Digestion and Absorption II, Nutrition I (Mock)
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| Lecture 46 | Digestion and Absorption II
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| Critical Micelle Concentration (CMC) | Concentration of bile acids at which micelles begin to form
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| As total bile acid concentration increases, the bile acid monomer concentration reaches ___ and levels off. | critical micelle concentration (CMC)
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| At the CMC point micelles begin to form and the concentration ___ as bile acid concentration increases. | increases
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| Bile acids are products of ___. | cholesterol
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| ___ property of bile acids are on both sides of the molecule. | Detergent
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| The primary bile acids are: | cholic acid and chenodeoxycholic acid (chenic acid)
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| Primary bile acids are synthesized in the ___, and are the “___”. | liver, “good guys”
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| Primary bile acids secreted into the intestine are acted on by bacteria and turned into ___. | secondary bile acids
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| The secondary bile acids are: | deoxycholic and lithocholic
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| Lithocholic is toxic to the ___. | liver
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| Ursodeoxycholic Acid | Stereoisomer of chenodeoxycholic acid, used as therapy for cholesterol gall stones (primary biliary cirrhosis)
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| Bile acids are conjugated with ___ and ___ to lower ___. | glycine and taurine, pKa
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| Monomeric, micellar lipids, and bile salts are in ___ equilibrium. | dynamic
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| Bile salt micelles increase fatty acid ___, increasing the capacity of water to carry fatty acids. | solubility
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| Fat absorption persists in the absence of ___ or ___. | bile salts or pancreatic lipases
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| Complete system fat absorption is approximately ___%. | 98% (>90%)
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| Bile salt deficiency has ___ fat absorption % than a complete system. | lower
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| Pancreatic lipase deficiency has ___ fat absorption % then both complete and bile salt deficient. | lower
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| Pancreatic lipase deficiency presents with: | fat malabsorption, diarrhea, failure to thrive, and ravenous appetite
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| Total bile salt pool is ___-___g. | 3-5g
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| The body uses ___-___g of bile salt per day. | 20-30g
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| Bile salts are constantly ___ to meet the daily consumption from limited pool size. | recycled
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| Reabsorption of bile salts occur in the ___. | distal third of the ileum (terminal ileum)
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| Absorption of fat occurs primarily in the ___. | duodenum.
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| If cholesterol levels are ___ and bile salt and lecithin levels are ___, then in a CMC zone. | low, high
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| Stone formation occurs everywhere outside of ___, where cholesterol levels are ___ and bile salt and lecithin levels are ___. | CMC zone, high, low
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| ___ is not a good form of measurement in nutrition. | Moles
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| Typical U.S. diet is ___% fat, __% carbohydrate, and ___% protein. | 40%, 40%, 20%
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| Animal fat is ___% of fat consumed, with vegetable fat being the remaining ___%. | 50%, 50%
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| 1 kcal is ___ kJ. | 4.2
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| Protein is ___ kcal per gram. | 4
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| Fat is ___ kcal per gram. | 9
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| Carbohydrate is ___ kcal per gram. | 4
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| Ethanol is ___ kcal per gram. | 7
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| Majority of energy consumption is by ___. | basal metabolic requirement (BMR) or resting state expenditure
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| A highly active individual can have “physical work” expenditure ___ to their BMR. | equal
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| Respiratory Quotient (RQ) | Eliminated CO2 over consumed O2, mole ration of carbon dioxide expired to oxygen consumed
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| RQ ratio ranges from ___ to ___. | 0.7 to 1.0
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| RQ ratio of 1.0 indicates ___ diet. | carbohydrate diet (i.e. C6H12O2 + 6 O2 → 6 CO2 + 6 H2O equals RQ of 6/6 = 1.0)
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| RQ ratio of 0.7 indicates ___ diet. | fatty acid diet (i.e. C16H32O2 + 23 O2 → 16 CO2 +16 H2O equals RQ of 16/23 = 0.7)
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| A balanced diet will have RQ ratio somewhere in the ___. | middle
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| RQ can be used to calculate ___ (indirect calorimetry). | BMR
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| BMR is proportional to ___. | body surface area (BSA)
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| BSA is proportional to square-root of ___. | height times mass
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| Baby requires ___ of energy and ___ of protein. | 110 kcal per kg*day, 1.1 g per kg*day
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| Adult requires ___ of energy and ___ of protein. | 40 kcal per kg*day, 0.8 g per kg*day
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| Pregnant individual requires ___ % more energy and protein. | 15%
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| Lactating individual requires ___ % more energy and protein. | 25%
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| Adult energy requirement decreases by ___% per decade after 20’s. | 5%
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| Consume a mix of essential amino acids that matches the ___ of a human being. | composition
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| Human milk contains an almost perfect dietary ___ composition. | amino acid
