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899 Cards in this Set
- Front
- Back
What are the two parts of digestion?
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Anatomy and muscular actions
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What are the two parts of absorption?
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Anatomy and intestinal cells
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What are the two parts of the circular system?
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Vascular and Lymphatic systems
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What regulates digestion and absorption?
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Hormones and nerve pathways
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Where does digestion take place
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The GI tract
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Absorption?
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Walls of the GI tract, mainly the small intestine
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Transport?
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Blood and the lymphatic system
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Metabolism?
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Cells within target tissues
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Excretion?
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Large intestine (via anus), kidney, skin hair and nails.
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What is the first step of nourishment?
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Ingestion
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What internal and external cues prompt nourishment?
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Hunger, Appetite, and Satiety
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Is hunger internal or external?
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It is an internal physiological drive
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Is appetite internal or external?
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It is a learned response, nonphysiological, external cues (sight/aroma)
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What is satiety?
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When you stop eating
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Is satiety internal or external?
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Both feeling (Internal) and learned (external)
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What is digestion?
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Process when foods are broken down into absorbable units
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Digestive process
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Pharynx
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Moves food from mouth to esophagus
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salivary glands
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Secrete saliva that has enzymes to break down starch
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Epiglottis
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Protects airway during swallowing
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Trachea
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Allows air to pass to and from lungs
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esophagus do
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Passes food from mouth to stomach
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Esophageal sphincters
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Prevent backflow from stomach to esoph. And esoph to mouth.
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Stomach
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Acid + enzymes and grinds food to liquid mass
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Pyloric sphincter
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From stomach to small intestine
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Liver
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Makes bile salts, detergent like substances to digest fat
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Gallbladder
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Stores bile until needed
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Bile Duct
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Condcuts bile from gallbladder to small intestine
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Illeocecal valve
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(spincter): gmall to large intestine
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Appendix
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Stores lymph cells
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Small intestine
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Enzymes that digest nutrients into smaller parts. Cell walls absorb into blood and lymph
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Pancreas
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Digests nutrients and releases bicarbonate to neutralize acid chime
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Pancreatic duct
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Moves pancreatic juice from pancreas to SI
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Large intestine
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Reabsorbs water and minerals. Passes fiber, bacteria and unabsorbed nutrients w/ water to rectum
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Rectum
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Water pre-elimination
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Anus
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Holds rectum closed. Opens to allow elimination
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What are digestion and absorption?
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Processes that make nutrients available for body to use
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What is salivary amylase?
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Enzyme that breaks down starch in mouth
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How long is the esophagus?
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10 inches.
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What is peristalsis?
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Flexing of mucles that move food thru esoph to stomch
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What does the cardiac spyhincter do?
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Closes from esoph so food stays in stomach
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What is chime and what does it trigger in the stomach?
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Semi-liquid mass of partly digested ood that driggers the release of gastrin
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What does gastrin do
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Releases hydrocholoric acid
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What is HCL stomach PH
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2
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What does protease digest?
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Protein
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What does lipase digest
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Lipids
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What is pepsin
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Helps digest proteins
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What sphincter does the stomach use to move chime to the SI?
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Pyloric sphincter
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Length of the duodenum
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10 inches
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The jejunum?
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8 feet
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The ileum
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12 feet
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What triggers release of pancreatic juice?
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Chyme
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What do pancreatic enzymes do?
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Digest CHO, fats, proteins. Release bicarbonate to boost PH to 5.5-6.5
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What does liver secrete
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Bile which solubilizes or emulsifies water-insoluble fats
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What does gallbladder do?
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Stores and concentrates bile between meals and releases it during meals
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What is absorption?
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How simple nutrients move from GI lumen into GI cells
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Where does most absorption occur?
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Small intestine
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What are villi and microvilli and how much do they increase in area
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They are intestinal folds. Villi increase 15 times, microvilli, 300. Most absorption takes place here
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What does the ileocecal valve join?
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The small and large intestines
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What reabsorbs water and salts?
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The colon
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What is shit made of?
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Dietary fiber, microorganisms, water
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Where else does excretion take place?
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Kidney,skin, liver, epithelial cells, hair and naisl, lungs
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What are the three types of absorption?
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Passive diffusion, facilitated diffusion, and active transport
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What is active transport?
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A carrier loads a nutrient outside the cell and then releases it on inside of the cell
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Does passive diffusion require energy?
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No
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What is faciliatated diffusion?
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Requires some help moving across membrane. Min to no energy
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How do the following affect GI function
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Physical immaturity
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Infants vomit
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Aging
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You get constipated
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Illness
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You get diarrhea
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Nutrition
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Low fiber fucks up GI structure & function
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What are common digestive dishorders
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Constipation, heartburn. Ulcers, heatburn. Iritable bowel syndrome. Diarrhea. Flatulence. Stomach growling
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What system transports fats?
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The lymph system
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What transports carbs and prot?
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The vascular, or circulatory system
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What is the lymph system made up of
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Lymph nodes, tonsils, thymus, spleen, lymph vessels
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What is circulatory system
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Arteries, heart, veins
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What do you need to digest fat and carbs? To digest protein?
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Water, CO2 and heat. H20, N, CO2 and heat
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What is a calorie?
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Amount of energy to boost one kg/4 cups of water from 15 to 16 C. 59 to 61 F
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How does bomb calorimeter work
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Food gets burned, water temperature increase measured
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Where does energy go?
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Basal metabolism (at rest). Dietary thermogenesis. Exercise induced thermogenesis
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How much does basal generally consume?
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2/3rds of total energy
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Do tall thin ppl or short fat ones consume more energy. Why?
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Tall thin ones, bc they have more surface area
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Estimate basal metabolism
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Body weight * 11 (dudes). Bw * 10, women
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What is thermogenesis?
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Thermic effect of food. 1/10th of energy expenditure. Chewing, digesting, absorbing, transporting, storing excreting
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Energy expenditure calculation
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Basal Met: Weight x 10 or 11
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Phys Act: BM * .3, .5, .75
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Dietary Therm: .1 * (BM + PA)
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Total: BM + PA + DT
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What is adaptive thermogenesis
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Adapting to stress, temperature extreme or injury.
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What is obesity?
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Excess body fat. A chronic disease. Treated as a subacute illness in which time limited treatments lead to cure
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What is body weight composed of
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Fat, lean tissue and water
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What are obesity trends?
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Overweight increasing in 6-19 yos. Overweight adults, constant. Obesity in adults skyrocketing
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What is the body mass index?
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(Weight in Kg)/ (Height in meters ^2)
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What is Underweight?
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<18.5
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Normal weight?
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18.5-24.9
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Overweight?
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25.0 – 29.9
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Obesity I?
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30-34.9
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Obesity II
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35-39.9
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Morbid Obesity?
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>40
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In 1990, 10 states had obesity < A%, and no states had >B%.
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10%, 15%
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1998: no state had less than C%, 7 states btwn D% and E%. No state >E%
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10%. 20-24%. 25%
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2007: only Colorado had less than F%. 30 states > G%. 3 states > H%
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20%. 25%. 30%
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What % of US pop overweight or obese?
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72.90%
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What % obese?
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34.30%
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How many deaths?
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400,000
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What cost?
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117 billion in economic costs. 61 billion in direct costs
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Healthy male body fat %?
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10-25%
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Female:
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18-32%
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What does subcutaneous mean
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Under the skin
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Where do apples store their fat?
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Around their abdomen
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Where do pears store their fat?
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Around their hips and thighs
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Which is worse? Why?
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Apple. Central/android obesity more metabolically active and linked to type 2 diabetes, high BP, cancer. Does inflammation damage to blood vessels and is more common in men
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What are the failings of BMI?
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Does not consider. % fat, % lean. And fat distribution btwn subcutaneous and visceral
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What are anthropometrics?
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You use the waist to hip ratio, fat fold measures, and waist to height ratio
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What is hydrodensitometry
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Underwater weighing, which is the gold standard
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What are some other ways of measuring body comp?
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Bioelectrical Impedance, Potassium counters, dual X ray absorptometry
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What are problems w/ being underweight?
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Exacerbates diseases esp in wasting diseases. Cease menstruating when fat < 12%.
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How much does type 2 diabetes risk increase due to obesity?
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3x
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What cancers is obesity associated with?
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Breast, colon, gallbladder, cervix, uterus, ovaries, prostate.
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What is hypertension?
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High blood pressure
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What % of sleep apnea attributable to obesity? Type 2 diabetes? Gallbladder?
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95%. 61%. 30%
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Know the reasons for obesity
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Genetic, Metabolical and physiological, environmental.
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What is goal of weight management/treatment?
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Prevent further weight gain, reduce body weight, then maintain over long term
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Strategies for weight loss/ maintenance
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Dietary therapy, physical activity, behavioral therapy, combined therapy, pharmacotherapy, weight loss surgery
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What is a good weight loss goal for therapy
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Down 10% body weight in 6 months. Moderate calorie deficits: -500 or -1000. 1-2 lbs per week.
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How much in a pound of fat
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3500 kcla
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Why is gradual weight loss good?
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Prevents bone and muscle loss
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Lecture 3
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What BMI do you have to have for medical treatment?
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BMI >30 or >27 with comorbidities
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What 2 weight loss drugs approved
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Sibutramine (mEridia), orlistat (alli)
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How does Orlistat work?
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Bonds with gastrointestinal lipase to prevent about 1/3 of dietary triglyceride from being digested
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What is a disadvantage of weight loss drugs?
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The lost weight does not generally stay off when you discontinue treatment
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What are comorbid conditions?
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Cardiovascular, sleep apnea, uncontrolled diabetes
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What is gastric bypass
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The stomach almost is completely removed from GI nutrient flow
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What are complications of g bypass
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Nausea/vomiting, dumping syndrome, malabsorption of vitamin b12, folate, calcium and iron. Dehydration, inection, behavioral and psychological changes
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What is adjustasble gastric band
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You put a band around the stomach to create a small stomach pouch
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What is vertical banded gastroplasty
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You use a band and staples to create a small stomach pouch
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What is liposuction. What are its limits?
