Obesity and Diabetes

Question 1

where is galactose found

Answer 1

bound to glucose as a disaccharide form lactose

Question 2

what is the most common constituent in glycolipids and glycoproteins

Answer 2

galactose

Question 3

where is galactose converted?

Answer 3

converted to glucose in liver (reversible process in lactation)

Question 4

where is fructose converted?

Answer 4

converted to glucose in liver and intestine

Question 5

does the transport and metabolism of fructose depend on insulin?

Answer 5

no, also only a few tissues can metabolize it (liver, intestine, kidney, adipose, muscle)

Question 6

because so few tissues can metabolize fructose where is the majority done?

Answer 6

liver

it usually ends up replacing liver glycogen or being used in the synthesis of triglycerides

Question 7

By what is the majority of ingested fructose passively absorbed?

Answer 7

GLUT5 transporters

Question 8

what is the rate limiting step of fructose metabolism in the liver?

Answer 8

Trick question there is not one. metabolic changes do not act as feedback inhibitors so excess metabolites like pyruvate enter other pathways like FA synthesis or cholesterol

Question 9

what are the therapeutic considerations?

Answer 9

avoid additional damage to liver.

recognize other risk factors

Question 10

what amount of fructose can cause GI distress

Answer 10

25 to 50g or more (pop could contain 22g or more)

Question 11

Where does Maltose occur and is found in body?

Answer 11

occurs naturally in very few foods, formed in body as an intermediate product to starch digestion. mainly commercial grains

Question 12

what are some examples of sugar alcohols?

Answer 12

sorbitol
manitol
xyitol
these are found in nature but as used in food processing (labelled sugar free but includes sugar alcohols)

Question 13

metabolism of sugar alcohols? Why are they better for diabetics?

Answer 13

poorly absorbed by intestine, and poorly metabolized.

metabolism does not require insulin.

Question 14

do sugar alcohols cause cavities?

Answer 14

no the bacteria in the mouth that initiate dental carries do not attack them

Question 15

what produces short chain fatty acids?

Answer 15

resistant starch that moves to colon undigested where microbial fermentation produces the SCFAs such as butyric acid (preferred source of energy for cells lining the colon)

Question 16

why does the FODMAP Diet recommend the avoidance oligosaccharides?

Answer 16

oligosaccharides are formed with bonds that cannot be broken down and remain undigested, ex: stachyose and raffinose in legumes and beans that colonic bacteria fed on and cause gas. So its really about avoiding excess gas production.

Question 17

why is the glycemic index important for blood sugar?

Answer 17

CHOs are digested and absorbed at different rates. Refined are broken down more quickly. less refined more slowly. rapid entry stresses beta cells of pancreas to secrete more insulin to move glucose into body tissues and lower blood sugar.

Question 18

why does potato and wheat (more amylopectin) have a higher GI than barely (more amylose)?

Answer 18

starch has 2 forms: amylose (straight chain) and amylopectin (branched chain).

Amylase attacks the molecule at the end of the chain so it breaks down amylose more slowly than amylopectin because it has more branches available to enzyme action.

Question 19

How does protein lower the GI of a meal?

Answer 19

stimulates the secretion of insulin and hastens removal of glucose from blood

Question 19

how does fat influence the GI of a meal?

Answer 19

it slows gastric emptying and interferes with digestive enzymes so that high fat meals like ice cream has a low GI.

Question 20

What is the RDA for CHOs and why?

Answer 20

130 g/day
this is enough toe supply the energy demands of CNS for 1 day

Question 21

what is the foundation intervention for T2D

Answer 21

nutrition

HbA1c reductions of 1-2% can be achieved with nutrition therapy

Question 22

what can weight loss of 5-10% improve

Answer 22

glycemic control, insulin sensitivity, reduce hypertension and dyslipidemia

Question 23

what is considered more important for people with T1D or those with T2 taking insulin?

Answer 23

meal timing

Question 24

what are the general recommendations for macronutrients

Answer 24

CHO - 45-60%
protein - 10-35%
fat - 20-35%

Question 25

what are the score for low high and medium GI foods?

Answer 25

low - 55 or less
medium - 56-60
high - 70 or more

Question 26

a low GI diet is like a high fibre diet. what type of fibre is evidence highest for?

Answer 26

viscous soluble fibers from different plant sources as they slow gastric emptying and deplay absorption of glucose in SI.

ex: beta-glucan fro oats and barely

Question 27

general recommendation for protein?

Answer 27

0.8g per kg body weight

Question 28

DASH diet and low sodium diets are good if patient is hypertensive. How low can sodium intake be?

Answer 28

no less than 1500mg per day - increase in mortality