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BIochem Exam 1 Winter
Carbohydrate, Pregnancy, Malabsorption, Nutrition, etc. AZPOD
292
Biochemistry
Post-Graduate
12/13/2011

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Cards

Term
What are the monosaccharides we covered? 1 pentose and 5 hexoses.
Definition
5- Ribose
6- Glucose, Dextrose, Fructose, Galactose, Mannose
Term
What are disaccharides?
Definition
sugars made of two monosaccharides, linked by O-glycosidic bonds.
Term
What are the sugars that compose
sucrose
lactose
maltose
Definition
Sucrose- glucose fructose
lactose- glucose galactose
maltose- glucose glucose
Term
how is maltose created in the body?
Definition
result of digestion of starch in the intestine by pancreatic amylase.
Term
What is high fructose corn syrup's general makeup?
Definition
55%Fruc, 45% glu
Term
What are the two polymer forms of starch?
Definition
Amylose (linear, a-1,4)
Amylopectin (branched, a-1,4 and a-1,6
Term
What is glycogen
Definition
amylopectin polymer from animals that is more densely branched (every 1-0 residues) compared to starch (every 25) It crazy absorbs water.
Term
How can humans access raw starch?
Definition
cooking it makes it burst the plant cell walls
Term
what is retrograde amylose
Definition
resistant starch that forms during cooling after cooking, resistant to digestion and ferments causing gas
Term
What are the two types of fiber and their descriptions?
Definition
Insoluble- cannot be degraded nor be fermented by colonic bacteria
Soluble- cannot be degraded but can be fermented by colonic bacteria
Term
what are the main sites of carbohydrate digestion?
Definition
Mouth, intestinal lumen (not stomach)
Term
What are the 4 steps of carb digestion?
Definition
Mouth- salivary a-amylase breaks some a-1,4 bonds
Small Int- pancreatic a-amylase continues the breakdown
Upper Jejunum- several disaccharidases and oligosaccharidases break into monosaccharides
Duodenum and Upper Jejunum absorb monosaccharides
Term
Describe glucose uptake via enterocytes, how does insulin play a role in the process
Definition
Na-glucose (and galactose) symport
it doesn't
Term
Normal water and lactose metabo.
Definition
Lactose pulls water from cells, lactose broken down to galac and gluc, which are absorbed into the brush border, water follows, no net gain
Term
Abnormal water and lactose metabo. (osmotic diarrhea)
Definition
Lactose draws water from the enterocytes, lactose isn't degraded and continues with stool, water isn't sufficiently reabsorbed and causes diarrhea
Term
What is the enzyme lost in lactose intolerance?
Definition
lactase
Term
What reinforces the awefulness of osmotic diarrhea?
Definition
remaining carbohydrates are fermented by colonic bacteria, makes losts of co2 and h2 gas
Term
What hereditary defect in disaccharide digestion exists in 10% of greenland's eskimos?
Definition
Isomaltase-sucrase deficiency
Term
What is the test carb intolerance, briefly describe
Definition
Oral sugar tolerance- use individual disaccharides to determine which doesn't jive (what enz missing) intolerance determined by measuring h2 in breath (indicating fermentation)
Term
What are the two resons for monosaccharide osmotic diarrhea? (Fructose malabsorption)
Definition
poor digestion
poor absorption
Term
What two transporters exist for the absorption of fructose?
Definition
glucose indep
glucose dep
Term
When are symptoms of fructose malabsorption manifest? Why?
Definition
when fructose exceeds glucose, Fructose remains in stool and draws water from enterocytes
Term
Why is malabsorption more than additive when fructose and sorbitol are ingested togetther?
Definition
they may compete for same transport
Term
What is the RDA for carbs? Why do we have to consume carbs?
Definition
130g, absence of carbs leads to ketone body production and degredation of body proteins
Term
Give a few points on the glycemic index
Definition
-proposed to quantify postprandial blood glucose spikes per food
-considers the area under the glucose curve
-higher index=faster spike
-higher fat content, fiber = lower spike
Term
What is the AI for total fiber for men/women?
Definition
men-38g
women-25g
Term
how does high fiber reduce gastrointestinal disorders?
Definition
relieved constipation reduces hemmorhoids, lessens risk for diverticulosis and IBS
Term
how does high fiber reduce cholesterol levels?
Definition
soluble fiber binds with bile acids (made from chol) and carries it off in stool, the liver must take more from blood to make more bile salt (theoretically)
Term
How does high fiber reduce the risk of diabetes?
Definition
Soluble fiber slows absorption of glucose from small intestine= tighter control. High fiber foods generally=lower calories
Term
how does high fiber reduce the risk of colon cancer
Definition
it doesn't... oops
Term
how does high fiber reduce the risk of obesity?
Definition
high bulk=more chewing time=full signal sooner=not overeating. Gell from fiber makes small meal feel larger and linger longer (ha). Generally high fiber=low cal.
Term
What are nutrients?
Definition
essential constituents in food needed for life and health
Term
What are macronutrients?
Definition
nutrients needed in large amounts (CLP) to provide E, EFA, EAA
Term
What is a micronutrient?
Definition
vitamins and minerals needed in small Qs
Term
What are the four DRIs? (Dietary Reference Intakes)
Definition
EAR-Estimated average requirement (inadequacy at 50% pop)
RDA-Recomm. Dietary Allowance (inadq 2-3%)
AI-Adequate Intake
UL- Upper Limit
Term
What is the formulation for RDA?
