Quiz 2 Flashcards
Most common substance in body after water:
protein, 1/2 dry weight of body
True or False? Proteins function in energy production.
T
% of body proteins broken down and regenerated daily:
3%
excess protein intake is used for this, and how:
energy, amino acid to glucose
negative nitrogen balance with:
infection, fever, surgery, stress, blood loss
When will the body use proteins for energy?
Wo sufficient amino acids
Positive protein balance is needed for:
growth, pregnancy, illness recovery, training, increased *secretions of insulin, GH, Testosterone
Negative protein balance:
fasting, intestinal tract disease, inadequate energy intake, fever, burns, infection, bed rest, amino acids deficiency, increased protein loss, increased *secretion of some hormones (Thyroid Hormone and Cortisol)
4 protein functions:
osmotic pressure (albumin), acid-base balance, immunity (antibodies, complement), energy
Fluid will build up in ____ if a person is starving:
tissues
of proteins used for protein synthesis:
22
of essential amino acids:
9
list the essential amino acids:
his, ill, leu, lys, met, phe, thr, trp, valine (HILL MTV PT) (went up HILL MET VAL to TRiP THRee PHEnylalanines)
True or False? We can not synthesize any of the essential amino acids.
F. Some we can synthesize, just not enough
2 ways to describe Quality and Quantity of Protein:
PER (protein efficiency ratio) OR BV (biological value)
What does PER stand for?
protein efficiency ratio, weight gain when eating only that food
What does BV stand for?
biological value
What determines the quality of a protein?
Composition and digestibility, nitrogen absorbed and retained (retained ÷ absorbed X 100)
These proteins tend have high BV while these tend to have low BV:
animal, plant
What is a complete protein?
proper amounts and proportions of essential aa, similar to body levels, high BV
complete protein is aka:
high-quality protein
True or False? Low-quality proteins can be synthesized to body protein.
F, deficient in some essential aa.
True or False? Nuts and beans provide all amino acids.
F. may be deficient in some
Why are complementary proteins needed?
amino acid utilization for protein synthesis
What happens to amino acids if the correct proportions are not present for protein synthesis?
used for energy
Can amino acids be stored in the body for later use?
no
Within what time frame do complementary proteins need to be eaten?
within a couple of hours of each other
Ideal protein food:
albumin
Example of two incomplete proteins:
grains and legumes
What do grains lack?
Lysine (and threonine)
What do legumes lack?
Methionine
Examples of legumes:
beans, peas, lentils
Examples of grains:
Corn, Oats, Wheat
Complementary proteins are one protein that lacks this was one protein that lacks this.
lysine, methionine
When does a person have to decrease protein intake?
End stage kidney disease/ dialysis
What food lacks tryptophan?
corn (corn lacks trp, thr, and lys)
What food lacks threonine?
grains (also lack lysine)
RDA for protein:
0.8 g per kg for adults
RDA for protein is higher in:
infants: 1.5 g/kg, 1 to 18 years: 1.1 to 0.85 g/kg, pregnant or lactating: additional 25 g/day
We consume about __ times the required amount of protein in the U.S.:
2
Protein excess can lead to problem with:
kidney or liver disease (diabetics want to conserve kidney function), dehydration
True or False? A low-protein diet is recommended.
T
Effects of insufficient protein:
metabolic changes, reduced immunity increasing risk of infection, disease, and death
PEM stands for:
protein-energy malnutrition
PEM is seen in:
non-industrialized countries, diet low in both calories and protein
What usually causes death in a person with marasmus?
infection
Marasmus:
diet low in both calories and proteins (PEM), little or no fat stores, little muscle mass and weakness, death from infection
“the disease that the first child gets when the new child comes:”
Kwashiorkor
2 forms of PEM:
Kwashiorkor and marasmus
A switch from this nutritive source to this nutritive source often precedes Kwashiorkor.
breast milk to grains and roots, adequate calories but not protein
Kwashiorkor is compounded by:
infection, swelling (legs and abdomen), poor growth, weakness, some subcutaneous fat
When might you see Kwashiorkor in the hospital environment?
