Alcohol, Water, Sodium Flashcards
1
Q
How many alcoholic beverages can males drink max? Females? What is the max on any occasion?
A
Males: 1-2
Females: 1
Max 4
2
Q
What does alcohol has to be consumed with?
A
With food
3
Q
Who should avoid alcohol?
A
Avoid if pregnant, operating machinery, can’t control intake
4
Q
What is one drink in terms of ethanol?
A
1/2 oz pure ethanol
12 oz beer, 10 oz wine cooler, 1 1/2 oz liquor, 5 oz wine
5
Q
Why do men get to drink more than women?
A
Men have ADH in the stomach, unlike women, which is why they metabolize more
6
Q
What does ethanol do in the brain?
A
- Sedates inhibitory nerves
- Narcotic sedative and depressive
7
Q
What are the effects of alcohol in the brain? From smallest alcoholic consumption to largest:
A
1) Judgement and reasoning
2) Vision and speech (0.10%)
3) Coordination of voluntary muscles
4) Stupor, confusion
5) Respiration and heart action
8
Q
What is blood alcohol percentage?
A
grams per 100 grams/mL of blood
9
Q
What is the maximum blood alcohol percent when driving?
A
0.08%
10
Q
What happens when blood alcohol reach 0.4-0.6%?
A
- Potentially fatal
- Brain cells can’t regenerate (permanent damage)
- Liver can regenerate – up to a point
11
Q
How is alcohol metabolized?
A
Alcohol dehydrogenase converts it to acetaldehyde
12
Q
What is CoA?
A
coenzyme A
13
Q
What does the conversion of alcohol to acetyl CoA require?
A
The B vitamins in its role as the coenzyme NAD.
14
Q
What is NAD+?
A
NAD+ = niacin
15
Q
Where is ethanol absorbed from?
A
If we don’t eat, will absorb fast from the stomach
Absorbed quickly from the stomach and duodenum
16
Q
What is ADH? Where is it found?
A
Alcohol dehydrogenase and acetaldehyde dehydrogenase
- Located in liver and in the stomach (ONLY IN MEN)
17
Q
What is microsomal ethanol oxidizing system found?
A
Mitochondria of liver
18
Q
What is inducible? What is non inducible?
A
- Microsomal Ethanol Oxidizing System is inducible
- ADH is non inducible
19
Q
How is Microsomal Ethanol Oxidizing System inducible?
A
+ alcohol, - drug metabolism
+ drug, - alcohol metabolism
ex: crowded vs empty highway
20
Q
Acetyl CoA molecules are blocked from getting into the TCA cycle by high levels of what? What does that cause?
A
- By NADH
- Become building blocks for fatty acids
- increased serum TG, increased risk of fatty liver - cirrhosis, ketones,
21
Q
How does alcohol disturb metabolism?
A
- Less NAD+
- More H+ (generating acid)
- Acetyl CoA produced produces fatty acids and ketones rather than entering TCA cycle
- Decreased gluconeogenesis
- Decreased protein synthesis
- Liver damage
22
Q
How does less NAD+ compromise metabolism?
A
pyruvate produces lactate rather than acetyl CoA
Slows down glycolysis and TCA cycle
23
Q
How does more H+ compromise metabolism?
A
acidosis along with lactate and increased ketone bodies
24
Q
How does decreased gluconeogenesis compromise metabolism?
A
Ketosis
25
What kind of liver damage can alcohol produce?
Fibrosis then cirrhosis
26
What are heavy alcoholics likely to have? Why?
- Malnutrition
| - In part from the empty calories from alcohol
27
What can alcohol malnutrition lead to?
- Empty calories
- Compromised vitamin status
- Dehydration (diuretic)
- Increased FA synthesis, AA catabolism
- Decreased protein synthesis, gluconeogenesis
28
Name some compromised vitamin status due to alcohol and malnutrition.
Wernicke-Korsakoff Syndrome – thiamin destruction
Anemia – folate excretion
Decreased vitamin D activation in liver
B6 loss from binding protein
29
What is the incidence of fetal alcohol disorder?
1 and 9 per 1000 live births
30
How is alcohol toxic to the fetus?
Alcohol crosses the placenta freely & is directly toxic
31
What damage is caused by fetal alcohol disorder?
