Nutrition Exam 2

type 1 DM (born with it)
type 2 (aquire it thorugh lifestyle)
Gestational Diabetes Mellitus

3 types of Diabetes

Most often diagnosed in children or adolescents

o Pancreas is unable to produce insulin

o It is thought to be an autoimmune disease

type 1 DM

Accounts for more than 90% of all cases of diabetes mellitus

o Cells are insulin resistant
Typically over age 40 and overweight or obese when diagnosed

Type 2 Diabetes Mellitus

Type of diabetes that occurs in some women during pregnancy.

• Resolves after pregnancy

• Complications for infant:

o can cause fetal or infant illness or death

o high birth weight (macrosomia) of infant

o low blood glucose post-delivery

o diagnosis of DM later in life

Gestational diabetes

high birth weight of infant

macrosomia

Dark patch or rough skin which is marker for type 2

Acanthosis Nigricans

• Poly

  • Urea

  • Dipsia

  • P something

Gestational diabetes (signs) (3 polys)

• Resistant to digestion by human enzymes

• Mostly composed of polysaccharides

  • exception is lignin; not technically a

    carbohydrate

• Reduces risk of diverticulosis

Dietary fiber

Soluble fiber

Insoluble fiber (decrease transit time)

Two types of dietary fiber

• Some people have intolerance to the protein gluten

• intolerance to gluten that results in autoimmune response

Celiac disease

carbohydrate can adhere to enamel of teeth

o bacteria metabolize carbohydrate in mouth

o lactic acid produced by bacterial fermentation degrades tooth enamel

Process by which dietary sugar can lead to dental

decay

Some people unable to digest lactose due to loss of

function of enzyme lactase (so cannot breakdown lactose)

Lactose Intolerance (why)

• Triglycerides

• Phospholipids

• Sterols (ex: cholesterol)

3 major categories of lipids

Are CHO (Difference from carbs is that they can be polymerized)

Composition of Fat/Lipids

• The chain has a carboxyl group on one end and a methyl group on the other

  • The carboxyl group (COOH)

    • Hydrophilic

  • The methyl group (CH3)

    • Hydrophobic

Ends of the fatty acid chains

• Phospholipids

• Triglycerides

• Fatty acids are components in

• mono = 1 C=C

• Poly = 2 or more C=C

Saturated and unsaturated same as ochem

• Solid at room temp 

• Since they are straight and stack

Saturated characteristics

• Liquid

• Since they have bends (due to double bonds) which is why they are liquid

Mono saturated characteristics

Liquid

Poly saturated characteristics

• 2 types

  • Omega 6

    • Linoleic acid (parent)

  • Omega 3

    • Linolenic acid (parents) (ALA)

    • Benefits

      • Reduce inflammation

      • Reduce free radicals (serve as anti-oxidants)

      • Help in cellular repair

      • a lot more

        • Over 60% of 3.5 pounds of fat in brain is made of omega 3 (most of your brain is made of omega 3 like fish oil)

Essential fatty acids

omega 3: has first C=C 3 C away from omega end (methyl)
omega 6: has first C=C 6 C away from omega end (methyl)

how to ID and differentiate both omega 3 vs 6

methyl end

which end is the omega end

carboxylic acid end

which end is the alpha end

linolenic

is omega 3 linolenic or linoleic acid

linoleic

is omega 6 linolenic or linoleic acid

• 4 parts omega 6 

• 1 part omega 3

ideal consumption ratio for omega 3 vs 6

omega 3

Eicosapentanoic (EPA) found in which 3 or 6

omega 3

Docosahexanoic acid (DHA) found in which 3 or 6

omega 6

arachidonic acid found in which 3 or 6

• 2 servings of cold water fish every week to get essential fatty acids

how much EPA and DHA to eat

this

MEMORIZE THIS TABLE

Process of adding hydrogens to unsaturated fats

• Makes solid at room temp.

• Common dietary sources
MAKES FOOD LAST YEARS (cookies)

Hydrogenation

produced through addition of hydrogen atoms to double bonds of fatty acids
Small amount of naturally occurring trans fatty acids are found in:

• dairy milk and meat

Trans fatty acid (man-made/synthetic)

cis have bends
trans have no bends

cis vs trans fatty acids

3 carbon back bone (glycerol), with 3 fatty acid chains attached
primary form of lipid found in body

Triglyceride

• compounds that assist the body in transporting fat through watery substance

• Chemically similar to triglycerides

• Three-carbon glycerol backbone

• Two fatty acids bound to first two carbons

• Third carbon has phosphate group bound to it
HAVE HYDROPHILLIC HEADS

HYDROPHOBIC TAILS
FUNCTION AS EMULSIFIERS

Phospholipid

• Four-rings

• steroid nuclus

cholesterol/sterols

Liver makes most of cholesterol in the body

It is non essential

Below 300 mg a day

What makes the miost cholesteroil in the body

• Flavor and satiety

• Essential fatty acids can protect the heart

• Storage of energy (9kcal)