IV glucose for days
There is maintenance of some subcutaneous tissue in this PEM:
Kwashiorkor
There is little subcutaneous fat tissue in this PEM:
marasmus
Which PEM looks sicker?
marasmus
What do plants provide besides protein?
complex carbohydrates, vitamin A, C, E, beta carotene, magnesium, fiber
Benefits of consuming plant protein over animal:
no cholesterol, low in saturated fat, economical
Do lacto-vegetarians drink milk?
yes
What do lacto-ovo-vegetarians eat?
dairy products, eggs, and plant foods
Deficiencies possible with vegetarianism:
calcium, vitamin D, riboflavin, vitamin B-12, iron, zinc
Things not very bioavailable in vegetables:
Calcium, iron, zinc, no B12
Most important dietary supplement that vegetarians should take:
Vitamin B12
Vitamin C helps with:
iron absorption
What do people get from milk consumption?
riboflavin, vitamin D, and calcium
Where in the diet can a person get riboflavin?
milk, leafy vegetables, grains, yeast, and legumes
Vitamin B-12 in diet:
animal foods
Where do we get iron in the diet?
Grains, legumes, and fruits (vitamin C helps absorb iron)
Where do we get zinc in the diet?
Grains, legumes
Functions of fat in body:
energy, insulation, protection, myelin (action potentials transmission), membranes, precursor substances
Fats are precursors for:
Prostoglandins, leukotrienes
Examples of visible fats:
oil, fat, butter, margarine
Examples of invisible fats:
meats, potato chips, milk, nuts, seeds
Type of fat in nuts:
Mono- or poly- unsaturated fats
Types of fats:
True (glycerides), saturated, mono-, or polyunsaturated
oleic acid, # of chains:
1
Saturated fat, effect on body:
raise cholesterol
Polyunsaturated fat, effect on body:
lower cholesterol
True or False? Monounsaturated fats raise cholesterol.
F. doesn’t affect cholesterol
Give an example of a saturated, monounsaturated, and 2 polyunsaturated fatty acids:
stearic acid, oleic acid, linoleic acid, and alpha-linolenic acid respectively
omega 9 is found in:
olive oil
What types of fatty acid is linoleic, essential or non-essential?
essential fatty acids
Examples of saturated fats:
‘-ric’ and ‘tic’: Stearic, Palmitic, Myristic, and Auric acid (C18-C12) (alphabetical backwards, AMPS backwards)
2 monounsaturated fats:
oleic and palmitoleic (C18:1 and C16:1)
3 Polyunsaturated fats:
linoleic (C18:2), linolenic (C18:3) and arachidonic acid (20:4)
arachidonic acid is involved in:
inflammation, 4 double bonds
Animal fats and tropical oils such as coconut and palm are high in:
saturated fats
Most vegetable oils are high in:
unsaturated fats
Lipids help in the absorption of:
fat soluble vitamins
True or False? Large chain fatty acids don’t effect cholesterol as much as small.
F. small don’t affect as much as large.
Butter:
66% saturated, 33% monoun-
Coconut oil:
92% sat
Olive oil:
¾ monounsaturated, omega-9
Functions of EFA:
bind cholesterol lowering blood cholesterol levels, strengthen membrane structure, increase clotting time
Why are Omega 3, flax seed, and fish oil beneficial?
longer chain fatty acids, polyunsaturated, lower cholesterol
arachidonic and linoleic acids are:
essential, polyun-
Effect of Omega 3 fatty acids on body:
lowers risk of heart attack
Arachidonic acid can be synthesized in the body from:
linoleic acid, another polyun-
Precursors of prostaglandins and leukotrienes:
EFA derivatives
EFA’s:
linoleic acid, alpha-linoleic acid, eicosapentaenoic acid, docosahexaenoic acid, EPA, and DHA in fish oils, ALA - seeds like flax
ALA (alpha-linolenic acid) found in:
flax seed oil
Fish oil:
EPA (eicosopentanoic acid) , DHA (docosahexanoic acid) (20 or 22 chain)
Can be made from linoleic acid, but not quickly:
fish oil, contains arachidonic acid, EPA and DHA
True or False? Cholesterol is found in plant foods in very low amounts.