Definition
the EAR plus two standard deviations (to meet 97-98% of pop)
Term
How does one determin if he/she is getting the RDA?
Definition
take the average over a few-several days
Term
What is the RDA for Ascorbic Acid in Men, Women, and smokers?
Definition
75mg/day women
90mg/day men
+35 for smokers
Term
What are the two overreaching concepts behind the Dietary guidelines?
Definition
maintain calorie balance over a period of time
Consume nutrient dense foods and bevs.
Term
What is the definition of nutrient density?
Definition
nutrients provided/ kilocalorie of food
Term
What is the daily intake E range for the three macronutrients?
Definition
Protein 10-35%
Carbs 45-65%
Fat 20-35%
Term
What are the kcal/g for the three macronutrients and EtOH?
Definition
Carb-4
Protein-4
Fat-9
EtOH-7
Term
what percent of the calories consumed goes to produce ATP?
Definition
40%
Term
what percent of the calories consumed goes to produce heat?
Definition
60%
Term
What is direct calorimetry?
Definition
Measures heat given off by an individual in a closed environmental chamber
Term
what is indirect clorimetry?
Definition
mesuring o2 consumption (most human heat is result of oxidation rxn), or measure o2 consumed and co2 produced
Term
What are the 3 sections of metabolic rate?
Definition
RMR
MET (physical activity)
TEF (Thermic effect of food)
Term
What makes up the largest portion of our total daily expenditure?
Definition
RMR
Term
What are the top three organs/systems contributing to RMR?
Definition
Liver, Brain, Skeletal M
Term
RMR is proportional to what physical characteristic?
Definition
LBM (Lean Body Mass)
Term
What is LBM?
Definition
All non-fat body components
Term
What are the two arbitrary divisions of physical activity?
Definition
Exercise, NEAT (Nonexercise Activity Thermogenesis)
Term
What is a MET?
Definition
the ratio of the metabolic rate of the active individual to the rate fo the fasting individual at rest (metabolic equivalent)
Term
How do you calculate a MET for an activity?
Definition
Met value X Kg X hours
1lb=2.2Kg
Term
Describe TEF
Definition
Thermic Effect of Food, difference bt postprandial metabolic rate and RMR (increase induced by eating)
Term
TEF makes up what percent of daily caloric intake? Which macronutirent increases the MR the largest?
Definition
10%
Protein-Urea synthesis
Carbs increase bc of absorption and glycogenesis
Term
What is the simplest way to calculate a persons EER?
Definition
RMR+ physical activity+ TEF
Term
EER- What is the simplest formula for calculating the RMR?
Definition
Kg x 1 (.9 female)x 24
Term
EER- What's the percent scale for physical activity calculation?
Definition
sedentary-20
lightly active-30
moderately active-40
Very Active- 50
Extremely active- 60
Term
EER- what's the simplest way to calculate TEF?
Definition
(RMR + Physical Activity) x .10
Term
What accounts for the decreased RMR in women relative to men?
Definition
women have on average 10% more body fat, or 10% less LBM than men of the same ht/wt
Term
What is energy balance?
Definition
the difference between energy intake and expenditure
Positive- wt gain
negative- wt loss
Term
What are the ABCDs of Nutritional Assessment?
Definition
Anthropometric
Biochemical Parameters
Clinical Eval
Diet history
Term
How does Adult Ht indicate a society's well being?
Definition
Adult ht reflects environmental factors that increase or decrease nutrient intake during growth spurts
Term
What are the three growth spurts?
Definition
Infancy
bt 6-8 yrs
Adolescence
Term
What are the results in an iodine deficeincy during adolescence?
Definition
4"shorter 15pts lower IQ
Term
Variation within a pop is
Definition
genetic
Term
Variation b/t pops is
Definition
mostly environmental
Term
what is the single most significant measurement of nutritional status?
Definition
Weight change over time as a percentage. Unexplained loss of 10% or more may be considered malnutrition
Term
What are the calculations for Ideal Body Wt? IBW?
Definition
Male- 106lb + (6lb/inch over 5') +- 10%
Male- 100lb +- (5lb/inch over/below 5') +- 10%
Term
According to IBW what is underweight or obese?
Definition
Under<85% IBW
Obese>120% IBW
Term
What is the formula for BMI (metric and english)
Definition
Kg/M^2
(lb/inches^2)x 703
Term
Occording to BMI what is Caucasian Underweight and Obese?
Definition
Under < 18.5
Obese> 30
Term
What are the three major issues with measuring and using BMI?
Definition
-measures excess wt not fat
-doesn't account for gender
-Not universals per ethnicity
Term
What is the relationship between BMI and % body fat?
Definition
There is no relationship
Term
BMI cutoffs represent what?
Definition
Cutoffs based on disease risk.
Term
What are the gold standard for Body Fat Assesment?
Definition
Hydrostatic weighing and DXA
Term
Explain Bioelectric Imepdance Analysis
Definition
measurement of body water compartment using electric current, fat resists current b/c low water content. >Fat=>resistance
Term
Why is triceps skinfold thickness a plausible test for body fat content?
Definition
50-80% of adipose tissue is subcutaneous, thicker fold=more fat. better determined with multiple spots
Term
What are the two fat distribution ratios considered in fat assesment?
Definition
Waist to hip
wasit circumference
Term
Testosterone and estrogen favor what fat deposition patterns, respectively?
Definition
abdominal fat
gliuteofemoral
Term
What is the risk of central obesity? (apple shape)
Definition
2fold greater risk of hypertension, hyperinsulinemia, diabetes, Cardiovas disease
Term
How do risks differ for pear shaped women than apple men?
