test 2

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University of Texas Health Science Center at Houston School of Nursing *

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Jan 9, 2024

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Review Test 2 Ch. 4, 5, 6, 7, 8 Please make sure you are reviewing your textbook, Powerpoint notes, objectives, textbook resources, etc. when studying for the exam. This is only a guide to assist in your studying and it may not be all inclusive. Chapter 4 1. What elements make up carbohydrates? How are carbohydrates and dietary fiber classified? What are some examples of soluble & insoluble fiber, simple & complex carbs? What is the RDA for carbohydrates for adults (in grams per day)? a. Carbohydrates i. Carbon, oxygen, hydrogen b. Carbohydrates and dietary fibers are classified by number of molecules c. Soluble fibers (eg.): dissolves in water i. Pectin (skin of fruits), mucilage (slime), beta-glucans (sugars in the cell wall of bacteria), citrus, berries, oak d. Insoluble fibers (eg.): does NOT dissolve in water i. Cellulose, lignin, some hemicelluloses, whole grains, seeds, fruits, veggies e. Simple carbs: i. Glucose, fructose, galactose f. Complex carbs i. Starch, glycogen, fiber g. RDA carbohydrates for adults i. 130 grams/day 2. What monosaccharide is the most abundant “sugar” in fruits and veggies? Which monosaccharide is often referred to as “blood sugar” and is the most abundant sugar in the body? a. RBCs rely ONLY on glucose for their energy supply and this type of monosaccharide that is the most abundant 3. Outline how/where carbohydrates are digested, absorbed, & stored. a. Digestion i. Salivary amylase begins carbohydrate digestion in the mouth 1. Breaks carbohydrates down to maltose ii. Most carbohydrates digestion in the small intestine 1. Pancreatic amylase digests carbohydrates to maltose 2. Additional enzymes in the small intestine digest disaccharides to monosaccharides b. Absorption i. Monosaccharides are absorbed into the cells lining the small intestine and then enter the bloodstream c. Store i. Excess glucose is converted to glycogen by the liver 4. Discuss the functions of carbohydrates/glucose in the body. a. Glucose is our primary energy source (4kcal/g) i. Energy storage 5. Describe how blood glucose levels are maintained and where it is stored. What is the role of the pancreas? Which hormones work together to maintain the blood glucose level within an acceptable range and from what organ (and specific cell types) are

they released? What hormones are released from the adrenal glands during the “fight or flight” response? a. Hormones control blood glucose levels i. Insulin (pancreas), glucagon (pancreas), epinephrine (adrenal glands), norepinephrine (adrenal glands), cortisol (secreted by adrenal glands), growth hormone b. Pancreas produces alpha cells (glucagon) and beta cells (insulin) i. Insulin 1. Stimulates glucose transporters (absorption) to help take glucose from the blood across the cell membranes 2. Stimulates the liver to take up glucose and convert it to glycogen ii. Glucagon 1. Stimulates the liver to breakdown glycogen to glucose 2. Stimulates the breakdown of body proteins to amino acids to form new glucose c. Adrenal glands secrete epinephrine and norepinephrine i. Epinephrine: triggers the breakdown of glycogen to glucose; conversely, norepinephrine returns back the normal way ii. Responsible for fight/flight reactions to danger d. Cortisol i. Increases gluconeogenesis and decreases the use of glucose by muscles e. Growth hormone i. Increases fatty acid mobilization and utilization ii. Increases liver’s output of glucose 6. What is high fructose corn syrup (more specifically, what sugars make it up?) and why is it used in foods/drinks? a. High fructose corn syrup is a sweetener derived from corn syrup. It is made from processed corn starch, fructose makes the most up b. It is used in foods/drinks to bring the taste up 7. Briefly highlight what researchers suggest about the role(s) (both positive and negative) of carbohydrates in health conditions, such as diverticulosis, lactose intolerance, diabetes, and heart disease. What are the possible benefits and possible issues of consuming dietary fiber? a. Diverticulosis i. Increased pressure in the colon causes weak spots along its wall to bulge out and form pouches called diverticula ii. Best way to prevent is to eat a diet with adequate fiber b. Cardiovascular disease i. A diet rich in viscous, soluble fiber helps lower elevated blood cholesterol levels ii. Slow-moving viscous, soluble fibers may also reduce the rate at which fat and carbohydrates are absorbed from meals iii. Both high levels of fat in the blood and a decreased sensitivity to insulin are considered risk factors for cardiovascular disease c. Diabetes