F. not found in plants
Ideal intake of cholesterol per day:
100-300 mg
Fats that raise serum cholesterol:
saturated
Fats that lower serum cholesterol:
polyunsaturated
Recommended daily intake of cholesterol:
There is none
Foods with highest levels of cholesterol:
egg yolks (highest), chicken, beef, lamb, pork
Hypercholesterolemia:
up to 300 at early age, prescribe statin drug to prevent heart attack
True or False? Our body makes all the cholesterol we need.
T
True or False? There is a genetic component to cholesterol levels.
T
Bonds in naturally occurring unsaturated fatty acids:
cis double
Hydrogenated vegetable oils have what type of bonds?
trans double
Hydrogenated vegetable oils are present in:
margarine and shortening
____ bonds are straighter.
trans, part of bilayer of cells
Trans and hydrogenated fats are metabolized like:
saturated fatty acids
Effect of trans fatty acids on body:
raise cholesterol
True or False? Trans fatty acids have EFA activity.
F
Trans fatty acids hidden as:
monounsaturated fats (?, but broken down as if they were saturated?)
Trans fatty acids cause an elevation of:
Blood lipids
Effect of trans fatty acids on cellular membrane:
property changes
Hydrogenated oil has this type of fat:
trans fat
How are trans fatty acids are generated?
harden the fat
How to reduce breakdown of oils?
hydrogenation, reducing number of double bonds, less rancid
True or False? Double bonds in polyunsaturated fats are oxidized more readily than monounsaturated or saturated fats.
T
This reduces oxidation of hydrogenated fats:
Vitamin E in plant oils, antioxidant
What can cause the bad smell of canola, saflower, corn oil?
oxidation, being broken down
Which has a longer shelf life, hydrogenated or polyunsaturated?
Hydrogentated
Health benefit of fish oils, EPD, DHA, omega 3:
reduce heart disease risk, reduce PDD, reduce sclerosis
Which end is numbered starting at 1 for fatty acids?
carboxyl end
Where is the double bond in omega 3 fatty acids?
double bond 3 carbons from the carboxyl carbon
Where are EPA and DHA found?
in fish oil
Omega-3 Fatty Acids are synthesized from:
linoleic acid, process is slow
Omega-3 Fatty Acids have an effect upon:
vascular function, inflammation, and immunity, increased blood clotting time, reduced inflammation of asthma and psoriasis
Who is at much lower risk of a heart attack compared to people in Denmark?
Eskimos (Greenland), 40% of calories from fish oils, only 10% the risk
Rats on fish oil showed lower levels of these (2) when infected with Porphyromonas gingivalis:
pro-inflammatory cytokines and alveolar bone loss
What is the RDA for fats?
none
current US diet has ~ of __ % calories from fat.
35%
recommended % reductions for calories, saturated fats, mono-fats, and poly-fats:
a reduction to 25-30% of calories, 10% of each: saturated, mono-, poly
about ___% of total calories from vegetable oils will provide sufficient EFA
4, 100 cal in a 2,500 cal diet
Olestra (Olean):
a sucrose polyester, fatty acids + sucrose via ester linkages, not digested by humans or intestinal bacteria, provides no energy, may prevent absorption of fat soluble vitamins
Effect of scurvy:
petechiae/ecchymoses/diffuse tissue bleeding, hemorrhagic disease, muscle weakness, lethargy, painful, swollen joints, fractures, poor wound healing, gingivitis, loss of PDL integrity
Define petechiae:
small red or purple spot caused by bleeding into the skin
When was scurvy a major problem?
Civil War
What 2 early treatments for scurvy worked?
oranges and lemons AND cider
True or False? Vitamin C is found in all living tissues.