• Steroid hormone prod

lipid functions

• Linoleic acid

• Linolenic acid

• Both are precursors to eicosanoids 

  • Which have strong physiological effects

    • Relaxing blood vessels and promoting clotting

what are both essential fatty acids precurssors to

• Fat is required for absorption of fat soluble vitamins

  • Vit KADE

  • Fat soluble vitamin absorption decreases when there is incomplete fat absorption or fat malabsorption

• Absorption/transport of lipids

• Protects vital organs 

• Insulates skin

Organ protection of lipids

Phospholipids and cholesterol are major components of cell and organelle membranes

Cell membrane structure (phospholipids and cholesterols role)

Estrogen

Testosterone

Aldosterone

And VIT D

Cholesterol serves as important role to be precursor to these hormones

satiety

• fat slows stomach emptying

is fat satiating

Saturated fatty acids

• Beef, pork, poultry with skin and other meats

• Cheese, butter, and other dairy products

• Palm and coconut oils (tropical oils)

• Unsaturated fatty acids

• Vegetable oils

• Nuts and seeds

• Fish

• Cholesterol

• Only found in animal products

Primary Sources of Fat in the Human Diet

fat requirements

• Fat mimetics

• 1. Carbohydrate-based

  • • Add creaminess, bulkiness, and moistness

  • • maltodextrins, modified food starches, cellulose, and gums

  • • 1-4 kcal per gram

• 2. Protein-based

  • • denature under high heat

  • • used in frozen desserts

  • • 4 kcal per gram

• Fat substitute

  3. Fat-based

  • Non-digestible/partially digested

Fat Replacers

• Marketed as weight loss drugs

• Side effects:

  • anal leakage

  • reduced fat soluble vitamin A, D, E & K absorption

  • malabsorption of oral contraceptives

Fat blockers

• Leading cause of death in US 

• Modifiable risk factors

  • • high blood pressure

  • • high cholesterol

  • • cigarette smoking

  • • diabetes

  • • poor diet and physical inactivity

  • • overweight and obese

• Risk increases by overconsumption of nutrients that raise blood cholesterol

  • Fat

  • Saturated fat

  • Trans fat

• Heart disease and fats

• Primary type of heart disease linked with fat intake is atherosclerosis

• Build up of fatty deposits and streaks in the arteries

• May reduce blood flow to areas of the heart causing ischemia

cardiovascular disease

• Artery becomes completely blocked

• aka heart attack

myocardial infarction

blockage of artery supplying blood to brain

Stroke

• Spherical structures that are composed of lipids and proteins

• Transport lipids through emulsification

• Outershell is monolayer

  • Proteins

  • Phospholipids

    • Their hydrophobic and phillic ends make them be able to transport lipids in the body

Lipoproteins

• 1. Chylomicrons

• 2. VLDLs

• 3. LDLs

• 4. HDLs

The blood contains four types of lipoproteins.

• made in cells of small intestine

• transport dietary lipids to the liver

Chylomicrons

• synthesized in the liver

• contain both triglycerides and cholesterol

• deliver triglycerides to other tissues

• Very low-density lipoproteins (VLDLs)

• formed after VLDLs deposit triglycerides in other tissues

• cholesterol rich

• deliver cholesterol to other tissues, including blood vessels

  • • “Bad Cholesterol”

• Begins journey as VLDL

• Low-density lipoproteins (LDLs)

• made mostly in the liver, but also in the small intestine

• removes excess cholesterol from cells

• return to liver for elimination (to be recycled into bile)

  •  “Good Cholesterol”

• High-density lipoproteins (HDLs)

USDA’s 2015 Dietary Guidelines for Americans

o 20 - 35% of daily calories from fat

from AMDR

Recommendations for Dietary Intake of Fats

30–35 % calories from fat

o growth and nervous system development depend on adequate fat intake

Recommendations for Dietary Intake of Fats (children under 2)

polyunsaturated and monounsaturated fatty acids

saturated fats linked to cancer/heart disease

which fat is healthy

CHON

Composition of proteins (what molecules its made of)

• ino acids have a central carbon connected to four side groups

  • Amino group

  • Acid group (carboxyl)