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Maximum of 8 lbs per procedure in US. Fat active tissue releases hormones that causes you to redistribute body fat after the op
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Eating disorders
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What is anorexia nervosa
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Self starvation, when you are less than 85% of your healthy weight. 300-700 cals per day. Body dsmorphia
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What are side effects of AN
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Amenorrhea: early osteoporosis, lack of estrogen. Hypothermia, Death
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% of ppl w/ AN
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1% of women, and .1% of men. Risky for dieters, dancers, athletes, nutritionists and dieticians, diabetics
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Treating AN
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Takes years usually, requires prompt restoration of healthy and body weight. Use mdedication, therapy, eating behavior analysis and phys act programs.
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What is the relapse rate for AN treatment
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33%
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How often do you need to purge to have Bulimia nervosa
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At least twice a week for three months
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What % of pop. Has Bulimia?
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1-3% of women, .5% of men.
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What are side effects of BN
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Acid from vomit rots teeth. Dehydration and electrolyte loss. Depression, abdominal pain,history of abuse, normal or overweight
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What treats BN
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Breaking the cycle w/ an organized eating pattern. Psych counseling and antidepressants.
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How much does pregnancy improve BN
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In 70% of cases, pregnancy improves the condition
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What is relapse rate for BN?
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33%, same as AN
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What are traits of binge eating?
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Excessive intake without a purge that is both compulsive, secretive, and guilt inducing.
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What % of the obese exhibit binge eating
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30-90%
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What is Pica, Geophagia, Pagophagia, amylophagia, plumbism, and coprophagy
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Eating nonfood. Geo-clay dirt. Pago-ice. Amylo-laundry starch. Plumbism-lead. Coprophagy: feces
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Carbs
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What % of diet = carbs
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55-60%
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Chem structure
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C6H12O6
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What are the simple carbs?
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Mosnosaccharides and disaccharides
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What are the 3 monosaccharides
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Glucose, Fructose, and Galactose
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What is glucose also known as
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Dextrose
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Is glucose an essential energy source
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Yes
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How is glucose important to disaccharides
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It is one part of every disaccharide
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What is fructose also known as
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Levulose
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What is the sweetest sugar
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Fructose
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What is the rarest lone monosaccharide
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Galactose
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Glucose + Galactose =
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Lactose
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Fructose + Glucose
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Sucrose
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Glucose + Glucose
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Maltose
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Where do you find sucrose?
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Table sugar and honey
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Where do you find maltose?
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Broken down from starch
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What does maltose look like?
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Two hexagonal glucoses bonded with an oxygen in the middle
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Lactose
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Similar to glucose but trans: across the oxygen bond
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Sucrose
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Just like maltose with a fructose instead of a glucose
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What is glycogen?
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Storage form of glucose in animals. It is a branched molecule glucose polymer
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What is the function of glycogen?
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Maintains blood glucose between meals and provides muscle with energy during anaerobics
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What are the limited forms of glycogen?
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Liver and muscle
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What is the unlimited form>
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Stored in the fat
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What stores glucose in plants/
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Starch
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What are the two amyloplasts?
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Amylose and amylopectin.
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What are the prevalence %s of the amlyoplasts?
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Amylose is 30%. Amylopectin is 70% (more common)
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Which amyloplast is linear?
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Amylose
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Which is branched, but less extensively than glycogen?
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Amylopectin
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What digests carbs in the mouth
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Salivary amylase
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What digests salivary amylase and where?
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HCl in the stomach
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Do ppl break down starch?
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No
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What breaks down amylase and dextrins and where?
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Pancreatic amylase in the small intestines
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What digests sucrose, lactose, and maltose and where?
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Sucrose, lactase, maltase. Small intestine
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What form of transport occurs for CHO absorption?
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Active transport
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What vein is CHO absorbed into and where does it lead?
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The portal vein. It goes to the liver
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What do galactose and fructose get converted into and where?
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In the lvier, they get converted into glucose
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Where exactly in the small intestine do monosaccharides enter before going thru the portal vein?
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The capillaries of the intestinal villi
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Where do you find fiber in the digestive tract?
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The large intestine
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What breaks down some fiber?
|
Microflora, a bacteria in the large intestine
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What causes lactose intolerance?
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Not having enough lactase
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Walk thru the process of drinking milk for lactose int. person
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Undigested lactose gets fermented by GI bacteria and produces gas and acids which give bloating, pain and diarrhea
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What can you take to lessen this?
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Lactaid supplements (lactase tabs) or milk with lactase. Eating aged cheese is better than cottage cheese. Fermented milk easier
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What groups highly lact. Intolerant?
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Asian, native American, African American
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How else does L.I. develop?
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Damage to the villi from illness, medications, malnutrition. Def. from birth or old age.
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How are starch and fiber different
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Different glucose orientation. Cellulose has a beta acetal, starch has an alpha acetal
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Can we digest starch and fiber?
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No, only starch is an energy source for us
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What are the 4 types of indigestible starch?
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Cellullose, pectins, gums, and lignin
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Where do you get cellulose but not pectins?
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Legumes. You can get both in fruits and veggies
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Which fibers are water soluble?
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Gums and pectins
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Why is this useful?
|
Prolongs stomach emptying time so sugar uptake regulated. Means lower blood cholesterol.
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Where do you get water soluble fibers
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Oat bran, barley, legumes, fruits
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What are the water insoluble fibers? What foods have them>
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Cellulose and lignin, found in veggies wheat and grain
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What do they do metabolically?
|
Increase fecal bulk and decrease intestinal transit time.
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Is glucose essential?
|
Yes. Body incurs harm when converting fat/protein to glucose
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Proper glucose concentration
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80-120 mg/dl
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Where is excess glucose from meals stored?
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Liver and muscles; limited. Fat reserves; unlimited
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What are the two primary hormones regulating blood glucose
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Insulin and glucagon.
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Where are they released?
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Pancreas
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What does insulin do
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Transports glucose into cells
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What does glucagon do
|
Releases glucose from storage
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What is gluconeogenesis
|
When protein gets converted into glucose when you have too little glucose in the meal
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What is ketosis
|
Fat getting converted to ketone bodies to give muscles energy, does not give brain support
|
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Symptoms of low/high blood glucose
|
Low: weakness, coma, death. High: vasculature damage, peripheral nerve damage, wasting syndrome
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What does high blood glucose do to the pancreas?$
|
It tells it to release insulin
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What does extra insulin do?
|
Says, uptake glucose. Store it as glycogen in liver and muscles. Store as fat.
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When your blood glucose gets low, what does your pancreas do?
|
Releases glucagon into the bloodstream
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What does glucagon tell your liver to do?
|
Break down glycogen and turn it into glucose
|
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What is type 1 diabetes? Type 2? Gestational
|
Type 1: insulin dependent diabetes mellitus IDDM. Destruction of pancreas. Type 2: Non insulin dependent diabetes mellitus; insufficient use of insulin. Western diets and phys inactivity. 3-6% of preggers get gestational diabetes
|
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Does sugar cause diabetes and hyperactivity
|
No
|
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When you have lots of complex carbs in your diets?
|
Less CVD, blood cholesterol. Less diabetes, constipation, appendicitis, diverticulosis
|
|
How much fiber should you get a day
|
25 gm/day or 11.5g/1000 kcal
|
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What does too much fiber do
|
Can displace kcal and nutrients. Cause intestinal discomfort. Interfere w/ mineral and nutrient absorption.
|
|
Where does alcohol get absorbed
|
Stomach and small intestine
|
|
Is alcohol a nutrient
|
NO
|
|
Benefits of alcohol
|
Increased HDL-cholesterol, protects against heart disease
|
|
Adverse effects
|
Hypertension, stroke, liver cirrhosis, cancers, nerve system disorders. Fetal alcohol syndrome. Not enough thiamin: delirium tremens
|
|
Proteins and vegetarianism
|
|
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What is the basic structure of an amino acid
|
Central carbon, hydrogen, acid, amino group
|
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What differentiates amino acids
|
Their side groups
|
|
How are amino acids connected
|
A peptide bond
|
|
How are peptide bonds formed
|
Condensation reactions
|
|
What is the protein conformation?
|
The 3d structure which dictates the type and function of the protein
|
|
What is the amine group?
|
NH2
|
|
What is the acid group
|
COOH
|
|
How many essential amino acids are there
|
9. 11 nonessential
|
|
What is hydrolosis
|
Chem breakdown of a protein
|
|
What is denaturation and what causes it
|
Prot. Losing its 3d structure due to acidic env.
|
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What does HCL do to pepsinogen
|
Converts enzyme pepsinogen into active pepsin
|
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What other pep____ gets broken down
|
Pepdtidase
|
|
Where do the previous 4 qs happen
|
Stomach
|
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Where are the pancreatic and intestinal proteases and what do they do?
|
They are in the small intestines and they are used to break down peptide bonds
|
|
What are proteins broken into?
|
Oligopeptides, dipeptides, and tripeptides
|
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Once broken up what happens
|
They go into the intestinal cells thru the membrane via active transport
|
|
What is the function of protein?
|
Growth maintenance and repair of tissues. Regulate body processes such as fluid blance to prevent edema. Buffers immune system by keeping correct PH.
|
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In prot synth, what is transcription
|
Take DNA and turn it into RNA.
|
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What is translation
|
Take RNA and turn it into an amino acid
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What is cytoplasm
|
Lattice type structure that supports and controls movement of other cell structure
|
|
Where are the enzymes involved in glycolysis contained
|
The cytoplasm
|
|
Where is the DNA contained
|
The nucleus
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What are known as cell powerhouses and what are they shaped like
|
Mitochondria. Intricately folded membranes that house all enzymes in the TCA cycle
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|
|
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What is the process of DNA creation?
|
DNA serves as a template to make messenger strands, MRNA. MRNA attaches to cell ribosomes, protein making machinery. TRNA grabs amino acids from the cell fluids, and MRNA sets them up correctly
|
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What is an example of an error in protein synt
|
Sickle cell anemia. One AA is wrong, causing structure to get messed
|
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What does prot synth require
|
Calories, essential AA from AA pool. Non essential from synth or diet.