T
One form of Vitamin C:
ascorbic acid
What is Vitamin C synthesized from in most animal species?
glucose
Animals that do not make vitamin C:
humans, monkeys, guinea pigs, some birds, fish, and bats
Why can’t humans synthesis Vitamin C?
no oxidase to convert glucose to L-ascorbic acid
Most animals make Vitamin C by converting:
glucose to L-ascorbic acid
True or False? Vitamin C is an oxidizing agent.
F. reducing
Major functions of Vitamin C:
hydroxylation (proline and lysine in collagen), phagocytosis (microbial), and detoxification
Effect of scurvy:
slow wound healing, lack of hydroxylation of proline and lysine in collagen
Vitamin C plays a role in absorption of:
iron, maintain the Fe+2 oxidation state
Vitamin C is involved in the production of:
thyroxine, epinephrine, serotonin, bile acids, and steroid hormones
Mechanism of vitamin C as an antioxidant:
limit nitrosamine production, prevent destruction of vitamin A and folate, reduce cataract formation, scavenger of free radicals
Body pools of vitamin C, __ g:
1–2 g
Plasma levels of vitamin C:
are about 1 mg/100 ml
RBC contain about ____ the Vitamin C levels than of plasma.
twice, 2 mg/100 ml
How much Vitamin C do leukocytes contain?
20–40 mg/100 ml
RDA for Vitamin C:
90 mg/day for males, 75 mg/day for females, 85 mg/day during pregnancy, 120 mg/day during lactation, smokers - 35 mg additional vitamin C, 10-15 mg/day will prevent scurvy
How long will it take for signs of scurvy to develop?
~ 1–3 months
Who is most likely to develop a deficiency of Vitamin C in the U.S.
alcoholics, nutrient-poor diets
Sources of Vitamin C:
fruits and vegetables, destroyed in cooking
2 vitamins most easily destroyed with heating:
vitamin C and folic acid
Vitamin C toxicity can occur at these doses:
probably > 1-2 g/day (total body store levels on a daily basis)
When is rebound scurvy seen?
babies, excess vitamin C during pregnancy
False reactions for Vitamin C toxicity can be seen with:
glucose testing
symptom of Vitamin C toxicity:
upset stomach, kidney stones, tooth erosion (chewable), sickling of red cells in people with sickle cell anemia
B Complex Vitamins required for?
metabolic processes, coenzymes
When are B complex vitamins functional?
when combined with apoenzyme
What happens to excess B Complex vitamin?
float in blood or cell
True or False? B Complex Vitamins contribute to body structure
F. contribute to the formation of body structure
True or False? Vitamins supply energy.
F
What vitamins are carbohydrates rich in?
B
Fruits and vegetables are rich in:
Vitamin B and C
Corn and sunflower oil are rich in:
Vit E
Where are most B vitamins found in white rice?
outer coating, bran layer
True or False? All vitamins are amines.
F
True or False? Vitamin B is a group of vitamins
T
What is Beriberi?
is a disease caused by a vitamin B1 (thiamine) deficiency
Amounts of vitamins needed to be ingested:
in mg and ug amounts
Where do we get essential vitamins?
diet or provitamin
Treatment for thiamin deficiency disease (beriberi):
substance in rice polishings
All B complex vitamins:
water soluble, promote bacterial growth
Functions of B complex vitamins:
Energy production from carbohydrates and fats (B1,B2, niacin, pantothenic acid, biotin), formation of red blood cells (folic acid, B12), protein and amino acid metabolism (B6)
True or False? All B vitamins can be supplied with plant foods.
F. not B12
Thiamin deficiency (B1, beriberi) effects:
cardiovascular, muscular, and nervous system
Oral symptoms of beriberi:
burning tongue, loss of taste
Addition of what to the diet could prevent beriberi?
milk and meat
B1 present in:
the bran of brown rice
Thiamin is involved in:
ribose production, metabolism of fats, carbohydrates and proteins
Thiamin is destroyed by heating in ___ solution, and heat stable in ____ solution
neutral or basic, acidic
RDA for B1 for adults:
~1.1 mg/day f; 1.2 mg/day m
True or False? The body has B1 stores.
