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NTA Exam > Comprehensive Exam Study > Flashcards

Comprehensive Exam Study Flashcards

1
Q

Describe genetics vs. epigenetics

A
  • Epigenetics - how our genetics are expressed as determined by our environment and behaviors (genes repressed or stimulated)
    * The genes you have may be fixed but their expression can be influenced by choices
    * Your health is not dictated by your past, your parent’s health, etc!
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2
Q

What is bio-individuality and how is it relevant to work as an NTP?

A
  • Each person has unique lifestyle, environmental, and genetic factors that determine his/her nutrient needs. There is no one diet or lifestyle that is “correct” or perfect for all people. An individualized approach is required!
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3
Q
  • Hunter-Gatherer What were some challenges to survival?
A
  • Food was not easy to find
    • The size of community groups had to remain limited
    • Nomadic lifestyle to cover vast expanses of land and adapt to changing seasons to have enough food to survive
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4
Q
  • Agriculture - What benefits arose from the early development of cultivating plants?
A
  • Provided wealth of nutrients and health benefits to support a large population
    • Allowed for permanent communities to be established, created new jobs and economic opportunity, and more stable food supply for populations to grow
    • Sustainable practices that benefited the environment
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5
Q

Early colonization: What major impacts were seen, to people and to the land?

A
  • Introduction of new people, animals, and plants that created a blend of cultures (English, Indian, raw nature, improvisation)
    • Wandering animals disturbed habitats for native plants, introduced non-native species , increased erosion affecting aquatic food stems, destroying root systems, and competing with wildlife for food
    • Vegetation was cleared for cash crops such as tobacco
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6
Q
  • Plantations What key shifts happened with the emergence of “cash crops”?
A
  • Food for profit rather than nourishment, culture celebration, etc
    • Clearing out of vast areas of land/vegetation to grow the crops
    • Slavery/indentured servitude
    • Soil fertility diminished
    • Crop diversification/rotation ignored - land overuse
    • Profit for a few at the expense of many
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7
Q
  • Industrialization: What were some of the advancements? What were the resulting impacts?
A
  • Transcontinental Railroad - easy transportation of food/goods
    * Spread of cultural influences across the world/U.S.
    • Electricity/lightbulb allowed extension of working hours and created more job opportunities - people no longer ate according to the natural rhythms of the day
      • Influx of people to cities
    • Mechanized farming equipment sped up production
      • More product with less effort - framers started looking for additional employment opportunities in the markets
    • Barbed wire eliminated open-range grazing of farm animals
    • Establishment of grocery store chains led people away from farmed food and toward food with longer shelf life/less prep time
      • Pesticides
    • Overall increased separation of individuals from where their food came from and increase in purchase of convenience foods
      • Eating according to the work schedule vice intuitively
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8
Q
  • Modern landscape: What current impacts are people navigating with regard to food?
A
  • Media
    • Demonizing whole food groups (ie - carbs, fats, etc)
    • Hyper-palatable foods
    • Food convenience
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9
Q

Fermenting benefits

A
  • When a food is transformed by its environment into something more flavorful, nutrient-dense, easier to digest, and longer lasting
    *Reduces phytate, lectin, oxalate, and tannin
    * Promotes the growth of healthy microbes while inhibiting the growth of harmful microbes
    * Enhances the consumers relationship with food, minimizes food waste, and enhances health
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10
Q

Soaking Benefits

A
  • Helps breakdown the plant-protective compounds (lectins, oxalates, goitrogens, tannins, and phytic acid) that otherwise make it difficult for humans to digest/access the nutrients they offer
    *Can increase bio-availability of iron from 5% to 50%
    * Example - humans don’t have enough phytase (enzyme) to break down phytic acid in plants preventing us from access the minerals that are bound up in the phytates
    * Reduction in gas/bloating, faster cooking times, improved taste/texture
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11
Q

Nose-to-tail/root-to-stem

A
  • Encourage consumers to eat the whole plant/animal - especially parts that are normally discarded
    * Society creates perceptions about what part of the plant/animal is “best” and ignores the rest of the plant/animal - parts of which can provide unique nutrient value
    * Economical, environmentally friendly, respectful to resources, richer in nutrients
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12
Q

Souring

A
  • Another form of fermentation that is commonly used for preparing grains
    * “Enhanced soaking”
    * Promotes more phytase activation improving the bioavailability of minerals
    * Improves protein digestibility and extends shelf-life
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13
Q

Gratitude and food

A
  • Growing more aware of our food is contributing to our well-being
    * Our body responds to our psychological state
    * Milkshake experiment - those who thought they were receiving a nourishing drink actually did glean more nutrients and were more satisfied by it
    * Peace, nourishment, enjoyment in food = greater sense of health and wellbeing
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14
Q

What common themes surround traditional food practices?

A
  • Community
    • Traditional
    • Seasonal
    • Less waste
    • Intention
    • Can be applied to wide array of foods
    • Connection to food
    • Nutrient-dense
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15
Q

Anatomy vs physiology & how do they relate?

A
  • Anatomy - structure of the body
    • Physiology - function
    • How do they relate?
      • Often the anatomy of something points to its physiology. Certain organs, for instance, are shaped certain ways and located in particular areas in the body in order to fulfill their function or physiology.
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16
Q

Define homeostasis

A
  • The state of steady internal conditions regardless of external environment (ex - temp, O2 in blood, blood sugar, blood pH)
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17
Q

How is homeostasis regulated?

A
  • Through a feedback system/negative feedback loop. When the body senses a shift from a set point, information is relayed to the brain which further communicates an appropriate gland or organ to adjust in response.
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18
Q
  • What are some body parameters maintained through homeostasis?
A
  • Fluid balance, body temperature, O2 and CO2 in the body, blood pH, blood sugar
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19
Q

Six levels of structural organization

A

Chemical
Cellular
Tissue
Organ
Organ System
Organism

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20
Q

Purpose/example of chemical level of structural organization

A
  • Purpose - elements and molecules that build our cells
    * Example - carbon, hydrogen, oxygen, nitrogen
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21
Q

Purpose/example of cell

A
  • Purpose - basic unit of life
    * Example - WBC, RBC, epithelial cells, nerve cells
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22
Q

Purpose/example of tissue

A
  • Purpose - groups or layer of common cells that work together to form a common function
    * Example - muscle, connective, adipose, nervous
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23
Q

Purpose/example of organ

A
  • Purpose - anatomically distinct structure (recognizable shape) with a specific function when it comes to physiology
    * Example - heart, stomach, liver
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24
Q

Purpose/example of organ system

A
  • Purpose - organs working together to serve a common function
    * Examples - lymphatic, circulatory, immune
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25
Q

Purpose/example of organism

A
  • Purpose: To perform the physiological functions that maintain and sustain life
    * Example: Human beings
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26
Q

Why do the levels of structural organization matter nutritionally?

A
  • The foods we eat provide the chemical elements to build our cells which affects all of the other levels.
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27
Q

Describe the structure and function of the plasma membrane

A
  • Structure: a network of lipids and proteins that form the boundary between a cell’s contents and the environment outside of the cell; phospholipid bilayer (water-loving head faces outward, water-fearing tail faces inward; also contains cholesterol and proteins
    * Function: to protect the cell from its surrounding environment and regulate substances that enter/exit the cell
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28
Q

Describe the structure and function of the nucleus

A
  • Structure: central organelle surrounded by the nuclear envelope (regulates passage of molecules between nucleus and cytoplasm) and the nucleolus (which produces ribosomes)
    * Function: controls and regulates activities of the cell such as growth and metabolism; houses cell’s DNA
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29
Q

Describe the structure and function of the mitochondria

A
  • Structure: consist of an outer and inner lipid bilayer; inner bilayer is folded and houses a series of pre tins and enzymes for chemical reactions to create ATP
    * Function: Generate the energy needed to fuel the cell’s biochemical activity
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30
Q

Describe the structure and function of the endoplasmic reticulum

A
  • Structure: network of channels adjacent to the nucleus; can be rough or smooth; rough ER has ribosomes, smooth ER has no ribosomes but constrains enzymes for lipid synthesis
    * Function: provides a network for passage of molecules from one area of the cell to another; ribosomes synthesize proteins; smooth ER breaks down and metabolizes toxins
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31
Q

Describe the key organs and roles of the integumentary system

A
  • Key organs: skin (epidermis, dermis, hypodermis), hair and nails, sweat glands
    • Key roles: protective barrier for the organism
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32
Q

Describe the key organs and roles of the skeletal system

A
  • Key organs: bones, cartilage and joints, tendons and ligaments
    • Key roles: provides supportive structure to the body, facilitates movement w/ muscular system, site of blood cell production and mineral storage
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33
Q

Describe the key organs and roles of the muscular system

A
  • Key organs: muscles (3 types of muscle tissue: skeletal, smooth, cardiac)
    • Key roles: body structure and movement, organ structure and movement
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34
Q

Describe the key organs and roles of the nervous system

A
  • Key organs: brain, spinal cord, cranial and spinal nerves
    • Key roles: 3 main functions
      • Sensory
      • Integration
      • Motor
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35
Q

Describe the key organs and roles of the endocrine system

A
  • Key organs: hypothalamus & pituitary, pineal, adrenal, thyroid, parathyroid, pancreas, gonads
    • Key roles: hormone production and regulation, hormone driven communication
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36
Q

Describe the key organs and roles of the cardiovascular system

A
  • Key organs: hearts, blood vessels and arteries, capillaries (exchange of gases)
    • Key roles: transporting blood through the body, carrying oxygen, nutrients, immune cells, waste products
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37
Q

Describe the key organs and roles of the lymphatic and immune system

A
  • Key organs: lymph nodes and vessels, spleen, lymph, thymus
    • Key roles: transporting immune cells through the body, filter lymph for pathogens, produce immune cells
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38
Q

Describe the key organs and roles of the digestive system

A
  • Key organs: mouth, stomach, pancreas, liver, gall bladder, small intestine, large intestine
    • Key roles: break down and absorb nutrients from the food we eat, remove waste products
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39
Q

Describe the key organs and roles of the respiratory system

A
  • Key organs: nose, nasal cavity, pharynx, larynx, trachea, bronchi, lungs
    • Key roles: breathing!
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40
Q

Describe the key organs and roles of the urinary system

A
  • Key organs: kidneys, bladder, ureters, and urethra
    • Key roles: filtration and elimination of liquid waste, maintain blood volume, pressure, and pH
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41
Q

Describe the key organs and roles of the reproductive system

A
  • Key organs: penis, scrotum, testicles, vagina, uterus, ovaries
    • Key roles: produce and maintain sex hormones, create new life
    • Note - if you have a client with issues regarding fertility/sex hormones, likely looking more at hormonal responses than A&P
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42
Q

What are the six classes of nutrients?

