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Nutrition 1 (Semester I) > 5a. Digestion & Health - Digestive System > Flashcards

5a. Digestion & Health - Digestive System Flashcards

1
Q

What are the three primary functions of the digestive system?

A

Digestion
Absorption
Excretion

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2
Q

What constitutes digestion?

A

Mechanical - chewing, peristalsis

Chemical - gastric juices, pancreatic enzymes, bile & enterocyte enzymes

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3
Q

Where does most absorption occur?

A

Small intestine

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4
Q

Where are most substances absorbed into?

A

Blood

Lymph

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5
Q

How are waste materials excreted?

A

As faeces
Via urine
Skin
Lungs

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6
Q

Which elements make up the digestive tract?

A 
Mouth
Pharynx
Oesophagus
Stomach
Small/large intestine
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7
Q

Which elements make up accessory organs?

A 
Salivary glands
Pancreas
Liver
Gall bladder
Biliary tract
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8
Q

Which is the first location in the GI tract where digestion occurs?

A

Mouth/oral cavity

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9
Q

What is the process of digestion in the mouth?

A

Chewing breaks down food into smaller chunks

Triggers the salivary glands to release saliva

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10
Q

Why is saliva important in digestion?

A

Contains enzyme amylase that breaks down polysaccharides (starches found in foods)

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11
Q

How often should food be chewed?

A

Up to 20 times per bite

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12
Q

What happens the more you chew?

A

More amylase is released

The more carbs can be broken down and made available to the body

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13
Q

Why should you avoid drinking with meals?

A

Drinking dilutes saliva and gastric juices

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14
Q

What does diluted digestive juices result in?

A

Fewer nutrients being made available to the body

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15
Q

What is the optimal pH for salivary amylase to function?

A

6.8

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16
Q

What happens to amylase once it reaches the stomach?

A

Denatured by stomach acid

Becomes inactive once the bolus arrives in the stomach

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17
Q

What happens to carbs not broken down in the mouth?

A

They remain unutilised as the small intestine can only absorb single sugars

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18
Q

What can challenge the optimal saliva pH?

A

Excess acidity in body tissues which are excreted via saliva

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19
Q

What does the lowering of salivary pH do?

A

Impairs the functionality of salivary amylase

Impacts the digestion of carbs in the oral cavity

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20
Q

What factors can lower pH in the mouth?

A 
Refined sugars
Meat
Dairy
Processed foods
Alcohol
Coffee
Chewing gum
Cigarettes
Chronic stress
Sedentary lifestyle
Heavy metal exposure e.g. fillings
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21
Q

How does digested food enter the stomach?

A

Through the lower oesophageal sphincter (cardiac sphincter)

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22
Q

What happens when food enters the stomach?

A

Food stretches the stomach
Stimulates the enteric nerves in stomach wall
And release of hormone gastrin
Both stimulate peristalsis leading to release and formation of gastric juices containing HCI and digestive enzymes
Stomach churns the bolus, mixing it with gastric juices to break down food

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23
Q

Which digestive enzymes are released from the stomach wall?

A

Pepsinogen

Gastric lipase

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24
Q

What is pepsinogen?

A

Inactive enzyme which becomes active when exposed to HCl

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25
Q

What does pepsinogen convert to?

A

Pepsin (the active form)

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26
Q

What does pepsin do?

A

Breaks down proteins into smaller protein chains

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27
Q

What does gastric lipase do?

A

Breaks down lipids

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28
Q

What substances can the stomach absorb?

A

Water
Alcohol
Iodine
Fluoride

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29
Q

What happens to the substances which are absorbed by the stomach?

A

They enter the venous circulation and escorted to the liver by the portal vein to be processed

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30
Q

What is the pH of HCl?

A

2-3

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31
Q

Which nutrients are needed to make HCl?

A

Zinc

B6

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32
Q

What are food sources of zinc?

A 
Nuts
Seeds (esp pumpkin)
Eggs
Fish
Meat
Oysters
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33
Q

What are food sources of B6?

A 
Whole grains
Sunflower seeds
Legumes
Walnuts
Green vegetables
Carrots
Potatoes
Avocado
Fish
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34
Q

What function does stomach acid have?