i. A higher consumption of fiber from cereals helped reduce the risk of developing certain types of diabetes mellitus ii. Viscous fibers slow the digestion and absorption of glucose = avoid a large spike in blood glucose after meals and improve the long-term control of blood glucose level 8. Given an FDA health claim regarding fiber, be able to determine if it is considered valid. a. 9. What is/are the role(s) of bacteria in the large intestine? Do humans have enough enzymes to digest all sugars (such as those found in beans, lentils, etc.)? a. Bacteria in the large intestine can break down some fibers i. Most fibers, however, remains undigested and is excreted in the feces 10. Define glycemic index and glycemic load. a. Glycemic index i. A food’s potential to raise blood glucose and insulin levels b. Glycemic load i. Amount of carbohydrates in a food is multiplied by the glycemic index 11. What is the AI for fiber for adults (ages 19-50) in grams? a. 25-38 grams per day 12. What are ketones and how/or why are they formed? What is gluconeogenesis? What is glycogenolysis? a. Gluconeogenesis: the breakdown of body proteins to amino acids to form glucose b. Glycogenolysis: the breakdown of glycogen to glucose c. Ketones are formed when fat breakdown during fasting states (insufficient energy from carbs) i. Can result in low blood pH and ketoacidosis Chapter 5 Review Terms to Know & Check Your Understanding 1. What are lipids, their roles, & how are they classified? Are they hydrophilic or hydrophobic? a. Lipids: diverse class of molecules that are insoluble in water i. Are classified based on solubility 2. What is hydrogenation, and why is it used in manufacturing foods? Are there any health concerns associated with consuming them? What are some grocery items that might contain trans fats? What are the labeling guidelines allowed for foods that contain hydrogenated oils (i.e. trans fats)? a. Hydrogenation: the addition of hydrogen atoms to unsaturated fatty acids i. Converts liquid oils into a more solid form ii. Use to create margarine from plant oil iii. Creates trans fatty acids iv. Increases risk for cardiovascular disease 3. Differentiate between: Essential & non-essential fatty acids. Saturated & unsaturated fatty acids. Be able to identify the degree of saturation of each fatty acid when given a figure (see fig. 5.2 b,c,d—saturated, monounsaturated, & polyunsaturated)

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a. Essential fatty acids: two fatty acids cannot be synthesized by the body and must be obtained from food i. Linoleic acid (omega-6 fatty acid) found in vegetable and nut oil ii. Alpha-linoleic acid (omega-3 fatty acid) found in vegetables, fish and fish oils b. Nonessential fatty acids: that are produced from the body c. Saturated fatty acids have hydrogen atoms surrounding every carbon in the chain i. Pack tightly together and are solid at room temperature d. Unsaturated fatty acids lack hydrogen atoms i. Monounsaturated = lack H in one part (one double bond) ii. Polyunsaturated = lack H in multiple sites (more than one double bond) iii. Do not stack together well and are liquid at room temperature 4. Outline how/where lipids is/are digested, transported (i.e. the role of lipoproteins/chylomicrons), absorbed, & stored. What % of energy should healthy adults consume (i.e. what is the AMDR for lipids)? a. Fats are not digested and absorbed easily because they are insoluble in water b. Digestion of fats begins in the watery environment of the mouth & stomach i. Lingual lipase ii. Gastric lipase c. Fat digestion continues & the majority occurs in the small intestine i. CCK causes bile to be secreted from the gall bladder into the small intestine ii. Bile disperse fat into smaller fat droplets iii. Pancreatic enzymes break fat into two separate fatty acids and a monoglyceride d. Fatty acids are arranged as lipoproteins for absorption and transport i. Chylomicron: a lipoprotein produced by cells lining the small intestine 1. Composed of fatty acids surrounded by phospholipids and proteins 2. Soluble in water 3. Are hydrolyzed by lipoprotein lipase then absorbed by cells of the small intestine, then travel through the lymphatic system, transferred to the bloodstream e. 20-35% of calories should come from fat 5. What is a triglyceride and what is its structure? What is cholesterol, why is it important, and what are the dietary guidelines for cholesterol (i.e. no more than how much should we consume)? What are some food choices that might help lower cholesterol? a. Triglycerides contain three fatty acid molecules and one glycerol molecule b. Cholesterol is the most important sterol in the body i. Used to make sex hormones ii. Used to make vitamin D and bile iii. Component of cell membrane c. To reduce the risk of cardiovascular disease, dietary cholesterol should be limited to less than 300mg/day i. Food reduce cholesterol: legumes, whole grains, fruits and berries, fatty fish

