Nutrition Weight Loss Lipids

Front 1

Name the essential FA's

Back 1

Linoleic 18:2 (n-6)
alpha-linolenic 18:3 (n-3)

Front 2

Trans fatty acids occur in modest amounts in meat and dairy products as result of bacterial fermentation. Catalytic hydrogenation of polyunsaturated vegetable oils to convert these oils to a hardened form of margarine that has the texture of butter is a significant source of trans fatty acids.

Back 2

saturated fatty acids and trans unsaturated fatty acids raise levels of LDL (low density lipoprotein), which increases risk of coronary heart disease (CHD). But, unlike the saturated fatty acids, the trans acids also lower blood levels of HDL (high density lipoprotein) a molecule deemed protective against CHD

Front 3

Essential FA deficiency

Back 3

scaly dry skin

RBC fragility, decreased myocardial contracitlity and resistance to capillary blood flow, decreased ATP from liver mito

skin fixed through omega-6 more than omega-3

Front 4

Diagnosis of essential FA deficiency

Back 4

FA oleate is elongated and desaturated to make 20:3 omega-9, the closest approximation to the eicosanoid 20:4

TRIENE/TETRAENE ratio 20:3 to 20:4
ratio above .1 = eFA deficiency

Front 5

Who gets it

Back 5

geriatrics on poor diets
fat malabsorption syndromes(surgical bowel resection)
parenteral nutrients deficient in eFA
Burn patients

Front 6

eFA and pregnancy

Back 6

Should be 1% of total energy

in preg should be 3%

Front 7

What breaks down triglycerides?
phospholipids?
cholesterol oleate?

Back 7

Tg, lipase
phospholipid, phospholipase
cholesterol, esterase

Front 8

Explain digestion and absorption of TG's (LCFA)

Back 8

TG combine with bile acids and phospholipids to emulsified droplets

add in lipase and esterase and get mixed micelles (LCFA, 2-MG(monoacylglycrol))

these are absorbed by intestinal villus cells (bile acids leave to be reabsorbed in the enterohepatic circ)

FA+MG -> TG -> chylomicrons (VLDL,LDL,HDL) which empty into lymph -> thoracic duct -> blood

Front 9

digestion/abs of Tg is almost complete, sterols are not

Back 9

kjb
sterols and CE incorp into mixed micelles

most CE is secreted,

Front 10

digestion and absorption of TG's(MC/SCFA)

Back 10

abs dir into cells. FFA go to portal vv (bound by albumin)

4X as efficient abs
do not facilitate lipid-soluble vit

Front 11

Lingual lipase

Back 11

dont do much with LCFA

pancreatic lipase and colipase, max activity above pH7
1:1 molar ratio
colipase - binds lipase to TG droplet displacing bile salt

Front 12

bile salts activate what enz

Back 12

cholesterol esterase, rate of hydrolysis is much less than for TG's

Front 13

specificity of sterol absorption

Back 13

beta sitosterol from plants abs poorly, plant sterols interfere with cholesterol abs

Front 14

beta-sitosterolemia

Back 14

1/3 of dietary sitosterol is abs(instead of 5%) --> deposits found in many tissues, plasma CE is normal

Front 15

fatty malodorous stools

Back 15

steatorrhea

Front 16

what are some situations assoc with steatorrhea

Back 16

1)pancreatic disease
2) insuff bile production(duct obstruction)/poor liver secretion(hep)
3) loss of small intestine segm
4) celiac disease and sprue (immune response to gluten, damage to intestinal villi)

Front 17

how can you diagnose celiac disease/sprue

Back 17

measure fat soluble vit in blood, test stool for fat

Front 18

metal soaps

Back 18

FA in lumen bind divalent cations like Ca Mg and Zinc

can't abs them

Front 19

Oxalates

Back 19

decrease Ca in intestine means increase abs of plant oxalates, a major source of kidney stones

Front 20

what can you give a patient who has steatorrhea

Back 20

remove dietary fat and replace with MC triglycerides (MCT), can be abs w/o pancreatic lipases

octanoic and decanoic acids are abs dir via portal vv

Front 21

cholesterol usual uptake

Back 21

200-600 mg/day

Front 22

macronutrients abs'd where?

Back 22

jejunum

Front 23

B12/bile salts abs'd where

Back 23

ileum

Front 24

water soluble vitamins absorbed where

Back 24

upper intestine

Front 25

whats more important in atherosclerosis and diet

dietary fat or cholesterol

Back 25

dietary fat

Front 26

diet can effect

Back 26

LDL/HDL ration, want low LDL

and changes in suseptibility to thrombosis(clotting)

Front 27

P/S ratio

Back 27

polyunsat/ sat FA's

Front 28

What type of fatty acid do you want to be eating? (sat vs unsat) and why

Back 28

saturated = more atherogenic

PUFA's (and oleic)are less atherogenic

Fish oil omega-3 are more antiatherogenic than other PUFA's

Front 29

Blood cholesterol

Back 29

200 mg/day is risk factor, over 240 requires serious intervention

measure LDL levels, HDL not a risk

Front 30

soft or hard margarine

Back 30

hard margarines are worse

Front 31

Homocysteine and atherosclerosis

Back 31

effects not well understood, may be from superoxide radicals,

Hcys levels determined by the rates with which it is recycled to met(using 5,methylTHF-->THF and B12) or cysteine(B6)

Tetrahydrofolate - normalize Hcys

B6/B12 defic = hyperHomocysteinemia