A

Breaks down proteins (pepsin)
Breaks down fats (lipase)
Triggers release of pancreatic juice and bile into the duodenum
Eliminates micro-organisms - bacteria. viruses, fungi

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35
Q

What can low HCl production in the stomach be caused by?

A 
Chronic stress
Low B6 and zinc
Medications e.g. PPIs
Chronic H. pylori
Ageing
AI gastritis
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36
Q

What can low HCl lead to?

A

Poor protein digestion

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37
Q

What can poor protein digestion result in?

A

Protein putrefaction in SI

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38
Q

What does protein putrefaction create?

A

Compounds called polyamines

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39
Q

Which pathology are polyamines implicated in?

A

Colorectal cancer

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40
Q

What does undigested food in the SI do to bacteria?

A

Allows it to proliferate

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41
Q

Which pathology is caused by a proliferation of bacteria in the SI?

A

SIBO

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42
Q

What can low HCl do to the production of intrinsic factor?

A

Reduces production

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43
Q

What can low intrinsic factor compromise?

A

B12 absorption

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44
Q

How can low stomach acid present within 1-2 hrs after meals?

A

Bloating
Belching
Flatulence

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45
Q

How can low stomach acid present after eating?

A

Abdominal pain
Fullness
Foul smelling stools

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46
Q

How can you increase stomach acid?

A 
Apple cider vinegar in a little water before meals
Zinc and B6-rich foods
Avoid overeating
Bitter foods and herbs
Eat fermented vegetables
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47
Q

Examples of bitter foods

A

Rocket
Artichoke
Watercress
Chicory

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48
Q

Examples of bitter herbs

A

Gentian
Barberry bark
Dandelion
Goldenseal

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49
Q

What is released as chyme is drip fed through the pyloric sphincter into the duodenum?

A

CCK

cholecystokinin

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50
Q

What is CCK?

A

Hormone released from the duodenal wall

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51
Q

What are the functions of CCK?

A

Triggers release of pancreatic juice
Triggers release of bile
Induces sense of satiety

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52
Q

What triggers the release of CCK?

A

Presence of proteins and/or fats in the chyme

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53
Q

What is the pH of chyme?

A

2

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54
Q

What neutralises chyme in the duodenum?

A

Bicarbonate

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55
Q

Where is the bicarbonate to neutralise the chyme released from?

A

Liver

Pancreas

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56
Q

What is the pH of the duodenum?

A

6.5

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57
Q

What is the main function of the SI?

A

Digestion

Absorption

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58
Q

What percentage of nutrients are absorbed in the SI?

A

90%

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59
Q

What are the three regions of the SI?

A

Duodenum
Jejunum
Ileum

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60
Q

What mainly happens in the duodenum?

A

Digestion

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61
Q

What mainly happens in the jejunum?

A

Absorption

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62
Q

What mainly happens in the illeum?

A

Absorption of B12

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63
Q

What feature does the SI have to aid absorption?

A

Villi

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64
Q

What do villi contain?

A

Blood capillaries

Lymphatic capillaries

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65
Q

What is the brush border also known as?

A

Microvilli

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66
Q

How are the nutrients absorbed in the SI?

A

Through the microvilli

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67
Q

What are attached to the microvilli to aid absorption?

A

Brush border enzymes

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68
Q

What are the names of the brush border enzymes?

A

Sucrase
Maltase
Lactase
Dipeptidase

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69
Q

What are the functions of maltase, sucrase and lactase?

A

Break down double-chained sugars into single sugars

e.g. glucose, fructose, galactose

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70
Q

What is the function of dipeptidase?

A

Breaks down proteins into amino acids

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71
Q

In what form do carbs, proteins and fats need to be in to be able to be digested?

A

In their simplest forms

e.g. single chains

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72
Q

What determines if macronutrients are able to be broken down into their simplest forms?

A

Optimal function of the mouth, stomach, pancreas and gallbladder

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73
Q

Once absorbed by the microvilli, where do carbs and proteins go?

