Environment and the Brain 3 Flashcards
True or false? Explain your answer if appropriate. (1)
Diet sits on a spectrum of impact on brain health, with a Mediterranean and anti-inflammatory diet on the good end, and Ultra-processed and Western diet on the bad end.
True
Give an example of a diet which is used as a medical treatment. (1)
Ketogenic diet for epilepsy
Give three circumstances where the ketogenic diet is used as a treatment for epilepsy. (3)
- In drug-resistant epilepsy
- In children especially (but can also be used in adults)
- In GLUT1 deficiency (where it is the standard treatment)
Does the ketogenic diet lead to improved symptoms in all patients with epilepsy? (1)
No
Complete the sentence regarding a ketogenic diet and epilepsy. (4)
When using a ketogenic diet to help treat epilepsy, patients must be monitored by a medical team to ensure …………………… of the diet, and …………………….
However, this treatment has been used for ……………….. years, and is advised by ……………………….
Effectiveness
nutritional balance
more than 100
the NICE guidelines
Describe the ketogenic diet, in terms of the intake of the following food groups. (3)
a) fat
b) carbohydrate
c) protein
a) high fat (75% of diet)
b) low carbohydrate (5% of diet)
c) controlled protein intake (about 20% of diet)
Describe how the ketogenic diet alters the body and brain’s main energy source. (1)
Changes the main energy source from carbohydrates (glucose) to fats (ketones)
Give five ways in which the ketogenic diet impacts neurobiology. (5)
- Increases mitochondrial function and biogenesis
- Reduces oxidative stress
- Impacts gut-brain axis via changes in gut microbiota
- Mediates reduction in neuroinflammation
- Widespread changes in gene expression
Suggest a mechanism by which the ketogenic diet may have an impact on neurobiology, such as gene changes, neuroinflammation, and mitochondrial function. (1)
Changes likely mediated by circulating miRNA and epigenetic molecules
The ketogenic diet is able to result in widespread changes in gene expression in the brain.
Give three general categories of genes (what brain function they are associated with) which are downregulated by a ketogenic diet. (3)
- Ion channels
- Neurotransmission
- Synapse structure
Suggest a general group of ion channel genes which may be downregulated in a ketogenic diet. (1)
Potassium channels
The ketogenic diet is able to result in widespread changes in gene expression in the brain.
Give three general categories of genes (what brain function they are associated with) which are upregulated by a ketogenic diet. (3)
- Ion channels
- Synapse structure
- Growth factor
Suggest a general group of ion channel genes which may be upregulated in a ketogenic diet. (1)
Calcium channels
Is the MAOA gene upregulated or downregulated in a ketogenic diet? (1)
Downregulated
Is the BDNF gene upregulated or downregulated in a ketogenic diet? (1)
Upregulated
Is gene expression of orexins upregulated or downregulated in a ketogenic diet? (1)
What role do the orexins play? (1)
- Downregulated
- Play a role in wakefulness
Fill the gaps relating to GLUT1 deficiency. (3)
GLUT1 deficiency results in low ………………. levels in the CSF, and a developmental delay featuring ………………….. and ……………………
glucose
movement disorders
a generalised intractable epilepsy
ketogenic diet is the standard treatment for GLUT1 deficiency.
What is GLUT1? (1)
What is the role of GLUT1? (1)
Glucose transporter
Expressed on erythrocytes and BBB endothelial cells, so facilitates glucose transport across the BBB
Describe how a ketogenic diet is able to successfully treat GLUT1 deficiency. (3)
It provides an alternative energy source to the brain
Ketones cross the BBB via the MCT1 transporter
So it ‘doesn’t matter’ that GLUT1 isn’t working
Describe the metabolic pathway which allows fat to be used as energy in the brain. (5)
Lipolysis of dietary or stored fat
forms free fatty acids
FFAs can be converted to beta-hydroxybutyrate in liver mitochondria and then cross BBB
Or can cross BBB first and then be converted to beta-hydroxybutyrate
Beta-hydroxybutyrate converted to Acetyl-CoA in neurones and used in TCA cycle
Give two general food groups that the Mediterranean diet is based around. (2)
- Plant-based foods
- Healthy fats
Give six key stapes of the Mediterranean diet. (6)
- Seafood
- Fruits and vegetables
- Wholegrains
- Nuts and legumes
- Good oils/fats (olive oils, avocado, nuts)
- Water as a drink (plus a little bit of wine)
Complete the sentence relating to diet and mental health. (1)
A Mediterranean diet, or even just a healthy diet, are associated with less …………………….. symptoms.
