nutrition

Question 1

what is the most metabolically active tissue (highest O2 consumption per gram of tissue per minute)? which two tissues comprises 25% of BMR?

Answer 1

heart,

liver & skeletal muscle

Question 2

what are the essential macronutrients?

Answer 2

carbohydrates (4kcal/g), fat (9kcal/g), protein (4kcal/g)

Question 3

components of energy expenditure

Answer 3

BMR- 60-70%
dietary thermogenesis- 10%
physical activity- 20-30%

Question 4

what is something that doesn’t affect metabolic rate? what is something that increases it? decreases it?

Answer 4

• weight doesn’t affect it
• increased by hyperthyroidism, burns/sepsis injuries
• decreased by hypothyroidism, anorexia, starvation

Question 5

T/F you can increase you metabolism by changing your diet?

Answer 5

FALSE

Question 6

T/F you can change your metabolism by increasing your fat-free mass

Answer 6

True

Question 7

in a semi-starvation state, you decrease BMR how?

Answer 7

1) 1/3 decreased body size
2) 2/3 down regulation in metabolism w/ calorie restriction (down regulation in metabolic rate not just because you’re losing fat-free mass (muscle))

Question 8

T/F A person’s metabolic rate decreases during caloric restriction, inhibiting the rate of weight loss

Answer 8

True

Question 9

what is used during early fasting?

Answer 9

• amino acids & glycerol for gluconeogenesis

- fatty acids for gng + ketone generation + directly by kidney/heart/muscle

Question 10

what is used during 5/6 weeks of semi-starvation?

Answer 10

• protein stores are conserved, brain uses ketone bodies, RBCs use glucose, kidneys/heart/muscle use FAs

Question 11

chronic, mild PEM (protein-energy malnutrition) can lead to

Answer 11

stunting - linear growth failure

Question 12

acute, mild PEM can lead to

Answer 12

underweight- weight-for-age

Question 13

acute, severe PEM can lead to

Answer 13

wasting- weight for height

Question 14

two types of wasting

Answer 14

Marasmus- loss of fat + muscle, old man face

Kawashiorkor- Marasmus + edema, changes in skin/hair color, fatty liver, poor renal function

Question 15

95% of lipids consumed by humans

Answer 15

triglycerides

Question 16

SFAs- structure, consistency at room temp, CVD risk factors

Answer 16

• no double bonds
• solid at room temp
• associated with hypercholesterolemia

Question 17

MUFAs- structure, CVD risk factors

Answer 17

• one double bond at n-9

- not associated with hypercholesterolemia or decreased HDL

Question 18

PUFAs- structure, consistency at room temp, CVD risk factors

Answer 18

• multiple double bonds
• liquid at room temp
• low serum LDL but low serum HDL

Question 19

EFA deficiency

Answer 19

dry, scaly skin

Question 20

what is an example of an omega 3 fatty acid?

Answer 20

alpha linolenic acid (3 double bonds)

Question 21

what is an example of an omega 6 fatty acid?

Answer 21

linolic acid (2 double bonds)

Question 22

what are trans fats?

Answer 22

human processing turns liquid oils into solid fats; associated with increased LDL, CHD, atheroscleosis

Question 23

what are the two types of fiber? which one lowers cholesterol?

Answer 23

soluble- legumes/fruits/nuts- lowers cholesterol

insoluble- whole grains/brans/veggies- good for bowl health

Question 24

3 ways soluble fiber lowers cholesterol

Answer 24

1) sequesters bile acids
2) slows carb absorption, decreases the rate of insulin rise
3) stimulates production of short-chain fatty acids which inhibit cholesterol synthesis

Question 25

what are the fat soluble vitamins? where are they stored?

Answer 25

ADEK | adipose tissue, liver, D is in dermis/epidermis

Question 26

what are the water soluble vitamins? what is their primary function?