|
|
How long is the life of a red blood cell
|
120 days
|
|
What are hormones
|
Compounds made in one cell or organ that elicit effects on other organs.
|
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How long is half life of insulin
|
6-10 mins
|
|
How do proteins regulate fluid balance?
|
They affect osmotic pressure, which defines movement of water.
|
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If prot concentration is low what happens to the solute conc. In the interstitial space/
|
It has increased. Now water will leave the blood vessels to enter the increased interstitial space. This is edema
|
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How do proteins regulate acid/base ballance
|
Proteins are negatively charged and attract hydrogens
|
|
What do proteins in blood transport?
|
Glucose, water insoluble compounds, fat steroids, hormones, vitamins
|
|
What are proteins receptors for?
|
Insulin, glucagon, estrogen (hormones)
|
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How do proteins ensure immune sys health
|
By serving as antibodies
|
|
Name 3 other random ass functions of protein
|
Neurotransmitter, preventing blood clotting, and changing visual pigments
|
|
What are the normal losses affecting our nitrogen balance?
|
Urine, feces, sweat, skin hair
|
|
What is a negative nitrogen balance
|
We do not get enough nitrogen compared to how much is leaving. Increased by stress or injury
|
|
What happens when you are deficient in nonessential amino acids
|
Your body protein will be broken down into the correct forms
|
|
What is deamination?
|
The removal of the amino group from a protein. It is the first step in protein metabolism
|
|
What is the second step of prot metab
|
The carbon skeleton is used to make glucose for energy. The rest is used to make fat in lipogenesis.
|
|
Is the nitrogen from amino acids reused?
|
Yes. Some for synthesis. The rest gets extcreted in urine
|
|
What happens when you have too much prot
|
Loss of calcium in urine, and causes kidney disease problems
|
|
Where do you find complete proteins?
|
Animals, and egg protein
|
|
How do you define an incomplete protein?
|
Lacks a limiting amino acid.
|
|
What is a limiting amino acid
|
One essential amino acid that is not present in sufficient amounts. Cereals lack lysine, legumes lack methionine.
|
|
What % of US protein is from animals
|
70%
|
|
What is a complementary protein?
|
Combine a legume with a different plant protein to get a complete protein (e.g black beans and rice, pb and bread)
|
|
What are protein requirements?
|
.8 gm/kg of body weight. 46 gm for women. 58 gm for men. 10-35% of kcal from protein
|
|
Athletes need about 1.26 gm/kg
|
|
|
How much does typical US person consume?
|
>80 gm for women. >110 g for men. 15% kcal from protein.
|
|
Amino acid supplements
|
Very bad. Tryptophan supps banned in 1990. Causes diarrhea, loss of appetite, bad GI
|
|
Lacto vegetarians
|
Omit all meat but eats dairy
|
|
Ovo vegetarians
|
Eats eggs
|
|
Vegan
|
Plant food only
|
|
Far vegetarians
|
Omits red meat
|
|
Quasi
|
Omit red meat and poultry
|
|
Ups and downs of veggies
|
Can lead to protein energy malnutrition. Can also lack b12, D, CA and Zn. Can be very healthy and preventative to diseases
|
|
What does PEM stand for? PCM
|
Protein energy malnutrition, and protein calorie malnutrition
|
|
What is the primary cause of PEM and PCM? Secondary
|
Inadequate food intake is the primary. Secondary causes are disease states that unbalance nutrient maintenance
|
|
What are the social and economical causes of PEM and PCM
|
Poverty, ignorance, inadequate weaning practices, social and cultural problems
|
|
How many ppl are undernourished
|
800 million ppl
|
|
How many infants die every year due to starvation
|
40,000
|
|
What is underweight and what % of children are? (All developing world)
|
36% underweight
|
|
Same for stunted
|
Height for age. 43%
|
|
Same for wasted
|
9%. Weight for height
|
|
What is it when you have low prot
|
Kwashiorkor
|
|
What is decreased energy
|
Marasumus
|
|
What is dec. prot and energy
|
Marasmic
|
|
Where is this most relevant in developed world?
|
Hospitals, where patients are too sick to eat
|
|
What is severe and chronic PEM?
|
Marasmus. Children 6-18 months. Impairs brain development and learning. Muscle wasting, including heart. Infection, diarrhea
|
|
What is acute PEM?
|
Kwashiorkor: “The sickness the older gets when the next child is born”. Inadequate protein intake or infection. 33% of children lower than 5 in developing countries. 21% of all ppl in developing countries. Weight loss, edema, enlarged fatty liver. Dry brittle hair, loss of hair color
|
|
Lecture: Fats and cholesterol
|
|
|
What are the 4 classes of lipids
|
Fats, Oils, cholesterol, and phospholipids
|
|
What is a glycerol with 3 fatty acid chains. What % of diet fat and body fat stores
|
A trygliceride. 98%
|
|
How long are most fatty acids
|
4-24 carbons. 18 most common. Always even numbers
|
|
How long should a meat/fish be
|
24-Dec
|
|
How long should a dairy be
|
6
|
|
What is Omega 3 called?
|
Linolenic acid. First point of
|
|
What is omega 6 called
|
Linoleic acid
|
|
What do the 6 and the three refer to?
|
The point of unsaturation on the carbon chain
|
|
Are lipids hydrophobic or hydrophilic?
|
Both. The carboxyl end COOH is hydrophilic. The methyl end is hydrophobic (CH3).
|
|
The presence of what kind of bonds make a fat “Unsaturated”
|
Carbon carbon double bonds. The fat is “saturated” with hydrogens and a double bond means less hydrogen
|
|
Are sat fats solid at room temperature?
|
Almost always
|
|
What foods have sat fats?
|
Meat, dairy products, butter, and palm and coconut oil
|
|
What is a monounsaturated fat?
|
They have one double bond
|
|
Are they liquid or solid at room temp>
|
Liquid
|
|
What is a polyunsat fat?
|
More than 2 double bonds. They are highly unsat
|
|
Liquid or solid?
|
Liquid
|
|
What kind of fatty acids are omega 3 and 6
|
Polyunsaturated
|
|
When you desaturate stearic acid and get oleic acid, what are you doing?
|
Making a nonessential fatty acid
|
|
What are linolenic fatty acids?
|
Primary omega 3. EPA (20:5) and DHA (20:6)
|
|
What are linoleic acids?
|
Omega 6, and arachidonic (20:4)
|
|
What defines the # after “Omega”
|
Where the double bond is closest to the methyl
|
|
Where can we get linoleic acid. What omega?
|
Omega 6. We can get it from veggie oils or poultry fat
|
|
Arachidonic acid?
|
Meats or from linoleic. Omega 6
|
|
What do oils, nuts, seeds and veggies give us?
|
Omega 3
|
|
What do human milk, shellfish and fish give us
|
EPA and DHA, which are types of omega 3
|
|
What is the ideal ratio of O6 to O3
|
4:01
|
|
What % of dail Kcal should omega 3 be
|
.6-.12%
|
|
What oils are rich in sat fats?
|
Coconut, butter beef tallow, palm, lard
|
|
Olive, Canola, and Peanut have lots of
|
Monounsat fat
|
|
Safflower, Sunflower, Corn, Soybean
|
Omega 6 and polyunsaturates
|
|
Are western diets insufficient in omega 3 or 6
|
Omega 3. Western diets have a 16:1
|
|
What problems caused by messed ratio
|
Cardio disease, cancer, autoiummune disease
|
|
What decrease in mortality by 4:1
|
70% decrease in mortality.
|
|
Why hydrogenate and what does it do
|
Improves texture, taste & cooking properties and shelf life. Adds H at double bond. Becomes solid at room temperature. Decreases health benefits bc it goes from Cis to trans
|
|
What is CIS
|
Hyrogens on the same side of the double bond, inverse C
|
|
What is trans
|
Hydrogens on opposite side so it forms a line
|
|
Does a trans act like saturated or unsaturated?
|
Saturated, solidified chain
|
|
What are prostaglandins
|
They are in charge of inflamtory responses, clot formation or clot prevention, hormone regulation
|
|
What are thromboxanes
|
In charge of clot formation.
|
|
Eicosanoid derived from omega 6 do what. What about omega 3
|
Constrict blood vessels, cause clotting and inflammation. Dilate blood vessels, discourage clotting, reduce inflammation
|
|
Cell membrane formation and lipid transport of lipoprots and cholesterol done by what FA containing thing?
|
Phospholipids
|
|
Can cholesterol be from nonanimal sources
|
Nope
|
|
How much of bile made in the liver
|
3-Feb
|
|
Does bile contain fatty acid?
|
No
|
|
What do plant sterols or phytosterols do?
|
Reduce cholesterol absorption
|
|
Does bile aid fat digestion?
|
Yes. It acts as an emulsifier. It holds fat in suspension so enzymes can break down tryglicerides
|
|
Where is bile stored?
|
The gallbladder
|
|
What does sterols cholesterol do?
|
Regulates hormone production of estrogen, testosterone, and adrenal hormones such as corticosteroids
|
|
Do sat fats or food cholesterol raise cholesterol more
|
Sat fats
|
|
How does fiber hope lower cholesterol
|
Sequesters cholesterol from bile
|
|
What does fat release when it enters the small intestine?
|
CCK, which gallbladder causes to release bile into the small intestine
|
|
When intestinal lipase attacks what happens
|
Breaks triglyceride into a free fatty acid and 3 monoglycerides
|
|
Describe bile process
|
Cholesterol into the liver, mixes with bile salts, goes thru gallbladder, thru small intestine, into colon. Then portal circulation sends it back to the liver
|
|
How much cholesterol is converted into bile acids and eliminated in ble every day
|
500 mg
|
|
How much of the bile acids going into the duodenum are absorbed back into the blood within the ileum?
|
95%
|
|
Where is bile synthesized?
|
The liver
|
|
Where is it stored?
|
The gallbladder
|
|
Where is it secreted?
|
The common bile duct
|
|
What is it called when bile is reabsorbed?
|
Enterohepatic circulation. Entero refers to the intestine. Hepatic refers to the liver
|
|
How are small fats absorbed?
|
Diffuse directly into the intestinal cells and absorbed into the blood
|
|
How are larger fats absorbed?
