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1

Mechanisms to Increase Blood Glucose

  • Glycogen in liver gets broken down into glucose
  • Gluconeogenesis - make new glucose from amino acids
  • Regulated by 2 hormones
    • glucagon
    • epinephrine

2

Mechansims to Decrease Blood Glucose

  • Regulated by the hormone INSULIN
    • causes cells to uptake glucose from the bloodstream
  • Excess glucose stored as glycogen or fat

3

Glycogen in where gets broken down to glucose?

  • LIVER

4

Gluconeogenesis

  • Make new glucose from amino acids
  • regulated by 2 hormones:
    • glucagon
    • epinephrine

5

2 Blood Glucose Disorders

  • Hypoglycemia
  • Hyperglycemia

6

Hypoglycemia

  • Low blood sugar
  • usually feel hungry

7

Reactive Hypoglycemia

  • Excessive production of insulin
  • Large sugary meals may induce larger insulin response

8

Hyperclycemia

  • Elevated blood sugar
  • 2 types
    • Type 1 diabetes
    • Type II diabetes

9

Type I diabetes 

  • "autoimmune"
  • Cause: Pancreas doesn't secrete any or enough insulin
  • Symptoms: Excessive hunger, thirst and urination; fatal without treatment
  • Treatment: insulin therapy

10

Type II Diabetes

  • Cause: Cells are insulin resistant; related to obesity
  • Symptoms: gradual weakness; kidney failure, vision loss, infections and amputations
  • Treatment: weight loss

11

Glycemic Effect

  • How much a food will affect blood sugar
  • High glycemic foods are rapidly abosrbed (simple sugars)
  • Low glycemic foods are absorbed slowly (starch)

12

Juice

13

Refined Grains

Low - fiber and other nutrients

*fortifying/enriching adds back some nutrients

14

Refined sugar

  • Lowers nutrient density of food
  • Contributes to dental caries
  • Source of Calories; large contribution to weight gain

15

The active ingredient in alcohol:

ethanol

16

Alcohol is denoted with a(n): 

OH

17

Congeners

  • impurities in beverages produced during fermentation

18

Congeners of beer

  • hops
  • malt
  • asbestos
  • yeast
  • cobalt

19

Congeners of Wine

resveratrol

20

congeners of hard liquor

asbestos

21

Variations in enzymes:

  • ADH: fast version in African Americans; slow version in Native Americans (prolongs ethanol action so increased addiction)
  • ALDH: slow version in Asians (results in flushing, more product is acetaldehyde)

22

Ethanol -> 

Acetaldehyde -> Acetic Acid

ADH then ALDH

23

More alcohol from each drink reaches the blod in women than men because:

  1. Women make lower levels of enzymes
  2. Women weigh less, generally
  3. Women typically have less lean mass

24

Absorption of alcohol is:

  • very efficient
  • 95% of alcohol in women gets abosrbed
  • 75% of alcohol in men gets abosrbed

25

1 drink = 

15 g EtOH (ethanol)

  • Beer: 12 oz
  • Wine: 5 oz
  • Hard Liquor: 1 oz

26

True or False: there are health benefits of consuming more than 1-2 drinks per day

False - there are NO health benefits of more

27

Liver has enzymes called

  1. Microsomal ethanol oxidative system
  2. cytochrome P450 system

28

Enzymes of the liver metabolize ethanol, but also:

  • Make free radicals - damage liver
  • metabolizes other drugs
  • Increases risk of cancer by making carcinogens

29

Ethanol is stored as:

  • fat
  • contains 7 kcal/g

30

> 2-5 drinks per week

  • Benefit: None
  • Consequence: Raise BP; Increase HR and stroke risk

31

3-9 drinks per week

  • Benefit: Reduce CVD risk by rasing HDL
  • Consequence: None if stay at this level

32

4-6 drinks per sitting

  • Benefit: None
  • Consequence: Decrease fat burning by 33%; "Holiday Heart"

33

Polyphenols

  • Benefit: Reduce blood clotting so reduce heart attack and stroke risk
  • Consequence: None

34

Ethanol's bad effects:

  • Mutagenic - causes mutations in DNA
  • Increase cancer risk
    • stomach, pancreas, liver, colorectal, breast, prostate
  • Displacement of protective nutrients with alcohol calories
  • Beverage content is unregulated

35

Fetal Alcohol Syndrome

  • the largest known cause of mental retardation
  • Symptoms: attention deficit, impulsive, inability to tell cause-and-effect

36

Drinking during pregnancy?