A

Carbohydrates
Protein
Fat
Water
Vitamins
Minerals

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43
Q

What is the purpose of carbohydrates and what are some examples?

A

Energy
Ex - saccharides, disaccharides, glucose

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44
Q

Describe protein and its purpose?

A

Protein is a chain of amino acids
Purpose - muscle synthesis, making antibodies, hormones, and neurotransmitters

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45
Q

What is the purpose of fats and give examples?

A
  • Purpose: build cell membranes, allow us to absorb our fat soluble vitamins, source of energy
    • Satiety, slow burning energy
    • Ex - oils,
    • Chemical - triglycerides (made of fatty acids [short/med/long chain], phospholipids, sterols])
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46
Q

What is the purpose of water?

A
  • Purpose: hydration, temperature regulation/sweat, hydrates mucous membranes, maintains blood volume/cell volume, large component of bodily fluids (blood/lymph), urinary system to flush waste, moistens oxygen we breathe, cushions bones and joints, universal solvent for chemical reactions
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47
Q

What is the purpose of vitamins?

A
  • Purpose: support immunity, metabolism, energy conversion, maintaining healthy skin/nails, cell growth, antioxidants help prevent damage to cells
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48
Q

What is the purpose of minerals?

A
  • Purpose: nerve function, pH balance, cofactors for countless bodily functions/enzymatic reactions, bone/teeth health
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49
Q

How do fats/proteins influence the integumentary system?

A

Act as a neutral moisturizing factor

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50
Q

How does protein affect the muscular system?

A

Helps build muscle; iron in protein carries oxygen to muscle tissue

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51
Q

How do calcium, Vit D, and Vit K affect the skeletal system?

A

Calcium absorption and bone mineralization; protein helps provide bone matrix

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52
Q

How to carbs, fat, and protein affect the nervous system?

A
  • Fat (60% of brain is fat)
    • Carbohydrates (glucose) - unrefined/complex carbs are important
    • Protein for neurotransmitters
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53
Q

What are the large scale considerations for endocrine health?

A

Blood sugar balance, digestion, liver support (large scale hormone conjugation goes on in the liver)

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54
Q

How does iron affect the cardiovascular system?

A

Iron is needed for hemoglobin

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55
Q

What vitamins/minerals are important for lymphatic/immune health?

A

Vit C, Vit D, antioxidant rich foods, protein for antibodies, water for lymph

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56
Q

What vitamins/minerals/nutrients are important for respiratory health?

A

water
Antioxidant vitamins (C,D,E)
Magnesium for relaxing smooth muscles of air passages and lungs

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57
Q

What nutrients are important for the urinary system?

A

Water

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58
Q

What nutrients support pre-conception/fertility, pregnancy, lactation?

A
  • Folate - brain and spinal cord development; enables DNA synthesis
    • Calcium, iron, omega-3s ***??
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59
Q

What nutrients support the infancy and toddler years?

A
  • 6 months - BM or quality formula
    • Iron - baby’s stored iron runs low around 4-6 mo
    • Calcium/Vit D for bones
    • Fiber for bowel movements
    • Toddler appetites are all over the place
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60
Q

What nutrients support childhood and adolescence?

A
  • Careful to avoid sugary foods
    • Calcium and Vit D ***?
    • Dietary fats***?
    • Formative time for children to form a relationship with food
    • What special considerations around diet arise in the adolescent years?***
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61
Q

What nutrients support adulthood?

A
  • Stable for calorie/nutrient need
    • Preventative - foods with antioxidants, phytonutrients**
    • Pre-conception/fertility, pregnancy, lactation Healthy fats
    • Quality protein at every meal
    • Reducing sugars and refined starches
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62
Q

What nutrients support older adult/senior years?

A
  • Essential fatty acids, micronutrients, fluids
    • Energy need starts to decline
    • Micronutrients and antioxidants are still required
    • Hydration very important as thirst declines with age
    • B vitamins for brain health
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63
Q

Define the different stages of sleep and optimal sleep ranges for diverse populations.

A
  • Stages (good graphic for this in the Why We Sleep book)
    • Awake
    • NREM1 - light sleep, easy to wake, alpha/beta brain waves?
    • NREM2 - spindles, spend the most time during, heart rate starts to slow, a bit deeper sleep
    • NREM3 - deep sleep, restorative, brain detox,
    • REM
  • Ranges
    • 0-6 years old: multiphasic
    • Adults: 7-9 hours
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64
Q

Explain the impact sleep has on our physical and mental wellbeing.

A
  • A poor night’s sleep leads to…
    • Increased ghrelin levels and decreased leptin levels
    • Increased cortisol levels and decreased insulin sensitivity
    • Suppressed immune function, renal stress, cardiovascular stress
    • Less recovery, physically, mentally, emotionally!
  • Focusing on the unconscious hours has the greatest impact on the conscious hours!
  • A good night’s sleep leads to…
    • Better everything!
    • Immune health
    • Blood sugar regulation
    • Stress hormone levels and stress management
    • Digestion
    • Food choices and choices in general
    • Recovery
    • Detoxification
    • Attitude and outlook on life!
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65
Q

Identify effective and accessible strategies for nutrition and lifestyle habits that support improved sleep quality.

A
  • Sleep hygiene + stress + NDD = good sleep? Will take you a long way!

**need to brain storm more

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66
Q

What is the difference between stress and stressors?

A
  • Stress - how your body responds to stressors
  • Stressors - things/events/circumstances (stimuli) that cause a stress response
    • Distress/eustress - cortisol vs adrenaline
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67
Q

Explain the impact stress has on our physical and mental wellbeing.

A
  • Chronic distress will literally rewire and change the shape of our brains
    • Can chronically elevate cortisol
    • High cortisol can impact melatonin release and, therefore, sleep
    • Cortisol is catabolic to muscle tissue (will break it down)
    • Adrenaline is anabolic to muscle tissue
  • As our body undergoes a stress response, we are drawing energy away from other systems in the body (ie - digestion)
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68
Q

Explain the brain’s role in the north to south path of digestion and identify possible dysfunction.

A
  • Need to be in the parasympathetic state
    • Vagus nerve connects the brain to the digestive tract (gut-brain axis)
    • Want to feel relaxed at meal time to ensure efficient signaling

Dysfunction
* Stress puts us in a sympathetic state
* Compromised vagal nerve communication
* Compromised output of digestive secretions

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69
Q

Explain the mouth’s role in the north to south process of digestion and identify possible dysfunction

A
  • Tongue sends message through the vagus about what you are eating to stimulate digestive secretions
    • Saliva moistens the food; salivary amylase and lingual lipase begins to breakdown of food
    • Chewing physically breaks down food

Dysfunction
* Not chewing well/eating quickly
* Taking big bites
* Doesn’t allow the saliva to coat the food surfaces so that the enzymes in saliva can start to act on the food

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70
Q

Explain the esophagus’ role in the north to south path of digestion.

A
  • Food passes through the esophagus and into the lower esophageal sphincter as a bolus
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71
Q

Explain the stomach’s role in the north to south path of digestion and identify possible dysfunction.

A
  • Protein begins to be digested and broken down into polypeptides/amino acids
    • Not much is being absorbed
    • HCl decontaminates food/kills any harmful microbes/food-borne pathogens we may have ingested before moving to the permeable parts of our digestive system

Dysfunction
* Low stomach acid
* Proteins won’t break down as well
* May not be able to kill pathogens that are ingested
* Delayed gastric emptying due to low acidity (follow on steps aren’t triggered) which can contribute to feelings of fullness/bloating and inflammation of the pyloric valve

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72
Q

Explain gastrin’s role in the north to south path of digestion.

A
  • Vagus nerve communicates the presence of amino acids in the food resulting in Gastrin which stimulates parietal cells to create HCl
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73
Q

Explain HCl’s role in the north to south path of digestion

A
  • Stomach acid - kills microbes in the food
    • Lowers pH of the stomach (1.5-3) triggering the opening of the pyloric valve and movement of the chyme into the small intestine
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74
Q

Explain pepsin’s role in the north to south path of digestion.

A
  • Part of gastric juice
    • Active form of pepcinogen
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75
Q

Explain mucous’ role in the north to south path of digestion.

A

Part of gastric juices

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76
Q

Food leaves the stomach as ______ and enters the _________.

A

Chyme
Small intestine

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77
Q

Explain the duodenum’s role in the north to south path of digestion.

A
  • First part of the small intestine
    • Chyme enters the duodenum in a very acidic state triggering the release of secretin and a series of other reactions (through bile); breaking down food; after duodenum, absorption starts to happen
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78
Q

Explain secretin’s role in the north to south path of digestion.

A
  • Released in response to the acidity of the chyme
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79
Q

Explain cholecystokinin’s (CCK) role in the north to south path of digestion.

A
  • Released if chyme has protein and fats in it for the release of pancreatic enzymes
    • Tells gallbladder to release bile
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80
Q

Explain bicarbonate’s role in the north to south path of digestion.

A
  • Released by pancreas after triggered by the acidic chyme
    • Brings the pH of the chyme up closer to the pH of blood which makes it easier for nutrients to pass into the blood (blood pH is closer to neutral)
    • Also neutralizes the acidity of the chyme for the preservation of the lining of the small intestine
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81
Q

Explain the role of pancreatic enzymes in the north to south path of digestion and identify possible pancreatic dysfunction.

A
  • CCK triggers the release of amylase, lipase, and protease
    • Active at a neutral pH - so chyme must be neutralized for these to be active!