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| Vegetarian diet deficiency of essential amino acids can be offset by ___ diets. | complimentary (i.e. offset methionine deficiency of beans with wheat, and offset lysine deficiency of wheat with beans)
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| Fat consumed exceeding essential levels are stored in ___. | adipose tissue
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| Carbohydrates consumed exceeding essential levels are stored in ___. | adipose tissue
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| Proteins consumed exceeding neutral nitrogen balance have the ___ stored in adipose tissue and the ___ broken down to ammonia for degradation to urea. | carbon skeleton, nitrogen
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| Essential fatty acid deficiency leads to defects in synthesis of ___ derived from the fatty acids. | lipids
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| EFA deficiency presents with ___, and progressive problem in synthesis of ___ leading to death. | rashes, higher order/complexity lipids
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| Essential Carbohydrates | No essential carbohydrates
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| Estimated Average Requirement (EAR) | Established empirically, determines nutritional requirement for 98% of population
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| The EAR does not account for 100% of the population because of ___. | outliers (i.e. IBEM disorders)
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| Recommended Dietary Allowance (RDA) | Defines the 98th percentile requirements
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| Adequate Intake (AI) | If insufficient data to establish RDA, a best estimate or “adequate estimate” of RDI is made base off an assumed complete data set
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| Upper Limit | Defines the nutrition limit with no toxicity in 98% of the population
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| Adipocytes produce ___ that binds to leptin receptors in the ___. | leptin, hypothalamus
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| Leptin simultaneously stimulates the ___ of appetite and ___ of BMR. | suppression, promotion
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| Leptin and ___ work together in the hypothalamus to decrease appetite and increase BMR. | insulin
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| Antagonist of leptin is ___. | ghrelin (“growling/ghrelin of stomach”)
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| Ghrelin stimulates in the hypothalamus the ___ of appetite and ___ of BMR. | increase, decrease
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| OB gene (obese) codes for ___. | leptin
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| DB gene (diabetic) codes for ___. | leptin receptor, OB-R
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| Leptin has no known ___ with known proteins. | homology
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| Leptin is expressed only by ___. | adipocytes
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| Leptin functions as a “true hormone” and is secreted into the ___ to inform the brain of total body fat. | bloodstream
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| Leptin receptor is a ___ segment. | single transmembrane
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| The extracellular domain of OB-R resembles ___. | cytokine receptors
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| In truncated (db/db) receptors, leptin ___ but the ___ is not transduced. | binds, signal
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| Leptin binding OB-R activates ___. | AMPK
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| Activation of AMPK by leptin phosphorylates ___, inactivating it. | acetyl-CoA carboxylase (ACC)
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| Inactivation of ACC leads to ___ concentration of malonyl-CoA. | decreased
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| Malonyl-CoA inhibits ___. | carnitine palmitoyltransferase I (CPT I)
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| Decreased inhibition of CPT I leads to ___ fatty acid β-oxidation. | increased
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| Human obesity due to genetic leptin deficiency is ___. | small minority
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| Possible human obesity maybe due to ___. | leptin resistance
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| Insulin receptor knockout leads to increased ___, ___, and ___ serum levels. | leptin, triglyceride, and insulin
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| Ghrelin is secreted by the ___ into the bloodstream when the stomach is ___. | stomach, empty
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| Pro-Opiomelancortin (POMC) | Releases α-melanocyte stimulating hormone (α-MSH), inhibiting food intake and stimulating energy expenditure
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| Cocaine/Amphetamine-Related Transcript (CART) | Inhibits food intake and stimulates energy expenditure
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| Neuropeptide Y (NPY) | Stimulates food intake and inhibits energy expenditure
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| Agouti Related Peptide (AgRP) | Stimulates food intake and inhibits energy expenditure
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| Body Mass Index (BMI) | BMI = [Weight (kg)] / [Height (m) ²]
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| Malnourished BMI | <18.5
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| Underweight BMI | 18.5 to 20
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| Desirable BMI | 20 to 25
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| Overweight BMI | 25 to 30
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| Obese BMI | >30
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| Morbidly Obese BMI | >40
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| US Dietary Goals for Total Fat (i.e. 42% total fat): | Decrease in total fat (30% total fat), but increase in polyunsaturated fats (“good” fat, heart healthy)
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| US Dietary Goals for Protein (i.e. 12% protein): | Unchanged
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| US Dietary Goals for Total Carbohydrates (i.e. 46% total carbohydrates): | Increase in total carbohydrates (58%), but increase in complex carbohydrates and natural sugars with decrease in refined/processed sugars
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| Malnutrtion | Combined deficiency of energy and protein, also vitamins and minerals
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| Marasmus | Severe protein and energy malnutrition
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| Kwashiorkor | Protein deficiency leading to pitting edema (“Kwashi is squashy”)
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