Irreversible brain damage Growth restriction Cognitive impairment Facial abnormalities (eyes unevan, absence of groove in upper lip)
Vision abnormalities
32
How does the damage occur in fetal alcohol syndrome?
direct - intoxication, teratogenic effects
| indirect – malnutrition
33
How much alcohol is safe during pregnancy?
No safe limit
| Women should stop drinking as soon as they PLAN to become pregnant
34
What does the French Paradox study state?
France: low CVD despite high saturated fat
intake
France was the only country that did not have a high death rate from CVD despite high saturated fat intake
35
What causes the French Paradox?
Very unclear, points to an association
- Alcohol or flavinoids or combination
- Resveratrol protects against LDL oxidation
36
What does alcohol increase?
Increases HDL levels
37
What does consuming alcohol in moderation increase the risk of?
```
hypertension
stroke
cirrhosis
cancer - oral, stomach, colon, breast, prostate
ulcers
osteoporosis psychological depression fetal alcohol syndrome drunk driving
insomnia
Alcoholism
Cost $200 billion/y
```
38
What are personal strategies to prevent alcoholism?
```
drink non-alcoholic beverages
drink in moderation
drink slowly
drink with food
don’t drive
seek help if needed
```
39
How many North Americans abuse alcohol? What # leading cause of preventable death?
- 20 million
| - 3rd leading cause
40
What are medications used to treat alcoholism?
Antabuse (blocks AcAld DH) - higher sensitivity to alcohol, effects of a hangover are felt almost immediately after consumption
Reviva (decrease craving and the high)
41
What is cirrhosis? What is it caused by?
IRREVERSIBLE liver damage caused by alcohol, hepatitis B or C, iron toxicity (hemachromatosis)
42
How does cirrhosis develop? What can it lead to? How do you treat?
- As liver constantly repairs, accumulation of fibrosis tissue, scars and nodules and connective tissue – impaired function
- Leads to carcinoma --> liver resection, transplant
43
What is the fatty accumulation called in cirrhosis? Inflammation?
Fatty accumulation: steatosis
| Inflammation: hepatitis
44
Which one is outside and which one is inside of cells: Na+ and K+?
Outside: Sodium
Inside: K+
Sodium Potassium ATPase pumps potassium in and sodium out
45
What happens is there is too much extracellular potassium?
Stopping the heartbeat --> do this in surgery during a bypass
46
Name some functions of water.
nutrient absorption and transport
biochemical reactions
solvent
lubricant
shock absorber (ex: cerebral spinal fluid in brain)
temperature regulation (move water around to help get rid of heat --> sweating)
excretion of wastes
47
Name some function of electrolytes.
fluid compartments and balance
acid/base balance
muscle contractions
conduction of nerve impulses
48
What is the recommended water intake? What is the average recommended intake for women? Men?
ecommended intake 1 to 1.5 mL/kcal /energy expenditure
| 2.7 L for women and 3.7 L for men
49
Name the 3 electrolytes.
Sodium, Potassium, Chloride
50
What circumstances would increase water intake?
pregnant and lactating women
diarrhea and vomiting (more importantly, they lose electrolytes)
fever, heavy exercise
elderly, air travel
hot environment (sweat evaporates really fast, we may not realize how much water we're losing)
51
What is implicated in thirst mechanisms? Are they fast or slow?
- Dry mouth sensations, stomach, hypothalamus
| - They are slow, can lag behind the need, often confused with the "hungry" signal
52
What are the components of water intake?
1200: liquid
1000 mL: food
300 mL: metabolic
53
What are the components of water output? How much urine do the kidneys NEED to excrete per day?
```
1200 mL: kidneys
800 mL: skin
350 mL: lungs
150 mL: feces
- MUST lose 500 mL of urine
```
54
Can water be toxic? How?
We can't process and excrete it all --> edema
55
What is the role of sodium? Where is it located?
- Blood volume regulation
| - Extracellular cation
56
What is the role of potassium? Where is it located?
- Function of nerve and muscle cells
| - Intracellular cation
57
How do potassium losses occur? Who is that a concern for?
- Vomiting and diarrhea
- Elderly and children
- People who are on diuretics (for hypertension)
58
What happens when you add salt to an eggplant?