NEVER - never safe to drink during pregnancy

37

What does Alcohol target?

  • Alcohol targets brain receptors that control rewards and pleasure

38

Alcoholism

  • Caused by:
    • 50% Genes
    • 50% environmental causes

39

Nutrient

An essential substance to the body that we cannot synthesize or live without

40

Where does toxicity usually come from?

Concentrated supplements

41

Recommended Dietary Allowance (RDA)

  • A level of recommended intake set at two standard deviations from the Estimated Average Requirement
  • designed to meet the needs of about 97% of the population

42

Food Components to reduce:

  • Salt (sodium) - leads to high blood presure
    • < 2300 mg a day
  • Saturated fat (animal fats) - leads to heart disease
    • < 10% sat. fat a day
  • Cholesterol (animal products) - leads to heart disease
    • < 300 mg a day
  • Trans fats
  • Refined grains
  • Alcohol

43

Food components to increase:

  • Vegetables and fruits - dark green, orange and yellow, legumes
  • Make half your gains whole - increased fiber, vitamins/minerals
  • fat-free or low-fat milk products - calcium
  • Variety of proteins - focus on low fat, lean meats (poultry, fish)

44

Digestion Summary:

Mouth

Esophogus

Stomach

Small Intestine

Large Intestine / Colon

Rectum

45

4 Digestive functions:

  • motility
  • secretion
  • digestions
  • absorption

46

Two types of motility

  1. Peristalsis - rhythmic contraction of muscles surrounding gut to move food through
  2. Segmentation - random contraction that serves to break up and mix food

47

Mouth

  • Function: Chewing (mechanical breakdown/mixing)
  • Secretions: mouth releases 1st digestive secretions
    • saliva - moisten food, contains amylase
  • Enzymes: Amylase (works on amylose, or starch)

48

Esophogus

  • Function: Peristalsis (rhythmic contractions to move food to stomach) begins

49

Stomach

(Reservoir for slow release of food into intestine)

50

Functions of the Stomach:

  1. Churning (grinding & mixing)
  2. Begin some protein breakdown, little digestion happens in the stomach
  3. Reservoir for slow release of food into the small intestine
  4. A little absorption (20% of alcohol)

51

Secretions of the stomach:

  • Acid - helps sterilize food, start chemical breakdown of (denaturing) proteins
  • Protease - starts protein digestion (breakdown of protein)
  • Mucus - protests walls of stomach; ulcers - thin lining of mucus

52

Enzymes of the Stomach

  • Protease acts on proteins

53

3 Parts of the Small Intestine:

  1. Duodenum
  2. Jejunum
  3. Ileum

54

Functions of the Small Intestine:

  • Motility - peristalsis and segmentation
  • Major chemical breakdown of food
  • Majority of absorption of nutrients - large surface area created by bili

55

Aborption of nutrients in Small Intestine

  1. Nutrients: glucose, fat, amino acids, water soluble vitamins, B-12, Calcium, Magnesium, Iron, Sodium, Potassium, Free water, 80% of total alcohol, bile
  2. Blood vessels / capillaries - water soluble nutrients
  3. Lymphatic system vessels - fat soluble nutrients (lipids and some vitamins)

56

Secretions in the Small Intestine

  • Enzymes secreted via the common bile duct
    • Amylase 
    • Protease
    • Lipase
    • Sodium bicarbonate
    • Bile
    • Disaccharidases

57

Enzymes of the Small Intestine

  • Amylase
  • Protease
  • Lipase
  • Disaccharidase

58

Amylase

  • Made in pancreas, breaks down starch

59

Protease

  • Made in pancreas, breaks down protein

60

Lipase

  • Made pancreas, breaks down lipids/fats

61

Sodium bicarbonate

  • Secreted by pancreas
  • helps neutralize acid in intestines

62

Bile 

  • Made in liver
  • stored in gallbladder
  • emulsifier (mix fat & water)

63

Disaccharidases

  • Made in small intestines/mucosa
  • breaks down double sugars (di-) into single sugars (mono-)

64

Large Intestine (Colon)

  • Major function: water re-absorption (from foods)
  • some nutrient absorption, not the main job
  • Large Bacteria population - Such as E. coli
  • Fiber affects movement of food through the colon, shortens the transit time

65

Secretions and Enzymes in the Large Intestine (colon)

None

66

Function of Rectum

  • Reservoir for elimination

67

Carbohydrates (CHO)