T, minimal
dietary sources of B1:
cereals, meats, legumes, sunflower seeds
major deficiency of B1 is frequently seen in:
alcoholics, poor absorption and utilization, thiamin injections in the E.R.
Why are alcoholics more prone to thiamin deficiency?
poor absorption and utilization of B1
Function of Riboflavin (B2):
works with other B vitamins to provide energy, electron transport functions
True or False? Riboflavin is heat and oxygen stable, light sensitive.
T
B2 is aka:
riboflavin
Riboflavin deficiency is usually seen with:
other B complex deficiencies
What is the riboflavin deficiency disease?
no specific disease
Symptoms of B2 deficiency:
gloss-, stoma-, and dermatitis
Angular chelitis can result from a deficiency in:
B vitamins
RDA for B2 (riboflavin) for adults:
- 1 mg/day females
1. 3 mg/day males
dietary sources of B2:
milk, organ meats, whole grain and enriched cereals.
milk is high in _____ compared to the other B complex vitamins in milk.
riboflavin
Good source of riboflavin:
milk
Niacin is chemically related to:
nicotine
Niacin is a __ derivative.
nicotinamide
Niacin can be synthesized from:
tryptophan (60 mg Trp yields 1 mg niacin)
Niacin is present in:
NAD and NADP
What is niacin used in?
most cellular metabolic processes
Function of niacin:
energy production, works with other B vitamins
Niacin is aka:
Vit B3
True or False? Tryptophan is essential amino acids.
T. can make, but need more
Niacin deficiency disease:
pellagra
Niacin deficiency disease is seen in:
high corn (low Trp)
Niacin is present here, but not biologically available without treatment with alkali
in corn
Symptoms of Niacin deficiency disease:
4 D’s: dermatitis, diarrhea, depression, and death (stomatits, glossitis)
Oral manifestations of niacin deficiency:
stomatitis, glossitis, sore mouth, inflamed tongue
How can the Trp in corn be made bioavailable?
Alkali treatment, lime stone
RDA adults for niacin:
~15 mg/day; 14 mg w, 16 mg m
dietary sources of niacin:
mushrooms, meat, liver, yeast, legumes, whole grains
Niacin toxicity:
temporary tingling and flushing of the skin – high doses treat elevated cholesterol levels
You need more of this B Vitamin:
niacin, B3
High doses of niacin can be used to treat:
high cholesterol, side effect: histamine release, flushing/ tingling of skin 200 – to couple 1,000 mgs
Pantothenic acid is associated with:
coenzyme A, fa metabolism
True or False? Pantothenic acid is very heat stable.
F. poor heat stability
Symptoms of pantothenic acid deficiency state (uncommon):
tired, headaches, nausea
True or False? There is a wide distribution of pantothenic acid in foods.
T
AI for pantothenic acid:
~ 5 mg
What is the RDA for panthoenic acid?
none, AI of 5 mg
Biotin plays a role in:
synthesis of fat, glycogen and amino acids
Biotin deficiency symptoms:
hair loss, dermatitis
AI for biotin:
30ug, very small amount
Dietary sources of biotin:
milk, egg yolk, yeast, liver
True or False? Biotin is synthesized by intestinal bacteria.
T
True or False? We may excrete more biotin than we consume.
T, because biotin is synthesized by intestinal bacteria.
RDA for biotin:
none, adequate intake = 30 micrograms, 1 mg a month
Biotin can be bound by:
avidin, raw egg white
Frequency of biotin deficiency in infants
~1 in 10,000 infants
Treatment for biotin deficiency:
~ 100 x AI
Examples of Vitamin B6:
pyridoxINE, pyridoxAMINE, and pyridoxAL
True or False? Pyridoxine, pyridoxamine, and pyridoxal occur naturally in food and have the same biological activity.
T
Biological activity of pyridoxine, pyridoxamine, and pyridoxal (B6 Vitamins):
conversion of Trp to niacin, glycogen to glucose, metabolism of fatty acids, synthesis of hemoglobin, protein, and neurotransmitter
True or False? Vit B6 deficiency is common.
