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nutriton exam 2

Natalie Britten Inglés 113 fichas

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  1. 1Water soluble vitamins areactively absorbed at low doses
    readily excreted, rarely toxic
    energy releasing , hematopoeitic
    usually work as coenzymes
    vary in stability under oxidative conditions
  2. 2Fat soluble vitamins areA, D, E, K
    A + D have hormone like activities - influence cellular response
    absorption and transport closely associated with lipids
    vitamin A readily stored
    Vitamin D held onto
    Vitamin E and K not stored
    Poorly stable under oxidative conditions
  3. 3EERaverage dietary intake (kcal) to maintain energy balance in a healthy adult
    based on age, gender, weight, height and level of physical activity
  4. 4AMDRDescribes the portion of the energy intake that should come from each macronutrient
  5. 5EARThe average daily intake level of a nutrient that will meet the needs of half of the healthy people in a particular category
    used to determine the RDA of a nutrient
  6. 6RDAthe average daily intake level required to meet the needs of 97-98% of healthy people in a particular category : lifestage and gender
  7. 7AIRecommended average daily intake level for a nutrient that "healthy" people eat
    used when the RDA is not yet established: calcium, vitamin D, vitamin K, fluoride
  8. 8ULhighest average daily intake level likely to pose no risk of adverse health effects to most people
    avoidance of GI stress
  9. 9Energy production from oxidation of macronutrientsutilizes variety of B vitamins as co-enzymes
  10. 10Thiamin structurepyrimidine and thiazole rings
    phosphorylated forms are active
  11. 11Thiamin Food SourcesFound in protein rich foods
    Whole and enriched grains, nuts, yeast (not brewers yeast) meats (pork), legumes
    Plant sources provide free thiamin - more readily absorbed
    Animal sources - phosphorylated (usually TPP)
  12. 12Absorption of Thiaminmainly in jejunum
    80% thiamin as TPP - phosphorylated
    10 % as TTP
    Remainder = free thiamin
  13. 13Phosphatase activity of thiaminphosphatases hydrolyze phosphate groups from TPP and TMP prior to absorption - non specific and cleaves one at a time
    Free Thaimin is readily absorbed
  14. 14active transport at low concentrationsThTR 1 and 2 to get into enterocyte
    ThTR 1 to get out of enterocyte
    carrier mediated egress from enterocyte
    we excrete out what out body doesn't use - can cause a transient use of this flowing thru body
  15. 15ThTR 1normally expressed
  16. 16ThTR 2inducible - get more thiamin in during a deficient state
  17. 17Typical diet related with thiamin deficiencyraw fish and white rice
  18. 18Passive diffusion of thiaminwhen intake is high but not significant
  19. 19enterocyte activity on thiaminphosphorylated in enterocyte and dephosphorylated to leave
  20. 20Metabolic trapping of thiaminphosphorylation - makes available for use in that specific cell sets stage for use - phosphorylated and use in enterocytes
    retains nutrients
  21. 21inhibitors of absorption and bioavailabilitythiaminases
    Ethanol
    Tanins
    Ph
    Oxidation
    heat
    radiation
  22. 22Thiaminasesvery active and stable
    degrade thiamine
    found in raw fish
  23. 23Tanins (anti-thiamin factors) found intea, coffee, blueberries, brussel sprouts, red cabbage
    these all can degrade thiamin to the point where we cant use it anymore
  24. 24Ethanol inhibition of thiamininhibits active absorption of thiamin - increases excretion of thiamin
    interferes with ThTR1
    impedes uptake into and exit from enterocyte
  25. 25Loss of thiamin with cooking/handlinglow pH (when you boil brown rice you lose 20-30% thiamin)
    heat
    oxidation
    radiation
  26. 26Transport and Metabolism in Livervia portal vein (from gut to liver)
    in the liver - free thiamin is phosphorylated to TPP
    most thiamin in blood is inside RBC - they need thiamin for hexomonophosphate shunt
  27. 27Thiamin in bloodalso found as free thiamin, albumin bound, and TMP
    Only free thiamin crosses membranes
    ThTR1 and 2 transport unphosphorylated thiamin in the cells throughout the whole body
  28. 28Body Pool of Thiamin~30 mg but not readily stored
  29. 29Where are high concentrations of thiamin found?highly metabolically active cells -
    skeletal muscle, heart, liver, kidneys, brain - most in muscle
  30. 30Excretion of thiaminurine
    excess thiamin rapidly excreted in free form
  31. 313 main functions of thiamin1. energy transformation (coenzyme) in pyruvate dehdrog. alpha keto glutarate dehydrog. and branched chain keto acid dehydrog.