depressive
When looking at studies investigating the impact of Mediterranean and Healthy diet on development of depression, in which of the following ranges would you expect the odds ratios to be in, for development of depression with Healthy/Mediterranean diet? (1)
a) 0-1
b) 1-2
c) 2-3
d) 3-4
Describe what this means in words. (1)
0-1
Mediterranean or healthy diet decreases risk of developing depression
Give four anti-inflammatory molecules found in a healthy/Mediterranean diet which may be responsible for the decrease in depressive symptoms seen with these diets. (4)
- Omega3 polyunsaturated fatty acids
- Unsaturated fatty acids
- Polyphenols
- Dietary fibre
Omega3 polyunsaturated fatty acids have been suggested to be part of a Mediterranean/healthy diet that decreases inflammation and is good for health.
Give a food group which contains high levels of omega3 fatty acids. (1)
Seafood
Unsaturated fatty acids have been suggested to be part of a Mediterranean/healthy diet that decreases inflammation and is good for health.
Give a food group which contains high levels of unsaturated fatty acids. (1)
Olive oil
Polyphenols have been suggested to be part of a Mediterranean/healthy diet that decreases inflammation and is good for health.
Give three foods which contain high levels of polyphenols. (3)
- Cocoa
- Blueberries
- Curcumin/turmeric
Dietary fibre has been suggested to be part of a Mediterranean/healthy diet that decreases inflammation and is good for health.
Give two food groups which contain high levels of dietary fibre. (2)
- Vegetables
- Wholemeal products
Suggest a way that dietary fibre may act as an anti-inflammatory food and confer a health benefit. (1)
Can promote beneficial gut microorganisms
Give the two most abundant components/molecules of the brain. (2)
FIRST = water
SECOND = fat
Give two general roles of fat in the brain. (2)
- Formation of cell membranes
- Formation of myelin
Apart from forming cell membranes and myelin, give two other specific roles for omega 3 and omega 6 fatty acids in the body and brain. (2)
- Precursors for molecules regulating blood pressure
- Precursors for molecules regulating inflammation
Approximately 90% of dietary fats are in what form? (1)
a) monoglycerides
b) diglycerides
c) triglycerides
c) triglycerides
Describe the general structure of a triglyceride molecule. (2)
3 fatty acid molecules
Attached to a glycerol backbone
Describe what is meant when referring to the alpha and omega end of a fatty acid. (2)
Alpha end is acid end with COOH
Omega end is other end with just carbon bonds and no functional group
Briefly describe the general structure of an omega-3 fatty acid. (2)
Polyunsaturated fatty acid
with a double bond connecting the 3rd and 4th carbon from the omega end
Name the three main omega-3 fatty acids. (3)
- Alphalinoleic acid (ALA)
- Eicosapentaenoic acid (EPA)
- Docosahexaenoic acid (DHA)
Name an omega-6 fatty acid which must be obtained from the diet. (1)
Linoleic acid
Fill the gaps relating to omega-3 fatty acids. (4)
The body is ………………………(able/unable) to make alphalinoleic acid. Therefore it ………………………(must/must not) be obtained from the diet.
ALA can then be used to make small amounts of two other omega-3 fatty acids, called ……………………… and ………………………..
unable
must
eicosapentaenoic acid (EPA)
docosahexaenoic acid (DHA)
Docosahexaenoic acid (DHA), an omega-3 fatty acid, can be synthesised from alphalinoleic acid (ALA), another omega-3 fatty acid, in the body.
Despite this, a dietary source of DHA is still required. Describe why this is. (3)
- ALA must also be obtained from the diet
- And only a small amount can then be converted to DHA
- So relying on ALA to DHA conversion is not a reliable way of getting DHAs
Docosahexaenoic acid is a dietary component which is thought to confer a health benefit.
What type of molecule is docosahexaenoic acid? (1)
Omega-3 fatty acid
Docosahexaenoic acid is an omega-3 fatty acid. Small amounts can be made in the body, however most must come from the diet.