Dysfunction
* If signaling north of the pancreas is off, we may have sub-optimal enzyme output
* Can result in lower bicarbonate output which may result in more acidic chyme - can irritate the small intestine/prevent the release of pancreatic enzymes

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82
Q

Explain the role of the gallbladder in the north to south path of digestion and describe possible dysfunction of the liver/gallbladder.

A
  • Releases bile (triggered by CCK)

Dysfunction
* Gall stones due to billiarystasis can prevent the efficient delivery of bile and result in poor digestion of fats
* Low quality bile if not I taking the necessary adequate nutrient co-factors

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83
Q

Explain the role of bile in the north to south path of digestion.

A
  • Made in the liver
    • Made of fats, cholesterol, amino acids
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84
Q

Explain the role of villi/microvilli in the north to south path of digestion.

A
  • Increases the surface area of the lining of the intestine
    • Lining held together closely via tight junctions
    • Very thin lining of the intestine
    • Molecules that will be absorbed are first filtered through the liver and then into the blood stream
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85
Q

Explain the role of the large intestine in the north to south path of digestion and identify possible dysfunction.

A
  • Everything that wasn’t absorbed in the small intestine move to the large intestine (fiber, water, bile)

Dysfunction
* If poorly digested food, bacteria, etc reach the colon, setting the stage for dysbiosis and the opportunity for pathogenic bacteria to feed/grow
* Imbalance of microbes

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86
Q

Explain the role of the microbiome in the north to south path of digestion.

A
  • Community of bacteria, yeasts, microbes, viruses, parasites, etc located in the large intestine
    • Break down fiber, produce SCFAs (ex - butyrate - beneficial to colon); can produce serotonin
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87
Q

Describe possible dysfunction of the small intestine in the north to south path of digestion.

A
  • If poorly digested food is in the small intestine, can result in bacterial overgrowth (where it shouldn’t be)
    • Can increase intestinal hyper-permeability which creates a route for larger particles of poorly digested food to enter the blood stream - can trigger an immune response
    • If had low HCl, harmful microbes may reach small intestine and then leak into the blood stream as well, also triggering immune response
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88
Q

What are some examples of functional foods?

A

bone broth, leafy greens, mushrooms

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89
Q

What is the key difference between SIBO and Candida overgrowth?

A
  • SIBO = bacterial overgrowth; when opportunistic or pathogenic microbes proliferate into abnormal populations in the small intestine
    • Candida = yeast (fungi); can diminish populations of beneficial bacteria
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90
Q

Define cofactors

A

Nutrients that we need to build the secretions from north to south

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91
Q

Example of cofactors required for the north to south path of digestion

A

Zinc for HCl
Vit C for bile

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92
Q

What are some examples of compounds that provide mucus membrane support?

A

Aloe, licorice root (for someone who has reflux/irritation)

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93
Q

What are some examples of compounds helpful for tissue repair?

A

L-glutamine, collagen, aloe, licorice root, other mucinogenic compounds

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94
Q

What are some examples of digestive stimulants?

A

ACV, citrus, bitters

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95
Q

What are some examples of replacement compounds to support the north to south process?

A
  • Replacing something the body should be making on its own
    • Exogenous HCl
    • Digestive enzymes
    • Supplemental ox bile for fat digestion
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96
Q

What are some examples of microbiome modulators?

A
  • Probiotics/prebiotics to boost commensal gut flora
    • Oregano oil to eradicate bacteria (be cautious using as a practitioner - non-discriminate…will also kill good bacteria)
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97
Q

Describe the intent and process behind an elimination trial.

A
  • Remove foods completely for a set amount of time to allow the immune system to calm down, reduce symptoms to see how the body reacts
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98
Q

Describe the two phases of an effective elimination trial

A
  • Elimination and re-introduction (systematic) to assess how body responds
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99
Q

Understand the difference between IgE allergies, non-IgE hypersensitivities, and functional intolerances

A

IgE allergy - true allergy; B cells from the adaptive immune system produce IgE antibodies (immunoglobulins) to a specific protein sequence resulting in an innate and adaptive immune response including the release of cytokines and histamine (think - classic allergy symptoms)

Non-IgE hypersensitivities - not considered allergies; elevated levels of immunoglobulins in response to trigger foods (IgG and IgA); reactions are often delayed (ex - joint pain, headaches, irritable bowel, etc)

Functional intolerances - non-immunological reactions; relate to the body’s inability to digest and eliminate certain food components

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100
Q

Explain the three phases of bio transformation and elimination (detoxification).

A
  • Phase I
    • Activation - makes toxins more water soluble
    • CYP450 enzymes
    • Lots of Phase II but not Phase I = inefficient.
  • Phase II
    • Conjugation - adds a chemical group to the compound
    • Also makes toxins more water soluble
    • If we have a lot of Phase I activity but not Phase II, we will have a build up of the intermediary metabolites which can be more reactive than Phase I.
  • Phase III
    • Elimination
    • Issues with Phase III - not going to the bathroom - can result in recirculation of toxins throughout the body
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101
Q

What is the difference between glycogen stored in the liver vs skeletal muscle tissue?

A

Skeletal muscle - can only be used locally
Liver - can be circulated throughout the body for us

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102
Q

What happens to any excess glucose in the blood stream that can’t be stored in the muscle tissue/liver?

A

Converted into triglycerides for deep storage in adipose tissue

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103
Q

What part of the body acts as the “watch keeper” of blood sugar?

A

Hypothalamus/pituitary glands - if BS is too high/low, will trigger a hormonal response to mediate

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104
Q

What happens when blood sugar is too high?

A

Pancreas releases insulin which helps us to store sugar in the skeletal muscle and liver (glycogenesis)

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105
Q

What happens when blood sugar is too low?

A

Pancreas releases glucagon to increase glucose levels

3 process: glycogenolysis, lipolysis, gluconeogenesis
Liver transforms stored glycogen into glucose (glycogenolysis)
Liver creates glucose from amino acids/glycerol (gluconeogenesis)

Cortisol and epinephrine will be called on to raise blood sugar levels if the above processes are insufficient

Once blood sugar rises, these releases shut off due to negative feedback loops

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106
Q

How does cortisol and epinephrine help raise blood sugar levels?

A

Hypothalamus releases CRH > communicates to the pituitary > pituitary releases ACTRH > ACTRH tells the adrenals to release cortisol which **?

Cortisol and epinephrine will also continue to promote glycogenolysis, lipolysis, and gluconeogenesis

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107
Q

What is the theory behind supplementing glandular tissue?

A

These are tissues from the pancreatic, adrenal, liver tissues of animals that tend to drive function. The tissues have mineral cofactors that the glands in our body need (enzymes, phospholipids, etc)

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108
Q

What are examples of insulin sensitivity enhancers?

A

Chromium, magnesium

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109
Q

What are examples of foods/supplements that slow carbohydrate absorption and metabolism?

A

Fiber, dietary fats and proteins, magnesium, gemnima (?)

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110
Q

Explain the role antioxidants play in BSR

A

Oxidative stress contributes to BSDR due to inflammation. Antioxidants help minimize oxidative stress and the overall stress response of the body thus promoting healthy BSR

111
Q

What are adaptogens?

A

Herbals/botanicals/mushrooms that help normalize ours stress response

112
Q

Whole foods are ? Provide examples

A

unprocessed foods that have nothing added to them or taken away. Examples include fruits, vegetables, legumes, grains, pulses, dairy, eggs, meat, and fish.

113
Q

Nutrient Density means

A

High vitamin and mineral content relative to caloric value, meaning the less calories and the more vitamins and minerals, the better it is rated

114
Q

The importance of diversity in the diet is

A

To ensure adequate intake of all the necessary vitamins, minerals, phytonutrients, and essential fatty acids

To allow our body to determine what it thrives on

115
Q

We should consider eating in season when we can because

A

Lends itself to eating a variety of foods
Produce in season is more readily available limiting the possibilities of it being picked too early, sprayed with preservatives, and shipped long distances to the customer
More affordable

Also helps support local farmers and the environment as a whole - mono crops planted season after season and the use of pesticides destroys the soil as well as vital insect cultures and our own health (overburdened detox systems)

116
Q

Sourcing our food matters because

A

-Animals are often raised inhumanly and pumped full of antibiotics and growth hormones to increase their size
-large monocrop farms often plant the same thing season after season and spray pesticides which destroys the soil, insect populations, and more

-Sourcing food allows us to have a say - we can support small business and encourage the cultivation of food that is cleaner, more nutritious, healthier for the planet, and kinder to plant/animal populations

117
Q

What are some of the most common nutrient inhibitors, and what possible benefits do they provide?

A

Phytate (phytic acid) - stored form of phosphorus within plant foods
-Because humans lack phytase, phytate can travel through the digestive tract and bind to minerals such as zinc, magnesium, and calcium, and prevent their full absorption
-Phytates can also act as antioxidants

Oxalates (oxalic acid)
-Can bind to calcium and prevent its absorption in the small intestine

Lectins - protein structures that bind to carbohydrates
Can inhibit iron, zinc, and calcium and affect the microbiome

glucoinsolates - sulfur containing compounds
-Can inhibit iodine uptake

Tannic acid
-Can inhibit iron absorption

118
Q

The benefits of soaking include

• The benefits of sprouting include

• The benefits of fermentation include

• What are the pros and cons to raw foods and cooked foods?

A
119
Q

Sprouting benefits

A

-Produces enzymes that assist with the digestion of the vitamins and minerals present in the plant
-Reduces nutrient inhibitors
-Increases nutrient values (more than soaking) such as B12, folate, iron, zinc, magnesium, Vitamins A, E, and C, and protein and fiber absorption
-Decreases phytic acid significantly

120
Q

What are the pros and cons to raw foods?

A

Raw Foods Benefits
-Easy
-Avoid heat spares some nutrients and enzymes from being destroyed
-More hydrating
-Raw foods are naturally lower in calories - promotes weight lost

Raw Foods Drawbacks
-Less variety/difficult to get protein
-May be less appealing in certain seasons
-Difficult to digest
-More likely to be exposed to food-borne pathogens
-Potential to overly-restrict if only eating a raw foods diet

121
Q

What are the pros and cons to cooked foods?