Answer 26

``` B's and C thiamin- B1 niacin- B3 folic acid- B9 B12 - primarily function as co-enzymes ```

Question 27

what is another name for vitamin A?

Answer 27

retinol

Question 28

another name for vitamin D?

Answer 28

cholecalciferol

Question 29

another name for vitamin E?

Answer 29

tocopherol

Question 30

another name for vitamin K?

Answer 30

phylloquinone

Question 31

what are the two most important forms of vitamin A and their functions?

Answer 31

retinaldehyde (vision) & retinoic acid (cell growth & differentiation via gene expression)

Question 32

what is a vegetable source retinal (retinaldehyde) can come from?

Answer 32

beta-carotene

Question 33

what does a deficiency in vitamin a cause? key sign of excess vitamin A?

Answer 33

deficiency- night blindness, immune dysfunction, poor growth, alopecia excess- red gingiva/vomiting/nausea

Question 34

what is the main role of vitamin D?

Answer 34

to maintain serum Ca2+ and phosphorus levels

Question 35

what disease does a deficiency in vit d result in? is it rich or poor in breast milk?

Answer 35

rickets; poor in breast milk

Question 36

what is the main role of vitamin E?

Answer 36

protects cell membranes from oxidative stress

Question 37

how does vitamin D maintain plasma Ca2+ levels?

Answer 37

1. increased intestinal absorption 2. increased renal absorption 3. increased bone resorption

Question 38

3 mechanisms vit E uses to protect cell membranes from oxidative stress?

Answer 38

- peroxide scavenger for cell membrane PUFAs and lipoproteins - breaks chain rxn of oxidation - regenerated to reduced form by vit c

Question 39

what is the main role of vitamin k?

Answer 39

co-factor for proteins that coagulate, including gamma-glutamate and pro-thrombin, carboxylases

Question 40

what disease is seen in relation to low vitamin k?

Answer 40

hemorrhagic disease in newborns

Question 41

which vitamin do you suspect to be deficient in alcoholism?

Answer 41

thiamin- need for PDH

Question 42

what diseases do you see with thiamin deficiency?

Answer 42

beriberi- dry and wet | peripheral neuropathy, wrist and ankle drop + edema, cardiomegaly, tachycardia

Question 43

For which disease would you administer thiamine prior to glucose?

Answer 43

Wenicke's encephalopathy- if you don't have thiamine, get build up of pyruvate & possible death

Question 44

vitamin B1 name

Answer 44

thiamin

Question 45

vitamin B2 name

Answer 45

riboflavin

Question 46

vitamin B3 name

Answer 46

niacin

Question 47

vitamin b9 name

Answer 47

folic acid/folate

Question 48

vitamin b12 name

Answer 48

cobalamin

Question 49

what enzymatic reactions is riboflavin important for?

Answer 49

succinate dehydrogenase and acyl coa dehydrogenases (FADs)

Question 50

what can niacin be synthesized from?

Answer 50

60 tryptophan

Question 51

what does a deficiency in niacin lead to?

Answer 51

pellagra (photosensitive dermatitis) + 4 d's | dematitis, diarrhea, demetia, death

Question 52

what are the 2 important enzymes associated with folic acid?

Answer 52

thymidylate synthetase, methionine synthase

Question 53

which two b vitamins are closely related?

Answer 53

folate and cobalamin (9&12)

Question 54

what are some common symptoms of B9/B12 deficiency?

Answer 54

megoblastic anemia, hyperhomocystemiemia

Question 55

what is vitamin c important for?

Answer 55

co-enzyme for collagen hydroxylation (proline lysine)

Question 56

what are some common symptoms of vitamin c deficiency?

Answer 56

pinpoint hemorrages, impaired would healing, teeth falling out, scurvy

Question 57

high estrogen increases/decreases Ca2+ absorption

Answer 57

increases

Question 58

explain refeeding syndrome

Answer 58

give malnorished individiuals glucose & saline expands ECF take up lots of Na+ and carbs get rapid glycogen synthesis - uses up all of the phosphorus causes cardiac arrhythmias

Question 59

with an iron deficiency what do you see?

Answer 59

increase in transferrin (transporter) | decrease in ferritin (intracellular storage)

Question 60

what are some common symptoms of zinc deficiency?

Answer 60

delayed sexual maturation, hypogonadism, hypospermia