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Pharmacotherapy 1 > Macronutrition > Flashcards

Macronutrition Flashcards

1
Q

What are excess carbs converted into?

A

glycogen

triacylglycerol

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2
Q

What are sources of simple carbs?

A

sugars
fruits, veg
milk

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3
Q

What is the formula for simple sugar molecules?

A

C6H12O6

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4
Q

What are the monomers in maltose?

A

glucose

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5
Q

What are the polysaccharides produced in animals?

A

glycogen

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6
Q

what are the polysaccharides produced in plants?

A

starch

fiber

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7
Q

What’s another name for glucose?

A

dextrose

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8
Q

What is the most important carb for the body?

A

glucose

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9
Q

Where is fructose found?

A

fruits, veg

more than half the sugar in honey

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10
Q

What effect does fructose consumption have?

A

does not have big rise in BG

increases blood lipids

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11
Q

What is sucrose?

A

common white table sugar

sugar cane, sugar beets, honey, and maple syrup

glucose + fructose

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12
Q

What is lactose?

A

milk sugar

glucose + galactose

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13
Q

What is maltose?

A

disacchardie in starch

glucose + glucose

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14
Q

What ar e the components of starch?

A

amylose

amylopectin

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15
Q

What is amylose?

A

linear chains of glucose molcules

alpha-1,4-glucosidic bonds

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16
Q

What is amylopectin?

A

branched chains of glucose molecules
branch points with alpha-1,6-glucosidic bonds
ratio of 1,4- to 1,6-glucosidic bonds is about 20:1

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17
Q

Describe the structure of glycogen.

A

like amylopectin, glycogen is branched.

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18
Q

What is responsible for the digestion of carbs?

A

alpha-amylose

enzymes on the luminal surface of small intestine

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19
Q

What carb unit is absorbed by the body?

A

monosaccharides

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20
Q

Describe the function of alpha-amylase.

A

Hydrolyzes starch and glycogen to maltose and maltotriose.

Exists in saliva and pancreatic juice.

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21
Q

What enzymes are on the surface of the small intestine?

A

maltaste
sucrase
lactase

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22
Q

What is the function of maltase?

A

aka alpha-glycosidase:

maltose and maltotriose –> glucose

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23
Q

What is the function of sucrase?

A

sucrose –> glucose and fructose

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24
Q

What is the function of lactase?

A

lactose –> glucose and galactose

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25
Q

What is the pathology of lactose intolerance?

A

not enough lactase is produced

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26
Q

How do bacteria contribute to carb digestion?

A

Bacterial enzymes converts indigestible carbs to monosaccharides. This are metabolized anaerobically by bacteria, resulting in the production of short-chain FAs, lactate, H2, CHR, and CO2.

May cause flatulence and abdominal discomfort.

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27
Q

What is raffinose?

A

oligosaccharide in leguminous seeds (beans and peas)

cannot be hydrolyzed by human enzymes (flatuence)

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28
Q

What is the glycemic index?

A

a measur eof how quickly individual foods will raise blood glucose level.

defined as the ratio of the area of the blood glucose response curve to that of glucose

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29
Q

What is an example of a food with a high glycemic index?

A

potato, white bread

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30
Q

What is an example of a good with a low glycemic index?

A

ice cream

kidney beans

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31
Q

What is the brain’s preferred energy source?

A

glucose!

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32
Q

What glucose transporters are not insulin -dependent?

A

GLUT3 in brain

GLUT2 in liver

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33
Q

Which glucose transporter is for muscle and adipose tissue?

A

GLUT4 (insulin -dep)

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34
Q

How to RBCs metabolize glucose?

A

no mitochondria so convert pyruvate to lactate

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35
Q

What are examples of dietary fibers?

A

cellulose and hemicellulose
lignin
pectin

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36
Q

Describe cellulose and hemicellulose.

A

insoluble dietary fiber.
incr stool bulk and decr intestinal transit time
found in unrefined cereals, bran, whole wheat

37
Q

Describe lignin.

A

insoluble dietary fiber.
binds cholesterol and carcinogens.
Found in the woody parts of veg

38
Q

Describe pectin.

A

Soluble dietary fiber.
Found in fruits.
Decreases rate of sugar uptake and decreases serum cholesterol.

39
Q

What are the functions if lipid in the diet?

A

energy: 9kcal/g
satiety
flavor and aroma
carrier for fat-soluble vitamins

40
Q

What is most dietary fat?

A

triacylgycerol (90%):

glycerol + three fatty acids

41
Q

Which types of lipids make up <10% of dietary fat?

A

phospholipids, cholesterol, cholesterol esters, fatty acids.

42
Q

Describe saturated FAs.

A

contain no double bond; higher melting temp.

associated with many health risks such as heart disease and stroke.

43
Q

Which are the most common saturated FAs found in foods?

A

palmitic acid and stearic acid

44
Q

Describe unsaturated FAs.

A

contain double bonds, lower melting temperature

45
Q

What are the most common unsaturated fatty acids found in foods

A

oleic (monounsat, 18:1) and linoleic (polyunsat, 18:2)

46
Q

What are the essential omega-3 FAs?

A 
alpha-linolenic acid (18:3) in veg oils
eicosapentaenoic acid (EPA) (20:5) and docosahexaenoic acid (DHA) (22:6) in fish oils
47
Q

What are the essential omega-6 FAs?

A 
linoleic acid (18:2) in corn oil
arachidonic acid (20:4) in meat and fish
48
Q

What are the functions of essential FAs?

A

used to synthesize eicosanoids in the body

49
Q

What does the ratio of omega-3 to omega-6 FAs in the diet regulate in the body?

A

blood pressure
blood clotting
immune function

50
Q

What is the prevalence of essential FA deficiency in US?

