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CNS Exam > W12 Detoxification & Fatty Acid Metabolism > Flashcards

W12 Detoxification & Fatty Acid Metabolism Flashcards

1
Q 
What are the main detox organs?
A. Gut
B. Liver
C. Skin
D. Kidney
E. Lungs
F. A-C
G. All of the above
A

G. All of the above

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2
Q

One of the most common concerns with improper detox in the gut is?
A. Diarrhea
B. Constipation
C. A & B

A

B. Constipation

Leads to recirculation of biotransformed toxins

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3
Q 
What are some of the top herbs that help with gut motility and constipation for proper detoxification?
A. Aloe Vera
B. Psyllium
C. Magnesium
D. All of the Above
A

D. All of the above

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4
Q

Which herb stimulates and promotes proper liver detoxification?
A. Lemon Balm
B. Fenugreek
C. Milk Thistle

A

C. Milk Thistle

Supports the hepatic system

Supports the health of liver cell
membranes

Facilitates the elimination of
toxins in the body

Acts as a powerful antioxidant

Reduces free radical production,
lipid peroxidation, inflammation
and fibrogenesis

Promotes glutathione production

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5
Q 
\_\_\_\_\_\_\_\_\_\_\_\_ is a precursor to cysteine, and a component of glutathione
synthesis that is often rate limiting.
A. Selenium
B. Vitamin E
C. NAC
A

C. NAC

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6
Q

High dietary intake of _________ and _________ result in a reduced
dietary net acid load (and improved alkalinization) and indirectly
improves detoxification processes in the kidney.
A. Vegetables, fruits
B. Vegetables, omega-3 sources
C. Protein, fiber

A

A. Vegetables, fruits

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7
Q

What factors play a role in proper detoxification via the lungs?
A. Deep breathing
B. Fumes of products
C. Essential oils
D. Exercise in good quality air
E. Acknowledge grief, Importance of tears
F. All of the above

A

F. All of the above

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8
Q 
Some of the best ways to support and ensure proper production of glutathione include:
A. Green tea
B. Proteins
C. Omega-3 Fatty Acids
D. Phytonutrients
E. Brassica Vegetables
F. Fruit and vegetable juices
G. C-E
H. All of the above
A

H. All of the above

Green tea and green tea extract significantly increases plasma antioxidant capacity and whole blood glutathione.

Impaired protein digestion may also be a limiting factor in ensuring healthy
glutathione levels. A lack of or reduced hydrochloric acid production in the gastric mucosa and/or pancreatic enzyme insufficiency would be important to assess in a patient with low plasma albumin and low glutathione levels and/or symptoms of impaired glutathione activity. Since the precursors and foundation of glutathione are amino acids, intake of dietary protein may influence the amino acid pool from which to draw to synthesize glutathione.

Due to their involvement in the production of inflammatory and anti-inflammatory prostaglandins, omega-3 fatty acids have been studied for their effects on glutathione levels.

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9
Q 
Foods rich in glutathione, NAC, or cysteine consist of?
A. Asparagus
B. Avocado
C. Grapefruit
D. Cucumber
E. Banana
F. A, C, D
G. All of the above
A

G. All of the above

Each either contains all 3 (glutathione, NAC, and cysteine) or at least one element for antioxidant support.

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10
Q

What vitamin and minerals support proper detoxification?
A. Selenium, ALA, B Vitamins, Vitamin E, Vitamin C
B. Selenium, ALA, copper, zinc, Vitamin E
C. Vitamin E, Vitamin C, ALA

A

A. Selenium, ALA, B Vitamins, Vitamin E, Vitamin C

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11
Q

True or False. Effective excretion through the stool and urine is a focus for detoxification by utilizing high fiber foods and adequate fluid intake.

A

True.

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12
Q

One of the best plant sources of protein and fiber to aid in proper detoxification is?
A. Legumes
B. Protein powder
C. Hemp seeds

A

A. Legumes

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13
Q 
Which antioxidant nutrients and phytonutrients below protect against overproduction of phase I metabolites?
A. CoQ10
B. Carotenes 
C. Zinc
D. Riboflavin
E. A-C
F. All of the above
A

E. A-C

CoQ10, carotenes (vitamin A), zinc, among many more.

