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899 Cards in this Set

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What are the two parts of digestion?
Anatomy and muscular actions
What are the two parts of absorption?
Anatomy and intestinal cells
What are the two parts of the circular system?
Vascular and Lymphatic systems
What regulates digestion and absorption?
Hormones and nerve pathways
Where does digestion take place
The GI tract
Absorption?
Walls of the GI tract, mainly the small intestine
Transport?
Blood and the lymphatic system
Metabolism?
Cells within target tissues
Excretion?
Large intestine (via anus), kidney, skin hair and nails.
What is the first step of nourishment?
Ingestion
What internal and external cues prompt nourishment?
Hunger, Appetite, and Satiety
Is hunger internal or external?
It is an internal physiological drive
Is appetite internal or external?
It is a learned response, nonphysiological, external cues (sight/aroma)
What is satiety?
When you stop eating
Is satiety internal or external?
Both feeling (Internal) and learned (external)
What is digestion?
Process when foods are broken down into absorbable units
Digestive process
Pharynx
Moves food from mouth to esophagus
salivary glands
Secrete saliva that has enzymes to break down starch
Epiglottis
Protects airway during swallowing
Trachea
Allows air to pass to and from lungs
esophagus do
Passes food from mouth to stomach
Esophageal sphincters
Prevent backflow from stomach to esoph. And esoph to mouth.
Stomach
Acid + enzymes and grinds food to liquid mass
Pyloric sphincter
From stomach to small intestine
Liver
Makes bile salts, detergent like substances to digest fat
Gallbladder
Stores bile until needed
Bile Duct
Condcuts bile from gallbladder to small intestine
Illeocecal valve
(spincter): gmall to large intestine
Appendix
Stores lymph cells
Small intestine
Enzymes that digest nutrients into smaller parts. Cell walls absorb into blood and lymph
Pancreas
Digests nutrients and releases bicarbonate to neutralize acid chime
Pancreatic duct
Moves pancreatic juice from pancreas to SI
Large intestine
Reabsorbs water and minerals. Passes fiber, bacteria and unabsorbed nutrients w/ water to rectum
Rectum
Water pre-elimination
Anus
Holds rectum closed. Opens to allow elimination
What are digestion and absorption?
Processes that make nutrients available for body to use
What is salivary amylase?
Enzyme that breaks down starch in mouth
How long is the esophagus?
10 inches.
What is peristalsis?
Flexing of mucles that move food thru esoph to stomch
What does the cardiac spyhincter do?
Closes from esoph so food stays in stomach
What is chime and what does it trigger in the stomach?
Semi-liquid mass of partly digested ood that driggers the release of gastrin
What does gastrin do
Releases hydrocholoric acid
What is HCL stomach PH
2
What does protease digest?
Protein
What does lipase digest
Lipids
What is pepsin
Helps digest proteins
What sphincter does the stomach use to move chime to the SI?
Pyloric sphincter
Length of the duodenum
10 inches
The jejunum?
8 feet
The ileum
12 feet
What triggers release of pancreatic juice?
Chyme
What do pancreatic enzymes do?
Digest CHO, fats, proteins. Release bicarbonate to boost PH to 5.5-6.5
What does liver secrete
Bile which solubilizes or emulsifies water-insoluble fats
What does gallbladder do?
Stores and concentrates bile between meals and releases it during meals
What is absorption?
How simple nutrients move from GI lumen into GI cells
Where does most absorption occur?
Small intestine
What are villi and microvilli and how much do they increase in area
They are intestinal folds. Villi increase 15 times, microvilli, 300. Most absorption takes place here
What does the ileocecal valve join?
The small and large intestines
What reabsorbs water and salts?
The colon
What is shit made of?
Dietary fiber, microorganisms, water
Where else does excretion take place?
Kidney,skin, liver, epithelial cells, hair and naisl, lungs
What are the three types of absorption?
Passive diffusion, facilitated diffusion, and active transport
What is active transport?
A carrier loads a nutrient outside the cell and then releases it on inside of the cell
Does passive diffusion require energy?
No
What is faciliatated diffusion?
Requires some help moving across membrane. Min to no energy
How do the following affect GI function
Physical immaturity
Infants vomit
Aging
You get constipated
Illness
You get diarrhea
Nutrition
Low fiber fucks up GI structure & function
What are common digestive dishorders
Constipation, heartburn. Ulcers, heatburn. Iritable bowel syndrome. Diarrhea. Flatulence. Stomach growling
What system transports fats?
The lymph system
What transports carbs and prot?