|
Micelles are emulsified fat droplets surrounded by bile. Glycerides and fatty acids reform to triglycerides in intestine to form chylomicrons from triglycerides protein and cholestoerl
|
|
Where can chylomicrons travel thru
|
The lymph
|
|
What are the end products of fat digestion?
|
Monoglycerides, fatty acids, and glycerol.
|
|
Where does digested fat go thru?
|
The lymph system
|
|
What helps them travel?
|
Lipoproteins
|
|
What do chylomicrons do?
|
Move food fat from gut to body?
|
|
What does VLDL stand for/do?
|
Very low density lipoprotein. Carries fat to adipose
|
|
LDL?
|
Carries cholesterol to body
|
|
HDL?
|
Removes cholesterol from body
|
|
When triglyceride level is higher density is
|
Lower. High good. Bad low.
|
|
What is a chylomicron?
|
A water soluble transport vehicle for dietary fatty acids
|
|
Where is it made?
|
Inside the intestinal cell.
|
|
Where does it go for destruction?
|
Liver
|
|
Where is VLDL made?
|
Liver
|
|
What does it consist mostly of?
|
Triglycerides.
|
|
What does VLDL do?
|
Transports lipids to various parts of body.
|
|
After a VLDL downs off triglycerides to the body it becomes
|
An ldl
|
|
What are LDLls mostly made of
|
Cholesterol
|
|
What do they do?
|
Transports content to all cells
|
|
Is it good or bad?
|
Bad
|
|
Where is HDL made?
|
Liver.
|
|
What does it do
|
Transports cholesterol away from cells to liver
|
|
Healthy level of HDL?
|
>60 mg. <40 is very bad
|
|
LDL level?
|
<100 mg/dl. >130 very bad
|
|
Total cholesterol
|
<200 mg/dl
|
|
What increases heart disease?
|
Sat fat, ldls, trans fat. Less unsat fat, poly unsat fats (fish oils omega 3),
|
|
Recommended fat intake
|
20-35% of total intake. Less than 10% sat fat
|
|
American intake
|
33-42%
|
|
What is white fat?
|
Adipose tissue
|
|
Difference btwn vldl and chilomicrons
|
Chilomicrons from the intestine, VLDL from the liver. CHilomicrons deal w/ dietary stuff whereas VLDL deals with liver stuff
|
|
What does lipoprotein lipase do to vldl
|
It strips off triglycerides and therefore increases the density of the lipoprotein, making it into bad LDL.
|
|
Where does LDL transport cholesterol to
|
Arteries
|
|
Where is HDL made?
|
The liver
|
|
What does HDL do
|
Pulls cholesterol out to deliver to the liver. The liver then takes the cholesterol and turns it into bile. HDL also goes to adrenals, ovaries and testes for hormones.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Vitamins and Minerals Lecture
|
|
|
How many organic compounds are there?
|
13
|
|
Are vitamins linked together like fatty acids or glucoses?
|
No
|
|
What is the function of vitamins?
|
To serve as regulators and allow metabolic reactions to occur
|
|
What is a coenzime
|
Loosely bound to a protein and required for the protein’s biological activity. Coeznymes often donate or accept electrons, atoms or groups of atoms to build new products
|
|
What affects bioavailabilty of vits?
|
Efficiency of GI tract, previous nutritional intake, other foods in meal, method of preparation, synthetic vs natural.
|
|
What vitamins supplemented in food in inactive form?
|
Vitamin A, D2 and D3
|
|
How do you destroy thiamin? Riboflavin? Vit C?
|
Heating, UV Light, and oxygen
|
|
What are enrichment acts of 1941 and 1998?
|
Grains enriched with thiamin (b1), riboflavin (B2) niacin (B3) folate iron and b12. Whole grains contain original nutrients
|
|
What is lacking in enriched foods?
|
B6 and magnesium
|
|
What aer the water soluble vits?
|
All Bs, folate, biotin, panthothenic acid, C
|
|
Fat soluble
|
ADEK
|
|
How often do you need to take water soluble vits?
|
1-3 days
|
|
What are thiamin riboflavin and niacin and what do they do?
|
B1, B2, B3. Function as coenzymes for energy absorption and utilization.
|
|
What is thiamin deficiency?
|
Beriberi
|
|
Riboflavin deficiency?
|
Ariboflavinosis
|
|
Niacin deficiency?
|
Pellagra
|
|
What is dry beriberi?
|
Effects the nervous system. Emaciation, wrist drop, great weakness, lack of reflexes, painful tender muscles/
|
|
Wet beriberi?
|
Heart and circulation. EdemA!
|
|
Wernickes? And who does it happen to?
|
Brain and nerves. Happens to alcoholics due to thiamin def. Confusion! Coma! Death!
|
|
Delicious thiamin food sources!
|
Corn flakes, Grean peas. Water melon. Ham, pork chops. Navy beans.
|
|
What happens if you don’t get nough riboflavin?
|
Gen inflammation of mouth, skin and GI tract
|
|
Where you get yo riboflavin!?
|
MMM liver. Milk, yogurt, egg, corn flakes.
|
|
What is niacin deficiency called?
|
Why it is called pellagra dear sirs.
|
|
What does it cause? The 4DS!
|
Diarrhea, dermatitis, dementia and finallllly death!
|
|
How long does pellagra take to occur?
|
50-60 days
|
|
How can you prevent it?
|
Adequate protein diet
|
|
Why is pellagra special
|
Why other than the fucking outrageous side effects, it’s the only disease to reach epic proportions in the US OF A
|
|
So where I gon get my niacin?
|
Shrimp, chicken breast, Cod, Ham, Tuna, liver, halibut
|
|
What is biotin used for?
|
Glycogen fat and protein synthesis
|
|
What is panthothenic acid used for
|
Energy production
|
|
What happens if you don’t have enough biotin and PA
|
Fatigue, nausea, and muscle pain my darling.
|
|
What is pyridoxine?
|
Vitamin B6
|
|
What is it used for
|
Protein and amino acid metabolism, neural function, conversion of tryptofan into niacin. Conversion of tryptophan into serotonin
|
|
What does deficiency in this shit cause
|
Anemia, muscle weakness, depression and confusion! Oh noes
|
|
First case of tox?
|
2 gs a day for 2-3 months: nerve degredtaion
|
|
Good ways to get yo b6?
|
Banana watermelon, corn flakes, turkey,
|
|
What does folic acid do?
|
Produces red blood cells and helps you synthesize protein. Synth of nucleotides to make DNA
|
|
What does folic acid prevent?
|
Neural tube birth defects and homocystine problems
|
|
What should hoes take when they wan dat jizz to make babies?
|
Folic acid supplements!
|
|
What happens when you aint got no folate?
|
Heart disease, megaloblastic anemia, neural tube defects. Similar to vit b deficiencys
|
|
What is megaloblastic anemia?
|
When the red blood cells have lost their nuclei because they divide normally, they are healthy. Megaloblastic anemia is when the red blood cell precursors cannot divide due to folate or vitamin b12 deficiency. Then they get arrested in the bone marrow immaturely, still have their nuclei and are larger than normal red blood cells
|
|
What are causes of folated def?
|
Poor diets for the poor and elderly. Preggers need more of it. Alcoholics get fucked. Anticancer RA drug methorexate too.
|
|
What are neural tube defects
|
Spina bifidia and anencephaly cause shitloads of nasty fluid to enter spinal fluid sack. Bifidia is when the neural tube has failed to close near base of spine.
|
|
What has happened to spina bifidia rates?
|
Since 1991 they have massively decreased thanks to folic acid requirements
|
|
What is anencephaly
|
When the brain is absent or very poorly developed?
|
|
What is encephalocele
|
When the brain is protruding through an opening in the skull EEWW
|
|
Yummy folate things
|
Liver, fortified breakfast cereals, grains, legumes, foliage vegetables, RDA: 400 ug for adults, preggers 600. Breast feeders 500
|
|
B12 is called
|
Cobalamin
|
|
What is b12 used for
|
Red blood cell and nerve cell production
|
|
What is its deficiency
|
Megaloblastic anemia
|
|
Which is
|
Like a folate deficiency that causes large immature cells. Neuro degredation
|
|
Source of b12
|
Animal products and fortified grains
|
|
Elderly people sometimes need
|
B12 shots
|
|
What is atrophic gastritis
|
When older ppl’s stomach gets damage. Usuall stomach releases intrinsic factor with hcl that binds vit b12 and pulls it from proteins being digested. Without IF, hard to absorbed. Gastritis damages stomach cells and fucks up IF production.
|
|
What is gastritis induced megaloblastic anemia b12 deficiency
|
Pernicious anemia
|
|
How is b12 and folate deficiency different?
|
Elevated concentrations of blood homocysteine, and methylmalonic acid for b12. Only homocysteine for folate. Intrinsic Factor implies b12
|
|
Vitamin C is synthesized by
|
Animals but not human
|
|
What does Vit C helP
|
Collagen in skins. Is an antioxidant, increases iron absorption, and synthesizes neurochemicas
|
|
What does Vit C OD do (10x upper limit)
|
Gout, kidney stones, pre-oxidant, cramps nausea, diarrhea
|
|
Red bell peppers, kiwi, brussel sprouts etc
|
Vit c sources.
|
|
How do fat soluble vits get absorbed?
|
Lymph, then blood.
|
|
Transported with
|
Protein carriers
|
|
Stored in
|
Fat cells
|
|
Excreted?
|
Nope. They tend to remain stored
|
|
Toxicity?
|
Likely if you take supplements
|
|
You should take them
|
In periodic doses in weeks or months.
|
|
What is special about vitamin A
|
It comes in many forms.
|
|
Why is beta carotein 12x less efficient than vit A
|
Its cleavage sometimes only leads to one vitamin A. Other carotenids convert even less efficiently.
|
|
What is rhopsodin?
|
Opsin+retinal. It is responsible for our black and white vision, and is located in the rods. Controls our night vision
|
|
What is iodopsin?
|
Contains retinal and is responsible for color vision. Located in the cones.
|
|
What happens when rhopsodin absorbs light?