Most people do not get enough omega-3 in their diet - is it more beneficial to add in more omega-3-rich foods, or to take supplements? (1)
Adding in more omega-3-rich foods
Docosahexaenoic acid (DHA) is an omega-3 fatty acid which is thought to be beneficial to the body and brain.
Higher DHA blood levels are associated with a lower risk of developing which two neurological illnesses? (2)
- All-cause dementia
- Alzheimer’s disease
In older adults (>65yrs), eating one or more fatty fish meals per week reduces the risk of dementia and Alzheimer’s disease.
Why is this thought to be the case? (1)
Due to docosahexaenoic acid (DHA) in fatty fish
(DHA is an omega-3 fatty acid)
Describe two pieces of evidence that support the fact that docosahexaenoic acid and omega-3 fatty acids may protect against developing dementia and Alzheimer’s disease. (2)
- Omega-3 supplements can be beneficial in early stages of Alzheimer’s
- High dose docosahexaenoic acid (DHA) supplement could be beneficial for carriers of the APOE4 gene before onset (or potentially in early stages) of Alzheimer’s
Give a group of patients who may particularly benefit from a high-dose docosahexaenoic acid (DHA) supplement before onset or in early stage Alzheimer’s disease. (1)
Carriers of APOE4 gene
Fill the gaps relating to omega-3, docosahexaenoic acid (DHA), and dementia. (4)
The benefits of DHA on cognition may be due to its ability to control ………………………. via its downstream products.
Three examples of these downstream products are: …………………….., ………………………….., and ……………………..
neuroinflammation
D-series resolvins
maresins
protectins
It is thought that DHA may benefit the brain and reduce the risk of dementia via its downstream products. One of which is neuroprotectin D1.
Describe the general effects of neuroprotectin D1 in terms of the following domains. (4)
a) neuronal death
b) brain cell survival
c) ageing
d) neurodegenerative disease
a) prevents neuronal death
b) improves brain cell survival
c) improves repair in ageing
d) improves repair in neurodegenerative diseases
It is thought that DHA may benefit the brain and reduce the risk of Alzheimer’s and dementia via its downstream products. One of which is neuroprotectin D1.
Give four effects of neuroprotectin D1 related to Alzheimer’s disease. (4)
- Reduces amyloid beta 42
- Represses inflammation
- Represses oxidative stress
- Represses apoptosis
***Last three are all usually induced by amyloid beta 42 (so does DHA reduce these by reducing Ab42?)
Give three mechanisms which Neuroprotectin D1, a downstream product of docosahexaenoic acid (DHA), may use to reduce amyloid beta 42 and protect against Alzheimer’s disease. (3)
- Upregulation of PPAR-gamma
- Upregulation of amyloid precursor protein alpha
- Downregulation of beta amyloid precursor protein
What is PPARy? (1)
A ligand-activated transcription factor, which can induce changes in gene expression and act as an anti-inflammatory factor.
What is the NOVA food classification system? (1)
Food classification which groups foods (into 4 groups) according to how processed the foods are.
Describe group 1 of the NOVA food classification system. (1)
Unprocessed/minimally processed foods such as fruit/veg/milk/meat/nuts/eggs
Describe group 2 of the NOVA food classification system. (1)
Processed culinary ingredients such as olive oil/butter/sugar/salt/honey/vinegar
Describe group 3 of the NOVA food classification system. (1)
Processed foods such as ham/cheese/fresh bread/bacon/salted nuts/tinned fruit in syrup/tinned tuna
Describe group 4 of the NOVA food classification system. (1)
Ultra processed foods such as supermarket bread/ready meals/breakfast cereal/biscuits/cakes/crisps
What is an ‘ultra processed food’? (3)
An industrially formulated edible substance
generated from compounds extracted/derived/synthesised from food, food substrates, or organic compounds
and contain 5 or more ingredients which are rarely/never used in home kitchens (for example artificial food additives).
Ultra processed foods make up more than half of the total dietary energy consumed in high income countries.
Give three reasons why this is. (3)
- Cheaper
- More palatable
- Longer shelf-life
Meta-analyses have found that higher consumption of processed food increases risk of developing what two neurological conditions in the future? (2)
Anxiety
Depression