    2. Synthesis of NADPH and Ribose ( co-enzyme)
    3. non-coenzyme functions - nerve conduction (TTP and TPP found in neuronal cell membranes and nerve pulse transmission) and neurotransmitter function
  32. 32Pyruvate dyhdrogenase (energy production)1. decarboxylation with TPP
    2. Oxidation
    3. Regeneration
    thiamin is in the active site
  33. 33Synthesis of NADPH and Ribosecoenzyme of transketolase in pentose phosphate shunt
    NADPH required for fatty acid synthesis and reducing glutathione (glutathione reductase)
    Ribose required for nucleic acid synthesis
  34. 34Non - coenzyme functions - nerve conduction and neurotransmitter functionion channel regulation - energy deficient
    TTP and TPP present in neuronal cell membranes
    Nerve pulse transmission
  35. 35Thiamin in nerve pulse transmissionbrain uses BCAA's for neural health and energy needs
    pentose phosphate pathway - transketolase - is thiamin dependent and makes Ribose and NADPH
  36. 36TYPES OF THIAMIN DEFICIENCY (Beriberi)Dry
    Wet
    Acute
    Wernicke-Korsakoff Syndrome (Cerebral)
  37. 37Dry BeriBerimuscle weakness and wasting - no energy to drive movement
    peripheral neuropathy - parathesia (burning, numbness or tingling in hands or feet)
    weight loss
    apathy
    confusion
    nerve degeneration and loss of nerve transmission
    GI distress - neurological impairment of brain to send signals to release chemicals in GI tract
    Poor arm and leg coordination - ataxia
  38. 38Wet beriberiA lot of fluid leaking and pooling
    Edema = blood pooling - leaks out into interstitial space
    Enlarged heart
    congestive heart failure
    left ventricle wall - becomes very thin when it is supposed to be thick
  39. 39Acute beriberiinfancy - mom is thiamin deficient
  40. 40Wernicke Korsakoff SyndromeCerebral beriberi
    thiamin deficiency in brain
    Paralysis of eye muscles - fixed stare or nystagnus (random eye movement)
    ataxia
    confusion/apathy
    loss of short term memory
    confabulation (making elaborate stories up)
    mainly happens in alcoholics - 20-30% alcoholics get this
  41. 41other than alcoholics who is at risk for WKS?can happen in pregnancy (morning sickness)
    chronic dialysis (loss of B vitamins)
    IV Glucose infusion in people with marginal deficiency (cant convert pyruvate to acetyl CoA to TCA cycle)
    diminished thiamin absorption
    increased thiamin excretion
    poor quality diet
  42. 42causes of thiamin deficiencyinadequate intake
    high carbohydrate intake with low thiamin
    high intake of thiaminase containing foods
    infants breastfed by thiamin deficient moms
    alcohol - diminishes thiamin absorption and increases excretion
  43. 43Treatment for thiamin deficiencyhospitalized - IM (intramuscular injection of high dose of thiamine ~250 mg)
  44. 44Decreased absorption of thiamin caused byChronic alcohol use
    Folate Deficiency (required in cells that have to divide on a regular basis)
    Intestinal Resection
  45. 45assessment of thiamin statusDietary assessment
    Biochemical RBC Transketolase activity (one sample without added TPP and one with - measured for transketolase enzyme activity - if one with added TPP is higher by 25% - severely deficient in thiamine)
  46. 46RDA of thiamin~ 1 mg/day
    no UL
    adequacy of calories = adequacy of micronutrients
