Aminoacids/Trace minerals/Vitamins

Question 1

What are the 9 + 1 essential amino acids

Answer 1

PVT TIM HALL

Phenyalanine
Valine
Tryptophan

Threonine
Isoleucine
Methionine

Histidine
Arginine (for infants)
Lysine
Leucine

Question 2

What are/examples of

insoluble, souble, functional fibers.

and benefits

Answer 2

Soluble fiber: binds to more water, it will swell
Examples:
Pectin, Gum
1-promotes healthy bowel function (softens fecal matter, reducing strain)
2-it will delay gastric emptying which promotes sateity but will empty intestines/colon faster
3-that prevents colon cancer (removing toxins)
4-promotes growth of friendly bacteria

Insoluble fiber:does not dissolve in water
Examples:
cellulose (whole grains, seeds, vegetables)
-hemicellulose
1. increases fecal weight and volume, promotes healthy function
2- prevent and alleviate constipation

Functional fiber: added to food to provide beneficial physiological effect
Examples:
polydextrose, psyllium

Question 3

What are concerns of phytates found in fibers

Answer 3

It binds to minerals and decreases their absorption.

They also bind to essential fatty acids and prevent their proper absorption and fat soluble vitamins.

Question 4

What is glycemic index and glycemic load.

Answer 4

Glycemic index: the number assigned to foods on how foods contain 50 grams increases blood glucose concentrations.

-inaccurate measurement because certain foods, have low glycemic loads, and as a result you have to eat an enormous amount of certain foods.

A glycemic load takes into account glycemic index and the amount of carbs in a serving. GL = GI/100 x net carbs GL of 10 or below is low and 20 or above is high.

Question 5

What is RDA for carbohydrates

And AI for dietary fibers?

Answer 5

Carbohydrates: 130 g/day

Adequate intake = 20-40 g/day

Question 6

What are two important conditionally essential amino acid ‘

What is phenylketonuria (PKU)

Answer 6

Glutamine/Glutamate and Aspartate is used to make *Arginine
-conditionally essential for infants.

Phenylalanine is used to make *Tyrosine

PKU: disease where there is a lack in phenylalanine hydroxylase which converts phenylalanine to tyrosine. This makes tyrosine now conditional essential

Question 7

Describe how edema can form in regards to nutrition.

Answer 7

Severe protein deficiency impairs body’s ability to produce adequate albumin

So when nutrients and fluid escape the capillary bed to the interstitial tissue. It can’t return because albumin in the venous end increase osmolarity so that fluid will leave the interstitial tissue.

Another problem with protein inadequacy is leaky blood vessels which allow plasma proteins to move into tissues causing edema.

Serum albumin and serum prealbumin can indicate whether the protein malnutrition was long term or short term.

If there is low serum albumin that points to long malnutrition.
If there is low serum pre-ablumin, there is short term protein malnutrition.

Question 8

Iron

• main function
• deficiency
• toxicity
• sources

iron deficiency develops in stages
serum ferritin goes down, then decrease in transferrin saturation, then hemoglobin and hematocrit values decline.

Answer 8

Its main function is as a constituent of myoglobin.

Deficiency:

• • microcytic, hypochromic anemia (weakness, fatigue, headaches, impaired work, pale skin), concave nails,
• immunosuppression, -low IQ(fucked NT synthesis),
• **PICA: craving dirt.
• hypochromic, microcytic RBCs.
• glossitis, angular stomatitis)

Toxicity (hemochromatosis): cause GI distress, infections, joint pain, skin pigmentation, organ damage

• *bronze diabetes**
• brown pigmentation to skin
• damaged liver and pancreas causing diabetes

Sources: red meats, fish, poultry,

Question 9

Zinc

• main function
• deficiency
• toxicity
• sources

zinc transport: binds to metallothionen like how iron (+2) binds to ferritin.

it is transported bound to albumin while ferric iron is bound to transferrin.

Answer 9

• it is a part of insulin
• part of genes involved in gene regulation (synthesis of heme, DNA, and RNA)
• immune reactions
• wound healing
• making sperm and fetal development

deficiency:
can’t taste or smell*
growth retardation, delayed sexual maturation, impaired immune function,
*Acrodermatitis enteropathica: it is a rare inherited form of zinc deficiency, blistering skin , emotional lability, glossitis (inflammation)

Toxicity: loss of appetite, impaired immunity, copper and iron deficiencies (they compete)
*treatment for Wilson’s disease which is copper toxicity

Sources: protein containing foods, meats, whole grains.

Question 10

Copper

• main function
• deficiency
• toxicity
• sources

Answer 10

-iron recycling from RBCs,

Deficiency: anemia, bone abnormalities
-zinc, phytate, calcium intake interferes with copper uptake
-MENKES: an X linked recessive disorder that causes copper deficiency
(connective tissue disease)=, kinky brittle steel colored hair, growth retardation, intellectual disability, hypotonia.