A

Through blood capillaries to the liver

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74
Q

Once absorbed by the microvilli, where do lipids go?

A

Through lymphatic capillaries

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75
Q

What is the exocrine function of the pancreas?

A

To produce enzymes that digest carbs, proteins and fats

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76
Q

Where are the pancreatic enzymes secreted into?

A

SI as part of pancreatic juice

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77
Q

Which pancreatic enzyme digests carbs?

A

Pancreatic amylase

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78
Q

Which pancreatic enzyme digests fats?

A

Pancreatic lipase

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79
Q

Which pancreatic enzymes digest proteins?

A

Proteases - trypsin, chymotrypsin

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80
Q

How is the pancreas connected to the duodenum?

A

Pancreatic duct

81
Q

What happens in the intestines if pancreatic enzyme production is poor?

A

Foods ferment

82
Q

What symptoms are a result of foods fermenting in the intestines?

A

Bloating
Flatulence
Abdominal pain
Weight loss

83
Q

What happens to digestive enzymes if eating too often and too much?

A

They get used up

84
Q

What is the result of digestive enzymes being used up due to overeating?

A

Not all food is digested - malnutrition and bodily dysfunctions

85
Q

What happens to organs such as the pancreas and stomach during overeating?

A

They are put under stress to produce digestive juices
Capacity gets depleted
Energy used to produce digestive enzymes is directed away from healing/repair

86
Q

What percentage of daily energy expenditure is used by individuals eating a well balanced, nutritious diet to digest and absorb food?

A

10%

87
Q

What percentage of daily energy expenditure is used by individuals eating dense forms of protein (meat/soya) and junk food to digest and absorb food?

A

50%

88
Q

What are the implications of overeating and the excessive ingestion of animal proteins?

A

Compromises other bodily functions

Leads to fatigue, reduced immunity

89
Q

What should individuals do to support digestive health?

A

Don’t eat more than 3 meals a day
Avoid overeating and snacking between meals
Don’t drink with meals

90
Q

What did Bernard Jensen discover about overeating?

A

Undigested materials are stored in the mucus-secreting lining of the intestines
Impairs the absorption and delivery of nutrients to body tissues
The thicker the lining of undigested materials, the worse the absorption of nutrients

91
Q

What can a lining of undigested materials lead to?

A

Parasites
Candida
Under-nourished body tissues and organs

92
Q

How can we support the body’s detoxification of wastes so they don’t linger in the intestines?

A

Detoxification
Intermittent fasting
Dietary changes + vegetable broths

93
Q

What is the function of the gallbladder?

A

Stores and releases bile

94
Q

Where is bile initially produced?

A

Liver

95
Q

What does bile consist of?

A

Water
Bile salts
Cholesterol
Bilirubin

96
Q

Outline the movement of bile from the liver to the SI?

A

Moves from liver to gallbladder via bile ducts

Moves from gallbladder to SI via common bile duct

97
Q

What initiates the release of bile into the duodenum?

A

Ingestion of fats

98
Q

Functions of bile

A

Breaks down lipids into smaller molecules, increasing surface area for pancreatic lipase
Stimulates peristalsis
Excretes detoxified products from the liver
Excretes excess cholesterol

99
Q

What are the implications of poor bile flow?

A

Affects fat digestion

Affects body’s ability to eliminate toxins via bowel

100
Q

Explain biliary tree

A 
Bile is carried from hepatic ducts into gallbladder via cystic duct
Upon CCK stimulation, gallbladder contracts and ejects bile
Pancreatic duct (carrying pancreatic juices) meets the common bile duct and carries both through the sphincter of Oddi into duodenum
101
Q

What is the adequate production and release of bile and pancreatic juice dependent upon?

A

Sufficient water consumption

102
Q

What can stimulate the release of pancreatic juice and bile?

A

Bitters

103
Q

Which vein transports all nutrients and toxins from the GIT to the liver?

A

Portal vein

104
Q

How much blood does the liver filter every minute?

