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Nutrition 1 (Semester II) > 14b. Lipids & Essential Fatty Acids > Flashcards

14b. Lipids & Essential Fatty Acids Flashcards

1
Q

Which two fatty acids can’t be made in the body so are essential in the diet?

A 
Alpha-linolenic acid (ALA)
Linoleic acid (LA)
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2
Q

Which omega is alpha-linolenic acid?

A

3

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3
Q

Which omega is linoleic acid?

A

6

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4
Q

In Western diets, what is the average 06:O3 ratio?

A

16:1

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5
Q

Why is the Western diet high in O6?

A

Plant oils
Grain-fed meat
Dairy

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6
Q

Why are EPA and DHA conditionally essential nutrients?

A

Conversion rate to them from ALA is low (10%)

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7
Q

How many portions of oily fish are recommended to achieve desired EPA/DHA intake?

A

2-3 portions

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8
Q

Examples of functions of EFAs

A

Cell membranes - maintain membrane fluidity
Transport of substances in and out of the cell
Cell-to-cell communication
Foetal and child brain development
Precursors of eicosanoids (local hormones)

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9
Q

Examples of skin indicators of EFA requirements

A 
Dry, flaky, scaly skin
Chapped lips
Delayed wound healing
Acne
Eczema
Psoriasis
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10
Q

Examples of nail indicators of EFA requirements

A

Dry, brittle cuticles

Red, swollen cuticles

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11
Q

Examples of hair indicators of EFA requirements

A

Dry, oily
Split ends
Alopecia

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12
Q

Examples of endocrine indicators of EFA requirements

A

Weight imbalances
PMS
Painful menstrual cramps
Sore breasts

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13
Q

Examples of reproductive indicators of EFA requirements

A

Infertility
Impotence
Repeated miscarriages
Ovarian cysts

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14
Q

Examples of circulatory indicators of EFA requirements

A

Frequent nosebleeds
Bleeding gums
Easy bruising
Delayed recovery from exercise

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15
Q

Examples of MSK indicators of EFA requirements

A

Chronic joint pain
Arthritis
Delayed recovery from injuries

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16
Q

Examples of neurological indicators of EFA requirements

A 
Dementia
AZD
Irritability
Nervousness
Tingling arms/legs
CFS/ME
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17
Q

Sources of alpha-linolenic acid (O3)

A 
Flaxseeds
Chia seeds
Hemp seeds
Dark leafy greens
Pumpkin seeds
Walnuts
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18
Q

Therapeutic uses of ALA (CAN)

A

CV disease
Anti-inflammatory
Neurological health

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19
Q

What are the specific therapeutic uses of ALA in CV disease?

A 
Reduces risk of myocardial infarctions
Reduces C-reactive protein levels
Anti-arrhythmic effect
Anti-hypertensive
Lowers LDL cholesterol
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20
Q

What are the specific therapeutic uses of ALA as an anti-inflammatory?

A

IBD
Asthma
AI conditions
(dependent on EPA/DHA conversion from ALA)

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21
Q

What are the specific therapeutic uses of ALA in neurological health?

A

Strokes

Depression

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22
Q

What interactions does ALA have with blood thinning meds?

A

May increase the effects of anti-coagulants

e.g. warfarin, aspirin

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23
Q

What interactions does ALA have with cholesterol lowering drugs?

A

May have an agonist effect with combined with statins

e.g. improve the effect of

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24
Q

Sources of EPA/DHA

A

Oily fish

Marine algae

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25
Q

What are the therapeutic uses of EPA/DHA (CANF)?

A

CV disease
Anti-inflammatory
Neurological health
Foetal health

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26
Q

What are the specific therapeutic uses of EPA/DHA in CV disease?

A

Reduces blood triglyceride levels
Lowers blood pressure
Preventative against formation of atherosclerosis
Reduction in myocardial infarction

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27
Q

What are the specific therapeutic uses of EPA/DHA as an anti-inflammatory?

A 
Inhibits NFkB, TNF-a, IL-6
Arthritis
IBD
Eczema
SLE
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28
Q

What are the specific therapeutic uses of EPA/DHA in neurological health?

A

Neuroprotective properties
Depression
ADHD
AZD

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29
Q

What are the specific therapeutic uses of EPA/DHA in foetal health?

