560F Nutritional Therapeutics Flashcards

1
Q

What is mainly digested macro nutrient in the stomach?

A

Protein. A little fat due to lipase. No CHO.

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2
Q

What amino acid can help restore the gastric mucusal lining?

A

Glutamine.

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3
Q

What supplements can help heal ____ ____ in the GI tract?

"Juicing (esp cabbage; methylmethionine sulfonium can be a substitute for cabbage juice)
Licorice 
Zinc carnosine
L-glutamine
Gama-oryzanol
High fiber diet
Probiotics
Plant-based digestive enzymes"
A

ulcerative conditions

e.g. peptic ulcers, ulcerative colitis

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4
Q

What is needed to neutralize the acidic chyme as it enters the duodenum?

A

Bicarbonate ions released by the pancreas.

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5
Q

What would you suggest for IBS?

A

Probiotics

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6
Q

A good tea to relieve gas and bloating?

A

Fennel tea

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7
Q

These commonly cause what kind of GI reaction?

Morphine, Codeine, Percocet
Antacids & those containing aluminum hydroxide

Antihistamines
Antispasmodic drugs
Anticonvulsants
Antidepressants 
Iron tablets
A

constipation

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8
Q

What type of fiber is better for diarrhea vs constipation?

A

Soluble fiber (pectin)

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9
Q

What beverages should those with GERD avoid?

A

Carbonated beverages, coffee, alcohol

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10
Q

What substances can relax the ____ ___ ___?

Foods: chocolate, tomatoes, fatty foods, onions, peppermint, junk food
Medications: Ca channel blockers, beta blockers, alpha-adrenergic agonists, theophyline, nitrates, progesterone, aspirin, NSAIDs

A

lower esophageal sphincter

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11
Q

What herbs are used for parasites?

A

Fresh garlic
Olive leaf extract

Parasite formula: wormwood, black walnut, cloves

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12
Q

What symptoms may indicate presence of ____?

Anemia of unknown origin
Chronic diarrhea or/alternating with constipation
Nausea/vomiting
Intestinal cramps
Changes in appetite/loss of appetite
Foul smelling gas
Indigestion
Bloating
A

parasites

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13
Q

What should be avoided with Celiac disease?

A

Gluten (rye, wheat, spelt, barley)

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14
Q

What are some common drugs that cause dysbiosis?

A

Antibiotics, corticosteroids, birth control pill

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15
Q

What foods and supplements can help with dysbiosis?

A

Probiotics:

  • supplements
  • sauerkraut and other fermented veg, kefir

Prebiotics:

  • Dietary fiber: legumes, artichoke, onions, garlic, bananas, fermented soy
  • Inulin and fructooligosaccharides
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16
Q

What disorders are associated with ____ ___?

Allergies
Food intolerances
Fatigue and malaise
Arthritic conditions
Painful muscle conditions
Fevers of unknown origin
Abdominal pain/distension
Diarrhea
Skin rashes
Brain fog
Poor exercise tolerance
A

leaky gut

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17
Q

What interventions can help a leaky gut?

A
Hydration
Fruits and vegeables
High fiber
Digestive enzymes (if needed)
L-glutamine
Gamma oryzanol
Probiotics
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18
Q

What is the source of energy for enterocytes and colonocytes?

A

SCFA: n-butyrate, acetate, propionate, valerate

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19
Q

What nutrient deficiencies are associated with Crohn’s disease?

A

Zinc (loss in stools due to development of fistulas or high stool output)
B12 (if illeum has been removed/damaged)
Iron, Mg, Se
Vitamins A, D, E, K, folate

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20
Q

What are symptoms of diverticulitis?

A

Fever, chills, abdominal cramps, diarrhea, constipation, nausea, vomiting.

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21
Q

What should those with diverticulosis avoid?

A

Corn, nuts, popcorn and seeds to reduce the risk of complications.

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22
Q

What would you recommend for diverticulosis?