The vascular, or circulatory system
What is the lymph system made up of
Lymph nodes, tonsils, thymus, spleen, lymph vessels
What is circulatory system
Arteries, heart, veins
What do you need to digest fat and carbs? To digest protein?
Water, CO2 and heat. H20, N, CO2 and heat
What is a calorie?
Amount of energy to boost one kg/4 cups of water from 15 to 16 C. 59 to 61 F
How does bomb calorimeter work
Food gets burned, water temperature increase measured
Where does energy go?
Basal metabolism (at rest). Dietary thermogenesis. Exercise induced thermogenesis
How much does basal generally consume?
2/3rds of total energy
Do tall thin ppl or short fat ones consume more energy. Why?
Tall thin ones, bc they have more surface area
Estimate basal metabolism
Body weight * 11 (dudes). Bw * 10, women
What is thermogenesis?
Thermic effect of food. 1/10th of energy expenditure. Chewing, digesting, absorbing, transporting, storing excreting
Energy expenditure calculation
Basal Met: Weight x 10 or 11
Phys Act: BM * .3, .5, .75
Dietary Therm: .1 * (BM + PA)
Total: BM + PA + DT
What is adaptive thermogenesis
Adapting to stress, temperature extreme or injury.
What is obesity?
Excess body fat. A chronic disease. Treated as a subacute illness in which time limited treatments lead to cure
What is body weight composed of
Fat, lean tissue and water
What are obesity trends?
Overweight increasing in 6-19 yos. Overweight adults, constant. Obesity in adults skyrocketing
What is the body mass index?
(Weight in Kg)/ (Height in meters ^2)
What is Underweight?
<18.5
Normal weight?
18.5-24.9
Overweight?
25.0 – 29.9
Obesity I?
30-34.9
Obesity II
35-39.9
Morbid Obesity?
>40
In 1990, 10 states had obesity < A%, and no states had >B%.
10%, 15%
1998: no state had less than C%, 7 states btwn D% and E%. No state >E%
10%. 20-24%. 25%
2007: only Colorado had less than F%. 30 states > G%. 3 states > H%
20%. 25%. 30%
What % of US pop overweight or obese?
72.90%
What % obese?
34.30%
How many deaths?
400,000
What cost?
117 billion in economic costs. 61 billion in direct costs
Healthy male body fat %?
10-25%
Female:
18-32%
What does subcutaneous mean
Under the skin
Where do apples store their fat?
Around their abdomen
Where do pears store their fat?
Around their hips and thighs
Which is worse? Why?
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
What are the failings of BMI?
Does not consider. % fat, % lean. And fat distribution btwn subcutaneous and visceral
What are anthropometrics?
You use the waist to hip ratio, fat fold measures, and waist to height ratio
What is hydrodensitometry
Underwater weighing, which is the gold standard
What are some other ways of measuring body comp?
Bioelectrical Impedance, Potassium counters, dual X ray absorptometry
What are problems w/ being underweight?
Exacerbates diseases esp in wasting diseases. Cease menstruating when fat < 12%.
How much does type 2 diabetes risk increase due to obesity?
3x
What cancers is obesity associated with?
Breast, colon, gallbladder, cervix, uterus, ovaries, prostate.
What is hypertension?
High blood pressure
What % of sleep apnea attributable to obesity? Type 2 diabetes? Gallbladder?
95%. 61%. 30%
Know the reasons for obesity
Genetic, Metabolical and physiological, environmental.
What is goal of weight management/treatment?
Prevent further weight gain, reduce body weight, then maintain over long term
Strategies for weight loss/ maintenance
Dietary therapy, physical activity, behavioral therapy, combined therapy, pharmacotherapy, weight loss surgery
What is a good weight loss goal for therapy
Down 10% body weight in 6 months. Moderate calorie deficits: -500 or -1000. 1-2 lbs per week.
How much in a pound of fat
3500 kcla
Why is gradual weight loss good?
Prevents bone and muscle loss
Lecture 3
What BMI do you have to have for medical treatment?
BMI >30 or >27 with comorbidities
What 2 weight loss drugs approved
Sibutramine (mEridia), orlistat (alli)
How does Orlistat work?
Bonds with gastrointestinal lipase to prevent about 1/3 of dietary triglyceride from being digested
What is a disadvantage of weight loss drugs?
The lost weight does not generally stay off when you discontinue treatment
What are comorbid conditions?