  • 4 kcal/gram
  • produced by photosynthesis
  • Sources: grains, fruits, vegetables, beans, some in nuts and dairy
  • chemical formula: CnH2nOn

68

Monosaccharides

  1. Glucose - 6 sided ring; brain only burns glucose
  2. Galactose - 6 sided ring
  3. Fructose - 5 sided ring

69

Disaccharides

  1. Sucrose
    • glucose + fructose; table sugar (cane, beets)
  2. Maltose
    • glucose + glucose; barley malt syrup
  3. Lactose
    • glucose + galactose; milk & dairy (ONLY)

70

Oligosaccharides

  • Not nutritionally significant
  • Hard to digest, but bacteria in colon causes gas & discomfort
  • In beans, onions, legumes, and some vegetables
    • Raffinose
    • Stachyose

71

Polysaccharides

  • Starch
    • many glucose units, amylose (straight), amylopectin (branched
  • Grains: wheat, oats, rice, corn, and barley
  • Legumes: beans, lentils, and peas
  • Dextrins (malodextrins)
    • intermediate of starch digestion
    • shorter = sweater; often in sports drinks
  • Glycogen
    • storage form of glucose in the body (liver & muscles): important in blood sugar maintence and exercise
  • Dietary Fiber
    • structural material in plants only
    • indigestible polysaccharide

72

Insoluble Dietary Fiber

  • Cellulose
  • Hemicellulose
  • Lignin

73

Cellulose

  • can't be digested by humans

74

Hemicellulose

  • digested by ruminant animals

75

Lignin

  • woody part of plants; not a polysaccharide

76

Soluble Dietary Fibers

  • Pectin
  • Gums & Mucilages

77

Pectin

  • forms gel (jams & jellies)

78

Gums & Mucilages

  • Thickens food
  • gives creaminess to food
  • Note: soluble, but still not digestible

79

Insoluble Dietary Fiber functions:

  • Abosrbs water and add bulk feces
  • Stimulates peristalis and decreases transit time
  • Prevents/treats constipation

80

Soluble Dietary Fiber

  • Reduce cholestorol reabsorption; helps lower blood cholesterol
  • Slows CHO absorption; helps lower blood sugar

81

Sources of Insoluble Dietary Fiber

  • Whole grains
  • vegetables
  • fruits
  • bran
  • oatmeal

82

Sources of Soluble Dietary Fiber

  • Oats
  • barley
  • legumes (beans)
  • rice
  • fruits

83

CHO digestion of Starches

Starches -------------->maltose------->glucose

Salivary & pancreative amylase - between starches and maltose

84

CHO digestion of Disaccharides

Disaccharides ------------------------>monosaccharides
Enzymes in the intestinal mucosa
 
i.e of monosaccharides = lactase enzyme

85

Lactose intolerance

  • Comes from a deficiency in lactase enzyme
  • Bacteria in gut utilize lactose creating GI distress
  • Substitute cultured milk products: yogurt, cheese, keefer, buttermilk
  • May be dose dependent with only slight defiency in enzyme

86

Glucagon

  • mobilizes glycogen to raise blood sugar

87

Glycogen

  • storage form of glucose

88

The form of CHO that most other forms of CHO are changed to before being used for energy:

Glucose

89

In what condition is an excessive amount of insulin produced when a normal amount of available CHO has been consumed?

reactive hypoclycemia

90

What does a Type I (juvenile-onset) diabetic fail to produce?

Insulin

91

Gluconeogenesis is the...

Synthesis of glucose from amino acids

92

Type I diabetes  facts

  • the pancreas does not produce insulin
  • symptoms include sugar in the urine

93

Glycogen is formed and stored in the liver and muscle when...

Excessive glucose is present in the blood

94

The major site of alcohol removal is the...

liver

95

Congeners

  • are substances other than alcohol found in alcoholic beverages
  • like alcohol, may also have effects on the body

96

Enrichment process for grain products

  • Some of the micronutrients lost in processing have been restored

97

Typical response of the body to blood glucose:

  • Excessive fall in blood glucose triggers the release of glucagon

98

A person with Type I diabetes is most likely to receive 

Insulin by insulin injection

99

When blood glucose levels start dropping to the low-normal range, which substance is produced in larger amounts to promote the breakdown of stored carbohydrate to glucose?

Glucagon

100

What has the greatest impact in terms of person's ability to handle alcohol?

Lean body mass and total body water

101