  • Hygrogrn group

  • R group

    • Central carbon is alpha carbon

structure of amino acids

essential and non essential

2 catagories of amino acids

Must be acquired from our diet

essential amino acids

Normally made by body in adequate amounts

Nonessential amino acids

• Transfer of amino group from one molecule to another to create an amino acid

• Lets you make nonessential ones from essential ones

Transamination

usually non essential amino acids that under certain conditions become essential

Conditionally essential amino acids

incorrect AA sequence can lead to improper function like sickle cell

Shape dictates protein function

500 exist
20 make our genome

how many amino acids exist and how many make up our genome

ID comes from the R group

How are Amino acids ID’d or different

• Peptide bonds link amino acids together

  • They start linking through dehydration synthesis from the carboxylic group

  • So amino 1 would be at the exposed amino end (N terminus) 

  • Amino acids are added to the carboxylic group (C Terminus)

how are peptide bonds formed between amino acids

• Heat 

• Acid

• Enzymes

• Agitation

• Alcohol

• electrolysis

• Salting

how are proteins denatured

• Proteins in blood maintain optimal balance between fluids inside and outside cells and blood vessels 

• Hydrostatic pressure causes water to leave blood capillaries

• Osmotic pressure pulls water back in

• Proteins in blood are solutes

  • Like Na 

  • These proteins in the blood albumin and solutes work together to pull water back in

  • Albumin

  • Edema

    • Develops when blood albumin is low

• Hydrostatic usually wins

• Fluid Balence with proteins

chyl

When chylomicrons enter the lymph it becomes?

• 7.35-7.45

  • Proteins help us maintain this

The body PH is usually?

• foreign substances that enter body and trigger immune response

  • Can be both good or bad things

Antigen

• proteins made by immune system to fight antigens

Antibodies

• Skin 

• Mucus

Proteins form first barriers against immune invaders

• Messengers that help regulate body functions and systems 

• Made of lipids and proteins 

Hormones

• sodium/potassium pumps 

• Retinol-binding protein

Protein Transport

Tyrone Argued for Pro Glute Cycling

• tyrosine

• arginine

• proline

• glutamine

• cysteine

What are the non essential amino acids that are conditionally essential

1. carbs

2. fats

3. protein

primary secondary and tertiary energy resources for body

Protein synthesis 

Protein breakdown

1. Protein synthesis

• requires presence of essential amino acids in adequate amounts 

• Limiting amino acid (present in lowest amount relative to body’s needs)

2. Protein breakdown

• Free amino acids become part of amino acid pool

Deamination

• required for elimination of excess amino acids

• occurs primarily in the liver

•  keto-acid used for energy production

• amino group converted to urea

  • excreted in urine

Nitrogen balance

• nitrogen consumed vs. nitrogen excreted

•  basis of many nutrition recommendations

  • If your pregnant you should have a positive N balance (or recovering)

  • If recovering from disease (negative)

• Protein turnover

• Intake exceeds excretion

• Occurs during growth, recovery from illness, and during pregnancy

Positive nitrogen balance

• Excretion exceeds intake or intake is inadequate to meet body’s needs

• Occurs during AIDS, cancer, starvation, and low calorie diets.

Negative nitrogen balance

• Provide all essential amino acids in amounts needed by body

• Easily digested and absorbed

• Includes: Animal Proteins and Soy

Complete proteins or high quality proteins Contain:

• Value assigned to proteins that accounts for protein quality and digestibility.

• Based on scale of 0 –100

Protein Digestibility-Corrected Amino Acid Score

(PDCAAS)

• dont have all essential aminos

• ex. legumes, grains, veggies

• COLLAGEN (missing tryptophan)

Incomplete Proteins

• AA contents combined provide all EAA

Complementary proteins

additional source of protein for specific populations

• vegatarians, underweights ppl

Supplemental Proteins

know this!!!!

• complete protein

• prevent bone loss

• B VIT, Calcium, Potassium, VIT A, iron

• isoflavones (phytoestrogens)

soy protein

• DRIs for protein:

  • RDA: 0.8 g per kg of body weight (high-quality protein)

  • AMDR: 10% – 35%

• Protein needs increase durring injuries, illnesses, and pregnancies

Recommendations for protein intake

benefits:

• less risk of heart disease
  less obesity risk

disadvantage is that they’re usually deficient in

• VIT B12

• Zinc

• iron

• calcium

• VIT D

• proteins

Health impacts of vegatarians

• Disorder that occurs with inadequate protein and energy consumption

• Most common deficiency in hospital 

• Greater concern internationally

  • Children more susceptible

• PEM is most lethal form of malnutrition (WHO)

• Protein energy malnutrition (PEM)

• Condition of starvation characterized by emaciation, or skeletal appearance

• Causes

  • Inadequate protein and calorie intake

Marasmus

• Characterized by a swollen appearance, essentially the abdomen

•  Proposed causes

  • Low protein intake, altered gut bacterial populations

  • Frequent in children being weaned from breast milk to cereal

Kwashiorkor