Definition
they have to weigh 20lbs more to show the same risks as apple men
Term
What's different about abdominal fat cells?
Definition
they are larger and more metabolically active, men lose wt in abdominal fat first
Term
Visceral obesity for men and women can be classified by waist inches, what are the limits?
Definition
male>40
female>35
Term
What is Waist to hip ratio, what is the high/risk ratio for men and women?
Definition
simple- ratio.
men>1
women>.86 (women allowed 14% bigger hips)
Term
What attributes most to any change in lean mass?
Definition
change in muscle wt.
Term
What are the two compartments for body protein?
Definition
Somatic
Visceral (prealbumin, etc.)
Term
Biochemical Markers- how do you test for thiamin deficiency?
Definition
Measure ertythrocyte transketolase activity with and without added thiamin. If results increase >25% when adding thiamin = deficiency.
Term
What is a Subjective Global Assesment?
Definition
A clinical assesment of a person's nutrition, a few questions including dietary/wt history, no biggie, can be done quickly.
Term
What are 5 conditions that increase a patient's risk of developing a nutiritional deficiency?
Definition
MADD-L
Malabsorption
Alcoholism
Dental Disease
Drug Use
Living Alone (sad but true)
Term
What is the difference in type of metabolism between Type I, II and IIx M fibers?
Definition
Slow-oxidative
Fast- Oxidative glycolitic
Lightning-Glycolytic
Term
What is the difference in the fuel type between Type I, II and IIx M fibers?
Definition
TAG
CrP, Glycogen
CrP, Glycogen
Term
What is the difference in level of myoglobin between Type I, II and IIx M fibers?
Definition
High (red)
Middle (pink)
Low (white)
Term
What is the difference in mitochondria levels between Type I, II and IIx M fibers?
Definition
High (50% cell vol)
Not as High, but High
Low
Term
What is the difference in capillary densities between Type I, II and IIx M fibers?
Definition
High
Int.
Low
Term
What is the difference in fiber sizes between Type I, II and IIx M fibers?
Definition
Small
Med
Large
Term
What is the difference in duration of use between Type I, II and IIx M fibers?
Definition
Hours (fatigue resistant)
<30 min
<5 min
Term
Three random facts in notes concerning M ATP, Heart ATP consumption/Production
Definition
M only has 3 seconds worth of atp at max contraction
1min of heartbeat = total atp consumption x3
heart produces 8-11lbs of ATP daily
Term
ATP production can increase flawlessly up to __fold to match consumption.
Definition
100
Term
Anaerobic metabolism produces how many moles ATP/min and has what duration length?
Definition
2.5Mole/min for 1.3-1.6 min
Term
Immediate ATP (ATP,CrP, and Adenylate Kinase) produces how many moles ATP/min and has what duration length?
Definition
4Moles/min for 8-10 sec
Term
Aerobic metabolism produces how many moles ATP/min and has what duration lenght?
Definition
1Mol/min unlimited (as long as nutrients last)
Term
What is Adenosine Nucleotide Translocator (ANT,) km, mechanism?
Definition
transport protein that moves ADP into the mitochondrial matrix, low Km for ADP, Antiport (one in for each ATP out)
Term
What does Creatine kinase do?
Definition
catalyzes the reversible transfer fo high energy phosphate to and from creatine.
Cr+ATP=CrP+ADP
Term
How do CrP and Creatine Kinase isonezymes work together?
Definition
They help maintain an energy shuttle between ATP production sites and ATP consumption sites
Term
What do the mitochondrial CK do?
Definition
combine ATP and Cr to make ADP and CrP
Term
What do M-band or SERCA CK do?
Definition
Remove P from CrP and add it to ADP to make ATP and Cr
Term
What causes dramatic increases in blood Creatine Kinase?
Definition
Microtears in M sacrolemmae
Term
Creatine Kinase is present in both fiber types (I and II) but it is more important in which type? Why,why not the other?
Definition
II, they have fewer mitochondria, CK allows for atp generation in regions of cell with fewer mito. Less important in I b/c good distribution of mito.
Term
What is the function of Adenylate kinase (myokinase) in the M cells?
Definition
During exercise ATP levels drop and ADP, AMP increases. AK combines two ADP to make ATP and AMP, Rxn controlled by level of ADP
Term
What are the benefits of type II fibers having low levels of hexokinase?
Definition
prevents using too much glucose
forces to use glycogenolysis for G6P for anaerobic glycolysis
Term
Where is glycogen stored in the M
Definition
in granules close to the I band
Term
Draw the AMP map for glycogenolysis and anaerobic glycolysis
Definition
compare with slide 12,13,14 from MM
Term
What are the 3 AMP degredation products? how do they promote ATP production and/or perfusion?
Definition
Adenosine-Promotes vasodilation
Pi-required for ATp production, glycogenolysis, glycolysis
Ammonia-activates PFK1 by buffering hydrogen ions, M forms glutamine w/ammonia
Term
What activates AMPK, "the fuel gauge of the cell"? What inhibits it?
Definition
increased AMP levels from exercise,
Inhibited by insulin and high levels of glucose
Term
What is AMPKs two prong strategy for increasing cellular ATP?
Definition
inhibit pathways that consume ATP (glycogen synthase)
Activates pathways that produce ATP (NO synthase, MitoGenesis, Sarc Glut4 insertion, activate GlycogenPase, activate FAbetaox)
Term
AMPK inibits ACC-2 but activates MCoADC, both reduce malonyl coA levels, but which one,in particular, activates CPT-1?