A

High fiber diet, but low fiber bland diet during flares
Antibiotics when pain is severe
Proper hydration

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23
Q

What would a person without a_____ probably need?

High fiber diet
Eat small meals frequently rather than a large meal
Reduce animal protein
Avoid dairy
Avoid caffeine, alcohol, greasy food, refined sugar
Use sour and bitter foods to improve digestion of fat: lemons, limes, radicchio lettuce, chicory, endive, dandelion leaves
Fermented foods
Digestive enzymes particularly pancreatin (contains amylase, protease, lipase)
St. Mary’s thistle, dandelion root, globe artichoke leaves all increase bile production and bile flow.
Taurine essential for bile production. Increases feeling of comfort after meals. Reduces risk of stone formation in liver.

A

gallbladder

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24
Q

In the CDSA, what may indicate an increased risk of breast cancer?

A

High fecal pH (result of excess ammonia)

High beta-glucuronidase (increases recirculation of toxins, hormones, carcinogens)

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25
Q

What is the difference between high and low glycemic foods?

A

High glycemic foods excessively increase blood sugar and insulin. Low glycemic foods do not.

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26
Q

What are the primary sources of energy in the body?

A

Carbohydrates: basic fuel supply, reserve fuel supply.

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27
Q

What is sucrose composed of?

A

Fructose and glucose

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28
Q

How many kcals AND grams in 1 tsp table sugar?

A

16 kcal = 1 tsp sugar = 4g sugar

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29
Q

What supplements can help lower serum glucose and protect against diabetic complications?

A

Ca, Mg, Vit D
Fish oil

Chromium
Antioxidants (C & E)
B-complex
Extra B6 and B12 to protect against neuropathy/nerve damage
Biotin
Alpha-lipoic acid
Evening primrose oil
Green tea, ginseng, bitter melon, gymnema, bilberry, ginkgo, onions, garlic, fenugreek, cinnamon
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30
Q

What is a common cause of reactive hypoglycemia?

A

Consuming high glycemic meals can be followed by a period of reactive hypoglycemia where blood sugar falls too low.

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31
Q

What would you suggest for reactive hypoglycemia?

A

Pay attention to meal composition (complex CHO) and timing (more frequent may be necessary, no skipping meals)
Chromium picolinate.

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32
Q

Besides hypertension, what blood markers can be elevated with Metabolic Syndrome?

A

Cholesterol
TG
Blood sugar

33
Q

How should we best deal with Metabolic SYndrome?

A

Low glycemic diet
High complex CHO, high fiber, high legume
Smaller, more frequent meals preferable to 3 large meals
Low glycemic snacks between meals.

34
Q

What are the common symptoms of hypoglycemia?

A

Brain is first organ to react.
Headache, depression, weakness, food cravings, anxiety, irritability, psychological disturbances, blurred vision, excessive sweating, mental confusion, inability to focus, incoherent speech, bizarre behavior, convulsions. In severe cases, coma and death.
Low blood sugar can contribute to uncontrollable eating binges (usually the wrong foods)

35
Q

What is aspartame composed of?

A

Aspartic acid, phenylalanine, methanol.

36
Q

In the body, what does aspartame break down into?

A

Methanol is metabolized to formaldehyde; due to its low excretion rate, the EPA considers methanol a cumulative poison.
Aspartate and phenylalanine

37
Q

What are negative effects of_____, especially for dieters?

Brain excitotoxicity (aspartate can cross BBB)
Phenylalanine dangerous for those with PKU
Phe competes with tryptophan for absorption in the brain - can cause decreased serotonin and contribute to depression.
Formaldehyde and formic acid toxicity
For dieters, artificial sweeteners do not work - increase food consumption overall and cravings for sweet foods.