Cardiovascular, sleep apnea, uncontrolled diabetes
What is gastric bypass
The stomach almost is completely removed from GI nutrient flow
What are complications of g bypass
Nausea/vomiting, dumping syndrome, malabsorption of vitamin b12, folate, calcium and iron. Dehydration, inection, behavioral and psychological changes
What is adjustasble gastric band
You put a band around the stomach to create a small stomach pouch
What is vertical banded gastroplasty
You use a band and staples to create a small stomach pouch
What is liposuction. What are its limits?
Maximum of 8 lbs per procedure in US. Fat active tissue releases hormones that causes you to redistribute body fat after the op
Eating disorders
What is anorexia nervosa
Self starvation, when you are less than 85% of your healthy weight. 300-700 cals per day. Body dsmorphia
What are side effects of AN
Amenorrhea: early osteoporosis, lack of estrogen. Hypothermia, Death
% of ppl w/ AN
1% of women, and .1% of men. Risky for dieters, dancers, athletes, nutritionists and dieticians, diabetics
Treating AN
Takes years usually, requires prompt restoration of healthy and body weight. Use mdedication, therapy, eating behavior analysis and phys act programs.
What is the relapse rate for AN treatment
33%
How often do you need to purge to have Bulimia nervosa
At least twice a week for three months
What % of pop. Has Bulimia?
1-3% of women, .5% of men.
What are side effects of BN
Acid from vomit rots teeth. Dehydration and electrolyte loss. Depression, abdominal pain,history of abuse, normal or overweight
What treats BN
Breaking the cycle w/ an organized eating pattern. Psych counseling and antidepressants.
How much does pregnancy improve BN
In 70% of cases, pregnancy improves the condition
What is relapse rate for BN?
33%, same as AN
What are traits of binge eating?
Excessive intake without a purge that is both compulsive, secretive, and guilt inducing.
What % of the obese exhibit binge eating
30-90%
What is Pica, Geophagia, Pagophagia, amylophagia, plumbism, and coprophagy
Eating nonfood. Geo-clay dirt. Pago-ice. Amylo-laundry starch. Plumbism-lead. Coprophagy: feces
Carbs
What % of diet = carbs
55-60%
Chem structure
C6H12O6
What are the simple carbs?
Mosnosaccharides and disaccharides
What are the 3 monosaccharides
Glucose, Fructose, and Galactose
What is glucose also known as
Dextrose
Is glucose an essential energy source
Yes
How is glucose important to disaccharides
It is one part of every disaccharide
What is fructose also known as
Levulose
What is the sweetest sugar
Fructose
What is the rarest lone monosaccharide
Galactose
Glucose + Galactose =
Lactose
Fructose + Glucose
Sucrose
Glucose + Glucose
Maltose
Where do you find sucrose?
Table sugar and honey
Where do you find maltose?
Broken down from starch
What does maltose look like?
Two hexagonal glucoses bonded with an oxygen in the middle
Lactose
Similar to glucose but trans: across the oxygen bond
Sucrose
Just like maltose with a fructose instead of a glucose
What is glycogen?
Storage form of glucose in animals. It is a branched molecule glucose polymer
What is the function of glycogen?
Maintains blood glucose between meals and provides muscle with energy during anaerobics
What are the limited forms of glycogen?
Liver and muscle
What is the unlimited form>
Stored in the fat
What stores glucose in plants/
Starch
What are the two amyloplasts?
Amylose and amylopectin.
What are the prevalence %s of the amlyoplasts?
Amylose is 30%. Amylopectin is 70% (more common)
Which amyloplast is linear?
Amylose
Which is branched, but less extensively than glycogen?
Amylopectin
What digests carbs in the mouth
Salivary amylase
What digests salivary amylase and where?
HCl in the stomach
Do ppl break down starch?
No
What breaks down amylase and dextrins and where?
Pancreatic amylase in the small intestines
What digests sucrose, lactose, and maltose and where?
Sucrose, lactase, maltase. Small intestine
What form of transport occurs for CHO absorption?
Active transport
What vein is CHO absorbed into and where does it lead?
The portal vein. It goes to the liver
What do galactose and fructose get converted into and where?
In the lvier, they get converted into glucose
Where exactly in the small intestine do monosaccharides enter before going thru the portal vein?
The capillaries of the intestinal villi
Where do you find fiber in the digestive tract?
The large intestine
What breaks down some fiber?
Microflora, a bacteria in the large intestine
What causes lactose intolerance?
Not having enough lactase
Walk thru the process of drinking milk for lactose int. person
Undigested lactose gets fermented by GI bacteria and produces gas and acids which give bloating, pain and diarrhea
What can you take to lessen this?