Definition
the removal of malonyl CoA by MCoADC
Term
What can supplement muscle glycogen during exercise despite the low levels of hexokinase?
Definition
Blood, contains 5g glucose, can support moderate running for 2-3 mins.
Term
What 2 processes maintain glood glucose levels from which organ (during intense exercise)?
Definition
Low ins, high epi= glycogenolysis, gluconeogenesis via the liver
Term
What are two important precursors for gluconeogensis during exercise?
Definition
lactate from anaerobic glycolysis
glycerol from lipolysis
Term
What does the Cori cycle do?
Definition
Regenerates glucose from lactate. M to liver cycle
Term
When are FFAs the preferred fuel in M?
Definition
in resting M, when fasting, postpradial state uses glucose, and in prolonged exercise
Term
What does "hitting the wall" represent physiologically?
Definition
when an idnividual depletes muscle glycogen and can no longer keep the TCA cycle primed
Term
What fuel increases as exercise intensity increases?
Definition
Glucos
Term
Where does energy normall come from in the transition from rest to exercise?
Definition
normally glycogenolysis and anaerobic glycolysis
Term
after 10-15 min of exercise, induced increase in blood flow from ? results in aerobic metabolism of ??
Definition
Increases in NO and adenosine
Fatty acids mostly, blood glucose
Term
What is McArdle disease?
Definition
Glycogen phoshporylase is defective which prevents normal transition from anaerobic to aerobic glycolysis. Brief intense exercise, or less intense sustained exercise causes muscular pain.
Term
Endurance training increases the capacity for aerobic fatty acid metabolism via what 3 mech?
Definition
increases LPL levels
Increases M FAT (uptakes FFAs)
Increases (up to 5x) mitochondria in skeletal M
Term
What spares M glycogen in trained individuals when exercising?
Definition
they have an increased capacity for fat oxidation from the 3 mechanisms gained from endurance training
Term
Resistance training increases what two carachteristics of M fibers?
Definition
size, glycogen content
Term
The heart is primarily an aerobic tissue, what are the major fuel substrates?
Definition
FFAs (60-80%) glucose and lactate (20-40)
Term
What does the heart rely on as a fuel during hypoxia?
Definition
glycogen and anaerobic glycolysis
Term
Describe metabo in heart after high carb meal
Definition
high insulin=glut4 translocation=glucose uptake=glycogen synthesis, activated PFK2, increase malonyl CoA
Term
Describe metabo in heart during fasting state
Definition
increase FFA uptake=increase BOx= low malonyl CoA, low glycolytic flux, high NADH=PDHC inhibition
Term
Describe metabo in heart during exercise
Definition
Exercise activates AMPK, +epi=PFK2 active= F2,6BP active= glycolysis active= increasing lactate= decreased carnitine shuttle= decreased BOx= Lactate is major fuel.
Term
What organ has the highest levels of LPL?
Definition
heart
Term
What are the 2 ROS non-radicals, and 3 radicals discussed in lecture?
Definition
non= singlet Oxygen, H2O2
Radical=superoxide, hydroxyl, nitric oxide (most reactive)
Term
what does complex IV do that involves radicals?
Definition
It holds partially reduced oxygen molecules in place while collecting electrons, one at a time, from cyt C.
Term
What is the Q Cycle's involvment in ROS?
Definition
The Q cycle is the intersection of complex 1, 2, and 3 with the membrane electron carrier coQ (ubiquinone), if flow of e's is interrupted at coQ they will jump off and happily join O to make ROS Superoxides
Term
ROS are continuously fomred as byproducts of what 4 common reactions?
Definition
oxidative metabo
Rxn with Metal Ions
Rxn with Drugs
Rxn with environmental toxins (Ozone O3)
Term
Why does ROS production normally correlate positively with energy production?
Definition
the Mitochondria makes ~90% of ROS
Term
Oxygen reacting with heme-bound iron makes what in RBCs?
Definition
methemoglobin
Term
What is the fenton Rxn?
Definition
Superoxides can react with any agent to make H2O2 which can react with free ferrous iron to make hydroxyl radicals.

Fe2+ + H2O2 = Fe3+ + OH- + OHRadical
Term
What is the radiation radical equation?
Definition
2H2O= H3o +e' + OHRadical
Term
What is NADPH oxidase?
Definition
Enzyme in the membrane of phagolysosomes that catalyzes the rapid formation fo superoxide radicals from plain O2 in a respiratory burst.
Term
What is Myeloperoxidase?
Definition
enzyme in neutrophils that catlyzes the formation of hypochlorous acid (HOCl) a powerful antibacterial, from H2O2 and HCL
Term
What is Chronic granulomatous diseas?
Definition
a rare deficiency of NADPH oxidase, patients suffer severe, persistent bacterial infections
Term
What is oxidative stress?
Definition
imalance b/t ROS production and mechanisms to reuce them.
Term
What has been labeled the "biological bullet"
Definition
Hydroxyl radical OH. It hits any available target
Term
What is Lipid peroxidation
Definition
ROS remove a H from C=C bond, forms radical, radical reacts with O2 forming peroxide radical, peroxide radical reacts with other nearby fatty acids (chain rxn) 1:100s of converted fatty acids
Term
What happens to the phospholipid after lipid peroxidation chain reaction?
Definition
can insert into membranes b/c now hydrophylic, this creates leaking, loss of fluidity, potential cell death.
Term
What is SOD?