  47. 47Riboflavin structureB2
    nitrogenous ringed structure with sugar alcohol side chain
    active in coenzyme forms FAD and FMN
  48. 48Food sources of Riboflavinprotein rich foods
    milk, cheese, eggs, broccoli, fatty fishes, green leafy veggies, enriched cereals, legumes, meats, whole grains
    Unstable to light ~50% loss over a couple hours
    we consume FAD or FMN
  49. 49Absorption of Riboflavincarrier mediated
    mainly found as FAD in foods (requires proteases and phosphatases to free from FAD)
    We need to absorb as free riboflavin except when found free in fortified foods, dairy products and eggs
  50. 50Absorptionabsorbed as free riboflavin - saturable and energy dependent transporter - exceed a certain dose we can't absorb ~30 mg/day
    phosphorylated in enterocyte (trapped by flavokinase where it can be converted to FAD) and dephosphorylated to get out on basolateral side
  51. 51Transport, metabolism and excretiontransported mainly as free riboflavin
    transported into cells as free riboflavin
    - carrier mediated and converted to coenzyme forms by flavokinase and FAD synthetase
    -excreted in urine as free riboflavin and metabolites
  52. 52Riboflavin in liverdelivered from portal vein - converted to coenzymes - whatever is not taken up is put into general circulation but always needs a carrier to get into cells
  53. 53Functions of RiboflavinRedox reactions -
    interactions with niacin, B6 and folate
    energy production - ETC, pyruvate dehdrog (accepts the electrons and becomes reduced as substrate gets oxidized)
    Fatty Acid Oxidation (every time FAD gets reduced it sends electrons to ETC)
    Antioxidant activity - glutathione recycling
    FAD is a coenzyme for MTHFR activity
  54. 54Ribolfavin deficiency (ariboflavinosis)RARE - poor dietary intake in general predisposes one to deficiency with other B vits
    Cheilosis (vertical fissure in the lips) and agular stomatitis (cracks at corners of the mouth)
    Glossitis - swollen tongue
    Photophobia - eyes become sensitive to light
    Dermatitis - skin flaking around nose
    Anemia - depletes RBC production
  55. 55Groups at risk for Ribolfavin deficiency (ariboflavinosis)Alcoholics
    Newborns treated for hyperbilirubinemia (riboflavin is unstable to light)
    Lactose Intolerance
    Hypothyroidism (thyroid hormone regulates flavokinase and FAD synthetase)
    Anorexia
    Extreme trauma and stress
  56. 56Assessment of Riboflavin statusRBC glutathione reductase activity (same as thiamin transketolase activity)
  57. 57RDA Riboflavin~1 mg/day
    No UL
  58. 58NiacinNicotinic Acid (NA) and Nicotinamide (Nam)
    Active coenzyme forms NAD and NADPH
    NAD oxidative rxns
    NADPH in reduction rxns (FA and Cholesterol synth)
  59. 59Niacin food sourcesprotein rich foods
    fish, meat, poultry, enriched grains, cereals, peanuts, legumes, seeds
  60. 60Plant source of NiacinNA (nicotinic acid)
    in some plant foods (corn) niacin is bound to complex carbs/peptides and its unavailable (niactyins) - if you process corn using alkaline substance it becomes available (masa harina)
  61. 61Animal Sources of NiacinNam (nicotinamide) NAD and NADP
  62. 62Endogenous sources of NiacinWe can synthesize niacin from tryptophan - in the kidney and liver
    60 mg trypt. = 1 mg niacin
