ADV nut 4

*What is insulin resistance?*

A condition where muscle and adipose cells do not respond to insulin, preventing glucose absorption and causing pancreatic beta cells to produce more insulin.

How do obese people develop hyperglycemia?

through chronic, low-grade inflammation induced by excess adipose tissue, which causes insulin resistance

Beta cell compensation

involves increased beta cell mass and activity

Effects of Failure of beta cell compensation with prolonged inflammation leads to type 2 diabetes.*

can lead to type 2 diabetes

*What are the primary causes of Type 2 Diabetes?*

Insulin resistance and relative insulin deficiency.

*What is the primary cause of Type 1 Diabetes?*

Pancreatic beta cell destruction due to autoimmunity.

*T/F: Metabolic syndrome is best characterized as an individual having frequent hunger.*

False.

*T/F: Metabolic syndrome is characterized by abnormal weight loss and high HDL-C.*

False.

*What characterizes Metabolic Syndrome?*

Hypertension, elevated fasting blood glucose, and elevated triglycerides with low HDL.

*T/F: Metabolic syndrome causes increased risk of cardiovascular disease, Hypertension , stroke, T2D.*

True.

*T/F: Metabolic syndrome causes increased risk of type 1 diabetes.*

False.

*T/F: An agent that can reduce intestinal absorption of glucose, treats T2DM.*

True.

*T/F: An agent that can increase glucose release from the liver, treats T2DM.*

False.

*T/F: An agent that can increase insulin production by the pancreas treats T2DM.*

True.

*T/F: An agent that can increase glucose uptake by fat and muscle treats T2DM.*

True.

*Define the Cori Cycle.*

The metabolic pathway where lactate from muscles or RBCs is converted to glucose in the liver and returned to the muscles.

*Define Beta cell compensation.*

The process where the pancreas secretes more insulin and increases mass to maintain glucose homeostasis against insulin resistance.

*Insulin target enzyme for fatty acid synthesis in the liver.*

Acetyl CoA carboxylase activation.

*Insulin target enzyme for glucose uptake via vesicles.*

Glut4.

*Insulin target enzyme for liver glycogen synthesis.*

Glycogen synthase activation.

*Enzyme inhibited by insulin to prevent glucose synthesis from noncarbohydrates.*

PEPCK.

*List 4 characteristics of Metabolic Syndrome.*

Hypertension, elevated fasting glucose, elevated triglycerides, and low HDL.

*List 4 symptoms of Diabetes.*

Increased thirst, increased urination, weight loss, and fatigue.

*What is the standard management for Type 1 Diabetes?*

Lifelong insulin therapy via injection or pump.

*What are common drugs for Type 2 Diabetes?*

Metformin, Thiazolidinediones, and oral hypoglycemic agents.

*Sources of energy during endurance exercise.*

Muscle glycogen, plasma glucose, plasma fatty acids, and intramuscular triacylglycerol.

*What does the contribution of energy substrates for exercise depend on?*

Intensity, duration, training level, initial glycogen levels, and CHO supplementation.

* Endurance training increases.*

muscle mitochondrial density and oxygen uptake in lungs and transport.

*T/F: Endurance training increases protein utilization as fuel.*

False.

*T/F: Exercise training increases muscle glycogen storage capacity.*

True.

*T/F: Exercise training increases lung capacity.*

True.

*Exercise duration over 15 minutes activates which energy system?*

Long-term energy system (aerobic).

*When is the ATP-creatine phosphate energy system present?*

During the first 1-10 seconds of exercise.

*T/F: Lactic acid build-up alters the pH of the muscle.*

True.

*T/F: Lactic acid build-up improves muscle contractions.*

False.

*T/F: Low intensity activities can clear lactic acid from the blood.*

True.

*T/F: Creatine can come from diet, supplements, or body synthesis.*

True.

*T/F: Creatine generated ATP can diminish in 15-25 seconds.*

True.

*T/F: Carnitine is an immediate energy source for high-intensity short duration.*

False.

*T/F: Blood glucose is an immediate energy source for high-intensity short duration.*

False.

*T/F: Stored glycogen is an immediate energy source for high-intensity short duration.*

False.

*T/F: Fats in adipose tissue are an immediate energy source for high-intensity short duration.*

False.

*What is the immediate energy source for high-intensity short duration?*

Creatine phosphate.

*T/F: Carbohydrate loading is an advantage because it increases water mass.*

False (water mass is a disadvantage).

*T/F: Carbohydrate loading is greatly beneficial for short-duration exercises.*

False.