6. What is lipogenesis? a. The formation of fats 7. What is meant by visible and invisible fats? Provide an example of each? What is visceral fat and does it pose a health risk? Can a person’s body store unlimited amounts of fat? a. visible fats: add to food b. invisible fats: hidden in foods, naturally occurring or added during processing c. visceral fat i. is stored within the abdominal cavity and is therefore stored around a number of important internal organs. Storing higher amounts of visceral fat is associated with increased risks of a number of health problems including type 2 diabetes. d. human can store unlimited amounts of fat in body 8. How is it possible that someone could gain body fat while restricting lipid consumption from the diet? a. Eating excessive sugar can cause gain body b. Eating too quickly results excessive food in stomach before the brain tells stop c. Less exercise causes slow fat metabolism d. Less sleep can build up visceral fats 9. Why would a doctor or dietician recommend that a person eat salmon or other fatty fish or seafood? Would it be healthier to have fried fish or grilled? a. Salmon and other seafood contain omega 3 fatty acid that is good for the heart and they have high protein b. Grill fish is healthier than the fried fish, because grilled fish uses less oil that can lower cholesterol/fats in the blood 10. If a person wanted to limit his/her intake of saturate fatty acids, what are some food sources (i.e. examples of foods that tend to be too high in saturated fat) that might be eliminated? a. Animal products like butter, cheese, whole milk, cream, fat of poultry Chapter 6 Review Terms to Know & Check Your Understanding 1. What are amino acids? Differentiate among essential, nonessential, and conditionally essential amino acids. What elements make up proteins? What are some food sources that provide abundant amounts of protein. a. Proteins i. Made of carbon, hydrogen, oxygen, nitrogen, sulfur (sometimes) ii. Building blocks are 20 amino acids iii. Eg. Fish, lean meat, skinless poultry, legumes, whole grains, nuts, veggies, soy products, dairy products b. Amino acids are building blocks for proteins i. Essential (9 of them): cannot be produced by the body; most by obtained from food ii. Nonessential (11 of them): can be made by our body

iii. Conditionally essential: nonessential amino acids that become essential because they body cannot make them 2. Define complete versus incomplete proteins and identify food sources of each. How many different amino acids must humans get from their food? How many total amino acids do humans need? a. Complete proteins: contain all 9 essential amino acids; eg. Animal and soy protein; higher quality b. Incomplete proteins: low in one/more essential amino acids = limiting amino acids; eg. Plant sources c. Complementary proteins: protein combination d. Humans need 20 amino acids in total and 9 of them have to come from the food 3. What are the dangers to consuming large amounts of red meat? a. Possible food poisoning from microbes b. Increase risk of heart diseases, cancers, kidney problems, digestive issues 4. Describe the different structures of proteins. What results from protein denaturation? a. Primary: the order in which the amino acids are assembled and the total length of the chain; linear chain i. The amino acids are held together by peptide bonds ii. The gene that codes for that protein determines the sequence iii. A change in the sequence changes the eventual shape of the protein and therefore its function b. Secondary: hydrogen bonds between carboxyl and amine groups cause the straight chain to fold, twist, and coil i. Eg. Helix & alpha -pleated sheet shapes c. Tertiary: three-dimensional globular shape of the protein i. Side chains: hydrophilic and hydrophobic side chains cause the formation d. Quaternary : forms when two or more polypeptide chains bond together with a hydrogen bond e. Denaturation : heat, acids, bases, salts, or mechanical agitation can unfold, or denature proteins i. does NOT alter the primary structure of the protein, but does change the shape ii. factors disrupt the bonds between the amino acid side chains 5. Outline how/where proteins is/are digested, transported, stored, etc. Where does chemical digestion of protein begin? If excess protein is consumed (along with excess glucose, energy, etc.), what can it be stored as? a. Proteins begin the digestion process in the stomach i. Hydrochloric acid breaks down protein structure and activate pepsin 1. Pepsin: breaks down proteins into short polypeptides and amino acids ii. Continues in the small intestine 1. Cholecystokinin (CCK) stimulates the pancreas to secrete proteases like trypsin, chymotrypsin, and carboxypeptidase, through the pancreatic duct into the small intestine