A

1.4 litres

105
Q

Examples of nutrients stored by the liver

A

Carbs
Fats
Vits A, D, E, K, B12
Iron

106
Q

Examples of liver functions

A

Detoxification

Deactivating hormones

107
Q

Pathways that toxins can enter the liver

A

Lungs
Skin
GIT

108
Q

Pathways that toxins can exit the liver

A

Lungs
Skin
Bowels
Kidneys

109
Q

What can impair liver detoxification?

A 
Lack of essential nutrients
Trans fats
Heavy metals
Alcohol
Caffeine
Pesticides
110
Q

What happens to toxins that are only partially broken down?

A

They get recirculated

111
Q

What happens during Phase 1 of liver detoxification?

A

Volatile toxins are converted into smaller, more stable water-soluble substances
CYP450 enzymes create an active binding site on the toxin or hormone so it can be conjugated

112
Q

What happens to the toxin once Phase 1 of detoxification is complete?

A

The toxin gets oxidised

113
Q

What is created from the oxidation of the toxins at the end of the Phase 1 detoxification?

A

Free radicals

114
Q

What is needed to neutralise the free radicals formed from the oxidisation of toxins during Phase 1 detoxification?

A

Antioxidants

115
Q

What is needed to support the antioxidants neutralising the free radicals during Phase 1 detoxification?

A

Optimal digestion to ensure co-factors and AO are liberated from food

116
Q

What happens during Phase 2 of liver detoxification?

A

Conjugation
Chemical groups are bound to reactive toxins to make them safe and excretable
The bound toxins are then pumped into the blood or bile for excretion mostly via the kidneys or bowels

117
Q

Which nutrients are required for Phase 2 detoxification?

A

Sulphur
Magnesium
B vits

118
Q

Food sources of sulphur

A

Garlic

Onions

119
Q

Which herbs can support liver detoxification?

A

Dandelion
Milk thistle
Liquorice root

120
Q

Which is the key AO needed for neutralising free radicals during liver detoxification?

A

Glutathione

121
Q

Which proteins is glutathione made from?

A

Cysteine
Glutamine
Glycine

122
Q

Which valve does any remaining undigested material go through to enter the LI?

A

Ileocaecal valve

123
Q

What happens in the LI?

A

Final stages of digestion and absorption

124
Q

How is digestion undertaken in the LI?

A

By microflora

125
Q

What is produced by goblet cells in the LI?

A

Mucus

126
Q

Are there any digestive enzymes in the LI?

A

No

127
Q

What are the four regions of the LI?

A

Caecum
Colon
Rectum
Anal canal

128
Q

What is attached to the caecum?

A

Appendix

129
Q

What does the appendix contain?

A

Immune tissue

Reservoir for beneficial gut bacteria

130
Q

Regions of the colon

A 
Ascending colon
Hepatic flexure
Transverse colon
Splenic flexure
Descending colon
131
Q

Sphincters of the anal canal

A

Involuntary internal sphincter

Voluntary external sphincter

132
Q

Four vitamins absorbed in the duodenum

A

Vits A, D, E, K

133
Q

Four minerals absorbed in duodenum

A

Magnesium
Iron
Copper
Selenium

134
Q

Four vitamins absorbed in the jejunum

A

Vits A, D, E, K

135
Q

Four minerals absorbed in the jejunum

A

Magnesium
Iron
Chromium
Zinc

136
Q

Four nutrients absorbed by the ileum

A

B12

Vits C, D, K

137
Q

Four nutrients absorbed by the LI

A

Water
Sodium
Potassium
Chloride

138
Q

Where can GALT clusters be found?

A 
Tonsils
Oesophagus
Stomach
SI
Appendix
139
Q

Which immunoglobulin is secreted into the GIT mucosa?

A

IgA

140
Q

What reduces IgA production?

A

Stress

141
Q

Functions of the LI microflora

A 
Final stages of nutrient extraction
Synthesises biotin and vit K2
Support intestinal barrier
Protection from pathogens
Regulates appetite
Regulates mood
142
Q

What happens during the final stages of nutrient extraction in the LI?

A

Microbial fermentation of remaining carbs and amino acids

143
Q

What are the by-products of microbial fermentation in the LI?