A

Supports foetal brain development

Pregnancy support

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30
Q

What factors determine the quality of omega fish oil?

A

Sustainability practices
Independently tested for purity and toxins
Ensure EPA/DHA content is listed on label
Water extraction methods
Free from carrageenan
Cold-pressed
Organic
Extracted from echium seed oil (contains SDA)

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31
Q

How may EPA/DHA interact with anti-coagulants?

A

EPA may increase bleeding time

Make the effects of the drug stronger

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32
Q

How may EPA/DHA interact with aspirin?

A

Combining the two may be helpful in treatment of some forms of coronary heart disease

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33
Q

How may EPA/DHA interact with diabetes medication?

A

Fish oils may lower blood glucose levels

Make the effects of the drug stronger

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34
Q

How may EPA/DHA interact with blood pressure medication?

A

DHA may lower blood pressure

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35
Q

Sources of linoleic acid (LA)

A

Safflower oil
Sunflower oil
Corn oil

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36
Q

Sources of GLA

A

Borage oil
EPO
Blackcurrant seed oil

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37
Q

What are the therapeutic uses of GLA?

A

RA
Eczema
ADHD

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38
Q

How specifically does GLA help with RA?

A

Reduction in NFkB activity

Reduced joint pain, swelling, morning stiffness

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39
Q

How does GLA help with eczema?

A

Reduced inflammation

Improves skin conditions

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40
Q

How does GLA help with ADHD?

A

Improves attention and impulsivity

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41
Q

Which EFAs is EPO abundant in?

A

LA

GLA

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42
Q

What are the therapeutic uses of EPO?

A

PMS
Cyclical mastalgia
Female fertility

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43
Q

How does EPO support PMS?

A

GLA is a precursor to PG1

which inhibits prolactin

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44
Q

How does EPO support cyclical mastalgia?

A

GLA forms PG1 which inhibits the synthesis of AA metabolites

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45
Q

How does EPO support female fertility?

A

Increases and optimises cervical mucus to sustain sperm during conception

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46
Q

Which source of GLA shouldn’t be used during pregnancy?

A

Borage seed oil

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47
Q

What can dosages of GLA greater than 3,000mg/day create?

A

Increase of AA production

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48
Q

How can GLA interact with ceftazidime?

A

May increase effectiveness of the antibiotic

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49
Q

How can GLA interact with chemo?

A

May increase treatment effects

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50
Q

How can GLA interact with cyclosporine?

A

May increase the immunosuppressive effects

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51
Q

How can GLA interact with NSAIDs?

A

NSAIDs may counteract the effects of GLA

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52
Q

How can GLA interact with phenothiazines?

A

May increase the risk of seizures

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53
Q

In which foods is AA predominately found?

A

Meat
Eggs
Dairy
(especially when animals are raised on grain)

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54
Q

How does AA become inflammatory?

A

AA is metabolised by COX1 and COX2 enzymes

PG2

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55
Q

What inflammatory effects can AA/PG2 cause?

A 
Fever
Vascular permeability
Vasodilation
Pain
Oedema
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56
Q

How does PG2 prevent excessive inflammation?

A

Induces 15-LOX activity that leads to the formation of lipoxins
(anti-inflammatory)

57
Q

What are eicosanoids?

A

Signalling molecules that act like local hormones

58
Q

What are the functions of eicosanoids?

A

Inflammation (prostaglandins)
Blood vessel permeability (prostaglandins)
Vasoconstriction (thromboxane/leukotrienes)
Blood coagulation (thromboxane)
Immune cell behaviour
Lipid accumulation
Central nervous system signalling

59
Q

Examples of eicosanoids

A 
Prostaglandins
Thromboxanes
Leukotrienes
Resolvins
Protectins
60
Q

How are fatty acids turned into eicosanoids?

A

Fatty acids are released from membrane phospholipids by the phospholipase 2 enzyme
COX and LOX then convert them to eicosanoids

61
Q

Which fatty acids can eicosanoids be made from?

A

AA
EPA
DGLA

62
Q

Are eicosanoids pro or anti-inflammatory?

A

They can be both

63
Q

Which fatty acid makes PG1?

A

DGLA

64
Q

What are the functions of DGLA in inflammation?