Definition
Superoxide dismutase, found in cytosol, mito, extracellular; complexed with metal ions (cu, mn, zn). Malfunction in SOD gene correlated with ALS
Term
What are Catalase and Glutathione peroxidase? what is the rxn? where are they found?
Definition
both convert 2H2O2 into 2H2O and O2
Cat- contains heme, usually in peroxisome,
Glut-requires selenium (recycleed by Glutathione reductase)
Term
What are hydroxyproline and hydroxylysine?
Definition
products of they hydroxylation of residues by ascorbic acid during collagen synthesis
Term
Vitamin C plays a part in the synthesis of what three molecules? vague, I know.
Definition
Carnitine, norepi, bile acids
Term
Scurvy
Definition
Vit C deficiency
we know symptoms
3mo w/o fresh fruit or veggies
prevent w/ 10mg of vitC/day
Term
What is the RDA for vitamin C in males?
Definition
90mg
Term
What is a-tocopherol?
Definition
Active form of Vit E, reduces ROS to quinone intermediates, can be regenerated by vit C
Term
What are the symptoms of vit E deficiency? Very rare, restricted to premies or defective lipid absorption
Definition
peripheral neuropathy, retinopathy
Term
What is the RDA for vie E in males?
Definition
15mg
Term
Talk about selenium
Definition
trace mineral, Selenocystine requred for GlutathionePerox,excessive levels=hair and nail brittleness, garlic odor and CNS abnormalities, available in animal products.
Term
How do carotenoids neutralize free radicals?
Definition
they take on unpaired electrons, wich are then stabilized by conjugated double bonds (uncertain if works in vivo)
Term
Do antioxidants reduce the risk of cancer?
Definition
Diets high in antioxidants MAY reduce the risk of cancer but antioxidant supplments have shown no effect.
Term
Why can't we live off vitamin supplements and the dews of the universe?
Definition
ther is a complex interplay between vit, min, and dietary macromolecules that no supplment or combo can duplicate.
Term
What are the non-modifiable risk factors for CHD?
Definition
Age; Men>45, Women>55
Family history of HD =MI<55 men, 65 women
Term
What are the five modifiable risk factors for CHD (non-lipid) in lecture?
Definition
Physical Inactivity, Smoking, Hypertension, Obesity, Diabetes
PISHOD
Term
Lipid Modifiable risk factors in CHD
Definition
High Chol>200mg
Low HDL<40
Term
What are the primary features of Metabolic syndrome?
Definition
Central obesity and at least one of
fasting gluc >100mg
TAG>150
HDL-C<40,50 (him,her)
Hypertension

this equals insulin resistance (perty much)
Term
What are the borderline risk, and increased risk serum levels for CHD?
Definition
200-239=boderline risk
>240= increased risk
Term
Cholesterol levels >300 almost always have a major component of ?
Definition
Genetics
Term
Which fatty acids are the most atherogenic?
Definition
Medium chain (lauric and Myristic) FAs
Term
What are dietary sources of SatFAs
Definition
Milk/products, red meat, coconut/palm oils.
SFAs should be ,7% daily caloric intake
Term
what are TFAs?
Definition
Trans fatty acids, partially hydrogenated vegetable oil, increased shelf life, Increase LDLs, Lower HDL
Term
What are SFAs?
Definition
Saturated fats, increase LDLs, No effect on HDL
Term
what are PUFAs?
Definition
Polyunsaturated fatty acids, decrease Serum LDL, increase LDL receptors. Found in seed oils, walnuts, soybean oils. Keep to <10%
Term
What are MUFAs?
Definition
Monounsaturated Fatty Acids, Serum and LDL decreas, no change to HDL, found in Olive, Canola, Safflower oils.
Term
What are examples of fatty fish?
Definition
SMASH
Salmon, Mackerel, anchovies, sardines, herring
Term
Compare omega6 to omega3 prostaglandins
Definition
6-vasoconstrictive, platelet proaggregatory, proarrhytmic prostaglandins
3- vasodilatory, non-throbotic, less proarrhytmic
Term
What is the current ratio of omega3 to omega6 fatty acids in america? What is the goal?
Definition
1:17, 1:1
Term
What are stanols/sterols and how can they be beneficial?
Definition
similar in structure to chol, found in plants, compete with cholesterol for a place in micelle, chol not incorporated exits in stool. Only effective if taken w/meal
Term
Why do nuts lower chol even though they have high mono and polyunsaturated fat levels?
Definition
Nuts also contain a ton of protein, fiber (soluble, which reduces chol), Vit (E, folate) adn Minerals. Some are rockin' the omega threes as well.
Term
how does soluble fiber decrease serum cholesterol?
Definition
Fiber interfers with absorption of dietary and biliary cholesteral and the reabsorption of bile salts, b/c of the reduced reabsorption/absorption the liver must pull from serum for bile salt synthesis
Term
what is the correlation b/t CHD and cholesterol decreases? Weight and chol levels?
Definition
CHD risk decreas by 2% for every 1mg decrease in serum chol. 10% loss in body weigh =~ 12mg decrease in serum cholesterol= 25% reduction in risk.
Term
what are the two complexes of water soluble vitamin?
Definition
Non B (vit C)
B (1,2,3,12,6, Biotin, PA, FA)
Term
What are the 4 fat soluble vitamins listed in lecture?
Definition
A (retinol, Bcarotenes)
D (Cholecalciferol)
E (-quinones)
K (tocopherols)
Term
Water soluble vitamins have generally common food sources, animal products and fruits/veggies, What are the two exceptions?