A

Benefits of Cooked Foods
-Can improve the bioavailability of some nutrients
-Can reduce nutrient inhibitor content
-Generally more appealing to most people

Drawbacks of Cooked Foods
-Denatures some nutrients
-Cooking at too high of a temperature can create Advanced Glycation End Products (AGEs) and other harmful byproducts and create a burden of free radicals resulting in cell damage and increased inflammation levels

The more something is cooked, the more calories absorbed (can be good or bad)

122
Q

What are three different types of meal plans and what are the benefits of each?

A
  1. Weekly meal planning
    -for clients who are highly organized/purchase food at grocery store
    -helpful for busy clients with several obligations throughout the week
  2. Night-before planning
    -Allows for spontaneity/less restrictive
    -Good for clients who feel weekly planning is too daunting
    -Good for clients who shop at CSAs or farmers markets and are comfortable cooking without recipes
  3. Focusing on one single meal or snack a day to optimize it
    -Good for a client who needs to start small/feels overwhelmed by large meal plans and changes
123
Q

What are three strategies you can include in meal planning to make things easier?

A
  1. Finding a chunk of time to do most of the prep for the week (ie - weekend afternoon).
  2. Prepare various components of a meal ahead of time
  3. Selecting simple recipes with few ingredients

Others: batch cooking, pressure cooker, slower cooker

124
Q

What is the 3 step process for meal planning?

A
  1. Information gathering – food preferences, budget, cooking skills, timing needs
  2. Macro/caloric estimates – what’s realistic? Want to ensure we aren’t significantly under or over specific nutrients
  3. Create a plan - utilize info from steps one and two as well as simple strategies for meal planning
    -what does your client need and how will you achieve it using your strategies?
125
Q

What are 3 issues that can complicate meal planning?

A

-Food sensitivities/allergies
-Difficult schedules (shift workers)
-Known nutrient deficiencies

126
Q

Does intuitive eating have a role to play? What are the pros and cons of including it as part of your plan?

A

Can be mixed in depending on the bio-individual needs of the client

Pros
-Helpful if one is in tune with their body and eating for the right reasons
-Practicing intuitive eating can help improve one’s mindfulness around food
-Eases anxiety around the foods one is choosing to eat
-Helpful for those with a negative relationship with food or those who are neurodivergent

Cons
-Satiety and hunger signals may not be trustworthy - disrupted by daily stressors, lack of sleep, dehydration, sedentary lifestyle, etc

127
Q

Name the 4 stages of sleep and what happens in each (wakefulness is not included)

A

4 stages:
NREM 1
NREM 2
NREM 3
REM

NREM 1
-light sleep
-not fully conscious or unconscious
-theta brain waves

NREM 2
-50% of sleep time spent here
-heart rate slows, body temp drops
-spindles (decr brain activity w/ active bursts)
-memory consolidation

NREM 3
-Deep sleep
-delta brain waves (unconscious, restorative)
-most crucial for health/well-being (detox)

REM
-Dreams
-memory solidification
-body in brief state of paralysis
-increased heart rate/brain activity
-natural wakening most likely to occur

128
Q

How do we cycle between the stages of sleep?

A

Naturally, if uninterrupted
75% of time in NREM sleep, with the length of time spent in REM increasing as the night progresses and cycles continue (time spent in NREM 3 decreases)

129
Q

What is the suprachiasmatic nucleus, where is it located, and what does it control?

A

A small group of cells within the hypothalamus in the brain that controls the circadian rhythm and the subsequent bodily responses

(The hypothalamus as a whole controls hormone signaling - the SCN is just the piece that regulates the daily internal clock)

130
Q

What is the difference between a circadian rhythm and a diurnal rhythm?

A

Circadian Rhythm
-The cyclic hormonal pattern of the internal biological clock
-Associated hormonal and bodily processes fluctuate with the rising and setting of the sun

Diurnal Rhythm
-rhythms of night and day dependent on the rising and setting of the sun

131
Q

What role does melatonin play in sleep? How does cortisol interact with it?

A

-Doesn’t trigger fatigue for sleep, but rather sets up the internal bodily conditions to allow for rest to take place - best way to regulate is for regular sun exposure in the AM/PM
-Cortisol is a hormone that promotes wakefulness and alertness

The timing of these hormones is ideal. Cortisol releases early in the day promotes wakefulness and also suppresses their secretion at later points in the day allowing melatonin levels to rise at the appropriate time.

132
Q

How much sleep do we need during the different phases of life (infant – elderly)?

A

Newborns: 14-17 hrs
Infancy: 12-15 hrs
Toddlers: 11-14 hrs
Children 3-5: 10-13 hrs
Elementary (6-13): 9-13 hrs
Early Adolescence: 8-10 hrs
Adults (20-65): 7-9 hrs
Elderly (65+): 7-8 hrs

133
Q

What role does light play in sleep and wakefulness?

A

Sunlight - can help regulate cortisol/melatonin release to optimize circadian rhythm

Use of artificial light after natural darkness can work against our genetic and hormonal patterns (circadian rhythm) geared toward sleep

Blue light stimulates the brain in a way that makes us feel alert and suppresses melatonin release (the more luminance, the more disruptive)

Red light can promote relaxation

134
Q

How does sleep impact cortisol levels?

A

At the time of waking, cortisol levels have already been rising and will peak mid morning and decreases by the evening allowing for melatonin to increase. Cortisol is downregulated at night to help promote sleep.

Interrupted sleep can cause cortisol levels to be elevated the next day.

135
Q

How does sleep impact ghrelin levels?

A

Ghrelin is upregulated when sleep is delayed or disrupted

136
Q

How does sleep impact leptin levels?

A

Leptin is downregulated with poor sleep (one will feel less satiated)

137
Q

How does sleep impact insulin sensitivity?

A

Lack of sleep results in decreased insulin sensitivity as the body tries to make glucose available for the tissues that need it - particularly the brain

138
Q

Explain the connection between sleep and brain detoxification.

A

Brain detoxification occurs during deep sleep (NREM 3). The brain shrinks to 60% of its normal size creating pathways for cerebrospinal fluid to flush cellular build up from the ay’s activities allowing the brain to detox itself.

139
Q

How does a lack of sleep impact the immune system?

A

-Lack of sleep interrupts the creation/circulation of various T and B cells, neurotransmitters, and proteins that boost defenses
-Thus, more prone to infection with lack of sleep
-Interruptions in digestion and BSR due to poor sleep also impact immunity as 70-80% of immune cells are in GI tract

140
Q

How is the brain impacted by sleep – what symptoms might manifest because of it?

A

-Brain growth, detoxification, proper functioning will all be impaired by poor sleep
-Less metabolic activity occurring in a sleep deprived brain
-Downregulates more complex functions in favor or primitive functioning
-Brain inflammation

Symptoms
-poor condition
-poor control
-poor judgment
-grogginess
-unstable emotions
-temper
-mental health issues (depression, anxiety, etc)

141
Q

What is the mechanism by which caffeine impacts wakefulness?

A

Caffeine blocks adenosine receipts and prevents the drowsy feeling from “sleep pressure” that is normally experienced as the day goes on. Adenosine is a byproduct of cellular energy use and builds in concentration through the day as a result of being active and alert. It builds despite not having access to the receptors. Once the caffeine wears off, the adenosine floods the receptors resulting in a “crash” and feelings of drowsiness.

Additional factors related to caffeine crash are the rise and drop of adrenaline and cortisol throughout the cycle of caffeine ingestion and metabolism. They can exacerbate the crash and restart the cycle of reaching for more caffeine!

142
Q

How do we leverage diurnal rhythms to help with sleep?

A

Keeping it dark inside when it’s dark outside and light when it’s light out! Sleep and function in rhythm with the rising and setting of the sun.

143
Q

What is sleep debt, and how do we overcome it?

A

Sleep debt is the difference between optimal and actual sleep.

Focus on getting the minimum 7 hours every night vice “making up for the debt on the weekends” which doesn’t actually work and may worsen the issue.

Naps can help

144
Q

What is sleep inertia?

A

When nighttime grogginess spills over into the morning. A transition state between sleep and wakefulness which can be indicative of a disrupted circadian rhythm, interruption of sleep during deep sleep (NREM 3), etc. Can vary in severity from person to person.

145
Q

Are depressants (alcohol, nicotine, cannabis) helpful for sleep? Why or why not?

A

No

Though they trigger relaxation and drowsiness, they disrupt the normal homeostatic sleep cycle and hormone shifts that are supposed to occur resulting in poor quality and quantity of sleep (more like external sedatives than sleep aids).

Alcohol in particular eventually upregulates glutamate which promotes wakefulness and disrupts the end of sleep cycles keeping us from reaching deep sleep and REM

Alcohol, nicotine, and cannabis should be avoided within at least 3 hours of bedtime

146
Q

How should naps be leveraged, if at all?

A

Should be in the form of 15-30 minute power naps OR
Long enough to allow for 1 full sleep cycle (60-90 minutes) and be taken as far away from bedtime as possible

Long/improperly timed naps can be disruptive to nighttime sleep because it decreases the amount of “sleep pressure” in the body

147
Q

What are the 4 major sleep disorders?

A
  1. Insomnia
  2. Narcolepsy
  3. Restless leg syndrome
  4. Apnea
148
Q

How do we incorporate meal timing and macros to leverage better sleep and entrain ourselves into a better rhythm?

A

In general, avoid large meals/snacks 2-3 hrs before bed as it prevents internal temperatures from dropping appropriately and can interrupt the metabolic processes that our bodies prioritize during sleep. Also don’t want to go to bed hungry as BS too low can interrupt sleep!

Eating balanced, satiating snacks before bed as well as in the late afternoon/dinner time to support balanced blood sugar and restful sleep.

Complex carbs are required for hormone production, esp serotonin, which is converted to melatonin.

Avoid alcohol, spicy foods, fast foods, carbonation, etc before bed.

149
Q

What is sleep hygiene, and how can we leverage it with clients?