A

rare

need to be added to artificial infant formula

51
Q

How are trans fatty acids different from cis?

A

higher melting point
raise blood cholesterol levels and increase the risk of heart disease

produced as byproduct of hydrogenation (to produce margarine and shortening)

52
Q

How are fats digested?

A

solubilized
gastric and pancreatic lipases
esterase

53
Q

How are fats solubilized?

A

bile acids

54
Q

What is the function of gastric and pancreatic lipases?

A

Hydrolyze triacylglycerol to FAs and monoacylglycerol.

Produced FAs act as surfactants.

55
Q

What is the function of esterase?

A

hydrolyzes monoacylglycerol and cholesterol ester.

56
Q

How are lipids delivered to peripheral tissues?

A

directly by chylomicrons

57
Q

What uses fats as an energy source?

A

muscle

NOT the brain

58
Q

What is the fate of excess fat?

A

adipose tissue

59
Q

What does the liver do with FAs during starvation?

A

converts FAs to ketone bodies, whch are utilized as energy source by brain and muscle

60
Q

What are the functions of dietary proteins?

A 
structural component (20% of wt!)
enzymes, hormones, plasma proteins, antibodies
61
Q

What is excess protein used for?

A

energy source!
glucogenic amino acids are converted to glucose
ketogenic amino acids are converted to keto acids and FAs.

eventually these are converted to triacylglycerol in adipose tissue.

62
Q

What does a negative nitrogen balance indicate?

A

inadequate dietary intake of protein

trauma or illness

63
Q

What does a positive nitrogen balance indicate

A

net increase in body protein stores
growing children
pregnant women, or adults recovering from illness

64
Q

What does nitrogen balance describe?

A

balance between intake of protein in diet and excretion of urea and ammonia

65
Q

What are some examples of essential amino acids?

A

arginine
methionine
phenylalanine

(and many more)

66
Q

What is an example of a conditionally essential amino acid?

A

tyrosine if not enough phenylalanine

67
Q

How are proteins digested?

A

gastric
peptidases at luminal surface
intracellular peptidases

68
Q

Describe gastric digestion.

A

pH of gastric juice <2
denature proteins

pepsins–stable and active at acidic pH; aspartic protease

69
Q

Describe the action of peptidases at the luminal surface of intestine.

A

brush border is rich in peptidases

produce free amino acids and di- and tripeptides

70
Q

Describe the action of intracellular peptidases of intestinal cells.

A

amino acid and peptide transport systems.
IC hydrolysis of di- and tripeptides
practically only free amino acids are released into the blood.

71
Q

What happens to absorbed amino acids?

A

portal vein–> liver –> high Km enzymes miss most AAs –> tRNA-charging enzymes have lower Km values so AAs are used for protein synthesis or energy in other tissues

This means that AA are metab’d only when their conc is high

72
Q

What is Celiac sprue?

A

gluten intolerance

autoimmune disorder in genetically predisposed individuals

upon gluten exposure the intestinal lining becomes inflamed and damaged: diarrhea, weight loss, malnutrition.

73
Q

What are sources of gluten?

A

wheat, rye, barley

74
Q

What is the treatment for Celiac sprue?

A

life-long gluten-free diet

75
Q

What is the energy content of alcohol?

A

7 kcal/g

76
Q

What energy reserve do humans have?

A

adipose tissue
glycogen in liver (BG)
glycogen in muscle

NOT protein

77
Q

What occurs in the well-fed state?

A 
insulin release
glycolysis
glycogen synthesis
catabolism of AAs
FA synthesis
no gluconeogenesis (Cori cycle)
78
Q

What occurs in the early fasting state?

A

glucagon release
glycogen breakdown
gluconeogenesis –> cori and alanine cycles
no catabolism of AAs

79
Q

What is the Cori cycle?

A

aka glucose-lactose cycle

Glucose generated by gluconeogenesis in liver is used for glyclysis in peripheral tissue.

NADH generated by glycolysis is used to reduce pyruvate to lactate.

–> important when O2 low

RBCs rely on Cori cycle bc do not have mitochondria

80
Q

What occurs in the alanine cycle?

A

Like Cori cycle, glucose generated by gluconeogenesis in liver is used for glycolysis in a peripheral tissue.

NADH generated by glycolysis is used to produce ATP.

Amino nitrogen is transferred to liver and disposed of as urea.

81
Q

What occurs in the fasting state?

A

glucagon release
gluconeogenesis
protein is used as a carbon and nitrogen source (alanine, glutamine)
lipolysis in adipose tissue
FA oxidation
ketogenesis
reduced thyroid hormones –> basal energy req drops by 25%

82
Q

Below what concentration of glucose does coma and death result?

A

<1.5 mM

83
Q

What are consequences of hyperglycemia?

A

dehydration
hyperglycemic coma
complications of diabetes

84
Q

What are special aspects of energy requires of the brain?

A

needs a ton of glucose

maintains membrane potential through Na/K ATPase

No energy storage (no glycogen, no fat usage)

adapts to starvation using ketone bodies from acetyl-CoA in liver

85
Q

How is energy utilized during low level exertion?

A

FA oxidation

aerobic

86
Q

How is energy utilized during moderate to high actvity?

A

glycogen to glycolysis
switch over to FA oxidation
aerobic

87
Q

How is energy utilized during maximum exertion?

A 
phosphocreatine and glycogen
anaerobic
lactic acid production
very little inter-organ cooperation 
<1 min
88
Q

Describe Marasmus.

A

inadequate intake of both protein and energy

thin, wasted appearance

small for age

89
Q

Describe Kwashiokor

A

inadequate protein intake

usually in children 1-3 yoa

edema

Pharmacotherapy 1 (26 decks)

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