|
Cis retinal changes from cis to trans which triggers a nerve impulse that carries visual info to brain.
|
|
Vitamin a also helps produce what
|
Mucopolysaccharides which are mucus lubricants that protect against infecetions.
|
|
More vitamin a functions
|
Skin epithelial cells. Growth thru retinoic acid of bones and tissues.
|
|
How can you tell if youre A deficient
|
Night blindness. Slow recovery in flash of light
|
|
What is xerophalmia
|
Vit A deficiency blindness. Dry hard corneas, but reversible
|
|
Whwat is keratinization
|
Epithelial cell secretes keratin, skin becomes rough and skly
|
|
What infection disesases enhanced by vit A deficiency
|
Measles and malaria.
|
|
Vit A vs beta carotene toxicity
|
Beta carotene not toxic
|
|
What is the point of vitamin d
|
Helps you maintain proper calcium levels
|
|
Where does increased absorption result from Vit D
|
Small intestine. Kidney reabsorbs urinary calcium.
|
|
D deficiency
|
Rickets in children
|
|
Vitamin K
|
Blood koagulation. Synthesized by colonic bacteria in GI tract. Common in infants bc sterile GI tract at birth. Get it from leafy green veggies.
|
|
E- tocopherol
|
Antioxidant. Prevents artery plaque formation
|
|
Food sources:
|
Nuts, seeds, wheat germ, whole grain. Veg oil, marg, mayo, salad dressing
|
|
Antioxidants
|
Beta Carotene, vit E, vit C, selenium
|
|
Polyunsat fatty acids in cell membranes have a double bond susceptible to oxidation
|
Free radical + Fa = oxidized FA reactive. Antioxidants get oxidized instead of fat, which avoids cardiod damage
|
|
Minerals
|
|
|
Positively charged mineral
|
Cation. Negative is an anion
|
|
Major minerals
|
Calcium, phosphorus, potassium, sulfur, sodium, choloride, magnesium
|
|
99% of calcium in
|
Bones and teeth
|
|
What are hydroxyapatite
|
Calcium and phosphate crystals
|
|
Bones are constantly
|
Gaining and losing minerals
|
|
Fluoride does
|
Stabilization and hardening of teeth
|
|
1% of calcium in blood does:
|
Reduction in blood clot formation, blood pressuire. Improved nerve impulses, muscle contractions, enzyme regulation.
|
|
Blood in calcium is constant
|
Because bones give calcium even in dietary deficiency
|
|
When your blood calcium is rising your thyroid secretes calcitonin which
|
Inhibits activation of vitamin d. 2- prevents calcium reabsorption in the kidneys 3- limits calc. absorption in small intestines 4- inhibits osteoclas cells from breaking down bone
|
|
When your blood calcium is falling, your parathyroid glands secrete parathyroid hormone which
|
Stimulates the activation of vit d. 2. Vit d and parthyroid hormone cause kidneys to reabsorb calcium. 3. Vit D increases calc absorption in intestines. 4) vit D and PH stimulate osteoclast cells to break down bone
|
|
What are calcium needs for adults, adolescents
|
1000-1200 mg/ day: adults. 1300 mg/day adolescents.
|
|
|
Actual intake: 600-800 mg/day for women. 800-1000 mg/day for men
|
|
What is toxicity level
|
2.5g/day
|
|
When is peak bone bass
|
From 12-30. Active growth stops at 20. Bone loss begins at 35
|
|
How many affected by osteoperosis
|
20-25 million. 1.2 million bone fracture per year
|
|
What % of elderly suffering from a hip fracture will die of complications
|
20%
|
|
Osteoperosis is not a single disorder
|
But a group of discrete fracture syndromes
|
|
Four factors of fractures
|
|
|
Injury consists of
|
Trauma, soft tissue mass and protection
|
|
Strength of bone defined by
|
Mass density, three dimensional arrangement, intrinsic strength
|
|
Mass and density of bone
|
Physical activity, hormones, nutrition
|
|
Adequacy of nutrition
|
Calcium, vitamin d
|
|
70 to 80 year olds
|
Have compression fractures of the thoratic vertebrae which causes lower ribs to rest on iliac crests, and abdominal distention
|
|
What minerals mostly found inside cell?
|
K, P, Mg, S
|
|
Outside a cell?
|
NA, CL
|
|
Sodium
|
|
|
Cation or anion?
|
Cation, bc positive charge
|
|
Outside or inside?
|
Outside
|
|
Est requirement
|
500 mg/day
|
|
Max
|
2300 mg/day
|
|
Functions
|
Electrolyte balance, nerve impulse, muscle contraction
|
|
1 tsp of salt
|
2000 mg Na
|
|
Salt added in food is resp for
|
75% of dietary salt
|
|
Added at table and in cooking
|
15%
|
|
10% natural Na
|
From foods.
|
|
Deficiency:
|
Hyopnatremia. Muscle cramps, mental apathy, loss of apetite
|
|
Toxicity
|
Hypernatremia: edema, acute hypertension (usually not a prob w/ adequate h20)
|
|
Hypertension
|
Chronically high blood pressure
|
|
What % of hypertensive populations responsive to sodium
|
3-Jan
|
|
Increasing salt in blood stream
|
Increases osmotic pressure, causes cells to release water. More pressure in blood vessels, thirst, and retention of water by kidneys
|
|
Salt free, Low, Reduced
|
< 5 mg, <140 mg, < 25%
|
|
Chloride
|
|
|
Anion or cation
|
Anion
|
|
Used for
|
HCl in protein digestion
|
|
Lose Cl when you
|
Vomit. Increases pH called Metabolic alkalosis
|
|
Abundant
|
Bc of NaCl and no RDA
|
|
Potassium
|
|
|
Is the principle ____ in all living cells
|
Cation
|
|
Maintains
|
Fluid balance, nerve transmission, muscle contractions (like NA)
|
|
Get from
|
Whole and fresh foods, fruits and vegetables
|
|
Low K means
|
High blood pressure
|
|
Phosphorus
|
|
|
What % stored with CA in hydropaxite crystals
|
Located in the bone and the teeth, 85%
|
|
Useful for energy metabolism bc
|
ATP. Many enzymes and B vitamins activated by phosphorus or phosphorylated
|
|
Phospholipids
|
Carry lipids and form cell membranes
|
|
Also used in
|
DNA and RNA
|
|
Buffers system to maintain
|
Acid base balance
|
|
Consume
|
Brocolli, milk, yogurt, cottage cheese, sunfolower seeds, tofu,liver
|
|
Magnesium
|
|
|
Where is it stored
|
50% in bones mineralization and teeth.
|
|
Useful for
|
Enzymes, muscle contraction, nerve conduction
|
|
Antagonistic to
|
CA. Ca makes mucles contract. Mg makes muscles relax
|
|
Mg regulates
|
Lung and heart function
|
|
Deficiency caused by
|
EtOH abuse, kidney disorders
|
|
Tasty source
|
Leafy greens.
|
|
Problem of processed foods
|
May not taste salty because of NA+ bicarbonate, soda. And Na + saccharine: sweetener
|
|
As Na+ goes up thru processing, K+ goes
|
Down, which can impair fluid balance
|
|
Minerals
|
|
|
Who was John Lawrence Beard
|
Studied iron and impact on brain’s cognitive function.
|
|
What are iron’s two ionic states
|
Ferrous iron (reduced) Fe ++ and Ferric ion (oxidized) Fe +++
|
|
What is iron a cofactor in?
|
Oxidation and reduction in almost every cell
|
|
Invovled in
|
Making amino acids, collagen, hormones, neurotransmitters
|
|
Iron’s FE bouind with 2 proteins
|
Hemoglobin in RBC carries O2 and CO2 to lungs and body tissues
|
|
How much iron in hemogloblin
|
80%
|
|
Myoglobin
|
Is in mucles and stores O2
|
|
What does FE do exactly in Hemo and myoglobin?
|
Accept, carry and release oxgen
|
|
Ferritin is
|
The protein that receives iron from food in the intestine and stores iron in the mucosal cells lining the small intestine
|
|
Transferrins are
|
Proteins that transport iron
|
|
How does intestinal storage of iron work?
|
You eat iron. It gets stored in the mucosal cells in the intestine (mucosal ferritin). Mucosal ferritin releases iron to mucosal transferrin to send iron to the rest of the body.
|
|
When your body does not need iron
|
It is not absorbed and excreted in shed intestinal cells
|
|
What is heme and where is it found
|
Heme is the iron holding structure within the hemoglobin and myoglobin proteins. It is only found in foods derived from animal flesh, which also have nonheme iron.
|
|
How much of the avg daily intake is from heme?
|
10%
|
|
What % of heme is absorbed?
|
25%
|
|
What % of avg daily intake is nonheme. Absorption?
|
90%. 17% absorption.
|
|
One iron enters the body
|
Most is receylced
|
|
Some is lost with body tissues and must be replaced
|
By eating iron containing food
|
|
The iron process
|
|
|
Transferrin carries
|
Iron in the blood
|
|
Some iron delivered to
|
Myoglobin of muscle cells
|
|
Bone marrow incorporates
|
Iron into hemoglobin of red blood cells and sotres excess iron in ferrin and hemosiderin
|
|
Hemosiderin is
|
An iron storage protein primarily made in time of iron overload
|
|
Iron containing hemoglobin in red blood cells carries
|
Oxygen
|
|
If bleeding occurs
|
There is some loss
|
|
Liver and spleen dismantle ____, package iron into ____ and store excess iron in ____
|
Red blood cells, package iron into transferring and store excessiron in ferritin
|
|
Iron in the lungs
|
|
|
When you breateh in
|
Oxygen enters the lungs, attaches to iron in the hemoglobin. Then oxygenated hemoglobin goes in blood to body cells, drops off oxygen
|
|
When you breathe out
|
Iron in hemoglobin picks up Co2 rom cells and brings them to lungs. CO2 released from the iron in hemoglobin. CO2 is exhaled
|
|
What is the leading deficiency in the US
|
Iron
|
|
How many childbearing year women and adolescent girls
|
7.8 million
|
|
How many one and two year olds
|
700k
|
|
What happens when you start to get iron anemia
|
Your ferritin levels decrease (stored). Your transferring increases (transport form)
|
|
What are nonanemic iron deficiency symptoms
|
Tired tissues, enzymes not performing effectively
|
|
What is iron def. w/ anemia like
|
Severe depletion of Fe stores, low hemogloblin concentration
|
|
What is microcytic hypochromic anemia
|
You have small pale red blood cells w/ lower iron levels w/ reduced oxygen carrying capacity
|
|
What are 3 effects of iron toxicity
|
Hemochromitis, Hemosiderosis, and Massive liver damage
|
|
What does hemochromitis do, how many affected
|
Prevents unneeded iron from being absorbed. 1.5 million in US
|
|
Hemosideris?