A

Vasodilator
Anti-coagulant
Removes excess Na and water from body

65
Q

Is DGLA/PG1 pro or anti-inflammatory?

A

Anti-inflammatory

66
Q

Which fatty acid makes PG2?

A

AA

67
Q

What are the functions of AA in inflammation?

A

Coagulant
Promotes Na and water retention
Vasoconstrictor

68
Q

Is AA/PG2 pro or anti-inflammatory?

A

Pro-inflammatory

69
Q

Which fatty acid makes PG3?

A

EPA

70
Q

What are the functions of EPA in inflammation?

A

Weak platelet aggregating properties
Prevents release of AA from cell membranes
Limits PG2 production

71
Q

Is EPA/PG3 pro or anti-inflammatory?

A

Anti-inflammatory

72
Q

How do DGLA, AA and EPA work together in the inflammation process?

A

Eicosanoids made from AA (PG2) produces initial inflammation

This is then shut off by eicosanoids made from DGLA (PG1) and EPA (PG3)

73
Q

What determines which PG will dominate in an inflammatory situation?

A

The dominant fatty acid in the cell membrane

e.g. a diet rich in AA leads to the formation of more PG2

74
Q

Which fatty acids occupy the enzyme active sites?

A

The most abundant ones

highlighting importance of O3/6 balance

75
Q

What can affect the synthesis of EPA and DHA?

A

Genetic variability (polymorphisms)

76
Q

In which enzymes are polymorphisms common?

A

Delta-6 desaturase

Delta-5 desaturase

77
Q

How do enzymes convert one fatty acid to another?

A

Desaturation

Elongation

78
Q

What is desaturation?

A

Addition of a double bond between two carbon atoms

79
Q

What is elongation?

A

Addition of two carbon atoms

80
Q

What percentage of ALA is converted to EPA?

A

1-20%

81
Q

Do men or women convert ALA better?

A

Women of reproductive age convert ALA 2.5 times better than men

82
Q

What is the conversion chain of ALA to DHA?

A 
ALA
SDA
ETA
EPA
DPA
DHA
83
Q

Which enzyme converts ALA to SDA?

A

Delta-6 desaturase

84
Q

Which enzyme converts SDA to ETA?

A

Elongase

85
Q

Which enzyme converts ETA to EPA?

A

Delta-5 desaturase

86
Q

Which enzyme converts EPA to DPA?

A

Elongase

87
Q

Which enzyme converts DPA to DHA?

A

Delta-4 desaturase

88
Q

What are the cofactors needed to produce delta-6 desaturase?

A 
B3
B6
C
Mg
Zn
89
Q

What are the cofactors needed to produce delta-5 desaturase?

A

B3
C
Zn

90
Q

What are the cofactors needed to produce elongase?

A

B6

91
Q

What is the conversion chain of LA to DPA?

A 
LA
GLA
DGLA
AA
AdA
DPA
92
Q

Which enzyme is needed to convert LA to GLA?

A

Delta-6 desaturase

93
Q

Which enzyme is needed to convert GLA to DGLA?

A

Elongase

94
Q

Which enzyme is needed to convert DGLA to AA?

A

Delta-5 desaturase

95
Q

Which enzyme is needed to convert AA to AdA?

A

Elongase

96
Q

Which enzyme is needed to convert AdA to DPA?

A

Delta-4 desaturase

97
Q

What can inhibit the delta-6 desaturase enzyme?

A 
Mg/B6/Zn deficiency
Insulin resistance
Refined sugars
Alcohol
Stress hormones
High intake of EPA/DHA
Excess trans fats
98
Q

What can inhibit the delta-5 desaturase enzymes?

A 
Zn deficiency
Insulin resistance
Alcohol
Stress hormones
High intake of EPA/DHA
Excess trans fats
99
Q

What does EFA testing include?

A

O3 index
O6:3 ratio
AA:EPA ratio

100
Q

What is the O3 index a marker for in testing?

A

CV risk

101
Q

What is the O6:3 ratio a marker for in testing?

A

Chronic illness

102
Q

What is the AA:EPA ratio a marker for in testing?

A

‘Silent’ inflammation

103
Q

How can the O3 and O6 balance be addressed?

A

Supplementing EPA and DHA

Addressing any co-factor deficiencies needed for conversion

104
Q

Why is cholesterol important?