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a. Trypsin + chymotrypsin = break apart the peptide bonds and therefore produce smaller and smaller peptide chains b. Carboxypeptidase = break apart the first peptide bond closest to the carboxylic end of the chain c. Dipeptidases + tripeptidases = break small peptide chains into single amino acids 2. The single amino acids are absorbed into and pool inside the enterocytes, where they can be used for energy or to synthesize new compounds 3. Most enter the bloodstream and are transported via the portal vein to the liver 4. After reaching the liver, amino acids can be used to synthesize new proteins or can be converted to adenosine triphosphate (ATP), glucose, or fat 6. List the basic hormones/chemicals (specifically gastrin, CCK, HCl, pepsinogen, and secretin) involved in protein digestion, where they are released from (i.e. what organ, gland, etc.), what causes their release, and their function. a. Gastrin : hormone in the stomach that directs the release of hydrochloric acid from the parietal cells in the stomach wall; directs the release of pepsinogen from the chief cells b. CCK : stimulates the pancreas to secrete proteases like trypsin, chymotrypsin, and carboxypeptidase, through the pancreatic duct into the small intestine c. HC l: denatures the protein strands and activates pepsinogen to the active enzyme pepsin d. Pepsinogen: inactive form of pepsin, activated by HCl; break the polypeptides into shorter chains via hydrolysis 7. List the functions of proteins in the body (see Table 6.3). What happens if the shape of a protein is altered? a. cell growth, repair, maintenance b. enzymes and hormones c. fluid and electrolyte balance d. pH balance e. antibodies to protect against diseases f. nutrient transport and storage g. if the shape is altered can cause proteins to become dysfunctional 8. Simply know that the three steps of protein synthesis are in the following order: 1. Cell signaling 2. Transcription, & 3. Translation. Also, what is the role of our genes? a. Cell signaling happens in order to start transcription process b. Transcription: messenger RNA copies the genetic information from DNA in the nucleus c. Translation: the genetic information in RNA is converted into the amino acids sequence of a protein in the cytoplasm 9. What is C-Reactive protein & what health conditions is its elevation in the body associated with? a. C-reactive proteins are produced by the liver in response to inflammation.

b. High CRP indicates possibility in having an acute bacterial infection, high risk of heart attack, autoimmune conditions, cancers, obesity 10. Discuss protein deficiency and protein excess and the health problems that result. Do those with a vegan lifestyle need to be concerned with protein? Review Table 6.5. What are the different types of vegetarians? What are the health benefits to such lifestyles? a. Protein deficiency i. Marasmus: disease resulting from severely inadequate intakes of protein, energy, and other nutrients ii. Kwashiorkor: disease resulting from extremely low protein intake b. Protein excess i. High cholesterol and heart disease ii. May cause excess calcium excretion leading to bone loss iii. Associated with an increased risk of kidney disease and kidney stones c. Types of vegetarians i. Lacto-vegetarians: able to eat dairy foods ii. Lacto-ovo-vegetarians: dairy foods and eggs iii. Ovo-vegetarian: eggs iv. Vegan: only plant products, no animals’ products v. Semi-vegetarian: occasionally eat meat 11. The majority of food allergies are caused by protein-containing foods. Know a few examples of these types of foods. Define antibody. a. Food allergies i. Nuts, dairy products, eggs, soy, fish b. Antibody: are the key element in the adaptive immune system i. Help invaders from attacking the body Chapter 7 1. What factors affect the rate of alcohol absorption and metabolism? a. Alcohol absorption i. Amount and speed of alcohol consumption ii. Presence or absence of food iii. Gender, health status, genetics, ethnicity b. Alcohol metabolism i. Alcohol dehydrogenase (ADH) ii. Aldehyde dehydrogenase (ALDH) iii. Microsomal ethanol oxidizing system (MEOS) 2. Differentiate the 3 major enzymes/enzyme system involved in the breakdown of alcohol? a. Alcohol dehydrogenase (ADH) i. Break down part of the alcohol for elimination purpose b. Aldehyde dehydrogenase (ALDH) i. Break down part of the alcohol for elimination purpose