A

Sleep hygiene is all of the habits and environmental adjustments that can be made to ensure a restful night’s sleep

Examples
-wake up/wind down routine (sunlight exposure)
-going to bed/waking up at the same time every day
-dark room
-minimizing blue light exposure
-keeping home at around 65 degrees for sleeping
-reducing media consumption/work before bed

Can leverage by helping them find routines, options that they enjoy incorporating and starting small, seeing improvements, and growing from there. Encourage consistency!

150
Q

Define eustress, and distress.

A
151
Q

Define eustress vs distress

A

Eustress is “good stress” - causes only a small shift in the body’s effort to maintain internal balance and may strengthen certain physiological functions such as immunity (first date, strength training, etc)

Distress is “bad stress” - causes a major disruption in the body’s internal balance and impairs physiological function (family conflict, toxic work environment, etc)

152
Q

Define allostatic load.

A

The overall burden of chronic stress and life events and the body’s required effort to respond and re-establish internal stability

153
Q

What are the social determinants of health?

A

Conditions that have a major impact on people’s health, well-being, and life to include where a person lives, transportation, neighborhood/community crime rate, economic status, education level, income, healthy food and health care services, literacy skills, race

154
Q

What are the three main systems involved in the stress response?

A

HPA Axis
Sympathetic nervous system (SNS)
Parasympathetic nervous system (PSNS)

155
Q

Explain the role of cortisol in day-to-day living and in a stress response.

A

-Increased blood pressure and functioning of the cardiovascular system to provide additional blood to the muscles
-Activates gluconeogenesis
-The majority of cell’s contain cortisol receptors resulting in a wide array of impacts including metabolic impacts, insulin response, digestion, circadian rhythms and sleep, immune health, reproductive system, mental health, brain function, cellular health, hormone balance

156
Q

Explain the role of hormesis in stress.

A

Hormesis is the adaptive response of cells and organisms to moderate intermittent stress. Activates the stress response for a short period of time and are generally favorable as they benefit aging, longevity, resilience, and bodily functions such as immunity (ex - cold plunges, saunas, exercise)

157
Q

Distinguish between acute and chronic stress.

A

Acute stress - develops quickly but also ends quickly (ex - alarm going off, taking an exam, etc)

Chronic stress - prolonged activation of the sympathetic nervous system and HPA axis which can suppress immune function and lead to numerous health conditions

158
Q

Briefly explain some of the potential negative effects of chronic stress?

-Blood glucose levels
-Insulin signaling
-Ghrelin levels
-Leptin levels
-Cardiovascular system
-Immune function
-Oxidative stress
-Bone health
-Digestion
-Reproductive health
-Mental health

A

Blood glucose levels - stress increases blood glucose through gluconeogenesis

Insulin signaling - stress causes poor insulin signaling (muscle and liver cells become resistant to allow more glucose to remain in the blood for immediate energy/brain support)

Ghrelin levels - stress and rise in coristol elevates ghrelin which makes one feel hungry and also further inhibits insulin secretion and decreases insulin sensitivity

Leptin levels - cortisol decreases leptin levels leaving one feeling less satiated

Cardiovascular system - stress resulted in elevated heart rate and blood pressure as blood vessels constrict and heart contractions increase for the movement of oxygen and blood to the muscles

Immune function - chronic stress results in low grade inflammation throughout the body and suppressed immune function

Oxidative stress - can be caused by prolonged stress/inflammation; causes cell damage, accelerated aging, and various chronic conditions

Bone health - chronic psychological stress contributes to bone loss and increased risk of fractures and osteoporosis due to increased osteoclast activity and inhibition of osteoblast activity

Digestion - chronic stress contributes to alterations in the gut microbiome, intestinal permeability, slower motility, and inflammatory digestive conditions as blood is directed away from the GI tract in support of the body’s stress response

Reproductive Health - chronic stress results in decreased production of estrogen, progesterone, and testosterone; cortisol suppresses ovary function; hormone balance/fertility issues

Mental Health - stress can snowball into feelings of anxiety and depression, poor sleep, low self worth, weight gain, overwhelm; also causes alternations in neurotransmitter metabolism including lower levels of serotonin and dopamine and alterations in the gut microbiome

159
Q

What are the positive impacts of exercise on stress levels?

A

-Increase in self-esteem, self-efficacy, emotional well-being, self-confidence, life satisfaction, sleep quality, social support

-Lower cortisol response to psychological stress

Mechanism of action:
-endorphin release
-increase in brain-derived neurotrophic factor (BDNF) anti-inflammatory molecules and various hormones/neurotransmitters associated with a positive mood
-increase in dopamine, oxytocin, 5-HTP, and norepinephrine

160
Q

What are the positive impacts of sleep on stress levels?

A

Proper sleep habits help improve HPA function and regulate healthy cortisol levels

Maximizing rest/recovery helps us in our ability to handle stress

161
Q

How do the following nutrients help with stress handling:

Vitamin C
Vitamin E
Glutathione
B Vitamins
Magnesium
Omega 3s

A

Vitamin C - helps produce adrenal hormones (cortisol, norepinephrine); acts as an antioxidant during times of oxidative stress

Vitamin E - antioxidant

Glutathione - “master antioxidant” as it can regenerate Vitamin C into its active form which can recycle Vitamin E back into its active form (helpful in combating oxidative stress)

B Vitamins - reduces stress symptoms; support adrenals, regulate blood sugar, synthesis of mood-boosting neurotransmitters, conversion of food into energy for the nervous system (which controls the HPA axis!)

Magnesium - involved in almost all major metabolic and biochemical processes in the body and a cofactor in 300+ enzymatic reactions; promotes calm and relaxation; inhibits glutamate (excitatory neurotransmitter) and promotes GABA activity (calms nervous system); reduces the release of the pituitary hormone (ACTH) which controls cortisol production

Omega 3s - anti-inflammatory to combat the inflammation and cortisol levels caused by chronic stress/immune suppression

162
Q

Explain the importance of mindfulness to stress handling. What are some different forms of mindfulness that can be incorporated easily throughout the day?

A

Mindfulness is the practice of pausing and choosing to respond, vice react, to stressors

-Deep breathing, body scan, guided imagery, journaling, yoga, tai chi, gratitude, “find your feet”

163
Q

How do natural environments contribute to stress regulation?

A

-Exposure to sunlight, especially early in the morning, regulates circadian rhythm and supports mood, energy, and sleep
-Natural environments (green spaces) reduce perceived stress and cortisol levels

164
Q

Explain the role of finding purpose in managing stress levels.

A

-Allows one to find meaning in ordinary tasks promoting motivation over discouragement
-Fosters healthy self-esteem and self-efficacy

165
Q

How does reframing impact stress levels?

A

Helps lessen the damage stress has on the body

Can help shift one’s perspective of a situation and allow them to focus on how they are capable of handling it/opportunity to grow

166
Q

Explain the importance of incorporating hobbies for those that are not currently making time for them.

A

-Provide a meaningful break from work/responsibilities to recharge
-Promotes a sense of purpose
-Helps one feel productive, happy, and recharged
-Associated with lower blood pressure, cortisol, waist size, and BMI and better psychological, physical, and social functioning

167
Q

Explain the role of relationships in managing stress levels.

A

-Humans have a fundamental need to form emotional connections with others
-Helps buffer the negative effects of the stress by dampening the effect on the HPA axis and increases resilience by reducing stress-induced cortisol release
-Helps reduce anxiety and develops feelings of security
-Increases social support to help cope with stress and mitigate its ill effects

168
Q

Explain gastrin’s role in the north to south path of digestion.

A

Secreted by epithelial cells in the stomach in response to a meal being consumed.

Functions include:
-Mucous membrane protection
-Stimulates gastric motility
-Stimulates HCl and intrinsic factor (IF is necessary for absorption of B12 in the small intestine) secretion

Disfunction:
-Surgical procedures and/or low protein diets can reduce gastrin production
-Pylori infection can increase gastrin and thus HCl

169
Q

Explain pepsin’s role in the north to south process of digestion.

A

Active form of pepsinogen (which is released by chief epithelial cells in the stomach in response to HCl)

-Pepsin works with HCl to break down protein in the stomach As well as the bonds of potentially infectious microbes (ie. H. Pylori)

-Pepsin production will be reduced if we have reduced stomach acid which can result in delayed gastric emptying and maldigested food in the stomach as well as back pressure/reflux

170
Q

Explain the role of mucous in the north to south path of digestion.

A

Mucous is secreted along the lining of the duodenum (upper part of small intestine) in response to the acidity of the chyme

Mucous membrane lines the small intestine

Mucous membrane contains groupings of lymphoid follicles called Peyer’s patches which house a variety of immune cells

Helps shuttle nutrients from the lumen to the enterocytes for absorption

Also secreted by mucoid cells in the stomach - contains bicarbonate ions which buffers against the acidity of the gastric juices

Disfunction:
-Low mucous production in a stressed state
-H. Pylori can disrupt mucous production

171
Q

What is the relationship between cortisol and blood sugar regulation?

A

Hypothalamus tells pituitary to make adrenocorticotropic hormone (ACTH) which stimulates the adrenal glands to release cortisol

Cortisol promotes the release of stored fuel to increase blood glucose supply via glycogenolysis, gluconeogenesis, and lipolysis

Reduces insulin sensitivity
Decreases pancreatic production of insulin (“stop storing”)
Increases glucagon production (“release fuel”)

172
Q

Explain the role of adrenaline/epinephrine in blood sugar regulation.

A

Produced by the adrenal medulla in response to signals from the Central Nervous System (CNS) (considered “catecholamines”)

Part of fight/flight response - quick response time

Stimulates the same metabolic pathways as cortisol:
-glycogenolysis
-lipolysis
-gluconeogenesis

Lowers the pancreatic production of insulin

Cortisol and adrenaline will also be released in cases of reactive hypoglycemia (“emergency” low blood sugar)

173
Q

How does Peptide YY affect appetite?

A

-Released in the small intestine after eating
-Slows the rate at which food passes through the digestive tract to increase nutrient breakdown and absorption
-Signals satiety
-Highest within 2 hours of eating

174
Q

How does glucagon-like peptide-1 (GLP-1) affect appetite?