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14
Q

Which sex hormone goes through detoxification in the liver?
A. Testosterone
B. Estrogen
C. Progesterone

A

B. Estrogen

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15
Q

Which fatty acids are considered essential?

a. α-linolenic acid (ALA) - ω-3
b. linoleic acid (LA) - ω-6
c. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) - ω-3
d. a & b
e. a-c

A

d. a & b - α-linolenic acid (ALA) - ω-3 and linoleic acid (LA) - ω-6

Only one substance in each of the ω-3 (ALA) and ω-6 (LA) families is truly essential, because, for example, the body can convert one ω-3 to another ω-3, but cannot create an ω-3 from scratch. These two fatty acids cannot be synthesized by humans (so are “essential” to get from the diet) because humans lack the desaturase enzymes required for their production. ALA and LA form the starting point for the creation of longer and more desaturated fatty acids, which are also referred to as long-chain polyunsaturated fatty acids (PUFAs):

  • – ω-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
  • – ω-6 fatty acids: γ-Linolenic acid (GLA), Dihomo-γ-linolenic acid (DGLA), arachidonic acid (AA)
LinoLENic =  ω-3
LinoLEic = ω-6

(Mahan & Raymond, p. 930)

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16
Q

In many people, the ability to convert the ω-3 α-linolenic acid (ALA) to the ω-3 eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) is only ____ efficient.

a. 5%
b. 10%
c. 15%
d. 20%

A

a. 5%

AKA - this conversion is very inefficient in most people, which is why it’s important to incorporate the EPA and DHA directly into the diet as fish or a fish oil supplement (vs. flaxseed oil, which is rich in ALA, but poor conversion makes it not as useful)

(Mahan & Raymond, p. 930)

17
Q

Match the definition - Molecules synthesized from essential fatty acids that exert complex control over many bodily systems, mainly in inflammation and immunity, and act as messengers in the central nervous system.

a. eicosanoids
b. leukotrines
c. cannabinoids
d. lipoxins

A

a. eicosanoids

The “eicosanoid cascade” results in the formation of byproducts from ALA and LA:

    • ALA > DHA and EPA (ω-3)
    • LA > GLA, DGLA and AA (ω-6)
    • Makes three main groups of prostaglandin metabolites:
      1) LA > DGLA [ω-6] > prostaglandin 1 (PGE1); anti-inflammatory
      2) LA > AA [ω-6] > prostaglandin 2 (PGE2); pro-inflammatory when in excess
      3) ALA > EPA [ω-3] > prostaglandin 3 (PGE3); anti-inflammatory
    • These prostaglandins are precursors for a wide range of bioactive lipid mediators influencing inflammation within the body, and are the primary metabolic control for acute and chronic inflammation.
    • The omega-6 and omega-3 eicosanoids share the same desaturase and elongase enzymes, so there is a competition between the two, ready to move in response to the environment and availability of cofactor nutrients
    • In individuals who take > 500 mg EPA and/or DHA daily, arachidonic acid and gamma-linolenic acid (GLA) biosynthesis is suppressed with the potential to unbalance the levels of these two molecules – nutrient partners require balance for optimum metabolic function.

(Mahan & Raymond, p. 36-38; good chart of the eicosanoid cascade on p. 36)

18
Q

What are the primary eicosanoids?

a. GLA, DGLA, AA, EPA, DHA
b. ALA, LA, EPA, DHA
b. ALA, LA, GLA, DGLA, AA

A

a. GLA, DGLA, AA, EPA, DHA

Metabolically the five primary eicosanoids (GLA, DGLA, AA, EPA, DHA) collaborate and compete for shared enzymes in forming the prostaglandin groups:

  • prostaglandin 1 (PGE1)
  • prostaglandin 2 (PGE2)
  • prostaglandin 3 (PGE3)
19
Q

Betaoxidation is:

a. the formation of long chain fatty acids in an energy-rich state
b. the formation of cholesterol in an energy-rich state
c. the breakdown of long chain fatty acids in an energy deficient state
d. the breakdown of cholesterol in an energy deficient state

A

c. the breakdown of long chain fatty acids in an energy deficient (AKA fasting) state – to use as energy

Happens in the mitochondria - this process produces acetyl CoA and ultimately ATP

20
Q

Coenzyme A aids in the transfer of fatty acids from the cytoplasm to the mitochondria. It is derived from:

a. vitamin B2
b. vitamin B3
c. vitamin B5
d. vitamin B6

A

c. vitamin B5

coenzyme A = active form of B5

Fatty acids are broken down to acetyl-CoA by means of betaoxidation inside the mitochondria, whereas fatty acids are synthesized from acetyl-CoA outside the mitochondria, in the cytosol.