F. rare
RDA for Vitamin B6:
1.3 mg
dietary sources of Vitamin B6:
meats, yeast, legumes, whole grains, B6 is lost in grain milling
Vitamin B6 toxicity can lead to:
irreversible nerve damage, intake of ~2 grams for 2 - 40 months
B6 is lost from grain in this step of the processing:
milling
What vitamin deficiency can result in irreversible nerve damage?
Vitamin B6
2 major vitamins associated with red blood cell formation:
folic acid and B12, both stored in liver
Folic acid is essential for:
production of mature blood cells
Folic acid is aka:
Folacin, tetrahydrofolic acid
Folic acid prevents:
macrocytic anemia
Folic acid acts as a coenzyme in:
the production of purines and pyrimidines
Where is folic acid stored in the body?
stored in the liver (~10 mg)
True or False? Most B vitamins are not stored in the body
T
This is the most common vitamin deficiency in the USA:
folic acid
This was effective in treatment of microcytic anemia:
factor present in green leaves (foliage)
Macrocytic anemia is seen with:
both folic acid and B12 deficiency
True or False? folic acid deficiency leads to neurologic symptoms.
F. no neurological symptoms
Excess intake of folic acid leads to:
resolution of microcytic anemia, mask pernicious anemia, worsening of the neurological features
Where is folic acid found?
Foliage, green plants
Pernicious anemia:
not enough B12 (macrocytic: folic acid and B12 deficiency)
Prescription product women should take if they think they may be pregnant:
folic acid
How are red blood cells effected by a folate or vitamin b deficiency?
unable to divide
Folate and Vit B12 is required for:
cellular division, otherwise you will get macrocytic anemia
Greater than ___ mg is prescription strength folic acid
0.4
RDA __-mg/day m; f for folic acid; __ mg in pregnant women
0.4, 0.6
Dietary sources of folacin (folic acid)
liver, yeast, green leafy vegetables, nuts, orange juice
What were reduced in babies born to women taking 4 mg of folic acid daily during pregnancy
Neural tube defects (autism?)
Prescriptions strength folic acid:
> 0.1 mg for infants, >0.4 mg for adults
What is spina bifida?
large increase in volume of spinal fluid, protrudes through vertebrae
Low levels of folic acid are linked to:
higher risk of fatal coronary heart disease and stroke
Patients with high levels of homocysteine show a higher risk of:
coronary heart disease, stroke and peripheral vascular disease
Folic acid may help reduce levels of:
homocysteine. This is good. high levels of folic acid and low levels of homocysteine are better for heart health
How are homocystein levels measured?
Blood serum levels
Vitamin B12:
Cyanocobalamin, a cobalt ion, involved in the synthesis of purines and pyrimidines, folate metabolism, maintenance of myelin
Only source of cobalt in body:
cyanocobalamin
What is pernicious anemia?
macrocytic anemia with neurological symptoms
weakness and numbness in the extremities
inadequate absorption, not inadequate intake
early treatment for pernicious anemia:
raw liver (~1 lb/day) and gastric juice
Vitamin B12 requires this for absorption:
intrinsic factor (parietal cells of the stomach)
What is done if a patient has no intrinsic factor?
treatment is by injection of B12
oral symptom of Vitamin B12 deficiency
atrophic glossitis with some loss of papilla
How were B12 injections originally prepared?
preparation of 20 mg of B12 from 1 ton of liver
Anemia with neurological symptoms:
Vitamin B12 deficiency
Intrinsic factor is made by:
parietal cells
What do we need to absorb B12?
Intrinsic factor
TF Plants are high in VB12.
F. not found in plants
RDA of Vitamin B12:
RDA - adults 2.4 ug (0.0024 mg) /day
Where is Vitamin B12 soared in the body?
liver, may contain stores for 2–5 years
dietary sources of Vitamin B12:
found in animals
This is the richest source of B12
liver, (0.06 oz of liver for RDA, ~ 3 calories)
True or False? Vitamin B12 is made by bacteria.
T
Corn lacks these amino acids:
trp, thr, and lys
True or False? Protein excess can lead to dehydration.
T