    conversion requires B6, Riboflavin, and iron
  63. 63Absorptionfacilitated uptake in jejunum
    absorbed as NA and Nam
  64. 64Transport of Niacintransported mainly as Nam
    also transported as NA (free or bound to plasma proteins)
    Transported into cells as Nam, trapped by conversion to NAD or NADP (vitamers)
  65. 65metabolism of niacinin liver via portal vein - can get reabsorbed
    not readily excreted
  66. 66excretion of niacinurine
  67. 67Coenzyme functions of niacinredox rxns
    transfer of electrons in catabolic rxns and ETC (NAD)
    energy production
  68. 68Redox action of NADcatabolic pathways - oxidizing
  69. 69Redox action of NADPHanabolic pathway - reduction
  70. 70Oxidative pathways requiring NADGlycolysis
    PDC
    Oxidation of acetyl CoA
    Beta oxidation
    oxidation of ethanol
  71. 71Reductive pathways needing NADPHFatty acid synthesis
    cholesterol and steroid hormone synthesis
    synthesis of deoxyribonucleotides
    interconversions of folate derivatives
    regeneration of glutathione reductase and thioredoxin
  72. 72Cholesterol lowering function of Nicotinic acid (NA)known to reduce VLDL
    interferes with free fatty acids from adipocytes to blood so less substrate is given to the liver
  73. 73Niacin as a substrateNAD is a substrate for PARP for DNA repair, cell division, and regulation of gene expression
    and ADP-ribose cyclase enzymes (intracellular signalling)
  74. 74Niacin DeficiencyPellagra
    4 D's
    Dermatitis primarily in sun exposed areas
    Diarrhea (GI Changes) - inflammation in mouth (stomatitis and cheilosis) associated with ariboflavinoses or vitamin B6 deficiency
    Dementia - early - paresthesia, muscle weakness, depression, paranoia, hallucinations, violent behavior
    Death
  75. 75Niacin toxicitynicotinic acid (NA) in pharmalogical doses can lead to severe flushing (acute red face) and can lower cholesterol
    more side effects = burning, itching, headache, heartburn, vomiting, impaired liver function (hepatoxicity), impaired glucose tolerance
    Nam = nausea vomiting and hepatotoxicity
  76. 76UL niacin35 mg/day
  77. 77Assessment of niacin statusurinary metabolites of NAM
  78. 78RDA niacin15 mg/day
  79. 79Vitamin B6 vitamersPyridoxine (PN) --> PNP
    Pyridoxal (PL) ---> PLP
    Pyridoxamine (PM) ---> PMP
    activated by phosphorylation
  80. 80Digestion and absorption of B6absorb ~75% depending on glycoside content of food
    poorly absorbed in glycoside form
    50% B6 in veggies in glucoside form
    better absorbed from veggies, meat, fish and dairy than grains
    absorbed by carrier mediated pathway in jejunum
  81. 81Deposphorylation of B6in cell - gets phosphorylated
    to leave cell - gets dephosphorylated
  82. 82Liver function in B6PN, PL, PM are all converted to PLP
    FMN dependent
  83. 83Transport of B6mainly ablumin bound PLP and PL
  84. 84transport of B6 into cellsmust be non phosphorylated (PL form)
    membrane phosphatase activity
    carrier mediated
    trapped in cell via phosphorylation
  85. 85storage of B6mainly found in muscle (PLP bound to glycogen phosphorylase)
  86. 86Excretion of B6excreted in urine as 4-pyridoxic acid - assessed
  87. 87Functions of B6metabolism of amino acids - needed for transamination rxns as a coenzyme
    Decarboxylation rxns - neurotransmitter synth.