*T/F: Muscle glycogen contributes only minimally to ATP used by working muscles.*

False.

*T/F: Blood glucose contributes only minimally to ATP used by working muscles.*

False.

*T/F: Plasma fatty acids contribute only minimally to ATP used by working muscles.*

False.

*T/F: Muscle amino acids contribute only minimally to ATP used by working muscles.*

True.

*What enzyme does exercise activate to increase insulin sensitivity?*

AMPK (AMP-Activated Protein Kinase).

*T/F: Exercise increases sensitivity via PEPCK activation.*

False.

*T/F: Exercise increases sensitivity via Insulin Secretion.*

False.

*What are "slow twitch" muscle fibers?*

Type 1 fibers.

*Which muscle fiber type has high levels of myoglobin?*

Type 1 fibers.

*Which muscle fiber type has the lowest number of mitochondria?*

Type IIx fibers.

*Which muscle fiber type has the largest number of mitochondria?*

Type 1 fibers.

*Muscle fiber type with high levels of phosphofructokinase.*

Type IIx fibers.

*T/F: Creatine improves performance during resting states.*

False.

*T/F: Creatine improves performance during high-intensity exercise.*

True.

*Do RBCs and brain cells depend on glucose during fasting?*

Yes.

*CHO Loading Advantage: Intensity*

Extends the duration of high-intensity activity.

*CHO Loading Advantage: Storage*

Increases muscle glycogen storage.

*CHO Loading Advantage: Effort*

Allows athlete to exercise at a greater intensity for the same effort.

*CHO Loading Advantage: Blood Sugar*

Prevents the athlete from hypoglycemia.

*Correct order of energy use during a marathon.*

1. Muscle Glycogen, 2. Blood Glucose, 3. Fatty Acids.

*Major fuel source at rest.*

Fatty acids.

*Major fuel source for high-intensity activity.*

Glucose/Glycogen.

*T/F: DEXA is used to measure body composition and bone density.*

True.

*T/F: Air displacement is used to measure body composition.*

True.

*T/F: Bioelectrical impedance is used to measure body composition.*

True.

*T/F: Fat fold measures (anthropometry) measure body composition.*

True.

*T/F: Thermic effect of food (TEF) is BMR minus physical activity.*

False.

*What does the Thermic Effect of Food (TEF) represent?*

The increase in energy expenditure associated with the body's processing of food.

*T/F: Weight loss stall: TEF is reduced during calorie restriction.*

True.

*T/F: Weight loss stall: BMR is reduced during calorie restriction.*

True.

*T/F: Weight loss stall: restriction causes water retention for pH.*

False.

*Which macronutrient has the highest thermic effect?*

Protein (20-30%).

*T/F: Mineral consumption increases energy expenditure.*

False.

*What is the highest contributor to daily energy expenditure?*

Basal Metabolic Rate (BMR).

*List the three measurements of energy output.*

BMR, Physical Activity (PA), and Thermic Effect of Food (TEF).

*Does Hyperthyroidism increase or decrease BMR?*

Increase.

*Does Pregnancy increase or decrease BMR?*

Increase.

*Does Aging increase or decrease BMR?*

Decrease.

*Does Sleep increase or decrease BMR?*

Decrease.

*BMI: Underweight value.*

Below 18.5.

*BMI: Normal value.*

18.5 - 24.9.

*BMI: Overweight value.*

25 - 29.9.

*BMI: Obese Class I value.*

30 - 34.9.

*BMI: Obese Class II value.*

35 - 39.9.

*BMI: Obese Class III value.*

40 or greater.

*What is the BMI formula?*

Weight (kg) / [Height (m)]^2.

*How many kcals must be cut to lose 1 lb of fat?*

3,500 kcal.

*What are key enzymes for gluconeogenesis?*

PEPCK, Fructose bisphosphatase, and Glucose 6-phosphatase.

*T/F: Muscle can provide glucose to maintain blood glucose levels.*

False; muscle lacks glucose-6-phosphatase.

*Why avoid VLCHO diets if insulin resistant?*

Increased free fatty acids from lipolysis can lead to fatty liver and CVD risk.

*Define Catabolism.*

Metabolic breakdown reactions that turn nutrients into energy (ATP).

*Define Anabolism.*

Metabolic building reactions that require energy to form larger compounds.

*Is Acetyl CoA to CO2 catabolic or anabolic?*

Catabolic.

*Is Acetyl CoA to cholesterol catabolic or anabolic?*

Anabolic.

*Is Acetyl CoA to Malonyl CoA catabolic or anabolic?*

Anabolic.