|
Deposits iron in the tissues. You need massive supplement doses and repeated blood transfusions
|
|
Best sources of iron
|
Broccoli, tomato juice, clams, beef liver, parseley
|
|
Who needs most iron?
|
Women in reproduction, menstruation, pregnancy. Infants, young. People losing blood from ulcers and infections
|
|
Why do adolescent males need iron. Females?
|
Rapid growth and menstrual losses
|
|
Zinc
|
|
|
What enzyme systems is zinc a part of
|
Genetic materials, digestinve enzymes, heme synthesis, essential fatty acids
|
|
How is zinc involved in metabolism
|
CHO metabolism, protein synthesis, metabolism of alcohol, free radical disposal
|
|
What is the zinc process called?
|
Enteropancreatic circulation
|
|
How much of zinc is absorbed
|
15-40% depending on status
|
|
Describe zinc process
|
|
|
Eat zinc
|
|
|
Mucosal cells in ____ store excess zinc in ____
|
The intestine, in the metallothionein
|
|
Metallothionein releases zinc to ____ and ___ for transport to bod
|
Albumin and transferring
|
|
The ___ uses zinc to make digestive enzymes and secretes them to ___
|
Pancreas, intestine
|
|
If u don’t need zinc
|
It’s absorbed and is excreted in shed intestinal cells
|
|
What is albumin?
|
Blood protein containing zinc
|
|
What happens when you have high zinc?
|
Fucks w/ iron absorption bc both metals have 2+ charge, and zinc can bond with transferring
|
|
What other metal affects iron similarly to zinc?
|
Copper
|
|
What are effects of zinc defecit
|
Poor growth, sexual development, smell and taste. Acne like rash, mental confusion, lack of appetite
|
|
Small and large ODs of zinc:
|
Small, over time fucks w/ the heart due to copper. Larger ODs cause diarrhea, vomiting, fever, anemia and exhaustion
|
|
Best sources of zinc
|
Yogurt, ground beef, oysers, broccoli
|
|
Iodide
|
|
|
What hormone is iodide a part o?
|
The thyroid, which controls BMR
|
|
What is goiter?
|
Iodide deficiency
|
|
What is simple goiter?
|
When you don’t get enough iodide
|
|
What is toxic goiter?
|
When you get a ton of goitrogen, which interferes w/ Iodide absorbption in thyroid gland
|
|
Where can you find goitrogens
|
Cabbage, cauliflower, broccoli, brussel sprouts
|
|
What are effects of goiter?
|
Sluggishness, weight gain, retardation esp in utero.
|
|
How to get your iodine?
|
Seafood, iodized salt, food processing
|
|
Selenium
|
|
|
What is it a coenzyme for, and what does it do?
|
Glutathione peroxidase, which blocks free radical formation
|
|
What is this conenzyme complimentary to?
|
Vitaimin E, which neutralizes free radicals escaping from GP
|
|
What is Keshan disease?
|
First studied in Keshan province of china, heart enlargement, fibrous tissue in place of muscle tissues
|
|
What is the advantage of an Se rich diet?
|
Cancer prevention
|
|
Copper
|
|
|
What does copper do in enzymes?
|
Regulates hemoglobin formation, serves as antioxidant and anti-cancer, protein binding prevents damage
|
|
What is the anti-cancer enzyme called that copper works w?
|
Superoxide dismutase
|
|
Good source?
|
Seafood, nuts, grains, seeds
|
|
What interferes with CU absorption?
|
Zn, Fe
|
|
Is deficiency common or rare?
|
Rare
|
|
Fluoride
|
|
|
What does it do to bones and teeth
|
Makes them resistant to decay.
|
|
Fluroidation prevents dental decay. What about osteoporosis?
|
Unclear
|
|
What happens when you OD moderately?
|
You get mottled teeth with florapatite deposits (CaF)
|
|
What happens when you flat out OD
|
Nausea, diarrhea, chest pain, itching, vomiting
|
|
What % of deaths did malignant neoplasm account for in 2005?
|
23% (US)
|
|
What % of deaths is cancer worldwide
|
12-14%
|
|
What % of ppl will get cancer?
|
3-Jan
|
|
What % will die of cancer?
|
60% of those diagnosed
|
|
What rank is cancer in the “killer” list? Behind what
|
Second behind cardiovascular disease
|
|
Cancer rates around the world vary ____, but the types of cancer vary ___
|
Minimally, a lot
|
|
Two env. Factors linked to cancer
|
Tobacco, diet
|
|
Male cancer trends: stomach, lung, colon, prostate
|
Stomach way down since the 30s. Colon on its way down since 50s. Prostate on its way down since early 90s. Lung hardcore down since 90s
|
|
For women, how much lower is the lung cancer rate?
|
<2x what it was 25 yrs ago
|
|
Breast cancer rates were ___ between 1930 and 1990 but have been falling ___ sine then
|
Unchanged, 2.3%
|
|
Stomach and uterine cancers have ___ since 1930
|
Decreased steadily
|
|
Colorectal cancer death rates decreasing for
|
Over 50 years
|
|
How many new cancer cases in 2007 for men and women
|
720.2 k for men. 679.5k for women
|
|
What % of new diagnoses were prostate for men
|
33%
|
|
What % of new diagnoses were breast
|
31%
|
|
How old is cancer?
|
Known since 3000 bc in Egyptian tumors. 500 BC to 200 AD, hipocrates and other greek physician named it after crab
|
|
What is the term made by galen
|
Neoplasm. Galen in ad 200 defined cancers as new groths
|
|
What is cancer?
|
When abnormal cells grow out of control and spread throughout body. It happens when mitosis is out of whack
|
|
What is apoptosis
|
Normal destruction of cell by body due to damage
|
|
What is the most common type of cancer? Frequently where?
|
Carcinomas. Lung, breast, colon
|
|
What are sarcomas?
|
Cancer in bone, cartilage, fat, connective tissue, muscle
|
|
What are lymphomas
|
Cancers that arise in the lymph nodes and tissues of body’s immune system
|
|
What are leukemias?
|
Cancers of the immature blood cells that grow in the bone marrow and accumulate in large #s in the bloodstream
|
|
|
|
|
What are traits of melanomas?
|
Asymmetry, when border edges ragged, when mole color varies throughout, when mole’s diameter is larger than pencil eraser
|
|
% of cancer deaths for men and for women
|
Men: lung > colon > prostate. Women: lung>breast> colon and rectum
|
|
What % of cancers related to environmental factors that modify DNA?
|
80 – 90%. These include Carcinogens such as toxic chems, env contaminants, viruses, radiation and X ray
|
|
What % of cancer risk does diet contribute
|
40%
|
|
What are the 3 steps of cancer? Their attributes
|
Initiation. Begins with alteration of DNA within cells 2. Promotion: number of cells w/ altered dna rises 3. Progression: uncontrolled growth and spread (metastasis of cancer cells)
|
|
Every minute, how many cells in the body divide?
|
10 million
|
|
What starts cancer initiation in cells?
|
Toxic env. Contaminants and cehmicas, viruses, radiation, hormonal changes
|
|
Why do initiated cells survive?
|
Breakdown in repair pathways such as antioxidants, good foods, and body’s protective mechanisms
|
|
What is apoptosis
|
Programmed cell death for bad cells
|
|
What is superoxide dismutase?
|
Important antioxidant. Superoxide is an anion lacking an electron. It is a free radical.
|
|
What is the tumor suppressor gene
|
Initiates apoptosis if DNA damage cant be repaired.
|
|
How does colon cancer result from p53
|
When it gets deactivated by physical activity, large body mass, cigarette smoking, high red meat and simple sugar consumption
|
|
What does superoxide dismutase need to turn superoxide radicals into oxygen and hydrogen peroxide?
|
Iron or copper
|
|
How does step 2 of cancer, promotion work?
|
Cells with dmaged DNA divide into the localized area while cells around it are getting repaired correctly
|
|
How long does lag time in promotion work
|
10-30 years
|
|
What is step 3?
|
Uncontrolled growth and spread of cancer. Tumor metastasis is when the bloodstream makes them travel to new areas to invated
|
|
When are cells first classified as cancer cells?
|
The progression phase
|
|
What is TNM?
|
A way of naming cancers
|
|
What is T? 0, 1-4
|
The size or direct extent of the primary tumor
|
|
What is N? (0-3)
|
The degree of spread to the regional lymph nodes? 0: absent from regional lymph nodes. N1: tumor sprad to closest or small number of regional lymph nodes. N2: medium spread N3: tumor spread to numerous and distant lymph nodes
|
|
What is M? 0/1
|
Presence of metastasis. 0: no distant metastasis. M1: metastasis to distant organs (beyond regional lymphs)
|
|
What is stage 0 of cancer?
|
Carcinoma very localized- no potential for metastasis. Early cancer that is present only in the layer where it begam
|
|
What is stage 1 of cancer?
|
Localized to one part of the body
|
|
What is stage 2 of cancer?
|
When cancers are locally advanced
|
|
Stage 3?
|
When cancers are also locally advanced. 2 vs 3 depends on the type of cancer
|
|
Stage 4
|
Cancer has metastasized
|
|
What does cancer look like under the microscope?