Definition
c- fruit only
b12 (cobalmin)- animal only
Term
compare water soluble and fat soluble absorption mech
Definition
Water- specific membrane transporters
fat- need to be incorporated into mixed micelles
Term
fat malabsorption can cause deficiency of what vitamins?
Definition
Fat ones
AEK, not D, b/c can be synthesized by body
Term
Compare excess vitamin quanitities for water and fat soluble
Definition
water- generally non-tox, limit on C, B6, Folate, B6
Fat- Toxic other than K
Term
Which vitamins will be readily found in the urine?
Definition
Water soluble only
Term
What two water soluble vitamins does the body store? where are the two places fat soluble are stored?
Definition
No water stores (some b12,6)
Fat- Liver (A), Adipose (D,E)
Term
What is the general role for alcoholism and vitamins?
Definition
decreases absorption, but "under nutrition and an increase demand of vitamins (Bs) due to inc. carb. metabo. from ethanol and inc. excretion" from slide
Term
What does milling remove, how do food companies compensate?
Definition
removes bran and germ (lose fiber, vit. min.)
Enrichment-replacing lost nut.
Fortified- add nutrients that werent' originally there.
Term
What vitamins listed in lecture will have adverse effects if taken in high doses?
Definition
DANCE BoyFriend
D, A, Niacin, C, E, B6, Folate
Term
what is Beriberi?
Definition
A thiamine deficiency disorder that results in extreme weakness, thiamin def. comes from diet high in white rice or flower.
Term
What is Wernicke-Korsakoff syndrome
Definition
Symptoms: eye paralysis, ataia, memory loss
Cause: person genetically succeptible and recent thaimine deficiency (generally alcoholism)
Term
How do you treat Beriberi and Wernicke-Korsakoff syndrome
Definition
100mg thiamine, response in several hours (gotta make some ATP)
Term
Riboflavin is used to form what two coenzymes, and where is it found in diet?
Definition
riboFLAVIN= Fad, Fmn
milk and products
Term
Niacin is used to form what two Energy Carriers? Where can humans get it?
Definition
NIACIN= NAD+. NADP
humans can make up to 2/3 of it from tryp
Term
What is Pellagra?
Definition
4Ds from niacin deficiency (low tryp levels also) Dermatitis, diarrhea, dementia, death
Term
What is niacytin?
Definition
a protein where niacin is biologically unavailable becasuse it is covalently linked to lysine residues
Term
What is biotinidase?
Definition
an enzyme in the small intestine that hydrolyzes dietary biocytin and freeing biotin. Biotinidase deficiency is screened in all AZ newborns
Term
What is avidin?
Definition
heat labile protein in egg white, can bind biotin and prevent its absorption. Eat 24 raw eggs a day for half a year and you'll have a biotin deficiency
Term
What B vits are involved in hematopoiesis?
Definition
Folate, 12,6
Term
Talk about folate
Definition
methyl group donor, has to monoglutamate folate for absorption, comes in green leafy veggies.
Term
What can result from folate deficiencies?
Definition
Megaloblastic anemia
spina bifida and anencephaly in dev. fetuses (multifactorial)
Term
Whats the folate cancer catch 22?
Definition
too little increases risk of colon and breast cancer, too much increases risk of colorectal cancer
Term
Who are at risk for b12 deficiency? Where does it come from?
Definition
vegans
meat, made by bacteria (intestinal?)
Term
what is R-Binder?
Definition
binds to B12 during absorption, secreted by salivary glands, binds to B12 in stomach
Term
Describe B12 absorption
Mouth, Stomach, Duodenum, Ileum, Portal Blood
Definition
dietary b12 bound to proteins, salivary glands secrete R-binder, goes to stomach where glands secrete Intrinsic Factor and Pepsinogen is activated to release B12 from proteins. Now RBinder binds. In pancrease proteases degrade rbinder, b12 binds to IF/B12. In Ileum- complex binds to IF Receptor on cells, transfers b12 to PBlood. PBlood-B12 binds with Tanscobalamin II (its carrier protein)
Term
what is transcobalmin II
Definition
Vitamin B12's carrier protein
Term
What is Intrinsic Factor's role in B12 absorption?
Definition
Released in Stomach, binds to b12 in duodenum, cells in ileum have IF/B12 receptors that take them in
Term
How long does it take to deplete vit b12?
Definition
around 20 yrs
Term
Pyridoxal Phosphate si a coenzyme for what two enzymes? what is their role?
Definition
ALA-S1, S2, both are rate limiting enzyme for heme biosynthesis
Term
What is sideroblastic anemia? what causes it?
Definition
B6 deficiency, inability to synthesize heme
Term
What is Retinol?
Definition
Transport and storage form of vitamin A
Term
What is Retinal?
Definition
a component of rhodopsin and is important for vision
Term
why is Vit A important for reproduction
Definition
Precursors for retinol and retinal: spermatogenesis in male and and prevents fetal resorption in female
Term
what is retinyl phosphate
Definition
colecule necessary for synehtsis of mucus components in the eye, GI and lung
Term
What is Retinoic Acid?
Definition
a homrmone that binds tot he nuclear receptor, inhibits the expression of keratin, keeps crystal clear cornea!
Term
what are early symptoms of vitA deficiency? servere?
Definition
night blindness, hyperkeratosis
Xeropthalmia (most common blindness worldwide)
Term
Vitamin K is required for what processes?
Definition
Terminal carboxylation of glutamate residues in clotting factors 7,9,10,2
Term
what is the method for Ca absorption in the three parts of the small intestine? Large?