    glycogenolysis (glycogen phosphorylase coenzyme) and gluconeogenesis (transamination)
    Heme synth. delta-aminolevulinic acid synthase
    trans and desulfurization
  88. 88B6 deficiencyrare -
    fatigue, depression, confusion, glossitis, angular stomatitis, cheilosis (like riboflavin and niacin), anemia, neurological issues, impaired immune function
  89. 89who is at risk for B6 deficiency?inadequate intake
    isoniazid treatment (antituberculosis that binds to B6 and makes it unavailable)
    Alcohol impairs conversion of PN/PM to PLP --> increases metabolism of PLP
  90. 90B6 Toxicityperipheral neuropathy
  91. 91B6 assessmentUrine for 4-pyridoxic acid
    plasma PLP
    erythrocyte transaminase activity
  92. 92Food sources and requirementsprotein rich foods along with bananas and potatoes
    stable in heat
    RDA ~ 1.4 mg/day
  93. 93Biotin is involved in what rxnscarboxylation rxns
    Pyruvate carboxylase, acetyl CoA carboxylase, propionyl CoA carboxylase(odd chain FA's)
  94. 94Biocytinbiotin + lysine
  95. 95proteolytic enzymes and biotinyield free biotin, biocytin and biotinyl peptides
  96. 96Biotinidasehydrolyzes biocytin into free biotin and lysine -->absorbed into enterocyte by the multivitamin transporter
  97. 97biotin in circulationmainly (80%) as free biotin and albumin bound
  98. 98biotin transport into cellsactive, carrier mediated transport
    free biotin excreted via urine
  99. 99Functions of biotincatabolism of biotin holocarboxylase enzymes
    apoenzyme --> holocenzyme
    w/o coenzyme --> w/ coenzyme
    yields biocytin - biotinidase degrades to free biotin ---> reused, excreted and degraded
  100. 100Carboxylases that biotin is the coenzyme for and what pathway they are inAcetyl CoA carboxylase (FA synth.)
    Pyruvate carboxylase (TCA cycle or gluconeogenesis)
    Propionyl CoA carboxylase (odd chain FA's and AA's)
    3 methylcrotonyl CoA carboxylase (leucine metabolism)
  101. 101Non coenzyme function of biotinbiotinylation of histones - proteins that DNA winds around
    epigenetics -- changes expression of a gene
  102. 102biotin deficiency symptomsdermatitis - scaly red rash around eyes, mouth, nose, genitals (mucosal membranes)
    depression, lethargy, hallucinations, paresthesis (numbness and tingling)
    Alopecia
  103. 103who is at risk for biotin deficiencyBiotinidase deficiency - reduced intestinal absorption, reduced recycling and increased excretion
    Holocarboxylase synthetase deficiency - cant put biotin into active site
    Prolonged raw egg consumption- egg whites have avidin (binds to biotin and makes unavailable)
    Parenteral nutrition without biotin supplementation.
    long term anticonvulsant therapy
    pregnancy (donald mock) ~50%women lose biotin
  104. 104Assessment of biotin statusurinary metabolites - biotin and 3-hydroxyisovaleric acid
  105. 105Food sources of biotinprotein rich foods
    egg yolk, peanut butter, soybeans, legumes, nuts, whole grains
  106. 106Pantothenic acid component of what CoenzymeCoenzyme A
  107. 107Free pantothenic acid absorbed usingmultivitamin transporter
    40-60% absorbed
  108. 108transport of pantothenic acidmainly in RBC as PA or phosphopantothenic acid
    Actively transported into cells (metabolically active cells)
  109. 109Excretion of PAin urine as PA - assessed for PA - excreted in tact
    no metabolites
  110. 110functions of pantothenic acidpart of CoA and acyl carrier proteins (fatty acid synth.)
    Energy production -
    Dehydrogenase complexes
    synthesis of cholesterol, ketone bodies, CoQ10, acetylcholine, phospholipids, sphingomyelin, triglycerides
  111. 111PA deficiencyrare
    burning feet syndrome/paresthesia
    fatigue
    weakness
    depression
    vomitting
    lethargy
  112. 112what does panto mean ?found everywhere
  113. 113Requirements and food sourcesAI = 5 mg/day
    found in almost all goods - good sources=avocado, bran, broccoli, whole grains, legumes, eggs, mushrooms

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Fichas sobre nutriton exam 2, creado por Natalie Britten el 10/11/2016.
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