|
There are a large number of dividing cells. Large variably shaped nuclei. There is a small cytoplasmic volume relative to the nuclei. There is variation in cell size and shape and a loss of normal special features. They are disorganized and have poorly defined boundaries in groups
|
|
Malignant tumors
|
Invade neighboring tissue
|
|
|
|
|
Benign tumors are different from m bc
|
They are not cancerous, can easily be removed, does not spread. Still can be dangerous though
|
|
What is the best way to avoid cancer
|
Diet genetics and lifestyle
|
|
Environmental factors linked to cancer
|
Obesity, low fruit and veggies, phys inactivity, smoking, excess alcohol
|
|
Genetics account for
|
42% of risk for prostate cancer. 5 to 27% of risk for breast. 36% of pancreas
|
|
What cancers are not genetic
|
Endometrial, oral thyroid, bone
|
|
How much cervical cancer from hpv
|
70%
|
|
Do phytochemical supplements protect against cancer?
|
Nope
|
|
Which foods are great for antiox
|
Broccoli, cabbage, cauliflower, brussel sprouts
|
|
Smoking, curing, salting, pickling
|
Introduces nitrosamines that cause cancer
|
|
High salt intake
|
Causes stomach cancer
|
|
Grilled and charred meats cause cancer bc
|
When creatinine breaks down due to heat, heterocyclic amines are formed that are carcinogens. Also when fat drips into heat source and smokes, it creates free radicals
|
|
How is fat related to cacner
|
When you have a lot of fat, especially around the waste, you get cancer. It stimulates hormone production. More sat fat means more cancer
|
|
What can you eat to get phytochemicals that help ward off cancer progression
|
Dried beans, soy products, nuts, and seeds
|
|
Regular consumption o fish
|
Helps prevent cancer
|
|
Why consume plant protein
|
Plants provide unsaturated fats
|
|
Do the effects of tobacco and smoking compound
|
Yes.
|
|
Why does booze cause cancer
|
Local effects of alcohol damage cell linings, can cause dna mutations, nutritional deficiency, lower immune function. Acetaldehyde is a week carniogen. Free radicals. Turns off tumor suppression genes
|
|
What is cisplatin
|
It inhibits the division of rapidly dividing tumor cells
|
|
Cisplatin has a shitload of side effects. The bunch is called emesis
|
Kidney damage, nerve damage, hearing loss, inflammatory, GI distress, nausea, vomiting, fatigue. Peaks within first day, then sine curves up
|
|
1980-200
|
|
|
Water
|
|
|
What % of adult body weight is water
|
60%
|
|
More or less in children?
|
More
|
|
More or less in obese
|
Less
|
|
Muscle tissue is __ % waer
|
75%
|
|
Fat cells are %
|
10%
|
|
Where do we get water
|
Fluid, foods, metabolic. 75% fluid, 25% food
|
|
Rec intake
|
Men: 3.7 L, 2.7 L/ day. 1-1.5ml/kcal expended. 1.5ml/kcal expended
|
|
In NHANES III what did ppl drink
|
13 cups a day of fluid. Women drank 9 cups. 3/2.2 l. 81% of water from fluid
|
|
We lose 1600 mls of water a day but can lose 1450-2800 (6-11 cups) where?
|
Skin, evaporation and respiration: 800 ml.s Minimal sweat loss: 100 mls. Fecal loss: 200 mls. Minimal urine loss: 500 mls
|
|
How much water do we get from liquids
|
550-1500 ml
|
|
From metabolic water
|
200-300 ml
|
|
From foods
|
700-1000 ml
|
|
How much goes out o our kidneys
|
500-1400
|
|
How much out of our skin
|
450-900
|
|
How much out of our lungs
|
350
|
|
How much out of our shit
|
150
|
|
What % water is plasma?
|
90%
|
|
What is osmotic pressure?
|
The force that moves H2O across a membrane when solute concentrations are unequal
|
|
Is sodium an electrolyte? Does it attract or repel water?
|
Yes. Electrolytes attract water. Sodium is a cation
|
|
You have H2O and NA and Cl. What is attracted to what
|
O attracted to NA. H attracted to CL
|
|
How are NaCl most easily lost
|
Vomiting, diarrhea, sweating and bleeding
|
|
What does 1 liter of oral rehydration therapy solution contain
|
2.6 g of NaCl. 2.9g of trisodium citrate dihyrdate. 1.5g of potassium choloride. 13.5 g of anhydrous glucose
|
|
What happens to blood volume and pressure when you get dehydrated?
|
Both go down
|
|
What in the brain regulates thirst
|
The osmoreceptors in the hypothalamus
|
|
What hormone causes the body to retain water
|
Antidiuretic Hormone. It causes the kidney to reabsorb water
|
|
What are the osmoreceptors
|
The thirst sensors
|
|
As % of body weight loss, what happens at 1-2%, 3-4%, 5-6%, and 7-10%
|
Thirst. 3-4: weakness, lowered endurance 5-6: heat intolerance and severe weakness 7-10: coma and death
|
|
What is fitness (3 parts)
|
Ability to perform phys act. Ability to meet routine demands with extra for challenge. Ability to withstand stress. Strength, Flexibility, and Endurance
|
|
Muscle size is correlated to
|
Muscle strength
|
|
Why are chimps stronger than ppl
|
Their muscles are set up as levers. With their bone ligaments
|
|
What generates fight or flight strength
|
The medulla hindbrain generates epinephrine (adrenaline) and norepinephrine and the adrenal glands, which are next to the kidneys
|
|
What caused that dog in the slides to get ginormous
|
Myostatin inhibition.
|
|
What is cardiorespiratory endurance
|
Ability to maintain activity at an elevated heart rate. To have a healthy heart and circulatory system.
|
|
What is VO2 max
|
It measures cardiorespiratory fitness by seeing what your maximum O2 uptake or consumption during maximum aerobic metabolism is
|
|
How does the cardiorespiratory system work
|
The respiratory system delivers oxygen to the blood. The circulatory system then carries oxygenated blood around the body. The muscles and other tissues spend the oxygen and release carbon dioxide into it. The blood takes the carbon dioxide to the lungs which breathe it out
|
|
Is 100% VO2 max sustainable?
|
No
|
|
Where do you train at first w/ VO2 max
|
40-60%
|
|
Where can you improve to?
|
70-85%
|
|
What is the maximal heart rate and what is it equal to?
|
The heart rate where you are consuming the greatest amount of oxygen, roughly equivalent to the VO2 max
|
|
What is the target exercise heart rate
|
(220-Age) * % intensity of exercise in reerence to maximum heart rate
|
|
When you exercise, what do these do:
|
Down: Blood pressure, cholesterol, obesity.
|
|
Blood pressure, total blood cholesterol, HDL, Obesity, Bone mass Endurance strength flex, muscle size
|
Up: HDL, Bone mass, endurance, strength, flex, muscle size
|
|
What does inactivity cause?
|
Risk of CVD, Stroke, Cancer, Diabetes, Hypertension
|
|
What is the main nutrient source for low and intermediate intensity sport
|
Fatty acid
|
|
What about high intensity sport?
|
Glucose, glycogen
|
|
Does boosting vit and minerals give you athletic advantage
|
No
|
|
What does aerobic mean?
|
Requireing oxygen
|
|
Why do fatty acids need oxygen?
|
They get oxidized to release fuel in prolonged athletic activity
|
|
What happens when you train athletically?
|
You easily oxiize fat, which spares your glycogen stores
|
|
What does anaerobic mean
|
Not requiring oxygen
|
|
How long is an anaerobic activity
|
Less than 3 minutes
|
|
Generally requires
|
Strength, agility, and power
|
|
How is it fueled
|
Glucose breakdown without oxygen
|
|
Why do you need carbs as an anaerobic athlete
|
It provides energy without being oxidized
|
|
What is the energy currency of the body
|
Adenosine Triphosphate
|
|
What is the reaction by which this currency breaks down
|
ATP turns into ADP and PO3, which releases energy breaking phosphate bonds.
|
|
What % of all carbs have ATP in their cells
|
90%
|
|
You’re doing high intensity shit for 3-20 minutes. What’s your primary fuel? Is O2 needed. What’s your goal?
|
You mainly use ATP from CHO, and some fat depending on your training level. You need O2 to use your fat. An example would be swimming or running. You want to use your fat before depleting your glycogen, which comes w/ training
|
|
Say you’re hiking moderate/low intensity for more than 20 minutes. What’s your fuel. Do you need O2
|
ATP from fat. You need O2
|
|
Due to aerobic exercise what happens to A.cardiac output (m/min) o2 delivery, stroke volume (ml/beat), breathing efficiency?
|
They all go up
|
|
What about your resting pulse, your blood pressure
|
They go down
|
|
How much glycogen in 100g of muscle
|
.5-2.0 g
|
|
What is glycogen used for?
|
High intensity, short duration activity
|
|
What is glycogen loading?
|
When you get 60-70% of your calories from CHO 3 days prior to the event. You do 20 minutes a day of training on the 1rst and second day and rest on the third
|
|
What are good pre-event meals:
|
Complex carbs, low fat, fruits, veggies and fluids. LOW fiber
|
|
What breaks down glycogen to glucose
|
The liver
|
|
First the muscle uses its
|
Own glycogen
|
|
Then it uses the glycogen from the
|
Liver
|
|
Glycogen storage is directly related to
|
Carbohydrate intake
|
|
How long before glycogen gets totally depleted
|
2 hrs, can be improved with training
|
|
Lactic fermentation changes glucose into __. And requires __ atp
|
Lactate. 2 ATP
|
|
Lactate then goes thru the blood to the liver to undergo __ which requires __ ATP
|
Gluconeogenesis 6 ATP
|
|
What are the above two questions called
|
The Cori cycle: how glucose is recycled into lactate then reconverted itno glucose
|
|
What is “hitting the wall”?
|
Glucose exhaustion. Occurs when glycogen storage is depleted. Neuromuscular functions nearly stop. Takes several xtreme hours
|
|
How do you max your glycogen stores
|
Eat high CHO diet regularly (70% of kcal)
|
|
What type of snacks should you eat during events?
|
High glucose
|
|
How soon do you need to eat carbs post exercise? What benefit do you get
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15 mins. 300% increase in storage efficiency of glycogen
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What does training regularly do to your glycogen stoage?