A

Methane
Hydrogen
Hydrogen sulphide

144
Q

What can excess flatulence with a strong odour indicate?

A

Poor digestion

145
Q

What does the GI mucosal membrane protect against?

A

Ingested toxins
Pathogens
Undigested food

146
Q

What happens to the GI mucosal membrane when damaged?

A

Tight junctions (that keep out toxins, pathogens, undigested food) become leaky allowing these larger molecules to enter circulation

147
Q

What can be the result of gut bacteria abnormally entering the blood via a leaky gut

A

Excessive immune responses including allergies and autoimmunity

148
Q

Examples of what can damage the intestinal barrier

A 
Poor nutrition
Heavy metals
Drugs
Stress
Dysbiosis
Candida overgrowth
Alcohol
Smoking
Radiation/chemo
Early weaning
149
Q

How does the typical Western diet of refined sugars, trans fats, concentrated proteins and low fibre influence the diversity and dominant species in the gut microflora?

A

Makes the strains pathogenic

150
Q

What does a diverse gut microflora help to support?

A

Immune system

151
Q

What is the meaning of ‘dysbiosis’?

A

Imbalance of the colonies of the gut microflora, leading to a disruption in health

152
Q

What conditions can be associated with gut dysbiosis?

A 
Vit/mineral insufficiencies
Malabsorption of carbs/fats
IBDs e.g. Crohn's
Colorectal cancer
AZD
Parkinsons
AI, allergies, intolerances
Obesity
Mood disorders
153
Q

What are the physiological effects of eating junk food?

A

Gut dysbiosis - inflammation, reduced immunity, leaky gut
Spikes in blood glucose - T2D, PCOS, obesity, acne
CVD
Vit/mineral deficiencies
Addictive eating behaviour

154
Q

What is the migrating motor complex (MMC)?

A

Pattern of electromechanical activity in the smooth muscle between the stomach and distal ileum during the periods between meals

155
Q

What is the role of the MMC?

A

Sweeps residual undigested material through the digestive tube

156
Q

How does the MMC sweep through residual undigested material?

A

Opens the pyloric sphincter

Increases gastric, biliary and pancreatic secretions

157
Q

What role do the gastric, biliary and pancreatic secretions increased during the MMC help with?

A

Cleansing of the MMC

Assist in preventing SIBO

158
Q

How can you support the functioning of the MMC?

A

Avoid overeating
Minimise heavier proteins (animal based + soya)
Leave longer gaps between meals
Chew better
Intermittent fasting
Optimise sleep
Stimulate the PSNS using diaphragmatic breathing
Pro-kinetics (ginger, artichoke) and bitters before meals

159
Q

What substances are key for the elimination of wastes via the bowels?

A

Water

Fibre

160
Q

Which substances can also optimise bowel elimination?

A

Psyllium husk
Aloe
Linseed

161
Q

What is the benefit of insoluble fibre?

A

Bulks up stool

Used for diarrhoea

162
Q

What is the benefit of soluble fibre?

A

Softens stool

Used for constipation

163
Q

What is considered the brain of the gut?

A

Enteric nervous system

164
Q

What makes up the enteric nervous system?

A

Myenteric plexus

Submucosal plexus

165
Q

What does the myenteric plexus govern?

A

GIT peristalsis

166
Q

What does the submucosal plexus govern?

A

Digestive secretions

167
Q

What is the role of the vagus nerve?

A

Stimulating activity in the digestive system

168
Q

Where is the vague nerve located?

A

Extends from the head and travels through the thorax and diaphragm
Innervates the digestive organs, connecting the brain and gut

169
Q

When is vagus nerve activity suppressed?

A

During periods of chronic stress

170
Q

When is vagus nerve activity enhanced?

A

With diaphragmatic breathing

171
Q

What is the gut-brain axis

A

Brain and gut share many nerve endings and chemical transmitters
Nearly every chemical that controls the brain has been identified in the GIT

172
Q

What percentage of serotonin is produced in the gut?

A

95%

173
Q

What is the function of serotonin?

A 
Peristalsis
Secretion
Sensation
Mood
(hence link between gut health and depression)
174
Q

How can dysbiosis affect serotonin production?