Lactaid supplements (lactase tabs) or milk with lactase. Eating aged cheese is better than cottage cheese. Fermented milk easier
What groups highly lact. Intolerant?
Asian, native American, African American
How else does L.I. develop?
Damage to the villi from illness, medications, malnutrition. Def. from birth or old age.
How are starch and fiber different
Different glucose orientation. Cellulose has a beta acetal, starch has an alpha acetal
Can we digest starch and fiber?
No, only starch is an energy source for us
What are the 4 types of indigestible starch?
Cellullose, pectins, gums, and lignin
Where do you get cellulose but not pectins?
Legumes. You can get both in fruits and veggies
Which fibers are water soluble?
Gums and pectins
Why is this useful?
Prolongs stomach emptying time so sugar uptake regulated. Means lower blood cholesterol.
Where do you get water soluble fibers
Oat bran, barley, legumes, fruits
What are the water insoluble fibers? What foods have them>
Cellulose and lignin, found in veggies wheat and grain
What do they do metabolically?
Increase fecal bulk and decrease intestinal transit time.
Is glucose essential?
Yes. Body incurs harm when converting fat/protein to glucose
Proper glucose concentration
80-120 mg/dl
Where is excess glucose from meals stored?
Liver and muscles; limited. Fat reserves; unlimited
What are the two primary hormones regulating blood glucose
Insulin and glucagon.
Where are they released?
Pancreas
What does insulin do
Transports glucose into cells
What does glucagon do
Releases glucose from storage
What is gluconeogenesis
When protein gets converted into glucose when you have too little glucose in the meal
What is ketosis
Fat getting converted to ketone bodies to give muscles energy, does not give brain support
Symptoms of low/high blood glucose
Low: weakness, coma, death. High: vasculature damage, peripheral nerve damage, wasting syndrome
What does high blood glucose do to the pancreas?$
It tells it to release insulin
What does extra insulin do?
Says, uptake glucose. Store it as glycogen in liver and muscles. Store as fat.
When your blood glucose gets low, what does your pancreas do?
Releases glucagon into the bloodstream
What does glucagon tell your liver to do?
Break down glycogen and turn it into glucose
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
Does sugar cause diabetes and hyperactivity
No
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
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
What is the basic structure of an amino acid
Central carbon, hydrogen, acid, amino group
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.
What does HCL do to pepsinogen
Converts enzyme pepsinogen into active pepsin
What other pep____ gets broken down
Pepdtidase
Where do the previous 4 qs happen
Stomach
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
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.
In prot synth, what is transcription
Take DNA and turn it into RNA.
What is translation
Take RNA and turn it into an amino acid
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
What are known as cell powerhouses and what are they shaped like
Mitochondria. Intricately folded membranes that house all enzymes in the TCA cycle
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
What is an example of an error in protein synt
Sickle cell anemia. One AA is wrong, causing structure to get messed
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.
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.
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
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)
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
15 mins. 300% increase in storage efficiency of glycogen
What does training regularly do to your glycogen stoage?
Increases it and allows you to use oxygen to convert fat to energy more effectively
When should a pre-event meal be eaten? Light or heavy? Food tolerance? Beverages?
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
Three diets: tell their max endurance time. Fat and protein. Normal. High carb.
57 mins, 114, 167 mins
How much % of diet for endurance athletes needs to be fat
20-30%
What happens w/ fat if you are too intense?
You stop fueling yourself with stored fat bc it’s anaerobic. Rock sustained moderate intensity.
What % of diet from protein?
10%
How much can you add to muscle mass per day
About 15g. Can be as high as 45g
When you have a high fat and low carb diet, what happens to amino acids
They get converted to glucose
Active ppl get more nutrients from food except when it comes to __ bc
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.
Sports anemia is characterized by a temporary __ defecit
Hb
What’s a good % glucose for a sports drink?
7%. It should also have sodium and other electrolytes
How long do you need to dilute blood sodium? What’s the dangerous condition called from this?
4+ hours of heavy sweating can induce hyponatremia
What reason do caffeine and booze share for being a shitty fluid?
They both are diuretics, which dehydrates you
Why else is booze bad?
Impairs ability to regulate body temperature, decreases reaction time, strength and agility
What are dangers for female athletes?
Iron deficiency and anemia. Low bone density. Low body fat (<12%)
What’s the deal w/ amino acid supplements
Supplements cause imbalanced absorption of other amino acids, which are needed for muscle. Eating enough is more important
Diabetes Lecture
Factors of diabetes melitus
Genetics, env, chems, infections, autoimmune events, nutrition, phys act, phys stress
What are diabetes
Disorders characterized by excessive urine excretion
What does Diabetes mean
To flow through (romans in 70 AD)
DM affects how many US ppl?