A

-Secreted in the small and large intestines
-Stimulated by food intake and remains elevated for a few hours after
-Slows gastric emptying, decreases appetite, promotes release of insulin for BSR

175
Q

What is a prebiotic?

A

Refers to nutrients (primarily carbs) that preferentially feed strains of bacteria associated with health benefits

Other benefits:
-Support healthy bowel movements
-Reduce IBS symptoms
-Reduce markers of inflammation
-Improve metabolic health

3 criteria:
1. Resistant to gastric acidity and hydrolysis by mammalian enzymes and GI absorption
2. Can be fermented by intestinal microflora
3. Selectively feeds good bacteria

-Foods rich in prebiotics include legumes, dandelion greens, Jerusalem artichokes, berries, garlic, onions, leeks, asparagus, bananas, oats, apples, flax, seaweed

176
Q

What is a probiotic?

A

Refers to living organisms/food and supplements that contain microorganisms to support a healthy symbiosis between multiple populations of beneficial microbes in the microbiome

Probiotic foods:
-fermented foods
-cultured dairy

177
Q

What is a postbiotic?

A

Refers to the metabolic byproducts from microbes which are more recognized for eliciting biological responses in the host and other members of the microbiota

178
Q

What is dysbiosis?

A

An imbalance between the beneficial and harmful bacteria in the gut microbiome

Ex:
-Alterations in the ratios between the major phyla groups (firmicutes and bacteroides)
-Decline in the number of diversity of beneficial bacteria
-Overgrowth of opportunistic strains of bacteria

-Strongly linked to autoimmune disease
-Can cause elevated levels of endotoxins as released by harmful bacteria
-Can exacerbate and be exacerbated by stress hormones

179
Q

IBS vs IBD

A

IBS - functional disorder (not autoimmune); no sign of tissue damage or inflammation during colon exam
Symptoms: constipation, diarrhea, gas, bloating, nausea, abdominal pain/cramping
-Mediated by microbiome and gut-brain axis communication

IBD - umbrella term for autoimmune disease that involves chronic (permanent) tissue damage/inflammation of the GI tract
Symptoms: abdominal pain/cramping, change in BM frequency, chronic diarrhea or constipation, urgent BMs, blood/mucus in stool, nausea, vomiting, feelings of incomplete evacuation
Secondary symptoms: body aches, fatigue, loss of appetite, deficiencies
Ex - Chron’s, ulcerative colitis

General:
Disease - clear cause, pathophysiology, progression, treatment
Syndrome - common group of symptoms that do no always have a well-known or shared cause

180
Q

Celiac vs. gluten allergy/non-celiac gluten sensitivity (NCGS)

A

Celiac - autoimmune characterized by the production of IgA antibodies against tissue transglutaminase (protein-based enzyme in the intestines); damages the tissues of the small intestine; symptoms: blasting, diarrhea, constipation, gas, loose, greasy, or foul-smelling stool, nausea, vomiting, abdominal pain as well as malabsorption and fatigue, joint/bone pain, depression, anxiety, headaches, etc

Gluten allergy - IgE-mediated (“true” allergy)

NCGS - thought to include IgA, IgG, and IgM anitbodies; symptoms: bloating, abdominal pain, diarrhea, other digestive symptoms, low grade inflammation outside of GI tract

181
Q

How does nutrient dense diet support digestion?

A

-Whole food diets provide the dietary fiber and polyphenols to feed and maintain a healthy and diverse gut microbiome
-Processed foods with many additives can alter the health of the gut microbiome
-Nose-to-tail (unique nutrient profile), herbs and spices, connection to food to support parasympathetic state

182
Q

How does stress impact digestion?

A

Sympathetic-dominant state inhibits and disrupts parts of the digestive system as the body diverts attention away from digestion
Symptoms: disruption in gastric motility, stomach acid and enzyme production, intestinal permeability, gut microbiome balance, hunger signals and appetite regulation

Disruption in the GI tract can contribute to stress and mental health disorders via the gut brain axis

183
Q

How can disregulated blood sugar impact digestion?

A

-In severe cases, high BS can damage the vagus nerve resulting in delayed gastric emptying (ex - diabetic neuropathy of the vagus nerve)
-In treating glucose disregulation, one may limit carb intake which can reduce dietary fiber and impact the health of the GI tract
-reduced MMC length with chronically high blood glucose levels resulting in disrupted nutrient absorption, BMs, and microbial balance
-Non-alcoholic fatty liver disease (NAFLD); symptoms: abdominal pain, feeling of fullness in upper right side of belly, nausea, diarrhea, weight loss, loss of appetite

184
Q

Explain how antioxidants relate to digestion

A

Help reduce oxidative stress on the body allowing the body to devote more energy to the digestive process. Help facilitate detoxification in the body particularly between Phase I and Phase II detox

185
Q

Explain how gut associated lymphoid tissue (GALT) relates to digestion

A

Represents 70% of the entire immune system
-Microbiome interacts with GALT impacting intestinal permeability, immune tolerance toward foods/pathogens/host tissues and dampens or amplifies systemic inflammation
-Probiotics and foods that promote a healthy microbiome can enhance GALT

186
Q

How do beneficial bacteria relate to digestion?

A

-A healthy and diverse microbiome in right balance supports immunity, mental health, and overall bodily health.
-Produce SCFAs which protect the tissues of the colon from damage, impact gut-brain interactions, and neuro-immunoendocrine function

187
Q

Explain how the endocrine system relates to digestion (nutrient absorption, digestive hormones, thyroid/metabolism)

A

Nutrient absorption - endocrine system is reliant on nutrients absorbed via the digestive tract as macro and micronutrients serve as cofactors in hormone synthesis and are essential to signaling of metabolic pathways of hormones
-ingestion of endocrine-disrupting chemicals can come via the digestive tract

Digestive hormones - pancreas endocrine function is the production of hormones for blood sugar regulation
(Note - pancreatic release of bicarbonate and digestive enzymes is considered exocrine - triggered by secretin and CCK); gastrin in stomach, secretin in gut which triggers pancreatic release of bicarbonate; ghrelin, leptin, peptide YY, GLP-1

Metabolism - thyroid hormone production (T4 and T3) influences catabolic and anabolic processes of metabolism which can affect the health of all bodily tissues; link between hypothyroidism and hypochlorhydria and constipation; hyperthyroidism and rapid bowel movements

188
Q

Explain the connection between digestion and reproductive health.

A

-Many nutrient cofactors must be absorbed to support steroid hormone/sex hormone production

-Strong links between reproductive disorders and inflammatory/autoimmune disorders (endometriosis, PCOS, irregular menstruation, infertility, pregnancy loss)

-Male infertility can be due to malabsorption of nutrients that are important for sperm production (zinc, selenium, Vitamin E)
-Poor microbiome health has been linked to reduced sperm health
-dysbiosis can result in bacteria that reconvert estrogen into its active form and ultimately result in higher levels of circulating estrogen in the body resulting in a myriad of reproductive issues for both men and women

189
Q

Explain the connection between the digestive system and the cardiovascular system.

A

Poor blood flow to digestive organs = digestive problems
-Blood helps pick up incoming nutrients

-Upper GI symptoms 2x more common in people with cardiovascular disease

Issues with the gut microbiome (inflammation) increases the likelihood for atherosclerosis

Lipopolysaccharides can increase LDL cholesterol

190
Q

Explain the connection between the Nervous System/Gut-Brain and the digestive system.

Gut/brain axis
Microbiome
Protective Factors

A

Gut-brain axis & vagus nerve - 80-90% of the signals transmitted via the vagal nerve travel from the gut to the brain

Microbiome produces neurotransmitters related to the function of the enteric nervous system (ENS)

Protective factors (SCFA, BDNF)
-SCFA: produced in large intestine, maintain gut barrier function, can impact brain physiology and function
-BDNF: Brain Derive Neurotrophic Factor; protein found in brain and spinal cord that promotes growth, maturation, and survival of neurons, active in the synaptic spaces between neurons where cell-to-cell communication takes place, modulates brain inflammation and immunity (low levels associated with a wide array of neurodegenerative disease and mental illnesses)

191
Q

Understand how each of the following categories has the potential to support digestive function, and at least one example of each:

• Phytonutrients

• Culinary spices and herbs

• Fermented foods

• Prebiotic foods

• Functional foods

A

• Phytonutrients - bioactive compounds found in plant foods; benefits include anti-inflammatory, antioxidant, detoxification capabilities, joint health support, brain health support, cardiovascular health, antimicrobial
Ex - carotenoids (red, orange, yellow fruits/vegetables); anti-inflammatory
Ex - Polyphenols - antioxidant, anti-inflammatory, and anticarcinogenic properties; prebiotic effects, enhances microbial diversity, modulates intestinal barrier function; found in nuts, seeds, legumes, grains, greens, tubers, berries, fruits

• Culinary spices and herbs - aid in the breakdown and absorption of nutrients; provide comfort and relief to. Stressed digestive system
Ex - cinnamon - increases appetite; eases gas, burping, bloating; reduces H. Pylori
Ex - oregano - antimicrobial

• Fermented foods - aid in digestion, liberate nutrients in our food convert less useful nutrients to forms we can benefit from, provide living populations of health microbes for the gut
Ex - kefir, kombucha, sauerkraut

• Prebiotic foods - food for beneficial bacteria which proliferate and produce SCFAs, support health bowel movements, reduce symptoms of IBS, reduce markers of inflammation, improve metabolic health
Ex - starch and glucose-derived oligosaccharides (found in unripe bananas and cooked then cooled potatoes); pectin (rinds of citrus fruits, skins of apples, pears, and berries)

• Functional foods
Ex - bone broth - contains vitamins and minerals, support joint health
Ex - leafy greens - act as a prebiotic and stimulate the production of digestive secretions in the body
Ex - mushrooms - wide array of vitamins and minerals and anti-inflammatory, antioxidant, anticarcinogenic, antibacterial, and anti fungal capacities

192
Q

What are three different methods one could use to better connect to a parasympathetic state?