Toxicity: abdominal pain, nausea, vomiting diarrhea
*wilson’s disease - copper deposits in organs including the eye. You will see a brown ring.

weak muscle tone, sagging facial features, seizures, intellectual disability, and developmental delay.

Question 11

Selenium

• main function
• deficiency
• toxicity
• sources

Answer 11

Selenium:

• defends against oxidation (it is a part of the glutathione peroxidase)
• regulates thyroid hormone (the conversion of T4 to T3 via deiodinases)

Deficiency is associated with Keshan Disease (enlarged heart with poor cardiac function)
-dietary deficiency of selenium with a strain of Coxsackievirus. Often fatal, it is characterized by heart failure and pulmonary edema

Toxicity:
Nail and hair brittleness, fatigue, irritability, nervous system disorders, skin rash
**garlic breath

Sources: seafood, meats, whole grain, vegetables
*brazil (macadamia) nuts have a lot of selenium, so should not be consumed regularly.

Question 12

Iodine:

• main function
• deficiency
• toxicity
• sources

Answer 12

-formation of thyroid hormone

Deficiency:
underactive thyroid gland, goiter, mental and health retardation, cretinism

Toxicity:
underactive thyroid gland, elevated TSH, goiter.

Sources: iodized salts, seafood.

Question 13

Fluoride

• main function
• deficiency
• toxicity
• sources

Answer 13

• maintains health of bones and teeth
• confers resistance to decay

Deficiency: vulnerable to tooth decay

Too much: fluorosis:

sources: fluoridated water, tea, seafood.

Question 14

Thiamin

• main function
• deficiency
• toxicity
• sources
• water soluble or insoluble?

Answer 14

• part of coenzyme TPP in energy metabolism
• DNA/RNA synthesis
• nerve function

Deficiency (often seen with alcoholics):

Beriberi- Thiamin (vitamin B1 deficiency),

1. dry: weight loss, severe muscle wasting
2. wet: edema
3. infantile: heart failure
4. Cerebral (Wernicke-Korsakoff)
   emotional disturbances, neurological disturbances

No toxicity

Source in whole grains and fortified milk

Water soluble

Question 15

Riboflavin B2

• main function
• deficiency
• toxicity
• sources

Answer 15

part of coenzymes FADH2 in energy metabolism
-*reduces blood pressure for those with a common polymorphism that is vitB2 dependent and possibly makes nitric oxide.

deficiency: inflammation of mouth, skin and eyes
* glossitis, stomatotitis, cheilosis

no toxicity

Source: enriched milk products, fortified grain.

Water soluble

Question 16

Niacin B3

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 16

Niacin

• part of coenzyme NADH (all the major steps) in energy metabolism
• lowers LDL and raises HDL (so niacin is good for treating high cholesterol)

deficiency:
Pellagra
4Ds: diarrhea, dermatitis, dementia, death

Toxicity: liver damage, impaired glucose tolerance, flush and itching

Source: protein rich food

Question 17

Biotin (B7)

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 17

• part of coenzyme in energy metabolism
• protein synthesis

Deficiency: skin rash, hair loss, neurologic disturbances.
-Biotinidase mutation can lead to deficiency** (if seen in infants, bam its that), racoon baby

-in egg whites it is strongly bound to avidin which prevents its absorption (raw)

Toxicity: rare, caused by huge ingestion of egg whites.

Source: in all foods, even GI microbes produce it.

Water soluble

Question 18

Pantothenic acid (B5)

• main function
• deficiency
• toxicity
• sources
• solubility]]

lame one.

Answer 18

• part of coenzyme A in energy metabolism
• rare deficiency but digestive and neurological disturbances .

No toxicity (found in all food) not a damn big deal lol)

Widespread in foods

Question 19

Vitamin B6

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 19

• part of coenzymes in amino acid and fatty acid metabolism
• heme synthesis

1. one carbon metabolism
   (serine glycine conversion and homocysteine catabolism)
2. L-dopa to dopamine conversion.

deficiency: scaly dermatitis, depression, confusion, convulsions,
* *Microcytic, hypochromic anemia
- inflammation occurs with reduced plasma PLP

Toxicity: irreversible nerve degeneration, skin lesions.

Protein rich foods.

water soluble

Question 20

Folate B9 (THF is active form in one carbon metabolism)

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 20

-activates B12
-helps synthesize DNA for cell growth and replication
1 carbon metabolism
-DNA and RNA synthesis
-Methionine recycling and using up homocysteine
-SAM synthesis
*describe folate as first step

deficiency:
1. Macrocytic anemia
2. Hyperhomocysteinemia
- increased risk of vascular disease and dementia
* folate was shown to reduce stroke

3. neural tube defects
   - scary spina bifida
   - scarier anencephaly

toxicity: masks vitamin B12 deficiency, maybe cancer growth? .