- High water concentration to low water concentration --> water droplets
59
How many liters do we secrete and absorb in the GI tract per day?
10 L/d
60
What kind of hormones do the kidneys contain?
hormone regulate water and sodium excretion
61
What is the issue with water and diabetes?
Lose glucose and water
62
What is oral rehydration therapy?
Solutions that are good for young children + elderly that contain water and sodium and potassium and some sugar. In Quebec, they are available at the pharmacy behind the counter.
63
What regulates the concentration of urine? What colour urine do you want?
- Kidneys
| - Colour as light as possible
64
What is the upper limit systolic/diastolic blood pressure? What is the unit?
120mmHg/80mmHg
The maximal pressure over the minimal pressure
65
What is a high systolic/diastolic blood pressure? What does this indicate?
130/85
| Hypertension
66
How did we used take blood pressure?
- Cuff attached fairly tightly on the upper arm (brachial artery - high pressure that corresponds to the contraction of the ventricles of your heart)
- Pressure meter
- Bulb that you pump, cuff becomes really tight, person gradually loosens and lets air out
- When you begin to hear that sound and when you don't hear that sound anymore (artery is open all the time)
67
How is blood pressure taken now?
It is automatic
68
Which number are we most concerned about in terms of blood pressure?
Diastolic, because that's the pressure that the system is under all the time
69
How much cardiac output do the kidneys receive?
Kidney receives 25% cardiac output (filtering all the blood)
70
Describe how blood is filtered and reabsorbed in a nephron.
Learn it.
71
What happens when the there is reduced blood flow? What happens if there is a problem with the renal artery?
- Retain more sodium so that water is retained as well, thus increasing blood volume
- Also, constrict blood vessels to make the size of the system smaller
If there is a problem with the renal artery (atherosclerosis that reduces blood flow), sets up a greater activation of this system and a greater retention of sodium
72
How does the brain respond to high salt concentration?
- Hypothalamus reponds by stimulating the pituitary gland
- Which releases antidiuretic hormone (ADH)
- Which allows you to save water
73
Explain how the kidneys and brain are involved in increasing blood pressure.
Learn it.
74
What is the AI and UL for sodium? How many men and women consume more than the UL?
AI: 1500 mg/day
UL: 2300 mg/d
90% of men and 60% of women consume more than UL
75
What is the AI and UL for potassium? Most people consume less than what % of RDA?
AI: 4700 mg/day
UL: none
most people consume less than 50% of the RDA
76
What is the goal in terms of sodium?
To be at the UL (2300 mg/d) by 2016 (Sodium Working Group Report in 2010)
77
What is DASH?
- Dietary Approaches to Stop Hypertension
- Increased V&F (increased potassium)
- 30% of kcals from fat (nuts, fish, whole grains, low-fat dairy)
- Emphasizes vegetarian protein sources
- Restricts sodium altogether with an increase in potassium
* * Quick and great reduction of blood pressure
78
What does the DASH diet provide that lowers blood pressure? What does it also help reduce?
- Fibre, Potassium, Magnesium, Calcium
lower blood pressure
lowers cholesterol and LDL cholesterol
prevents/reduces hypertension when combined with a low sodium diet
79
What is the prevalence of hypertension and prehypertension in Canada? What does this mean in terms of blood pressure number?
> 120/80
- 20% has HT
- 20% has prehypertension
80
What is an achievable, cost effective, efficient way to decrease CVD and stroke?
Reducing sodium intake (independent of energy)
| - Saves 3 billion by reducing to 1800 mg/d
81
How many grams of salt does one teaspoon contain? What should we focus on lowering to reduce sodium?
6 grams = 1 tsp = 2400 mg = around the UL
| - Read labels on processed and prepared foods (77% of sodium)
82
Name some functions of salt and sodium-containing additives in food.
- Microbial food preservation
- Texture, flavour, colour
- Control fermentation in bread and cheese
83
Name some ways to reduce sodium and increase potassium to prevent hypertension.
- Consume a diet rich in vegetables and fruit
- Use low-fat dairy products
- Reduce saturated and total fat intake
- Reduce sodium intake
- Limit alcohol intake
- Exercise regularly
- Lose weight if overweight
Basically the DASH diet, but this is the general public health recommendation.