A

Eat mindfully - eat slowly, focus on food, avoid distraction, take deep breaths before meals

Chew properly - 30x per bite! Mechanical breakdown of food and coating with saliva and salivary enzymes

Remove unsupportive habits - alcohol, smoking, eating late into the evening

Also: movement, stress management

193
Q

How does a nutrient dense diet support detoxification?

A

Phase I and Phase II require key nutrients/enzymatic cofactors: B2, B3, B6, B12, folate, glutathione, BCAAs, flavonoids, phospholipids

Antioxidants to support oxidative stress between Phase I and Phase II

Amino acids, allium, cruciferous vegetables, and Polyphenols for Phase II pathways

Eating cleaner food and drinking high quality water can lower the burden of toxicity on the body

194
Q

How does sleep support detoxification?

A

-Large share of detox happens while sleeping
-During the overnight fast, the circulatory and lymph systems don’t have as much of a work loading shuttling incoming nutrients and can focus on moving toxins out of the body
-Sleep hygiene: avoid late night eating, sweets, alcohol to allow the body to focus on detox while asleep

195
Q

How does stress management support detoxification?

A

Sympathetic dominant state can interrupt hormones, enzymes, and cellular processes involved in detox

Ex - impairs liver enzyme activity, depletes glutathione levels, chronic inflammation, oxidative stress, alterations in gut microbiome and intestinal permeability (increased risk for reabsorption of Phase II conjugates), mental health issues

196
Q

How does digestion impact detoxification?

A

Any disruption of bile production and release can inhibit Eli action of toxins via bile

Gastrointestinal motility issues can slow down transit time of food and waste products through the GI tract resulting in prolonged contact between toxins and intestinal lining/increased risk of reabsorption

Lack of fiber and dysbiosis can also increase the risk of reabsorption of toxins (certain forms of bacteria can cleave the bonds of Phase II conjugates)

Low nutrient absorption affects the level of cofactors available for detox pathways

197
Q

How does BSR affect detoxification?

A

Chronically high blood sugar overburdens the liver (converts dietary glucose into glycogen) impairing its ability to assist with detox

198
Q

What it metabolic flexibility and why is it important?

A

The capacity of an organism to adapt fuel utilization to fuel availability. Can shift between fuel sources based on circumstances that maintains our energy and overall function (ie - in a lack of available carbs, the body can use fats and proteins to make energy)

-Important for maintaining steady energy levels, reducing cravings, and the ability to tap into stored fuel which supports healthy weight management

199
Q

Briefly describe the process of glycogenesis.

A

When the liver converts dietary glucose into glycogen for storage in the liver or skeletal muscles

-Does so after consuming a meal rich in carbs and to avoid overloading the cells with glucose, the liver manages the extra via glycogenesis

200
Q

Briefly describe the process of lipogenesis.

A

When the glycogen stores in the liver and skeletal muscles are full, the liver converts excess glucose into fatty acids and triglycerides for storage in adipose tissue via lipogenesis

201
Q

Briefly describe the process of gluconeogenesis.

A

When the body converts sources other than carbs to glucose (ie - fats and proteins); usually utilized when carbs are low and protein supplies are high or during a prolonged fasted state.

202
Q

Briefly describe the process of glycogenolysis.

A

The breakdown of stored glycogen for use in order to increase blood glucose during times of low circulating glucose supply

203
Q

Briefly describe the process of lipolysis.

A

The breakdown of stored lipids (triglycerides) in the adipose tissue to be used as alternative fuel, fatty acid beta-oxidation rather than glycolysis to make ATP

204
Q

Understand glycation and why the formation of AGEs is problematic.

A

Glycation is a chemical reaction that occurs when glucose molecules in the bloodstream bind to proteins or lipids; a non-enzymatic process that occurs when blood glucose levels are elevated and leads to the formation of advanced glycation end products (AGEs)

Glycation is considered irreversible

AGEs persist and accumulate in tissues over time and cause damage to cells and tissues throughout the body; like “aging in fast forward”

205
Q

What are the four phase of dysglycemia and what are the key characteristics of each?

A
  1. Reactive hypoglycemia
    -sharp blood sugar swings
    -in reaction to a high glycemic meal
    -overproduction of insulin to shuttle glucose into cells resulting in sharp drop in blood sugar
  2. Insulin Resistance and Hyperinsulinemia
    -After years of hyperglycemia
    -Cells become less responsive to insulin, so blood glucose levels don’t drop as sharply
    -Results in the accumulation of glucose and insulin in the blood for longer periods of time
    -Can cause high BP, dyslipidemia, inflammation, hormonal disregulation, fatigue, weight gain
  3. Metabolic Syndrome & Pre-diabetes
    -MS: broader condition that encompasses a combination of specific biometrics related to metabolic health; a cluster of interconnected metabolic abnormalities that increase the risk of cardiovascular disease and T2D
    -PD: refers to elevated blood glucose levels just below diagnostic criteria for diabetes
  4. Type 2 Diabetes
    -When the increased insulin production is no longer sufficient to compensate for insulin resistance
    -persistent hyperglycemia
    -Possible impaired insulin secretion from pancreas
206
Q

What are the key characteristics of Type 1 diabetes?

A

An autoimmune condition characterized by the destruction of pancreatic beta cells, which produce insulin (not caused by insulin resistance in peripheral cells)

Results in uncontrolled elevations of blood sugar and prescribed insulin injections

207
Q

What is the relationship between genetics and blood sugar dysregulation?

A

Over 120 genetic variants have been associated with the development of T2D

208
Q

How does the health of the microbiome relate to blood sugar dysregulation?

A

Phyla ratios don’t clearly correlate with health outcomes:
-Elevated ration of firmicutes to bacteroidetes was considered an indicator of metabolic disorders in the past
-Several studies do not show significant changes in this ration in individuals w/ metabolic conditions

Intestinal dysbiosis contributes to blood sugar dysregulation via the following mechanisms:
-inflammation (endotoxins impair insulin signaling)
-barrier dysfunction resulting in immune response which contributes to insulin resistance
-Elevated zonulin
-reduced production of SCFAs which are known to enhance insulin sensitivity
-disrupted bile metabolism
-impaired gut hormone regulation (GLP-1 and PYY)
-production of metabolites associated with insulin resistance

Also, the opposite is true as well. Diets high in refined sugars and starch can contribute to alterations in the gut microbiome that promote insulin resistance

209
Q

How does intest

A
210
Q

How does blood sugar dysregulation relate to non-alcoholic fatty liver disease?

A

Caused by excess glucose associated with increased risk for GERD and other digestive complaints

211
Q

How does blood sugar dysregulation relate to general GI complaints?

A

In diabetics, symptoms are more common the less glycemic levels are managed

212
Q

How does blood sugar dysregulation relate to the migrating motor complex (MMC)?

A

Elevated blood glucose levels reduce the cycle length of the MMC

213
Q

How does blood sugar dysregulation relate to vagal nerve and gastric motility?

A

Diabetic neuropathy is a leading cause of gastroparesis

214
Q

How does blood sugar dysregulation affect sleep?

A

Increased night time urination can be the body’s attempt to lower glucose levels in the bloodstream

Reactive hypoglycemia can result in blood sugar levels dipping during the night, the elevation of stress hormones, and resulting sleep disturbances

215
Q

How does blood sugar regulation relate to the body’s stress response?

A

-Reactive hypoglycemia places a burden on the HPA axis
-The body views blood sugar crashes as an emergency and secretes adrenaline and cortisol in response

216
Q

How does blood sugar affect the nervous system?

A

-Diabetic nerves exhibit excessive glycation
-Higher levels of AGE deposits are associated with reduced myelination of nerve fibers
-AGEs promote neuronal cell death
-Peripheral diabetic neuropathy = most common diabetic complication

217
Q

How does chronic blood sugar dysregulation affect the brain?

A

-Prolonged hyperglycemia damages blood vessels in the brain
-Alzheimer’s Disease (AD): caused by insulin resistance in the brain
-Increased likelihood of depression, anxiety, and stress with the consumption of foods high on the glycemic index (GI)

218
Q

How does blood sugar dysregulation affect the cardiovascular system?

A

-Endothelial cells of the vascular lining are vulnerable to injury and glycation when exposed to elevated glucose
-Hyperinsulinemia can increase blood pressure
-Dyslipidemia: abnormal distribution of lipids (including elevated levels of LDL cholesterol, reduced levels of HDL cholesterol, and elevated triglycerides)

219
Q

How does blood sugar dysregulation affect the immune system?

A

-Chronic inflammation is a driver and a result of BSDR
-Chronic inflammation can impair insulin signaling and disrupt metabolism
-Elevated levels of glucose and free fatty acids in the bloodstream stimulate inflammation

-Chronic inflammation can impair immune responses making diabetic more susceptible to certain infections

-Impaired wound healing - reduced blood flow, immune cell migration, and production of growth factors necessary for tissue repair

220
Q

How does blood sugar relate to the endocrine system?

A

Blood sugar is regulated by endocrine hormones!

Thyroid
-Thyroid conditions can promote insulin resistance
-Link between insulin resistance and sub clinical hypothyroidism

221
Q

How does blood sugar relate to the reproductive system?

A

-Insulin resistance can lead to higher estrogen production
-In males, insulin resistance can directly lead to lower levels of testosterone
-In some females, insulin resistance can be related to high levels of androgens which relate to PCOS

222
Q

How does blood sugar relate to the urinary system?

A

-Prolonged hyperglycemia damages blood vessels in the kidneys, promotes oxidative stress and inflammation
-Diabetic (chronic) kidney disease - leading contributor to kidney stone formation, end-stage renal disease, and kidney failure
-Reduced ability for kidneys to convert Vitamin D2 into the active and usable form of D3
-Decreased calcium absorption into bone

223
Q

How does blood sugar relate to the skeletal system?

A

-AGEs negatively affect the collagen that makes up bone
-Significant associations between the consumption of sugar-sweetened beverages and decreased bone mineral density and increased risk of bone fractures

224
Q

In the mouth, what begins the chemical breakdown of carbs?

A

Salivary amylase

225
Q

HCL in the stomach is responsible for activating…

A

The enzyme pepsin

226
Q

What part of the digestive system is primarily responsible for nutrient absorption?

