Exam 2 Flashcards
What is DM1
an autoimmune disorder that destroys the insulin producing beta cells in the pancreas
What two processes increase in DM1
- gluconeogenesis
2. Beta oxidation
3 potential symptoms of DM1
- polydipsia (thirst)
- weight loss
- DKA/Coma/Death
What is DM2
decreased sensitivity to insulin
pancreas may or may not make the normal amount of insulin
What are 4 risk factors for developing DM2
- obesity
- poor diet
- family hx/genetics
- inactivity
DM2 comprises what percent of all diabetic cases
95%
What controls pancreatic hormonal secretions
liver
What are the BG levels that signify NORMAL, PRE-DIABETIC, and DIABETIC during an 8 hour fasting glucose test
70-100 mg/dL —> NORMAL
100-124 mg/dL —-> PRE-DIABETIC
125+ mg/dL —-> DIABETIC
What are the BG levels that signify NORMAL, PRE-DIABETIC, and DIABETIC during an oral glucose test
70-140 mg/dL —> NORMAL
140-200 mg/dL —-> PRE-DIABETIC
>200 mg/dL —-> DIABETIC
What is the number one cause of adult blindness
DM2
Diabetes is responsible for what percent of non traumatic lower extremity amputations and what are the two possible reasons for this
60%
- excess glucose damages nerves causing neuropathy which can lead to numbness/tingling/pain
- excess glucose damages the ability of cells to heal leading to the inability of wounds to heal. Wounds easily can become infected leading to further complications.
Pre-diabetes
early stages on insulin resistance
Which leads to greater increased risk of other chronic conditions DM1 or DM2
DM2
Gestational diabetes
increased blood sugar during fetal development
Glycemic index
a value that provides insight into how quickly a food will raise the blood glucose level
resistance starches
starches that are not broken down by digestive enzymes and are not absorbed in the SI. Have low glycemic index for this reason.
Why do foods high in fructose have a low glycemic index
fructose needs to be converted to glucose and that takes time.
How many calories are in 1 gram of carbs
4 Calories
3 monosaccarides
- glucose
- galactose
- fructose
3 disaccharides are their composition
- Maltose —-> glucose + glucose
- Sucrose —> glucose + fructose
- Lactose —-> glucose + galactose
3 complex carbohydrates and what humans do with them
- Starch —> digestable by humans
- Fiber —-> undigestable by humans
- Glycogen —> glucose storage
2 examples of starch
- amylose
2. amylopectin
2 examples of fiber
- cellulose
2. hemicellulose
Endosperm
Contains starch and protein - inner part of the grain and what is left over after the refining process
Bran/cellulose
Outer coat of the grain
Germ
embryo of the grain
Discuss the 3 types of grains
- whole grain —> all parts of the grain
- Enriched grain —> some parts are added back in that were lost in the refining process
- Refined grain —> Bran and germ are absent
What do whole grains stamps signify
a product that will contain >/= 8 grams of whole grains per serving
What is the carb to fiber ratio of whole grain
10:1 or LESS
What is the carb to fiber ration of refined grain
20:1 or GREATER
4 enzymes involved in carb digestion
- Amylase (starch)
- Sucrase
- Maltase
- Lactase
Function and origin of amylase in the mouth
salivary glands
breaks starch into shorter polysaccarides
Function and origin of amylase in the SI
Pancreas
Breaks starch polypeptides into maltose + oligosaccharides and then eventually down to glucose monomers
Discuss why lactose intolerance arises, what effects it can have, and its treatment
Due to decreased lactase enzymes
Can lead to digestive issues
Treatment is to decrease dairy intake
What percent of our daily calories should be carbs
45-65%
Explain how dental carries occur
When excess sugar is consumed the bacteria in our mouth metabolize the sugar into acid which damages our teeth
Energy provided by Nutrutuve sweeteners
< 4 Kcal / gram
Energy provided by Nonnutritive sweetners and what do they contain
very little if any
aspartame - 200 x sweeter than sucrose
3 benefits of insoluble fiber
- soften stools
- decreased hemorrhoids / diverticular disease
- decrease diabetes
4 benefits of soluble fiber
- increased satiety (via slower stomach emptying)
- slows digestion and absorption
- slows BG spikes
- Reduces CAD
2 forms of fiber
- soluble —> broken down by bacteria