A

Essential for the synthesis or action of:

Vit D and Ca metabolism
Stress hormones
Sex hormones
Aldosterone for mineral/fluid balance
Bile salts for digestion
Membrane integrity
Lipoprotein for triglyceride transport
105
Q

How is cholesterol synthesis stimulated?

A

A diet rich in triglycercides

106
Q

Where is cholesterol synthesised?

A

Liver

SI

107
Q

Where is cholesterol excreted?

A

In stool

mostly as bile products

108
Q

How is excretion of cholesterol increased?

A

Absorption of non-digestible carbs (fibre)

109
Q

What metabolises cholesterol, meaning less reabsorption?

A

Gut bacteria from healthy microbiomes

110
Q

What is more likely to affect plasma cholesterol levels?

A

Genetic factors

Nutritional factors

111
Q

What does VLDL cholesterol do?

A

Takes triglycerides to cells

112
Q

What does LDL cholesterol do?

A

Takes cholesterol from liver to cells

113
Q

What does HDL cholesterol do?

A

Collects cholesterol from cells and transports back to liver

114
Q

What other substances are carried in lipoproteins, as well as cholesterol?

A

CoQ10
Beta-carotene
E

115
Q

What can increases in cholesterol indicate?

A

An increased demand for cholesterol’s anti-inflammatory function
Increased need for cholesterol to repair membranes, make hormones etc

116
Q

What is atherosclerosis?

A

Inflammatory disease where LDL cholesterol deposits in arterial wall and becomes oxidised

117
Q

Does cholesterol always deposit in the arterial walls?

A

No

Not if there’s no inflammation or injury to arterial wall

118
Q

What is the better way of testing cholesterol?

A

Measuring particle size of the LDL rather than the total amount of cholesterol

119
Q

How does LDL particle size reflect coronary risk?

A

Small particles = dense = 3x greater risk of coronary artery disease
Large particles = more protective

120
Q

How does HDL particle size reflect potential coronary risk?

A

Larger particles are more effective at removing cholesterol from blood
Larger particles exert better anti-inflammatory and anti-thrombotic effects
Larger particles promote nitric oxide (vasodilation)

121
Q

What is lipoprotein (a) on a blood test?

A

Blood clotting agent

122
Q

What do high levels of lipoprotein (a) indicate on a blood test?

A

Greater risk of coronary artery disease

123
Q

What is Lp-PLA2 on a blood test?

A

Enzyme that plays a role in endothelial inflammation and atherosclerosis

124
Q

What can raised fibrinogen levels on a blood test indicate?

A

Risk factor for clot formation

125
Q

What does C-reactive protein on a blood test indicate?

A

Inflammatory marker

126
Q

What do raised levels of lipid peroxides indicate on a blood test?

A

Oxidative damage to membranes

127
Q

What level should serum cholesterol be in a blood test?

A

<5mmol/L

128
Q

What is the optimal range for triglycerides in a blood test?

A

0.79-1.24 mmol/L

129
Q

Which is more associated with obesity, diabetes and insulin resistance - LDL-P or LDL-C?

A

LPL-P

130
Q

What are phospholipids?

A

Structural basis of all cell membranes

131
Q

What are the different types of phospholipids?

A

Phosphatides
Phosphatidylcholine
Lecithin

132
Q

How are phosphatides structured?

A

Glycerol
Two long chain fatty acids
A phosphate group
Either inositol, choline or serine

133
Q

What is phosphatidylcholine?

A

The predominant phospholipid in the body

134
Q

Where is lecithin synthesised?

A

Liver

135
Q

What are the functions of lecithin?

A

Fat emulsification
Increases solubility of cholesterol
Helps improve cognitive function (source of choline)

136
Q

What are the therapeutic uses of phospholipids?

A 
Depression
Insomnia
Memory
Stress
Insulin resistance
Cognition
137
Q

What is the therapeutic use of inositol?

A

Diabetes

improves insulin sensitivity

138
Q

What are the therapeutic uses of phosphatidylserine?

A

Depression
Insomnia
Stress

139
Q

What are the therapeutic uses of phosphatidylcholine?

A

Cognition
Immunity
Memory
(neuro-protective)

Nutrition 1 (Semester II) (16 decks)

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