Sources: legumes, vegetables, fortified grains, folic acid
-folic acid is best absorbed with no food and food folate gives the least conversion of folate.

Water soluble

Question 21

B12 (supplement group, cyanocabalamin, cobalt in center

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 21

same as folate

• DNA RNA synthesis
• reducing homocysteine
• SAM synthesis.

deficiency:
1. Macrocytic anemia
2. Hyperhomocysteinemia
3. *neurological disease
(degeneration of spinal cord)
degeneration of brain)
we are talking elderly population for B12, infants for B9.

deficiency can be caused by autoimmune disorder which causes loss of IF, or atrophic gastritis which leads to loss of stomach acid.

no toxicity

source: foods from animals

water soluble

Question 22

Vitamin C

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 22

• synthesis of collagen
• carnitine - fatty acid metabolism
• neurotransmitters
• antioxidants (works with vitE)

**increase iron bioavailability (eat cereal with orange juice)
-vitC reduces nonheme iron from +3 to +2. +2 iron enters the cell and then it is stored as ferritin.
Ferroportin brings Fe2+ out of the cell and then it will be oxidized and bound to transferrin for transport.
-actually prevents colds with stress
-actually reduces duration of colds.

Deficiency: scurvy, bleeding gums, pinpoint hemorrhage

Too much: diarrhea, GI distress.

Source: vegetable and fruit

Question 23

Vitamin A

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 23

• vision (night vision and seeing black and white)
• maintenance of cornea
• differentiation of cells into specialized form (especially important for skin and intestines with high turnover)
• bone and tooth growth
• reproduction
• immunity (synthesis of lymphocytes and antibodies)
• epithelial cells maturation (in intestines and skin)

deficiency: infectius diseases, night blindness,
- hyperkeratosis: increased keratin synthesis
- more prone to infections due to immune function
- xerophthalmia (disturbing pic) damage to cornea, scarring and blindness.

Toxicity: reduced bone mineral density, liver abnormalities, birth defects, stomach pain.

Source: retinol (animal products)
beta-carotene: dark green leafy vegetables (you need 12 beta carotene to make the amount of vitA one retinal does)

Question 24

Vitamin D

• main function
• deficiency
• toxicity
• sources
• solubility

Answer 24

1. Calcium homeostasis:
   - increases calcium absorption and bioavailability
   - decreases calcium excretion
   - increases calcium release from bone
2. Gene expression and cell differentiation
   - vitamin D receptor
   - like vitamin A.

deficiency:
1. Rickets - childhood disease marked by defective mineralization or calcification of bones, fractures and deformity are common

2. osteomalacia is like rickets but after epiphysial closure: softening of bones, muscle weakness, diffuse body pains
3. Osteopenia and osteoporosis
4. Brain abnormalities - increases chance of alzheimers and dementia.

Toxicity: calcium imbalance leads to calcification of soft tissues and formation of stones, kidney, heart, just too much calcium

Source: produced in body with help of sunlight

Question 25

Vitamin E - main function - deficiency - toxicity - sources - solubility active form: alpha-tocopherol

Answer 25

- antioxidant (takes the hit and transfers to vitC), especially important for RBCs which are always exposed to oxygen stress. - stabilizes cell membranes - protects vitamin A and PUFA's (omegas 3 and 6) Deficiency: 1. hemolytic anemia** 2. neuromuscular problems Too much: hemorrhagic effects because it interferes with VitK function and nerve damage. vegetable oils

Question 26

Vitamin K - main function - deficiency - toxicity - sources - solubility ``` there are 3 forms Phylloquinone (plant source) Menaquinone (Colon bacteria) Menadione (made by men) fyi. ``` critical for amino acid gamma-carboxyglutamate and is a cofactor for the enzyme gamma-glutamyl carboxylase.

Answer 26

1. -synthesis of blood clotting 2. bone protein (catalyzes reaction) of hydroxyapetite formation Deficiency: hemorrhage, increased bleeding (vit K is inhibited by warfarin) -Babies are prone to deficiency because mothers milk is low in K and microbiome is not developed as well. no toxicity Source: synthesized by GI microbiota -leafy vegetables

Question 27

What are the energy releasing vitamins?

Answer 27

The first five prime numbers Thiamine (vit B1) Riboflavin (vit B2) Niacin (vit B3) Pantothenic acid (vit B5) Biotin (vit B7)

Question 28

Where are most water soluble vitamins absorbed and what is the exception? How are fat soluble absorbed

Answer 28

All water soluble vitamins are absorbed in the upper small intestine with the exception of B12 which is absorbed in the ileum. Fat soluble vitamins have to be absorbed with monoglycerides and fatty acids. They will require bile salts and the formation of mixed micelles, then to be packed in chylomicrons and enter the portal vein via the lymphatic system.