Definition
D-Trans 5-10%
J-Para 5-10%
I-Para 80%
Colon- Para 10%
Term
What three molecules can chelate calcium and reduce absorption?
Definition
Pytates (grains, legumes), Polyphenols (tea, coff), Oxalate (spinach)
Term
Increased Ca demand does what to absorption efficiency?
Definition
increases absorption (duh) Aging decreases efficiency.
Term
What is vitamin D independent Ca absorption?
Definition
paracellular- diffusion based
humans cant increase paracellular when ca low in diet, utilize by breaking up ca supplement doses
Term
What is the reason that lowering colon pH by fermentation of prebiotics increases calcium solubility?
Definition
Lower pH protonates phosphate so it can't bind to the ca in food, which it prefers to do.
Term
When does transecullar absorption play the biggest role?
Definition
When dietary calcium is low (paracellular takes up when dietary is high)
Term
What is caclitrol?
Definition
Vit D, Active form 1,25(OH)2D3,
it controls apical membrane Ca channels, calbindin, ATPase and NA/Ca exchanger
Term
How does vit d play a role in transcellular absorption?
Definition
Vit D binds VDR (a transcription factor, complex binds to nuclear DNA, incrases transcription of factors it controls
Term
what are
TRPV5/6
PMCA1b
NCX1
Definition
apical membrane ca channels (5intestines, 6kidneys)
Pmembrane Ca ATPase (active transport)
Na/Ca exchanger (2ndary transport)
Term
What are the three steps to transcellular ca absorption?
Definition
enters cell via TRPV5/6
calbindin binds
PMCA1b and/or NCX1 kicks it out into portal blood.
Term
What precursor to vit D is made in skin and how is it catalyzed to vit D?
Definition
7-dehydrocholesterol is converted via a nonenzymatic reaction catalyzed by UVlight.
Term
After the skin what hydroxylates vit D to an active form? in liver and kidney?
Definition
Liver- via hydroxylase enzymes to calcidiol
Kidney- via 25(OH)D3-1a-hydroxylase into calcitriol.
Term
What mobilizes ca stores from bone as a result of dicrease plasma ca levels?
Definition
PTH combined with 1,25(OH)2D3
Term
What increases intestinal absorbition of dietary Ca as a result of decreased plasma ca levels?
Definition
1,25(OH)2D3 alone, however this is activated via the PTH secreted as the result of decreased calcium levels
Term
What increases kidney reabsorbition of dietary Ca as a result of decreased plasma ca levels?
Definition
PTH combined with 1,25(OH)2D3, mainly in the proximal convoluted tubes
Term
What causes Calcurea?
Definition
calcium in the urine due to increased levels of na competing for the same resorption mechanism. only happens if ca homeostasis is compromised and ONLY with salt NACL
Term
What counteracts the effect of NaCl on urinary calcium?
Definition
Potassium citrate, facilitates resoprtion
Term
what is normal BMD? Osteopenia, Osteoporosis?
Definition
Normal Tscore>-1
Penia Tscore -1 to -2.5
Porosis Tscore <-2.5
Term
What is senescene-related bone loss?
Definition
age related bone loss in bot sexes
Term
What supplements increase bone density and decrease fracture rate?
Definition
D3, Ca
Term
What is rickets?
Definition
softeing or weakening of bones due to lack of vit D in children
Term
What is osteomalacia?
Definition
Rickets in adults
Term
What is osteogenesis imperfecta?
Definition
usually deficient or defective collage, leading to brittle bone
Term
What does marasmus mean?
Definition
to waste away (skin and bones, chronic not acute)
Term
What is repletion heart failure in refeeding syndrome?
Definition
heart atrophies during fast, sudden spike in calories increases RMR and plasma= overwork heart. increased insulin can lead to arrhythmias
Term
What is hypophosphatemia in refeeding syndrome?
Definition
low phosphorus with sudden glycolysis spike leaves none for ATP and 2,3BPG synthesis
Term
What does Kwashiorkor mean and what are the two principle factors?
Definition
disease of the child displaced from the mothers breast
1-insufficient protein
2-Acute Onset triggered by infection or parasites (increases RMR, Increases E and Protein needs= futile)
Term
what are the 5 major symptoms of kwashiorkor related to a lack of dietary protein?
Definition
edema- low albumin
Decreased immune function
Poor wound healing (alternating hyperpigmentation)
hair changes (alternating color bands)
Fatty liver
Term
Explain fatty liver resulting from Insulin resistance of Kwashiorkor
Definition
Ins resistance= increase in lipolysis= more TAG.
not enough protein to repackage as VLDL ApoB100=TAG remain in liver
Term
When do you give a Cachexia pt. parenteral nutrition?
Definition
only if they are going to die of starvation before they die of the disease
Term
Why is enteral nutrition preferred?
Definition
use it or lose it (intestines)
food stimulates release of hormones that maintain normal intestine and use reduces colonic bacteria infection
Term
When should you use a PEG tube?
Definition
enteral feedings for longer than 2 weeks.
Term
Compare TPN with PPN
Definition
Total is in large vein, hypertonic
Peripheral is isotonic and in peripheral vein
Term
Nursing releases what hormones and what do they do?
Definition
Prolactin- stimulates milk production
oxytocin- stimulates milk release
Term
Why is it beneficial that infants have insufficient lactase to digest all the lactose in breast milk?
Definition
it is fermented in the bowel by lactobacillus reducing colonic pH.
low pH inhibts pathogenic bacteria
lactobacillus crowds out other path bacteria
low pH icnreases solubility of calcium and increases availability
Term
What two components make up 92% of calories in human milk?