2. insoluble —> not broken down
2 sources of fiber
- dietary —> in food
2. functional –> added
4 functions of lipids
- energy
- cell membrane components
- increase absorption of fat soluble vitamins
- nutrient transport
How do lipids contribute to satiety
they slow gastric emptying of the stomach those prolonging the sensation of feeling full
Differentiate between saturated and unsaturated fat at room temp
saturated —–> solid
unsaturated —-> liquid
Give examples of foods high in polyunsaturated fat and monounsaturated fat
monounsaturated —-> olive oil
polyunsaturated —-> soy oil
2 functions of cholesterol
- maintain membrane fluidity
2. precursor for hormones, vitamin D, bile acid
Where does the majority of cholesterol we need come from
Our bodies - able to synthesize it
Fat digestion in the mouth
lingual lipase
Fat digestion in the stomach
gastric lipase
Fat digestion in the SI
- Bile (liver)
- pancreatic lipase (pancreas)
- phospholipase (pancreas)
- Cholesterol esterase (pancreas)
Briefly explain how bile works
Bile is an amphoteric compound so it will mix with fat molecules, break them down to smaller components, and allowing them to move freely in an aqueous environment and be broken down by lipase
Explain the process of triglyceride absorption in the SI
- Bile emulsifies fat
- pancreatic lipase digests triglycerides into 2 fatty acids an a monoglyceride
- fatty acids and monoglyceride are packed into a micelle
- micelle is absorbed by mucosal cells
- triglycerides are reformed from fatty acids and monglyceride
- triglycerides are packaged into a chylomicron
- Chylomicron enters lymph system
chylomicron
transports dietary fat and cholesterol from the small intestine to the muscle and adipose tissue
VLDL
transports mostly triglycerides (some cholesterol) to body cells
LDL
(BAD CHOLESTEROL)
Transports mostly cholesterol (some triglycerides) to body cells
HDL
(GOOD CHOLESTEROL)
Picks up cholesterol from body cells and transports it to the liver for use in synthesis
Receptor mediated pathway of cholesterol uptake
Normal process by which cholesterol via LDLs is taken up into’s cells. This process is supported by Low cholesterol/Saturated fat diet.
Scavenger pathway for cholesterol uptake
Process by which excess LDL’s Become oxidized via free radicals And will be damage such that they cannot be taken up into cells.Scavenger white blood cells will been Pick up these molecules.These Scavenger white blood cells can build up in the walls of arteries And cause inflammation and plaque buildup which can lead to disease.
Differentiate between omega-3 and omega-6 Fatty acids
Omega six fatty acids will produce omega 6 eicosanoids Which function to increase inflammation and increase Clotting.
Omega-3 fatty acids produce Omega three eicosanoids And function to decreased clotting and decrease inflammation.
4 roles that proteins have within the body
- enzymes
- transporter
- fluid balance
- antibodies
What protein digestion takes place in the stomach
- denaturation via HCl
2. Breakdown into smaller polypeptide via Pepsin
What protein digestion takes place in the small intestine
- Breakdown to smaller polypeptides via pancreatic protease
- Breakdown into tripeptides, dipeptides, and amino acids via brush border proteases
3 Fates of amino acids
- body proteins
- energy
- glucose/fat storage
How is a nitrogen balance study performed
measuring the amount of protein intake minus the amount of nitrogen excretion
what are the 3 sources in order of greatest output of nitrogen
- shit and pee
- bodily secretions
- hair skin nails
positive nitrogen balance and in what population is it typically seen
too much nitrogen intake
usually seen in the very active or those who do strenuous lifting
negative nitrogen balance and in what population is it typically seen
not enough nitrogen intake
seen in the elderly and those with skeletal muscle decay
Complete proteins
contain all amino acids
incomplete proteins
do not contain all amino acids
limiting amino acid
the amino acid that is deficient
Kwashikar disease
adqeuate calorie intake but inadequate protein intake
sudden onset
Edema, weight loss, stunted growth
Marasmus disease
deficient in both calorie and protein intake
gradual onset
severe weight loss, wasting appearance, death