Question 29

How does active vitamin D (D3 - calcitriol) aid in calcium absorption.

Answer 29

Vitamin D is needed for production of Calbindin. Calbindin binds to calcium and allows it to be actively transported into the circulation. Worry is because active vitamin D is important for calcium uptake in intestines. If you don't have that absorption, bone breakdown will just continue.

Question 30

Describe the one carbon metabolism which involves vit B6, B2, folate and B12. PLP is the active B6 which is phosphorylated.

Answer 30

It starts with folic acid (B9) which makes THF B6 (PLP) takes carbon off serine to donate to THF making it methylene THF Then B2 (FAD) makes methylene THF into methylTHF Then B12 sends it into the cycle that uses up *homocysteine and makes it methionine. Ultimately to SAM which methylates DNA = gene expression control Methylene THF also makes the nucleotides The homocysteine with B6 (pyroxidine) activity makes it into cysteine which helps form glutathione which is a chief oxidant.

Question 31

Describe B12 absorption

Answer 31

Haptocorrin is found in saliva. When B12 is in the stomach, it binds to Haptocorrin. Intrinsic factor is also released but it doesn't bind well in low pH. once it reaches the small intestine where pH gets higher. The haptocorrin releases the B12 and IF can bind Then B12 can be taken up.

Question 32

Describe the PUFAs

Answer 32

There are two 1. Linoleic acid, omega-6 (666) 2. Linolenic acid, omega-3 (lent) Omega-6: makes arachidonic acid, an important precursor for prostaglandins. This is why omega 6 is associated with an inflammatory response. It will decrease HDL and LDL. Omega-3: makes DHA, important for brain development and formation of retina, good for heart little effect on HDL and LDL. -also makes EPA, dilation of blood vessels. *the number refers to which carbon from the omega end has the first double bond. Both pufas also have a doulbe bond between the 9th and 10th carbon which can not be produced in the human body, making these fatty acids, essential fatty acids.

Question 33

What is Marasmus and Kwashiorkor They are both types of protein energy malnutritions.

Answer 33

Marasmus: is severe chronic overall malnutrition, fat and muscle is depleted leaving only skin and bones. They are alert. Kwashiorkor: (the story with the second child not getting mothers milk) - caused by the sudden deprivation of protein - they get severe edema (distended bellies) - enlarged fatty liver because they can't make the apoproteins to get VLDL out of the liver.

Question 34

How does fiber prevent disease?

Answer 34

- fiber increases fecal excretion of bile acids therefore diverting more cholesterol to bile acid synthesis - fiber binds to cholesterol and makes it unabsorbable - slows the rate of lipid absorption - insoluble fiber prevents hard, dry feces which can cause diverticulitis - delays gastric emptying and promotes satiety. - prevents colon cancer (allows the colon to empty faster and removal of toxic compounds

Question 35

What is chromium and cobalt for?

Answer 35

Chromium - enhances insulin activity, therefore deficiency leads to elevated glucose levels after meals "impaired glucose tolerance, elevated blood cholesterol, elevated blood TAGs" CoBalt is found in vitamin B12. If it is deficient it has same symptoms as vitamin B12 deficiency (macrocytic anemia, neurodegeneration, hyperhomocysteinemia)

Question 36

What are goitrogens?

Answer 36

They are compounds in food that decrease iodine's bioavailability. These are often found in raw vegetables and cooking it usually destroys them. Raw diet is concerning for this reason.

Question 37

What is ceruloplasmin

Answer 37

It is a major copper containing protein in the plasma. Its major role is recycling iron in macrophages. When macrophage phagocytoses RBCs, hemoglobin is divided into globin and heme. Then heme is converted to biliverdin and iron. The ferrous iron (+2) is brought out of the macrophage by ferroportin. There ceruloplasmin converts ferrous iron to ferric iron (+3). Ferric iron is what can be bound to transferrin.

Question 38

Discuss iron absorption

Answer 38

Only Fe2+ can enter the enterocyte. Fe3+ can be converted by the brush border enzymes. Heme can freely enter Excess iron is stored as Fe2+ bound to ferritin, if even more excessive iron is stored as hemisiderin. Only 2+ iron can travel through the ferroportin. Then it is oxidized by ceruloplasmin to +3 and then can be bound to transferrin ``` MPF Vitamin C Sugars Acids promotes absorption of nonheme iron ```

Question 39

What is isoniazid...

Answer 39

It causes the excretion of pyridoxine. You worry there will be neurologic toxicity. (vitamin B6 deficiency can lead to inhibited NT synthesis (serotonin)

Question 40

What two things cause malabsorption of B12?

Answer 40

Pernicious anemia (autoimmune disorder leading to loss of intrinsic factor) Atrophic gastritis: leading to loss of stomach acid.