18 mil
What rank in death list?
# 4 leading cause of death
What are two major effects?
Blindness, kidney disease
Where in the pancreas is insulin produced?
In the beta cells
What does insulin regulate?
Blood glucose levels, along with glucagon
Where does glycogen get stored?
Liver and muscle tissue
Insulin process: insulin binds with the __ which allows ___ to transport glucose into a cell
Insulin receptor. The glucose transporter GLUT 4
When you eat, your intestine causes
Your blood glucose to rise
This triggers your pancreas
To release insulin
Insulin causes your cells to
Uptake glucose
And your liver and muscle
To store extra as glycogen
Insulin also encourages the formation
Of fat
If you have low blood sugar your
Pancreas releases glucagon into the bloodstream
Glucagon pushes your liver to
Break down glycogen and push glucose into the blood
What other hormone helps?
The stress hormone, epinephrine
What kind of cell is glucagon in?
The alpha cells of the pancrease
What kind of cell is insulin in?
The beta cells of the pancreas
What does chronic hyperglycemia do
Gives you diabetes
How can the liver, pancreas, and muscle contribute to hyperglycemia
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
What does hyperglycemia cause
Increased blood triglycerides, atherosclerosis, and chronic inflammation
What is IDDM
Type 1 diabetes, or insulin dependent diabetes mellitus.
In IDDM, how much insulin does beta cell make
None or very little
How common is IDDM?
5-10% of cases
When does it start and why does it happen?
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
What is NIDDM
Type 2 diabetes, or noninsulin dependent diabetes mellitus
What is NIDDM characterized by
Insulin resistance and insulin receptor and post receptor probs
When does NIDDM happen
Post childhood, often at the end of diseases
What causese NIDDM risk to go up 10x
Obesity. Visceral fat increases your glucose intolereance and hyperinsulinimia
With type 1 diabetes, what happens when you eat
CHO turns into glucose, enters bloodstream. Pancreas beta cells don’t make insulin and glucose builds up
With type 2, what happens
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
How many cases of diabetes melitus
18 million 750k type 1s
How many undiagnosed type 2s
7 million
What % of US population in 1960, today?
1%, 9.6%.
Obesity responsible for what %
75% of type 2
How many diagnosed each year
600k
How do you diagnose diabetes?
Polyuria, polydipsia, unexplained weight loss. >200 mg.dl blood glucose concentration. Glucose concentration post 8 hrs of fasting >126 mg/dl.
What is polyuria
Excessive urine
What is polydipsia
Excessive thirst
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
What does lack of insulin cause in order
Decreased glucose use, hyperglycemia, dehydration, peripheral circulatory failure, coma and death
What are the causes of insulin resistance?
Pancreas makes fucked up insulin, your circulatory system fights insulin or its receptors, or the receptors are broken
Are gene mutations impairing beta cell function common?
Not as common as insulin resistance from visceral obesity
Is bodyweight or body fat and inactivity more important determining glucose metabolism?
Body fat and inactivity. If you have high subcutaneous and visceral adiposity
Is upper body or lower body fat worse?
Upper body. It produces pro inflammatory factors that fuck up insulin clucose transport.
What happens w/ protein restricted diet?
Lower beta cell mass, messed up insulin response in offspring
Malnourished feti
More likely to be insulin resistant.
What % of preggers affected by gestational diabetes
2-4%. That means about 100-130k per year
When is GDM more likely in pregnancy?
If oyu had a previous large infant, family hist of diabetes, maternal obesity, early pregnancy.
Body weight and regular exercise:
Reduces risk to less than 25%
What % may develop NIDDM in 15-20 yrs (after 20?)
40-60%
What are diseases resulting from diabetes
Atherosclerosis, kidney failure, disrupted cognition, motor function, retinopathy, gangrene
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)
What is diabetic neuropathy
Most frequent and most disabling form of neuropathy. Frequently causes high morbiditiy and death
Why do you get gangrene f/ diabetes
You have poor blood circulation. You often have to get amputations due to cellular necrosis
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
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.
What are routes of control
Dietary control, exercise, education, insulin and oral hypoglycemic drugs
Goals for medical nutritional therapy
1. Achieve physiological blood glucose levels
2. Maintain desirable plasma lipids
3. Reduce likelihood of specific diabet complications
4. Prevent atherosclerosis
Generally:
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
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
What level of exercise increase rate of glucose uptake?
Moderate. Has a direct impact on cv performance and glucose clearance