Definition
Fat-50
lactose-42
Term
Why does infant lingual and gastric lipase act so well on mammary lipids in milk?
Definition
Short and medium chain TAGs easily hydrolized and don't require bile salts
(lingual lipases act in the stomach b/c of pH optimum)
Term
Why are EFAs in breast milk important?
Definition
Breast milk has 7x cow
needed for neurodevelopment
High omega 3s for CNS and retina (cant elongate linoleic and lenolenic yet)
Term
Proteins account for what % of calories in human milk and what two classes are they?
Definition
7%
Casein- precipitates in acid,makes curds, slows gastric emptying
Whey-remain in solution, forms micelles with calcium increasing bioavailability
Term
what does breast milk contain to provide immune benefits?
Definition
macrophages and other WBCs
Growth modulators that stimulate the maturation of the baby's gut so it is less vulnerable to microorganisms
Term
What is lactoferrin?
Definition
2nd most abundant whey protein in breast milk, chelates iron to prevent bacteria from growing
Term
What to ImmunoglobulinA's do when they are in breast milk.
Definition
they work ni the lumen of the infant's GI tract to kill specific microbes in the baby's environment (mind the lag)
Term
What is a breast milk HMO?
Definition
Oligosaccharide that are attached to lactose. include bifidus factor (for lactoB growth) adn others that bind to bacteria (rather than bacteria binding to enterocyte)
Term
compare the minerals in human vs cows milk
Definition
cows have an insane quantity of calcium, phosphorus, sodium and 2x as much iron
Term
What three "flavors" can infants detect?
Definition
sweet, sour, and umami

salty and bitter comes at 4mo
Term
what are the main changes to cows milk to make formula?
Definition
replace butterfat w/oils
add lactose
reduce Na,K, Ca, P
Term
what is the difference in cows milk iron vs human? what is used in formula to increase bioavailability?
Definition
More bioavailable although 1/2 the content.
FerrousSulfate, VitC
Term
When should Soy formula be prescribed?
Definition
intolerable to whole cows milk
galactosemia
intolerable to lactose
Term
what are the two types of lactose intolerance?
Definition
Primary-congenital (rare)
Secondary- Adult onset (transitory)
Term
What has to be added to premie formula? why?
Definition
glucose, they don't have enough lactase, and it has to be more dense b/c of small stomachs
Term
what is the biggest problem of maternal undernutrition?
Definition
It restricts fetal blood volume to carry nutrients
Term
what glucose transporters are present in the pacenta?
Definition
GLUT1, 3, not insuline dependent, low Km for glucose
Term
The placental barrier allows for transfer of what 5 elements of blood to the fetus?
Definition
Term
What hormones does the placenta secrete that have anti isulin effects?
Definition
TNFa
Cortisol
Growth Hormone
Prolactin
Term
What is the design of insulin resistance in pregnancy?
Definition
glucose levels are high enough that the fetus gets fed prefferentially with its 1 and 3 transporters. intensifies in 3rd tri.
Term
What does insulin resistance in pregnancy increase and decrease
Definition
incrases blood glucose, ketogenesis, FA mobilization (for fetus) and oxidation (for mother)
Decreases maternal glucose uptake and utilization (mom uses FAoxidation)
Term
what is the calculation for how much weight should be gained during pregnancy?
Definition
initail wt x .2
Term
Talk about the Developmental Origins of human Disease Hypothesis
Definition
Starve a fetus starve the child (or will get fat)
Fat fetus reduce calories for child also (or will get fat)
LBW = fewer cells=lower function
maternal obesity=macrosomia
Term
Low birth weight is associated with excess weight gain at what point in a child's life?
Definition
9-11yrs
Term
What is the risk of neural tube defects in children to obese mothers?
Definition
2x
Term
Maternal Iron absorption increases up to 50% during gestation, why?
Definition
maternal transferrin is internalized in placenta (HUGE surface area for iron absorption)
Fetus uptakes iron whether or not the mother has enough
RDA is doubled
Term
What is DHA, why is it important during gestation?
Definition
DHA is a long chain omega 3 fatty acid, it is the msot abundant fatty acid in phosphlipids of the cerebal gray matter.
Important for neurological dev. and higher IQ scores.
Mom low= baby low (DHA levels that is)
Term
Why is the RDA for calcium increased during pregnancy?
Definition
its NOT!!! hahaha
absorption efficiency increases and RDA is usually enough
Term
What prevents bone Ca resorption during pregnancy?
Definition
absorption efficiency increases and RDA is usually enough
Estrogen protects from too much bone loss
Term
Why must women taking Accutane and other synthetic retinoids use birth control?
Definition
Excess vit A can be teratogenic during the first mo of pregnancy,
abortion, retardation, micrognathia/otia
cleft palate, cns malformations, etc
Term
what is zinc's role during pregnancy. RDA is increased by 35%
Definition
it is required by many enzymes including DNA pol, and is part of DNA synthesis, protein synthesis, and cell division
Term
Why is maternal smoking bad?
Definition
decreses fetal nutrition via vasoconstriction. ~10% reduction in O2 carrying capacity.
15% of preterm births to smokers
Incresed child obesity (starve fetus= starve child, or they get fat)
Term
Binge drinking or day to day drinking when pregnant?
Definition
neither preferably, but binge is worse than day to day.
Term
what are some prominent abnormalities in Fetal Alcohol Syndrome?
Definition
Face (micrognathia, think upper lip, flat midface)
small head, abnormal limbs
CNS problems
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