c. Microsomal ethanol oxidizing system (MEOS) i. reduces molecular oxygen to water as ethanol is oxidized to acetaldehyde 3. What are some short term and long term effects of alcohol consumption? a. Short term i. Products of alcoholism ii. Affected the central nervous system and other body systems iii. Alcohol poisoning iv. Unintentional injuries v. Sleep disruption vi. Hangovers b. Long term i. Impaired digestion, absorption, nutrient metabolism ii. Gastritis, pancreatitis iii. Malnutrition iv. Weight gain v. Fetal alcohol syndrome vi. Cardiac myopathy vii. Breast, esophageal, colon, rectal, liver cancers viii. Depression ix. Increased blood pressure x. Affects on medications 1. Insulin, PTH, estrogen 4. How many kcal/g of energy does alcohol provide? a. 7kcal/g = alcohol Chapter 8 Review Terms to Know & Check Your Understanding 1. Define metabolism/metabolic pathway and categorize metabolic pathways as either anabolic or catabolic. a. Metabolism is sum of all chemical and physical processes by which the body breaks down and builds up molecules i. Anabolic 1. Anabolism 2. Synthesis 3. Condensation 4. Eg. Insulin ii. Catabolic 1. Decomposition 2. Catabolism 3. Hydrolysis 4. Eg. Glucagon, epinephrine, cortisol

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2. Be able to discuss the steps/processes involved in cellular respiration:  glycolysis o occurs in the cytosol o anaerobic reactions o starting molecules: 1 glucose o ending molecules: 2 pyruvates, 2ATP gained, 2 NADH  Kreb’s cycle (aka the citric acid or TCA cycle) o Occurs in the mitochondrial matrix o Anaerobic reaction o Starting molecules: acetyl CoA, oxaloacetate o Ending molecules: 6 NADH, 4 CO2, 2 ATP, 2 FADH2  Electron transport chain/oxidative phosphorylation o Occurs in and across of the inner mitochondrial membrane o Aerobic reaction o Starting molecules: NADH, FADH2, oxygen o Ending molecules: 32 ATP, water and include where each step/process takes place in the cell, how many net ATP are formed, the starting and ending molecules, is the step/process aerobic or anaerobic, etc. 2. What is Beta oxidation? What is ketogenesis & ketoacidosis? a. Beta oxidation i. Dietary and adipose triglycerides are hydrolyzed by lipase to yield one glycerol and 3 free fatty acids b. Ketogenesis: i. Formation of ketone bodies 1. Occurs with the buildup of acetyl CoA 2. Peaks after an individual has fasted or consumed a limited carbohydrate diet for three days c. Ketoacidosis i. The excess accumulation of ketone bodies 1. Occurs with untreated type 1 diabetes 2. Can lead to impaired heart activity, coma, and even death 3. When would lactic acid be produced (under what conditions)? What is the Cori cycle? a. lactic acid would be produced when oxygen is not presented b. The cori cycle i. Refers to the metabolic pathway in which lactate produced by anaerobic glycolysis in the muscles moves to the liver and is converted to glucose, which then returns to the muscles and is cyclically metabolized back to lactate 4. What is ATP? How many ATP molecules are produced from the complete oxidation of one molecule of glucose? a. Adenosine triphosphate (ATP), energy used in the body

b. 38 ATP are produced from the complete oxidation of one molecule of glucose 5. What are some genetic disorders of metabolism? a. Results in the buildup of toxins b. Cannot be cured c. Can be controlled through diet d. Phenylketonuria (PKU) e. Maple Syrup Urine Disease (MSUD) f. Homocystinuria g. Galactosemia and Glycogen Storage Disease 6. What role does creatine phosphate play in energy production? a. Supplies high-energy compound in muscle cells when it combines with phosphate

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