38
Q

What are the possible side effects of ____

Decreased blood flow to the brain 
Disruption of growth hormone
Suppresses appetite
Permanent neurological tics (Tourette's)
Psychosis, depression, insomnia, agitation, social withdrawal, apathy, OCD
Possible brain atrophy
Weakening of heart muscle and arrhythmia
Inattention, hyperactivity, impulsivity
Addiction and abuse
Potential carcinogen
39
Q

What are advanced glycation end products?

A

Excess sugar in the blood reacting with proteins and lipids forming toxic AGEs, damaging structure/function.

40
Q

What drugs and substances can raise ___ ____ levels?

Anti-retrovirals
Protease inhibitors (amprenavir, nelfinavir, ritonavir, saquinavir)
Diuretics, anti-hypertensives (furosemide, hydrochlorothiazide, indapamide)
Hormones (corticosteroids, danazol, estrogen/progesterone/HRT, megestrol acetate, oral contraceptives)
Niacin, baclofen, caffeine, olanzapine, cyclosporine, interferon alfa-2a

A

blood glucose

41
Q

What are the effects of organic eggs on lipid levels?

A

?? DHA could lower oxidized cholesterol. Dietary cholesterol has little impact on blood levels.

42
Q

What does the liver convert ammonia into?

43
Q

Are extra amino acids stored as protein?

A

No, they’re converted to glucose to be used as energy, or if not required as energy that glucose is converted to fatty acids for storage.
Amino acids are wasted when not used for protein synthesis.

44
Q

What is formed immediately after protein deamidation from the released amine group?

45
Q

What are food sources of trimethylglycine?

A

Beets, spinach, broccoli

46
Q

What nutrients can lower homocysteine levels?

A

B6, B9, B12, choline, trimethyglycine

47
Q

What is the concern with hyperhomocysteinemia?

A

Homocysteine is toxic to liver, adrenals, nerves, joints
Independent risk factor for heart disease
Increases platelet stickiness
Enhanced binding of Lp(a) to fibrin
Promotes oxidation of lipids
Increases free radical damage to blood vessels
Prevents vessels from dilating –> HTN

48
Q

What diet/supplements are used for heart failure?

A
Low saturated fat
Fish oil
CoQ10
Magnesium glycinate
L-carnitine
L-taurine
Hawthorn
49
Q

What nutrient deficiencies can contribute to anemia?

A

Iron, B12, folate

50
Q

What is a common deficiency from statin drug use? What problems can it cause?

A

CoQ10 deficiency.
Deficiency impairs mit. function, raising the lactate/pyruvate ratio.
Supplementation with CoQ10 may reverse symptoms of statin myopathy (rhabdomyolysis)

51
Q

What is the toxic amino acid created by the body as an intermediary from methionine metabolism?

A

Homocysteine

52
Q

What are the possible consequences of a high protein/low CHO diet?

A

Acidosis, homocysteine, CRP, renal caliculi
Strain on liver (urea cycle)
Kidney disease (extra N must be expelled)
Cancer (increased risk for colon cancer)
Osteoporosis and kidney stones (increased Ca excretion)

53
Q

What are common foods that can contribute to osteoporosis?

A

Acid forming foods such as meats, dairy, soft drinks; also caffeine, alcohol and nicotine.

54
Q

What drugs can contribute to osteoporosis?

A

Corticosteroids, diuretics, aromatase inhibitors, thyroid medications.

55
Q

What type of diet would more likely produce weight loss from the excretion of large amounts of water?

A

High protein/Atkins

56
Q

What vitamin should be avoided/controlled when taking anti-coagulant heart medications?

57
Q

What is the basic difference between the Paleolithic and Atkins diets?

A
Atkins = lean meats, full fat dairy, no refined sugar, carbs <20g/d, adds legumes/grains at different phases.
Paleo = no dairy, no grains, no legumes, no sugar, no processed foods
58
Q

What type of diet is suitable for those with liver or kidney disease?

A

Low protein diets, particularly animal protein/

59
Q

What deficiency can be caused by excess zinc?

