Focus on the science of nutrition, particularly blood glucose regulation and diabetes.
Key components include metabolism, hormone function, and the management of glucose levels in the body.
Blood glucose levels are maintained within a narrow range.
Key hormones involved:
Insulin
Glucagon
Epinephrine
Norepinephrine
Cortisol
Growth hormone
Originates from beta cells in the pancreas.
Functions of insulin:
Stimulates glucose transporters, enabling glucose uptake by cells.
Encourages liver and muscle cells to store glucose as glycogen (glycogenesis).
Promotes fat storage through lipogenesis.
Fructose differs from glucose; it does not trigger insulin release, nor does it signal satiety.
Insulin secretion: Triggered post-meal when blood glucose rises.
Cellular uptake: Insulin enhances glucose transporter activity, facilitating glucose entry into cells.
Glucose storage:
Stored as glycogen in liver and muscles.
Converted into triglycerides in adipose tissue.
Produced by alpha cells of the pancreas during low blood glucose levels.
Functions of glucagon:
Stimulates the conversion of glycogen to glucose (glycogenolysis).
Promotes gluconeogenesis, creating glucose from amino acids.
Glucagon secretion: Activated when blood glucose is low.
Glycogenolysis: Converts stored glycogen into glucose.
Gluconeogenesis: Converts body proteins into glucose, increasing blood glucose levels.
Secreted by adrenal glands and nerve endings during low blood glucose.
Functions include:
Stimulating glycogen breakdown in the liver.
Enhancing gluconeogenesis.
Triggering the body’s fight-or-flight response.
Secreted by adrenal glands, affecting liver, muscle, and adipose tissue.
Cortisol:
Increases gluconeogenesis.
Reduces glucose uptake by muscles and organs.
Associated with stress and weight gain risk.
Growth Hormone:
Decreases muscle glucose uptake.
Increases fatty acid mobilization and gluconeogenesis.
Represents the potential of a food to raise blood glucose (reference: pure glucose = 100).
High glycemic foods cause rapid increases in blood glucose and insulin, potentially followed by drops in glucose.
Low glycemic foods result in moderate and stable blood glucose fluctuations.
More useful than glycemic index for assessing food's impact on blood glucose.
Calculation: grams of carbohydrates in food multiplied by its glycemic index.
Recommended strategies for people with diabetes include:
Increasing fiber intake.
Using the plate method for portion sizes.
Carbohydrate counting for type 1 diabetes.
Diabetes mellitus refers to impaired blood glucose regulation, leading to various symptoms.
Types:
Type 1 Diabetes:
Accounts for 5-10% of cases.
Autoimmune destruction of insulin-producing beta cells.
Requires insulin therapy.
Type 2 Diabetes:
Often linked to obesity and insulin resistance.
Requires lifestyle interventions, medication, and possibly insulin treatment.
Uncontrolled diabetes can lead to:
Neuropathy (nerve damage)
Nephropathy (kidney damage)
Retinopathy (eye damage)
Cardiovascular disease
Symptoms include polyuria, polydipsia, and polyphagia.
Hyperglycemia indicates elevated blood glucose levels.
Methods for diagnosis include:
Fasting plasma glucose (FPG)
Oral glucose tolerance test (OGTT)
Glycosylated hemoglobin test (A1c)
Lifestyle changes can lower diabetes risk:
Reduce added sugar intake.
Choose fiber-rich whole grains.
Limit red and processed meat consumption.
Engage in regular exercise.
Avoid smoking.
Occurs during pregnancy, affecting about 7% of pregnancies.
Increases risk of developing type 2 diabetes.
Potential complications for mother (e.g., preeclampsia) and child (e.g., macrosomia).
Symptoms include shakiness, sweating, anxiety.
Types include:
Reactive hypoglycemia: excess insulin post high-carb meal.
Fasting hypoglycemia: insulin secretion without food intake.