or less is low

Cholesterol: less than 200 mg/dl overall is optimal

What is the recommended level of essential fatty acids intakes?

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Alcohol

Is alcohol a nutrient? what is its energy yield?

It is not a nutrient, but has a 7 kcal/g nutrient energy

what defines a standard drink?

Beer: 12oz; Wine: 5oz; Liquor: 1.5oz

describe fermentation.

Via malting, complex carbs are broken down into simple sugars: ie potatoes, barley, and rice.

Using yeast, CHO is absorbed in aerobic conditions (o2 use); Yeast ferments and uses anaerobic conditions (used up 02)

where is alcohol absorbed? where is it done the most? How does food affect this? 20% in the stomach, 80% in the SI; when consuming a high fat meal the alcohol remains in the stomach longer, this allows it to be absorbed slowly and will not enter the blood stream thus impairing the brain.

Name the primary pathways for alcohol metabolism? when do they engage, and where do they occur?

ADH: first ethanol becomes alcoholic dehydrogenase, then Acetaldehyde dehydrogenase; lastly converted to Acetyl‐CoA and turning enzymes into fatty acids. This happens in the liver 90% of the time

MEOS: also ends in Acetyl‐CoA; however needs NADPH as energy; this processes builds tolerance and reduced the liver ability to metabolize medication. This happens in the liver.

Acetaldehyde: promotes the dizzy and nausea feeling, as well as flushed appearance when drinking

what enzymes are involved in metabolizing? what happens when it build up? ****

Describe the short­term effects of feeling drunk.

1) The pleasure chemicals, dopamine and serotonin are triggered

2) EtOH binds and excitatory synapses thus slows brain function; speech and motor skills 3) EtOH binds and inhibits synapses and enhances transduction

Therefore decreased mental capacity occurs and you are happy.

Women and alcohol vs East Asians and alcohol.

East Asians: have high alcohol dehydrogenase; have low levels of aldehyde dehydrogenase This results in high levels of acetaldehyde; causing nausea, dizziness, and flush face Women: have lower levels of alcohol dehydrogenase and 30‐35% alcohol remains in blood

This is based on how men usually have more muscle than women; the more muscle the more water to hold alcohol from reaching the brain and blood

What are the guidelines for intake?

Ideally: ½ drinks every hour; this allows consumption to even out with liver capacity Moderate Intake: 1 drink a day for women; 1‐2 drinks a day for men (UL recommendations)

what happens to the liver, describe the health effects?

Steatosis (fatty liver) can cause a beer belly, and happens every time you drink;

Hepatitis (occurs with persistent drinking) causing the liver to be inflamed, and killing cells and can create a case of jaundice

Cirrhosis (loss of function in the liver): caused by hepatitis and extreme drinking habits (~7 or more beers a day for 10 yrs); this is incurable and 50% of patients die

How does alcohol affect nutrition status? Which nutrients are impaired?

You can become Protein‐energy Malnutrition: where alcohol over takes the need for food

This inhibits the absorption of thiamine, B12, folate and calcium; you lose more B6 and magnesium; liver functions are impaired (lack of fat soluble vitamins); loss of iron from GI bleeding

What is the link between alcohol, thiamin, and the brain?

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How does alcohol affect pregnancy?

Inhibits nutrient and oxygen delivery to fetus, thus slowing growth and development Fetal Alcohol Syndrome: causing learning, behavioral, and brain abnormalities

As little as 1oz a day can cause this.