60
Q

What is the substrate for the cyclooxygenase inflammatory pathway?

A

Arachidonic acid

61
Q

Which prostaglandin goes into the inflammatory pathway?

A

Prostaglandin-E2 (PGe2)

62
Q

What commonly-used commercial oil may contain toxins and pesticide residues

A

Cottonseed oil -
contains 0.6-1.2% cyclopropene fatty acids which are liver and GB toxic
Destroy desaturase enzymes and interferes with EFA functions
Contains gossypol, which irritates the digestive tracts and can cause water retention in lungs
High levels of pesticide residues
Enhances aflatoxins

63
Q

Is partially- or fully-hydrogenated more dangerous?

A

Partially, since they are more unstable.

64
Q

What are the negative effects of trans-fatty acids?

A
Lowers HDL and raises LDL
Raises Lp(a)
Increases platelet stickiness
Increase insulin
Decreases testosterone in males
Interferes with CYP450 system
In absence of DHA, may be used by brain --> depression, poor memory, bad moods. In children can cause difficulty learning, behavior problems.
65
Q

What’s the best method for maintaining proper hydration?

A

Minimum daily water requirement 2 quarts (8 glasses)

66
Q

What are the diuretic effects of alcohol

A

Suppresses secretion of ADH (vasopressin)
Decreased ADH –>dehydration of body and brain
Vasopressin receptors help keep nerves fully hydrated
Vasopressin acts to retain water in the body and constrict blood vessels

67
Q

What is a good herbal tea for cystitis?

A

Parsley tea - 2 cups TID

68
Q

What are the actions of aldosterone?

A

Aldosterone is a hormone produced by the outer cortex of the adrenal gland that regulates the balance of water and electrolytes in the body, encourages kidneys to excrete potassium into the urine and retain Na, thereby retaining water.

69
Q

____ is a peptide molecule released by the pituitary gland at the base of the brain after being made in the hypothalamus. It regulates body water retention of water by acting to increase water reabsorption in the collecting ducts of the nephron of the kidney.

A

ADH (vasopressin)

70
Q

What hormone is activated during hyponatremia?

A

ADH –> activates thirst

71
Q

What hormone is activated during dehydration?

A

Histamine: regulates water intake and drought management. Regulates thirst mechanism to increase water intake.
Also: vasopressin, aldosterone (RAA), and prostaglandins

72
Q

What respiratory disorder can dehydration make worse?

73
Q

What organ has the most effect on blood pressure regulation?

A

Kidneys. Via excretion/resorption of sodium.

74
Q

What are good blood tests to monitor kidney function?

A

Serum creatinine levels are used to measure glomerular filtration rate. If kidney function is abnormal, creatinine will increase in the blood due to decreased excretion of creatinine in urine. Creatinine may also vary due to person’s size/muscle mass.

75
Q

What are some common signs of dehydration?

A
Dry mouth
Thirst
Fatigue, energy loss
Constipation
Digestive disorders, dyspepsia, GERD
Gastritis, ulcers
Respiratory troubles, asthma
Excess weight
Cystitis, urinary infections
Rheumatism, arthritis, chronic pain
Premature aging
Allergies
76
Q

Which organs and glands are stressed by hypoglycemia and low blood pressure?

A

Adrenal glands
Pancreas
Liver
Kidneys

77
Q

What type of diet would be preferable for a person with kidney disease?

A

Diet low in animal protein: vegan/vegetarian.

Proper hydration.

78
Q

What supplements can help with chemotherapy side effects?

A

Licorice extract for mouth sores and GI lesions
L-glutamine to heal GI tract
Ginger extract/tea and Pau D’Arco tea for nausea.

79
Q

What are the five functions of HCl in the stomach?

A
  1. Reduce stomach pH to about 2.0
  2. Kills bacteria in food
  3. Inactivates amylase (starch digestion stops)
  4. Converts pepsinogen to pepsin
  5. Starts protein breakdown