21
Q

What nutrient plays a critical role in betaoxidation?

a. glutamine
b. glycine
c. carnitine
d. citrate

A

c. carnitine

The addition of carnitine allows the fatty acid to pass through the inner mitochondrial membrane, where betaoxidation occurs - aka, the “carnitine shuttle” or “carnitine mediated transport”

  1. Free fatty acid is activated for oxidation by the addition of coenzyme A (CoA) to become fatty acyl CoA.
  2. Fatty acyl CoA is combined with carnitine to become fatty acyl carnitine - can now be transported into the mitochondria where complete oxidation of the original fatty acid occurs.

Carnitine is a peptide that’s made from several different amino acids & certain micronutrients (i.e. vit C) - body can synthesize carnitine. Carnitine is also found in certain foods.

22
Q

Carnitine deficiency might be present if:

a. body does not synthesize carnitine well
b. vitamin C deficiency
c. vegetarian/vegan diet
d. all of the above

A

d. all of the above

Remember: carnitine helps bring LCFAs into the mitochondria

  • – Lacking carnitine = can’t bring long chain fatty acids inside the mitochondria = not going through beta oxidation = not creating lots of acetyl coA
  • – Rate-limiting enzyme of gluconeogenesis = pyruvate carboxylase, which is stimulated by high levels of acetyl coA
  • – Lacking high levels of acetyl coA = no gluconeogenesis (no new glucose in energy deficient state = low blood sugar)
  • – THEREFORE - Potential symptoms of carnitine deficiency = reactive hypoglycemic symptoms: shakiness, fatigue/irritability in between meals, waking up in middle of night, brain fog, inability to concentrate
23
Q

What is the most abundant food source of carnitine?

a. white meat
b. red meat
c. avocado
d. tempeh

A

a. red meat like beef & lamb (by far) - followed by white meat (chicken + pork), tempeh, avocado

24
Q

Lipogenesis is:

a. the synthesis of new fatty acids in an energy-rich state
b. the synthesis of cholesterol in an energy-rich state
c. the synthesis of triacylglycerols in an energy-rich state

A

a. the synthesis of new fatty acids in an energy-rich state – to be stored for later use (i.e. excess in fed state = saved for later)

End result of this process is LCFAs - specifically, palmitate/palmitic acid (LCFAs are ideal for storage, since they can be used to make phospholipids, triglycerides)

Heavily ATP dependent process

25
Q

Lipogenesis occurs primarily in:

a. liver
b. small intestine
c. pancreas
d. mitochondria of adipocytes

A

a. liver

26
Q

What nutrient is needed for lipogenesis to take place?

a. B1
b. B3
c. B5
d. biotin

A

d. biotin

Biotin is a cofactor for acetyl coA carboxylase, which is the rate limiting enzyme in lipogenesis

27
Q

Lipolysis is:

a. liberating stored fatty acids from adipocytes
b. breaking down stored fatty acids for energy
c. breaking down cholesterol for energy
d. breaking down steroid hormones for energy

A

a. liberating stored fatty acids from adipocytes

Fatty acid breakdown = lipolysis (liberating of stored FAs) + beta-oxidation (breaking these down for energy use)

Lipolysis happens in an energy deficient state – hormone sensitive lipase is active + cleaves long-chain fatty acids off of triglycerides (aka, liberating stored fatty acids from adipocytes)

28
Q

What is stored inside adipocytes?

a. cholesterol
b. triglycerides
c. phospholipids
d. long chain fatty acids

A

b. triglycerides

Enzymes are also stored inside adipocytes - including hormone sensitive lipase, which breaks down lipids & becomes activated or inhibited based on what hormones are present:

    • Inhibited by high insulin (insinuates surplus of glucose, which is when we store fat, not break it down for energy)
    • Stimulated by glucagon, epinephrine (elevated when glucose levels are low, no food coming in, energy-deficient state - need to liberate glucose / fatty acid to make ATP)
29
Q

Saturated fatty acids (SFA) contain ___ double bonds?

a. 0
b. 1
c. 2
d. 3

A

a. 0 – think “fully saturated” = no double bonds

    • saturated fatty acids = 0 double bonds – i.e. palmitic acid (coco oil) & stearic acid (animal products)
    • monounsaturated fatty acids = 1 double bond – i.e. oleic acid (olives, avocados)
    • polyunsaturated fatty acids = more than 1 double bond – i.e. ALA, LA, EPA, DHA, GLA, etc.
30
Q

Which of the following macronutrients has the most calories per gram?

a. protein
b. fat
c. carbohydrate
d. alcohol

A

b. fat

Fat contains 9 kcal/g
Protein/carbs contain 4 kcal/g
Alcohol contains 7 kcal/g

CNS Exam (45 decks)

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