560F Nutritional Therapeutics Flashcards
What is mainly digested macro nutrient in the stomach?
Protein. A little fat due to lipase. No CHO.
What amino acid can help restore the gastric mucusal lining?
Glutamine.
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"
ulcerative conditions
e.g. peptic ulcers, ulcerative colitis
What is needed to neutralize the acidic chyme as it enters the duodenum?
Bicarbonate ions released by the pancreas.
What would you suggest for IBS?
Probiotics
A good tea to relieve gas and bloating?
Fennel tea
These commonly cause what kind of GI reaction?
Morphine, Codeine, Percocet
Antacids & those containing aluminum hydroxide
Antihistamines Antispasmodic drugs Anticonvulsants Antidepressants Iron tablets
constipation
What type of fiber is better for diarrhea vs constipation?
Soluble fiber (pectin)
What beverages should those with GERD avoid?
Carbonated beverages, coffee, alcohol
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
lower esophageal sphincter
What herbs are used for parasites?
Fresh garlic
Olive leaf extract
Parasite formula: wormwood, black walnut, cloves
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
parasites
What should be avoided with Celiac disease?
Gluten (rye, wheat, spelt, barley)
What are some common drugs that cause dysbiosis?
Antibiotics, corticosteroids, birth control pill
What foods and supplements can help with dysbiosis?
Probiotics:
- supplements
- sauerkraut and other fermented veg, kefir
Prebiotics:
- Dietary fiber: legumes, artichoke, onions, garlic, bananas, fermented soy
- Inulin and fructooligosaccharides
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
leaky gut
What interventions can help a leaky gut?
Hydration Fruits and vegeables High fiber Digestive enzymes (if needed) L-glutamine Gamma oryzanol Probiotics
What is the source of energy for enterocytes and colonocytes?
SCFA: n-butyrate, acetate, propionate, valerate
What nutrient deficiencies are associated with Crohn’s disease?
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
What are symptoms of diverticulitis?
Fever, chills, abdominal cramps, diarrhea, constipation, nausea, vomiting.
What should those with diverticulosis avoid?
Corn, nuts, popcorn and seeds to reduce the risk of complications.
What would you recommend for diverticulosis?
High fiber diet, but low fiber bland diet during flares
Antibiotics when pain is severe
Proper hydration
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.
gallbladder
In the CDSA, what may indicate an increased risk of breast cancer?
High fecal pH (result of excess ammonia)
High beta-glucuronidase (increases recirculation of toxins, hormones, carcinogens)
What is the difference between high and low glycemic foods?
High glycemic foods excessively increase blood sugar and insulin. Low glycemic foods do not.
What are the primary sources of energy in the body?
Carbohydrates: basic fuel supply, reserve fuel supply.
What is sucrose composed of?
Fructose and glucose
How many kcals AND grams in 1 tsp table sugar?
16 kcal = 1 tsp sugar = 4g sugar
What supplements can help lower serum glucose and protect against diabetic complications?
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
What is a common cause of reactive hypoglycemia?
Consuming high glycemic meals can be followed by a period of reactive hypoglycemia where blood sugar falls too low.
What would you suggest for reactive hypoglycemia?
Pay attention to meal composition (complex CHO) and timing (more frequent may be necessary, no skipping meals)
Chromium picolinate.
Besides hypertension, what blood markers can be elevated with Metabolic Syndrome?
Cholesterol
TG
Blood sugar
How should we best deal with Metabolic SYndrome?
Low glycemic diet
High complex CHO, high fiber, high legume
Smaller, more frequent meals preferable to 3 large meals
Low glycemic snacks between meals.
What are the common symptoms of hypoglycemia?
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)
What is aspartame composed of?
Aspartic acid, phenylalanine, methanol.
In the body, what does aspartame break down into?
Methanol is metabolized to formaldehyde; due to its low excretion rate, the EPA considers methanol a cumulative poison.