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Increases it and allows you to use oxygen to convert fat to energy more effectively
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When should a pre-event meal be eaten? Light or heavy? Food tolerance? Beverages?
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Several hours before the event. Light meal, high in complex CHO. Low in fat, moderate in protein, low in fiber. Well tolerated foods. No caffeinated, or carbonated
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Three diets: tell their max endurance time. Fat and protein. Normal. High carb.
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57 mins, 114, 167 mins
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How much % of diet for endurance athletes needs to be fat
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20-30%
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What happens w/ fat if you are too intense?
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You stop fueling yourself with stored fat bc it’s anaerobic. Rock sustained moderate intensity.
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What % of diet from protein?
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10%
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How much can you add to muscle mass per day
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About 15g. Can be as high as 45g
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When you have a high fat and low carb diet, what happens to amino acids
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They get converted to glucose
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Active ppl get more nutrients from food except when it comes to __ bc
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Women eating iron, because exercise can fuck up red blood cells. They have increased need for mitochondria and myglobin for aerobic metabolism which leads to something called sports anemia.
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Sports anemia is characterized by a temporary __ defecit
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Hb
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What’s a good % glucose for a sports drink?
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7%. It should also have sodium and other electrolytes
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How long do you need to dilute blood sodium? What’s the dangerous condition called from this?
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4+ hours of heavy sweating can induce hyponatremia
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What reason do caffeine and booze share for being a shitty fluid?
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They both are diuretics, which dehydrates you
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Why else is booze bad?
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Impairs ability to regulate body temperature, decreases reaction time, strength and agility
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What are dangers for female athletes?
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Iron deficiency and anemia. Low bone density. Low body fat (<12%)
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What’s the deal w/ amino acid supplements
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Supplements cause imbalanced absorption of other amino acids, which are needed for muscle. Eating enough is more important
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Diabetes Lecture
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Factors of diabetes melitus
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Genetics, env, chems, infections, autoimmune events, nutrition, phys act, phys stress
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What are diabetes
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Disorders characterized by excessive urine excretion
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What does Diabetes mean
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To flow through (romans in 70 AD)
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DM affects how many US ppl?
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18 mil
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What rank in death list?
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# 4 leading cause of death
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What are two major effects?
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Blindness, kidney disease
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Where in the pancreas is insulin produced?
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In the beta cells
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What does insulin regulate?
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Blood glucose levels, along with glucagon
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Where does glycogen get stored?
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Liver and muscle tissue
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Insulin process: insulin binds with the __ which allows ___ to transport glucose into a cell
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Insulin receptor. The glucose transporter GLUT 4
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When you eat, your intestine causes
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Your blood glucose to rise
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This triggers your pancreas
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To release insulin
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Insulin causes your cells to
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Uptake glucose
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And your liver and muscle
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To store extra as glycogen
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Insulin also encourages the formation
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Of fat
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If you have low blood sugar your
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Pancreas releases glucagon into the bloodstream
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Glucagon pushes your liver to
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Break down glycogen and push glucose into the blood
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What other hormone helps?
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The stress hormone, epinephrine
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What kind of cell is glucagon in?
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The alpha cells of the pancrease
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What kind of cell is insulin in?
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The beta cells of the pancreas
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What does chronic hyperglycemia do
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Gives you diabetes
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How can the liver, pancreas, and muscle contribute to hyperglycemia
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Liver can release too much glucose after a meal. The pancreas can fail to secrete enough insulin. The muscles can collect and store insufficient glucose
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What does hyperglycemia cause
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Increased blood triglycerides, atherosclerosis, and chronic inflammation
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What is IDDM
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Type 1 diabetes, or insulin dependent diabetes mellitus.
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In IDDM, how much insulin does beta cell make
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None or very little
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How common is IDDM?
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5-10% of cases
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When does it start and why does it happen?
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Childhood. It’s not clear why it’s caused, but could be viral infection early in life or genetic destruction of part of the pancreas
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What is NIDDM
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Type 2 diabetes, or noninsulin dependent diabetes mellitus
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What is NIDDM characterized by
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Insulin resistance and insulin receptor and post receptor probs
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When does NIDDM happen
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Post childhood, often at the end of diseases
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What causese NIDDM risk to go up 10x
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Obesity. Visceral fat increases your glucose intolereance and hyperinsulinimia
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With type 1 diabetes, what happens when you eat
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CHO turns into glucose, enters bloodstream. Pancreas beta cells don’t make insulin and glucose builds up
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With type 2, what happens
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CHO convereted to glucose enters bloodstream, pancreas makes insulin which enters bloodstream. Insulin fails to signal cells to let glucose enter, so it builds up
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How many cases of diabetes melitus
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18 million 750k type 1s
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How many undiagnosed type 2s
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7 million
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What % of US population in 1960, today?
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1%, 9.6%.
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Obesity responsible for what %
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75% of type 2
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How many diagnosed each year
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600k
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How do you diagnose diabetes?
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Polyuria, polydipsia, unexplained weight loss. >200 mg.dl blood glucose concentration. Glucose concentration post 8 hrs of fasting >126 mg/dl.
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What is polyuria
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Excessive urine
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What is polydipsia
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Excessive thirst
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What is the oral glucose test
|
Give someone a plasma glucose of 75g. Take their plasma glucose concentration 2 hrs later. If >200, they have diabetes
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What does lack of insulin cause in order
|
Decreased glucose use, hyperglycemia, dehydration, peripheral circulatory failure, coma and death
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What are the causes of insulin resistance?
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Pancreas makes fucked up insulin, your circulatory system fights insulin or its receptors, or the receptors are broken
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Are gene mutations impairing beta cell function common?
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Not as common as insulin resistance from visceral obesity
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Is bodyweight or body fat and inactivity more important determining glucose metabolism?
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Body fat and inactivity. If you have high subcutaneous and visceral adiposity
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Is upper body or lower body fat worse?
|
Upper body. It produces pro inflammatory factors that fuck up insulin clucose transport.
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What happens w/ protein restricted diet?
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Lower beta cell mass, messed up insulin response in offspring
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|
Malnourished feti
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More likely to be insulin resistant.
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What % of preggers affected by gestational diabetes
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2-4%. That means about 100-130k per year
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When is GDM more likely in pregnancy?
|
If oyu had a previous large infant, family hist of diabetes, maternal obesity, early pregnancy.
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Body weight and regular exercise:
|
Reduces risk to less than 25%
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What % may develop NIDDM in 15-20 yrs (after 20?)
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40-60%
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What are diseases resulting from diabetes
|
Atherosclerosis, kidney failure, disrupted cognition, motor function, retinopathy, gangrene
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What is diabetic retinopathy
|
Hemorrhages and aneurysms in the macula and optic disks bc of new blood vessel growths. Exudates (little debris in the eye)
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What is diabetic neuropathy
|
Most frequent and most disabling form of neuropathy. Frequently causes high morbiditiy and death
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Why do you get gangrene f/ diabetes
|
You have poor blood circulation. You often have to get amputations due to cellular necrosis
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What are diabetic neuropathy risk factors
|
Longer duration of diabetes, need for more insulin, high persistent glucose levels, renal disease, heart disaease,angina, stroke hypertension, age
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What is the goal of treating diabetes
|
To have a healthy individual w/ a complete lifestyle and normal longevity. To relieve symptoms, decrease severity of disease, and prevent pathologies.
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What are routes of control
|
Dietary control, exercise, education, insulin and oral hypoglycemic drugs
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Goals for medical nutritional therapy
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1. Achieve physiological blood glucose levels
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2. Maintain desirable plasma lipids
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3. Reduce likelihood of specific diabet complications
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4. Prevent atherosclerosis
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Generally:
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Optimal nutrients, healthy body weight, meet enrgy needs in timely manner, address special requirements, tailor for specific needs like renal disease
|
|
How do you treat type 1
|
Adjust food pattern, adjust insulin for activity changes, intense therapy-counting Carbs, adjusted for injections
|
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Diet plans with CHO: ADA says
|
Diet restricted in fat, high in complex carbs, and dietary fiber
|
|
Mediterannean diet:
|
Low CHO, high monounsaturated fat alters serum lipids favorably. Worried about obesity
|
|
Does fructose boos blood sugar levels?
|
Minimally
|
|
ADA recs for protein: normal, daibetic
|
10-20% normally. 10-15% for diabetics
|
|
What is diabetic nephropathy
|
When you get excess protein as a diabetic
|
|
Total fat should not give you more than
|
30% of energy
|
|
Sat fats should give you
|
Less than 10%
|
|
Polyunsats should give you
|
Less than 10%
|
|
Eat more
|
Monounsats like olive and canola
|
|
Cholesterol
|
200 mg/day
|
|
Hyperlipidemia is a risk factor for
|
CHD and insulin resistance.
|
|
What fat improves insulin sensitivitiy, lowers serum cholesterol and tryglicerides?
|
Intake fish oil for omega 3s
|
|
How much fiber should you get a day to manage diabetes?
|
35 g/day
|
|
What do fiber supplements help reduce
|
The postprandial glycemic response
|
|
What are advantages of fiber
|
Slow digestion and absorption, decrease postprandial glucose, increase insulin sensitivity, increase insulin receptor number, stimulate glucose use, attenuate glucose output, decrease counter-regulatory hormone release, lower trigylcerides and serum cholesterol, improve satiety
|
|
Disadvantages of fiber
|
Gas, abdominal discomfort, fecal bulk and bowel movements. Fucks w/ autonomic neuropathy
|
|
What % of ppl w/ diabetes take insulin
|
27%. 14% insulin only. 16% no medication. 57% oral.
|
|
Why is it now rare for ppl to have antibodies to insulin on the market
|
Recombinant dna
|
|
What is sulfonylureas
|
Increases sensitivity to glucose in beta cells, causing them to produce more insulin. It is oral and lowers probability of hypoglycemia
|
|
What is thiazolidinediones
|
TZDs. Increases sensitivity of insulin receptors to insulin
|
|
What is pancreatic cell transplanation
|
Improving function of beta cells does not work in humans after 2.5 yrs of trials
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|
What level of exercise increase rate of glucose uptake?
|
Moderate. Has a direct impact on cv performance and glucose clearance
|