A

Affects the availability of tryptophan and co-factors needed for serotonin production

175
Q

What is mindful eating?

A

Noticing your thoughts, feelings and sensations when eating

176
Q

What are the implications of poor digestion?

A

Less nutrient absorption
Fermentation of undigested food
Retention of undigested materials in intestines
Increased toxaemia

177
Q

How is vit B12 absorbed in the body?

A

Bound to a protein called R-protein
The complex enters duodenum and then split by pancreatic proteases which digest the R-protein
The released B12 then binds to IF (produced by parietal cells in stomach)
The B12-IF complex is absorbed in terminal ileum into blood

178
Q

What can impair B12 absorption?

A

Poor gastric function
Poor pancreatic function
Damage to ileum

179
Q

How is vit D3 synthesised from sunlight?

A

UV rays (sunlight) + provitamin D (skin cells) = cholecalciferol (D3)

180
Q

What is needed to synthesise vit D?

A

Cholesterol

181
Q

Which mineral converts vit D3/2 from sunlight/food in the liver and kidneys?

A

Magnesium

182
Q

What can impair vit D synthesis?

A

Alcohol
Drugs
Coffee
Refined sugars

183
Q

What is the role of vit D in the digestive system?

A

Increases intestinal absorption of calcium and phosphorus
Maintains calcium balance (with K2)
Helps regulate bacterial species in intestines

184
Q

What is needed to help absorb dietary vit D?

A

Healthy fats

185
Q

How is digestive health crucial for bone health?

A

SI responsible for the absorption of Na, P, Mg, K + amino acids needed to build collagen
Intestinal microflora produces K2 which causes calcium deposition in bones. Dysbiosis can result in osteoporosis

186
Q

What is needed to absorb calcium from food?

A

Calcitriol

187
Q

How is digestive health crucial to muscle health?

A 
Ca - for muscle contraction
Mg - for muscle relaxation
Fe - helps deliver O2 to muscles
Na/K - for nerve stimulation of muscles
Amino acids - for muscle growth and maintenance
188
Q

How is muscle health affected by poor absorption of key nutrients?

A 
Muscle weakness
Aching
Cramping
Fatigue
Pain
189
Q

How is muscle health also crucial in supporting digestive health?

A

Diaphragmatic movements provide a visceral massage on the abdominal digestive organs
Stimulates the release of serotonin
(promoting digestion and nutrient absorption)

190
Q

Which foods are similar to haemoglobin so can be used as ‘blood builders’?

A

Chlorophyll-rich foods
e.g. green leafy veg
Chlorella
Spirulina

191
Q

What is needed to aid the effective absorption of iron?

A

Stomach acid

Vit C

192
Q

If the mineral supply to support the heart is depleted, where does the heart get its minerals from?

A

Bones
Muscles
Gums
Arteries

193
Q

What can using mineral stores from the bones, muscles, gums and arteries lead to?

A

Osteoporosis
Cramps
Receding gums
Cellulite

194
Q

How does the endocrine system support the digestive system?

A 
Hormones released from GIT:
Stimulate pancreatic juice and bile flow (CCK)
Stimulate satiety (CCK)
Stimulate gastric activity (Gastrin)
Stimulate hunger (Ghrelin)
Sugar absorption/storage (Insulin)
195
Q

How does the digestive system support the endocrine system?

A

Provides nutrients for thyroid health

e.g. iodine, tyrosine, selenium, zinc

196
Q

How is the nervous system supported by the digestive system?

A

Electrical activity relies on Na, K, Cl and Ca
Neurotransmitter synthesis e.g. dopamine requires tyrosine, iron, B1, B3, B6
Axon myelination - B12

197
Q

How can the nervous system be affected if digestive health is poor?

A

Tingling
Numbness
Loss of balance
Pain

198
Q

What are the dietary risk factors for cancer?

A 
Red meats
Refined sugars
Low fibre
Dairy (esp cow)
Burnt, starchy food
N-nitroso compounds
Table salt
Pesticides
Artificial sweeteners

Nutrition 1 (Semester I) (15 decks)

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