Aspartate and phenylalanine
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.
aspartame
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
Ritalin
What are advanced glycation end products?
Excess sugar in the blood reacting with proteins and lipids forming toxic AGEs, damaging structure/function.
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
blood glucose
What are the effects of organic eggs on lipid levels?
?? DHA could lower oxidized cholesterol. Dietary cholesterol has little impact on blood levels.
What does the liver convert ammonia into?
Urea
Are extra amino acids stored as protein?
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.
What is formed immediately after protein deamidation from the released amine group?
Ammonia
What are food sources of trimethylglycine?
Beets, spinach, broccoli
What nutrients can lower homocysteine levels?
B6, B9, B12, choline, trimethyglycine
What is the concern with hyperhomocysteinemia?
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
What diet/supplements are used for heart failure?
Low saturated fat Fish oil CoQ10 Magnesium glycinate L-carnitine L-taurine Hawthorn
What nutrient deficiencies can contribute to anemia?
Iron, B12, folate
What is a common deficiency from statin drug use? What problems can it cause?
CoQ10 deficiency.
Deficiency impairs mit. function, raising the lactate/pyruvate ratio.
Supplementation with CoQ10 may reverse symptoms of statin myopathy (rhabdomyolysis)
What is the toxic amino acid created by the body as an intermediary from methionine metabolism?
Homocysteine
What are the possible consequences of a high protein/low CHO diet?
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)
What are common foods that can contribute to osteoporosis?
Acid forming foods such as meats, dairy, soft drinks; also caffeine, alcohol and nicotine.
What drugs can contribute to osteoporosis?
Corticosteroids, diuretics, aromatase inhibitors, thyroid medications.
What type of diet would more likely produce weight loss from the excretion of large amounts of water?
High protein/Atkins
What vitamin should be avoided/controlled when taking anti-coagulant heart medications?
Vitamin K
What is the basic difference between the Paleolithic and Atkins diets?
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
What type of diet is suitable for those with liver or kidney disease?
Low protein diets, particularly animal protein/
What deficiency can be caused by excess zinc?
Copper
What is the substrate for the cyclooxygenase inflammatory pathway?
Arachidonic acid
Which prostaglandin goes into the inflammatory pathway?
Prostaglandin-E2 (PGe2)
What commonly-used commercial oil may contain toxins and pesticide residues
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
Is partially- or fully-hydrogenated more dangerous?
Partially, since they are more unstable.
What are the negative effects of trans-fatty acids?
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.
What’s the best method for maintaining proper hydration?
Minimum daily water requirement 2 quarts (8 glasses)
What are the diuretic effects of alcohol
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
What is a good herbal tea for cystitis?
Parsley tea - 2 cups TID
What are the actions of aldosterone?
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.
____ 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.
ADH (vasopressin)
What hormone is activated during hyponatremia?
ADH –> activates thirst
What hormone is activated during dehydration?
Histamine: regulates water intake and drought management. Regulates thirst mechanism to increase water intake.
Also: vasopressin, aldosterone (RAA), and prostaglandins
What respiratory disorder can dehydration make worse?
Asthma
What organ has the most effect on blood pressure regulation?
Kidneys. Via excretion/resorption of sodium.
What are good blood tests to monitor kidney function?
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.
What are some common signs of dehydration?
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
Which organs and glands are stressed by hypoglycemia and low blood pressure?
Adrenal glands
Pancreas
Liver
Kidneys
What type of diet would be preferable for a person with kidney disease?
Diet low in animal protein: vegan/vegetarian.
Proper hydration.
What supplements can help with chemotherapy side effects?
Licorice extract for mouth sores and GI lesions
L-glutamine to heal GI tract
Ginger extract/tea and Pau D’Arco tea for nausea.
What are the five functions of HCl in the stomach?
- Reduce stomach pH to about 2.0
- Kills bacteria in food
- Inactivates amylase (starch digestion stops)
- Converts pepsinogen to pepsin
- Starts protein breakdown