A

Small intestine

227
Q

Which hormone stimulates the pancreas to release bicarbonate-rich juice?

A

Secretin

228
Q

CCK stimulates what?

A

Gallbladder to release bile

229
Q

Bicarbonate is important in the small intestine because it…

A

Neutralizes stomach acid

230
Q

What do the villi and mircovillie do in the small intestine?

A

Secrete digestive enzymes
Increase surface area for absorption
Transporting nutrients into the bloodstream

231
Q

The primary role of the large intestine in digestion is to..

A

Absorb water and electrolytes

232
Q

How does leptin affect appetite?

A

By signaling the brain to decrease appetite when fat stores are sufficient

233
Q

What is a potential outcome of hypochlorhydria?

A

Nutrient malabsorption issues

234
Q

How does pancreatic insufficiency affect digestion?

A

Causes malnutrition and digestive discomfort due to inadequate enzyme production

235
Q

What is a common cause of SIBO?

A

Compromised motility and structural issues

236
Q

How can symptoms of dysbiosis in the large intestine manifest?

A

Digestive discomfort and symptoms of IBS

237
Q

Diabetic neuropathy of the vagus nerve can affect the digestive system how?

A

Gastroparesis (delayed gastric emptying)

238
Q

How does dysbiosis affect the immune system?

A

By leading to an overactive immune response that can result in inflammation and autoimmune diseases

239
Q

How does the thyroid gland influence metabolism?

A

By producing thyroid hormones that regulate the body’s metabolic rate

240
Q

Which nutrient is essential for the production of thyroid hormones?

A

Iodine

241
Q

Which nutrient is essential for the synthesis of steroid hormones which are crucial for reproductive health?

A

Cholesterol

242
Q

Which digestive disorder is associated with increased rates of male infertility?

A

IBD

243
Q

How is poor microbiome health linked to reduced sperm health?

A

By decreasing the body’s overall nutrient absorption, including those crucial for sperm production

By alternating the hormonal balance necessary for sperm production

244
Q

What role does the gut microbiome play in the development of atherosclerosis?

A

It can contribute to atherosclerosis through inflammation and altering bile acids

245
Q

What effect do lipopolysaccharides (LPS) have on the cardiovascular system?

A

They contribute to the development of cardiovascular diseases by promoting inflammation and dyslipidemia.

246
Q

What are Short Chain Fatty Acids (SCFAs) and how do they benefit the brain?

A

SCFAs are metabolites produced by gut bacteria that can have a protective effects on the brain, including supporting neuron function

247
Q

What is brain-derived neurotrophic factor (BDNF) and why is it important?

A

A protein that promotes the growth and survival of neurons playing a key role in brain health and resilience against neurodegenerative diseases

248
Q

How does the gut brain axis influence mental health?

A

Gut microbiome produces neurotransmitters and other compounds that impact brain function and mood

249
Q

L-glutamine is recognized for its role in what?

A

Tissue repair in the digestive tract

250
Q

Digestive bitters are known as what?

A

Digestive stimulants promoting the production of digestive secretions

251
Q

______ is considered a cofactors that supports digestive function by aiding in enzyme activity.

A

Zinc

252
Q

Adiponectin, a hormone secreted by adipose tissue, plays a role in blood sugar regulation by…

A

Enhancing insulin sensitivity and fatty acid oxidation

253
Q

Describe the process of lipolysis.

A

The breaking down of triglycerides into fatty acids and glycerol for energy

254
Q

How does glycation specifically affect the body’s systems?

A

By altering the structure and function of proteins and lipids leading to cellular damage

255
Q

How does elevated blood glucose affect the migrating motor complex?

A

It reduces the cycle length of the MMC

256
Q

How does insulin resistance affect estrogen production?

A

It can lead to higher estrogen production

257
Q

How does AGEs affect the skeletal system?

A

Negatively affect collagen reducing blood strength and flexibility

258
Q

How does fat contribute to healthy blood sugar regulation?

A

-Can help maintain stable energy levels and increase satiety
-Low-carb, high-fat diets are proven beneficial for those struggling with metabolic conditions
-Aim for high quality fats in their original form
-Boost Omega 3s and limit highly processed omega 6s
-Fiber along with fats can help maintain health of microbiome limiting inflammation and supporting healthy BSR

259
Q

How does protein support healthy BSR?

A

-Protein stimulates insulin which can help clear blood glucose more quickly
-Certain amino acids can be insulinoogenic contributing to insulin resistance
-Increasing protein in the place of carbs is an effective strategy for those dealing with MS, prediabetes, and diabetes
-Protein sources that are low in BCAAs are best for those dealing with BSDR
-Collagen and plant-based protein powders have less insulinogenic properties than dairy-based powders

260
Q

How does fiber contribute to healthy BSR?

A

-Slows down the absorption of sugar in the intestines
-Improves insulin response
-Improves serum lipid profiles
-Promotes satiety
-Supports healthy microbiome
-Supports healthy BP
-Supports healthy weight regulation

Soluble fiber is the most effective in supporting blood sugar regulation

261
Q

How do probiotics support healthy blood sugar regulation?

A

-Improve glucose, lipid, and inflammatory markers
-Some strains show reduction in BMI, total cholesterol, LDL cholesterol, increased antioxidant capacity

262
Q

Understand the how the following categories can support blood sugar, and identify at least one example for each:

• Insulin Sensitivity Enhancers

• Carbohydrate Absorption and Metabolism

• Antioxidants

• Vitamin and Mineral Cofactors

• Adaptogens

• Glandulars

• Probiotics

A

Insulin sensitivity enhancers - improve body’s response to insulin
Ex - magnesium, Vitamin D, Omega 3 fatty acids

Carbohydrate Absorption and Metabolism - reduces/slows the absorption of glucose from the digestive tract, speed urinary excretion of glucose, help cells create energy from glucose
Ex - magnesium, l-carnitine, gymnema

Antioxidants - counteract oxidative stress which can contribute to insulin resistance and BSDR
Ex - Vitamin C, Vitamin E, CoQ10

Vitamin and Mineral Cofactors - act as building blocks for the enzymes involved in insulin action and glucose metabolism
Ex - zinc, magnesium

Adaptogens - normalize the stress response preventing chronically high stress hormones and BSDR
Ex - some mushrooms

Glandulars - tissues from other organisms consumed to nourish the corresponding gland in the human body
Ex - pancreas, liver, adrenal glands

Probiotics - nourish the microbiome which impacts inflammation and overall BSR
Ex - fermented foods are probiotic-rich

263
Q

What does calories in/calories out represent?

A

Calories in - what we wear
Calories out - total energy expenditure (thermic effect of food, RMR, physical activity energy expenditure [non-exercise activity thermogenesis vs. exercise])

264
Q

Is resting metabolic rate the same as basal metabolic rate?

A

Resting and basal metabolic rate (BMR) are similar and only differ in that BMR is usually measured in the morning, after an overnight fast, no exercise for the previous 24 h, free from emotional stress, familiar with the apparatus, and the subject completely rested.

265
Q

What is the thermic effect of food and how does it vary for fat, carbs, and protein?

What difficulties arise in measuring it?

A

Measurement of how much our metabolism increases after eating

Fat - 0-3%
Carb - 5-10%
Protein - 20-30%

Difficulties:
Range of increase in metabolism is variable and very difficult to accurately measure

266
Q

Describe physical activity energy expenditure and the difficulties that arise in trying to calculate it.

A

Difficulties:
-Excess Post-Exercise Oxygen Consumption (“after burn”)
-Devices we use to calculate are inaccurate
-Entirety of daily movement is difficult to account for
-Need to take into account stress and fed states

267
Q

What is EPOC?

A

Excess Post-Exercise Oxygen Consumption
“Afterburn”

The increase in metabolism to pay off the oxygen debt you accrued from exercise

268
Q

Define metabolism.

A

The sum of the chemical reactions that take place within each cell of a living organism and that provide energy for vital processes for synthesizing new organic material

OR

Total energy expenditure = RMR + Thermic effect of food + Physical Activity Energy Expenditure

269
Q

Define anabolism.

A

When the body uses energy to build up/create more complex molecules (growth and repair)

270
Q

Define catabolism.

A

When the body breaks down complex molecules to release energy

271
Q

What are catecholamines and how do they differ from cortisol? How does stress play in?

A

Catecholamines and cortisol come from two different systems and two sets of precursors

Catecholamines (ie - epinephrine/norepinephrine)
-Released by the Sympathetic Adrenal Medullary axis
-Precursor = phenylalanine
-Quicker-acting
-More involved with stressors that present as a challenge
-Can have anabolic and catabolic impact on muscles

Cortisol
-Comes from the HPA axis
-Precursor = cholesterol
-Slower acting/takes longer to break down
-Release is associated with stressors perceived as a threat
-Catabolic to all muscle tissues

Stress management and an improved outlook can help us view stressors as challenges vs. threats. Cortisol-driven stress responses puts one in a chronically catabolic state decreases metabolic active muscle tissue and increase adipose tissue that costs less to maintain.

272
Q

What are the basic caloric goals for weight loss, weight gain, and weight management?

A

Weight loss:
-Aim to lose no more than 1-2 lbs per week
-Focus on sleep, general exercise, stress, and diet (improving insulin efficiency, focus on Whole Foods)

Weight gain:
-Increase calories
-Increase insulin in a healthy manner
-Reduce excess and unnecessary movement

Weight management:
-As we age, we may gain weight from the same amount of calories we used to eat. May lose muscle, gain adipose tissue. To avoid, engage in strength training, eat enough protein, and trade refined foods for lower-calorie whole foods.

273
Q

How does each macronutrient (carb, protein, fat) play into weight management?

A

Carbs
-Reduce refined carbs
-Replace refined carbs with complex carbs/fiber and fats
-Can also improve insulin sensitivity/efficiency with a high-carb, low-fat diet

Protein
-Highest TEF
-Recommended to increase to aid in weight loss
-Consuming protein induces muscle protein synthesis
-Increases satiety

Fat
-Slows absorption of glucose
-Increases satiety and stabilizes energy levels

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